Back on 30 April I pronounced "we're long past the peak but they don't seem to want us to know that" - and then within an hour or two Boris Johnson announced that we were past the peak. As my blog had been in draft for two days I must be a bit more dynamic. (It wasn't the words, I was struggling to get the axis right on my excel graph and import it in a decent enough form. Meanwhile they kept publishing more data...).
In that speech Johnson held out the hope of an easing of the restrictions but without risking crashing into a second mountain as we come out from the tunnel under the first, as Johnson put it. Although it sounded mangled and contrived I thought it was actually quite a good and tangible analogy. Now Johnson has stuck with the mountain analogy, saying in his much awaited TV address on Sunday that there is often more risk in coming down the mountain.
The speech has received mixed reviews and Johnson is now at some political risk in trying to move forward. The "stay alert" message is blatantly less clear than "stay home": note how they have to be two words, die hard, lethal weapon, star wars.... It is presumably designed to be useful during a period of change in the measures, so its meaning can't be as unmistakably obvious. At least yet. I take it as a proxy for "keep your wits about you, heed the current advice" as the current advice will change and, like financial investments, can move in either direction. It may or may not prove to be a good slogan, but I don't think we can tell yet.
Criticism of the PM for not giving full detail on Sunday seemed petty - in a ten minute TV address in which he said further detail would follow in his full announcement to Parliament? (Maybe that's why, traditionally, it's done the other way round, telling Parliament first, Boris). But the Times had a poll which showed why people thought what they did about Johnson's performance. While their poll showed 44% support for the changes to enable unlimited exercise and that those who can go to work should, with 43% opposed, support was stronger from males, leave voters and over 50s. In other words people who were more likely to have voted for Johnson. So whether people agree with what he said or not actually tells you more about them than about what he said.
According to Dominic Sandbrook* the procession of people critical of the government interviewed on BBC recently nearly all turn out to be a motley collection of left wingers and Corbynites. It doesn't mean they are wrong about PPE, testing or whatever but it makes one wonder about balance. Tell me how you voted in the referendum and general election and I'll tell you what you think about the job the government is doing....
A specific criticism in Scotland and Wales of the PM's TV address was that the he should have made clearer that the specific changes he was trailing apply in England, the details for other countries being devolved which, on the face of it, is a fair cop. But then the devolved administrations like nothing more than to try to bounce the PM and the national government. And you can only get an agreed position if everyone wants to agree. I think it was 100% deliberate and I don't, personally, blame him trying to railroad the devolved administrations as they try it on him all the time.
So Mark Drakeford, the First Minister of what is now known officially as the Welsh Parliament rather than Assembly (it's still the Senedd in Welsh) got his retaliation in first by speaking on Friday lunchtime. And it was immediately clear to me that I wouldn't be playing golf in Wales this week, whatever Boris announced, as Drakeford announced no change except that garden and recycling centres could open.
To be fair to Drakeford he presumably knew that Johnson was going to go further and so he either had to fall in line or speak first, as speaking after Johnson would never have worked. And there are reasons for Wales taking a more cautious approach. While Wales and Scotland have a lower death toll per 100,000 of population than England (35 for Wales v 51 for England) Wales has more total cases - 365 per 100,000 against 251 for England**. I found this surprising as Wales is doing far fewer tests so it is presumably a genuine difference. And on that point about testing, whatever you think about the slow start England go off to on testing and the rapid increase in recent weeks, Wales is in a huge hole in comparison, with a capacity to do less than half the number of tests per million of population that England can do***. This has left the first minister plaintively sticking with the argument that it isn't necessary to test everyone in care homes, while Matt Hancock was desperately trying to find more people to test from care homes or anywhere else to get up to his 100,000 target. (For the record, I agree with Drakeford and may come back to testing when I get around to finishing reading a recent Harvard Medical School report on the subject I've found online).
As well as a higher pro rata number of cases and lower testing capacity, Wales has a weaker and less resilient NHS than England and an almost total lack of private healthcare capacity in much of the country. All of which may have been why we were left still firmly in lockdown in Wales while England has started to relax ever so slightly. Even though, painfully for me, this meant golf courses in Wales would remain closed while they re-open in England, I could understand the reasoning in Wales and so accepted it without being too glum. If it is decided to devolve powers it is only to be expected that there will be some differences, otherwise what is the point in doing it?
So I found it a bit puzzling that people fretted over the anomalies and the fact that the nations couldn't agree on every last detail. The devolved administrations are bound to take a different view on many issues because their situations differ in many respects. But then it is easy for Wales, Scotland and Ireland to be cautious and let England lead in re-opening the economy. After all, they probably feel that, in the limit, the English will bail them out.
A couple of days later Wales fell a bit more into line and said golf courses could open after all from next week, which also required the revision of guidance on travelling to take exercise. There is a different emphasis, requiring people to "stay local" which I think makes good sense. My only real criticism of the Johnson approach at this stage is that it seems unnecessarily risky to say that people can travel as far as they want to exercise, but setting specific limits is difficult. I'd stick with a formula on the lines of "for exercise purposes you should not travel further than the nearest suitable large open space". This would enable the Cumbrian police to turn back folk with canoes on the car roof who have driven for more than an hour to get there, which seems irresponsible.
Indeed, the main thrust of Johnson's speech was exactly what I thought it should be: those who can go back to work should try to do so. Indeed Mrs H will confirm that I've been saying for some time that the basis of the first relaxation message should be "if your work is not on the list of banned activities (like hairdressing, restaurants) and you can't work from home then you should speak to your employer about whether they have set up arrangements for you to be able to go back to work." Although the unions were initially hostile, when the further details came through the next day there was a sea change with a fair bit of support from many unions and some constructive dialogue about difficult issues such as transport.
But isn't it remarkable that Johnson should say "those who can go back to work should". One might ask why they haven't been working? I've noted before that many activities which were not prohibited were wound down because some businesses thought it was in their interest to furlough people. And some individuals chose, for their own reasons, to stay at home even when they weren't required to do so. Sources say Johnson, soon after leaving hospital, said that the opportunity to not work was "well and truly taken". The government have to pull off a number of well judged manoeuvres now and one of them is to decide how to keep businesses in the game while weaning the economy of Sunak's blanket dose of financial heroin, a task which he started on Tuesday.
Meanwhile the journalists continue to have a nightmare in terms of their generally pathetic contributions at the daily briefings. Beth Rigby, Sky's political editor with the low voice and, it would seem, equally low IQ is my current bete noir. On the Thursday before the VE Day bank holiday she put it to Dominic Raab that it was confusing to people that the PM had indicated changes from Monday, which they would have read (though only through press speculation) would include more outdoor exercise and sunbathing, but he "doesn't turn up" to tell those people what the changes might be ahead of the sunny bank holiday weekend. Now I feel that the politicians have been excessively polite, with the odd exception - I think it was Matt Hancock who called one journalist's question "stupid", earning a round of applause in our house at least. Raab said the government would take the right decisions at the right time and implied that it had not yet received all the necessary advice to take the decision. I felt he should have told her to go away and reflect on what happened in San Franscisco when the Spanish flu lockdown ended in 1918. Mass gatherings recommenced, there were street parties and, soon, a substantial second wave of infections. Beth needed to be told that's exactly why the announcement was delayed until Sunday.
On Sunday Rigby said the PM had acknowledged that we may never find a vaccine. Leaving aside the thought that her choice of words implies she thought we'd find one hiding behind the sofa, no politician or expert has, to my knowledge, ever claimed that development of an effective vaccine was certain. Johnson humoured Rigby before saying he hoped "we will achieve a virus" before correcting himself a few moments later. We already knew long ago that Johnson is not very good at dealing with questions. For someone obviously bright he seems to need quite a lot of time to process the question and so his answers rarely come out crisply. Presumably he was flummoxed by the thought that someone so brain dead could actually speak.
Other questions were more useful in so far as they put questions that many other people might be thinking even though the answer is obvious. There was a harmless lady who told the PM on Sunday evening that he was telling her to go back to work but her child was still off school, there was no childcare available and she didn't know how she could safely travel. Boris quietly gave the right answer: she should talk to her employer who he hoped would be sympathetic. Meanwhile I'm screaming at the TV that the prime minister can't possibly sort out childcare and study travel options for millions of people who need to take a reasonable degree of responsibility for themselves.
Back in the day psychometric profiling at work revealed that I can, on occasion, lack empathy (really? tell me something that wasn't obvious I hear some of you say). I fear the questions at the briefing sessions have confirmed that tendency......but sometimes it is necessary to tell people to just get on with it.
The government will quite rightly leave time for people to get their minds around their situation. But I seem to be in a minority who think the guidance and advice is, for the most part, perfectly clear and that many intelligent people who say it isn't are being deliberately obtuse. Maybe it's just me - Mrs H and I disagreed quite volubly on this on Monday evening, though she came round more to my view after listening to Alok Sharma's briefing on Tuesday. Nevertheless, I wish the government would let an attack dog off the leash to spell things out for those who need it.
Perhaps something like this:
"We are past the peak and the R value is somewhere below 1. We can't be absolutely sure by how much so we have to make small changes and see how we go.
We want to get schools open, get people back to work, allow people to have more social interaction and get pubs, restaurants, theatres and so on back open.
Given that we think R is between 0.5 and 0.9 we don't have a lot of scope to make changes without risking a second peak. So it's obvious that we have to prioritise the first two over the last two. That's why many of you could start going back to work from last Monday but we didn't want people partying in the parks over the sunny bank holiday weekend - sorry but that's just the way it is.
So we need people who work in activities that are not currently banned - and which actually have never been banned - to talk to their employer about going back to work if they aren't already working. We thought these activities were sufficiently safe to continue when the lockdown started so (surprise, surprise) we think they are capable of being made safe enough now.
Of course each employer's workplace is different and not every workplace can be adapted to meet the current guidelines. Good employers will have been addressing how best to make the workplace safe, taking account of government and industry guidance. They should also have been consulting with any relevant trade unions. Ask questions if you need to and look at reliable information sources like gov.uk and the Health and Safety Executive's website.
You will also need to think about childcare arrangements (if relevant) and how you travel to work. If public transport is your only option, talk to your employer about flexible working patterns to avoid peak hours and look again with them at how much of your work you could do from home. And, if it's practicable for you, ask about sponsored cycle to work schemes.
Oh and by the way the teachers saying it's not logical that they can teach a class while not seeing their family? Well it's a good job the ICU nurses haven't taken that view, isn't it?
We've got to minimise spread across society while using what scope we have for more interaction to save jobs and the economy. To plagiarise Bill Clinton, it's the economy, stupid rather than stupid partying.
We know this is easier for some people than others but the government can't provide every answer to every individual's questions. You are just going to have to think about some of this for yourself.
And yes, it might seem anomalous - or even unfair - but life isn't fair, coronavirus isn't fair and just what is it about all of that that you lot don't get?
No questions because you've already got more than enough answers. Just go away and get on with it."
I understand why government ministers are being emollient and polite. They need to retain public sympathy and support, which would be easy to lose. So I realise they can't address journalists and the public in that way. But I'd dearly love to see Michael Gove deliver that message. If not I'll volunteer. Alternatively it would be wonderful to tell Beth Rigby her questions are facile.....
* Amongst other things, Sandbrook claimed that all the medics and nurses who appeared on a recent edition of BBC's Panorama were Labour activists or supporters which, if true, makes his statement that the programme was 'shamelessly partisan' prima facie reasonable. Daily Mail 12 May
** My data on coronavirus cases comes from a super interactive map for much of the world and quite a few specific countries in the New York Times. Don't worry, the UK data is from the NHS and PHE. There is no paywall. It's at
https://www.nytimes.com/interactive/2020/world/europe/united-kingdom-coronavirus-cases.html#states. You can click on menus to get other countries and regional data for most of them.
*** Wales test capacity 2350 per day (from BBC 9 May) equates to 783 per million of population. Scotland capacity is 8350 per day which equates to 1670 per million of population but only a third of that is actually being done (560 per million) from Herald, 10 May. UK tests done 1-7 May, from Downing Street briefing pack 7 May (available on gov.uk) has average UK tests carried out 90,000 per day. With some mixing apples (test capacity) with pears (tests done) English tests are running at around 85000 per day, about 1500 per million of population, though the capacity is somewhat higher.
Sunak has to do this while helping businesses which have a realistic chance of getting back on their feet in a reasonable time. Hello Richard Branson, this isn't Virgin Atlantic. Not because he's a billionaire - it's his decision whether his airline is worth bailing out with his own money, that's the whole point of limited companies - but because it isn't at all clear when we'll need as much airline capacity as we currently have. There is no point in subsidising activities for which there may be no need for several years. The planes can be mothballed and Richard, or someone else, can start a new airline when the demand is there. But the problem for the government is that logic may be clear for airlines but what about retail, pubs, restaurants, entertainment and so on? I'd argue that most of these businesses (yes, including football clubs) could easily be restarted when they are needed again. If they run out of money and go bust that might be sad, especially for people who have sunk life savings and huge energy into their own restaurant or other endeavour. But that is part of the risk in starting any business: stuff can happen. Sunak is probably hoping things pick up quickly enough for him not to have to decide which businesses he really needs to sustain to restart or the economy because indefinite blanket support is not sustainable.
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The government is going to tell us next week what options there might be for easing the coronavirus restrictions. I doubt it will be much we haven't long since guessed. I'm sure many parents of school age children will be glad to see schools re-open - and probably now think teachers are underpaid. But if R is around 0.7 and opening schools might increase it by 0.2, as some have suggested, that wouldn't leave much scope for restarting the economy. And there's little point in kids going back to school if their parents are sitting at home, it's just not sustainable. One option could be to say the kids can go back if the parents are working, but I can imagine opposition to that idea. It might actually be easier to start some summer camp type options for child minding - I know a fair few youngsters who'd much prefer to be with a golf coach than a teacher and social distancing might be more practicable than at school.
A trickier aspect might be encouraging risk averse people back to work who might prefer to sit it out at home. Rishi Sunak might have to tweak his various schemes, for example putting more restrictions on which type of business can furlough staff going forward, to get the desired result.
For myself it would be good to get back to playing golf - surely one of the sports that lends itself most to social distancing other than perhaps long distance solo cross country skiing. It might also be good for Mrs H's state of mind for me to get back to golf..... Either way I doubt it will be a good idea for us to see our granddaughter yet a while even if it were allowed, notwithstanding her lovely but tearful voice message the other day, saying she can't come to build sandcastles on our local beach "because coronavirus hasn't gone yet".
While we try to get through the next 12-18 months of vaccine development, with no absolute guarantee of success, the elements of a containment strategy based around testing along with civil liberties infringing but absolutely essential track and tracing methods will be critical. This is the real reason why it is important that the government has ramped up testing capability. A lot of the pressure for increasing availability of tests seems to me misguided at best. While testing symptomatic health and other key workers who are self isolating but may not have the disease does add value by getting useful people back to work, it seems to me that randomly testing lots of asymptomatic people hardly adds any value. Unless, that is, it's part of large sample tests as described at Thursday's downing Street briefing which will provide data about spread of the disease and which there was presumably no scope for while testing capacity was limited.
So I understood why Mark Drakeford, Wales's First Minister, plaintively said that there would be no value in extending testing to everybody in care homes. I smirked a bit because this was a rare example of the Welsh or Scottish administrations being bounced by the English, in this case because Matt Hancock had extended testing in England in his desperation to deploy newly available testing capacity and get close to 100,000 tests performed per day by the end of April, Wales having much less testing capacity after the well publicised fiasco at the end of March of the contract they thought they had with Roche that never was according to the company.
It strikes me that it doesn't add much value to do a single test on a asymptomatic care home worker if they don't get the result back immediately. But as usual questions buzzed around my head. How long after exposure to the virus would a test show positive? How long then before symptoms appear? And how quickly can the test results be made available - what are the limitations imposed by the RNA-DNA transformation and polymerase chain reaction (PCR) that the the most reliable type of test currently available relies on?
So I've been reading what I take to be a fairly definitive article on testing from the Harvard Medical School and some other reputable sources*. The Harvard article is in bitesize Q&A form and helpfully jargon-limited. The PCR test is well established and reliable, with few if any false positives and false negatives mainly due to poor swab taking, not the test itself. But the method takes several hours to produce a result to which you have to add the time to batch up samples, get samples to the lab, run the test and check and return the results. Which is why it tends to take a couple of days, or longer, for people to get their test result. So you can't test someone and give them the all clear before they go on their shift. F
aster genetic tests being developed, typically based on a method called loop mediated isothermal amplification (LAMP), hold out the prospect of a test result within half an hour. Still not as quick as a dipstick diabetes or pregnancy test but perhaps we can get to the point where workers get up, take the test, have breakfast and get ready to head off to work having got a negative test result. But we're not there yet.
Testing only tells you not got it at time of test (a few days ago)
....
Isolate over 60s and only have tested people interacting?
Fine as long as over 60s can golf......
*
https://www.health.harvard.edu/diseases-and-conditions/if-youve-been-exposed-to-the-coronavirus
See also good articles in New Scientist:
https://www.newscientist.com/article/2238477-how-does-coronavirus-testing-work-and-will-we-have-a-home-test-soon/
and the American Association for the Advancement of Science:
https://www.sciencemag.org/news/2020/03/standard-coronavirus-test-if-available-works-well-can-new-diagnostics-help-pandemic#
