Beginning to See the Light: Covid, what we have learnt and where do we go next?

 

 

‘Inclination-somethin’ to dream on,

Deprivation-we are sons..’

 

Covid (‘C-19’, ‘the virus’, ‘the pandemic’) caught all countries by surprise. As this article shows some were better prepared than others, some reacted better than others, and we are all still learning from it.

The longer-term effect of pandemic may not be the health issues it raises, or the increased political risks, but its impact on the fundamental structure of society.

It has exacerbated the wealth gap, highlighting just how much richer and secure the wealthy have become while the poor have become poorer and less secure. Quite what the long-term political consequences we have yet to see.

The purpose of this article is to look solely at the UK, and compare our readiness, reaction, and ‘butchers bill’ to that of other countries.

In absolute terms C.127,000 have died, which represents 1,890.84 per million of population, 6^th worst on the global list ⁽¹⁾.

The PM has admitted there are many things he wishes he had done differently to tackle the pandemic, a comment supported by England’s chief medical officer, Prof Chris Whitty, who conceded the country had endured ‘a bad outcome’.
 

‘1,890.84 per million of population, 6^th worst on the global list’

 
Mistakes are legion, we locked down too late the first time, allowed people to mingle too much after the first wave, and have been consistently behind the curve.

One of the most surprising omissions was closing the borders, usually a favourite policy of this government. As a result, we were locked-in whilst the door was open for people to come in!

The door is still not shut, recent reports suggest that up to 8,000 tourists may be arriving in Britain every day, and that as many as 90% of arrivals at Gatwick airport are tourists.

David Lammy, the shadow justice secretary, said, ‘I’m not one for ‘let’s close the borders’ but you can’t have a situation where later on today Boris Johnson is announcing a sort of red, amber, green system for those of us who are thinking about a summer holiday, and then we find out that the whole world and their aunt can come in, breeze into Britain.’

Other mistakes during the pandemic include PPE/Cronyism, the decision to release people from hospital into care homes, are systemic errors that pre-date the pandemic, which show a lack of preparation, and funding necessary to support a fit-for-purpose health service. The health service itself acquitted itself beyond reproach, but for them the situation would have been much worse.

Exercise Cygnus⁽²⁾ was a 2016 government simulation of a flu outbreak, carried out to war-game the UK’s pandemic readiness. It involved 950 officials from central and local government, NHS organisations, prisons, and local emergency response planners. A report on the exercise was compiled the following year and distributed among its participants.

The Cygnus report was frank about the state of the UK’s readiness, finding, ‘The UK’s preparedness and response, in terms of its plans, policies and capability, is currently not sufficient to cope with the extreme demands of a severe pandemic that will have a nationwide impact across all sectors.’
 

‘its plans, policies and capability, is currently not sufficient to cope with the extreme demands of a severe pandemic’

 
One problem was that while each government body participating in the exercise had its own bespoke plans, enabling a flexible and decentralised response, there was no central oversight, meaning that participants found it much harder to shift resources between one another so as react to unexpected rises and falls in demand for services such as social care beds

Social care deficiencies were of particular concern; it found extreme difficulties in locating capacity in the care homes sector, partly because care homes are almost entirely privately run, making it difficult to clear hospital beds by moving patients into care homes.

Cygnus found that the social care sector was ‘currently under significant pressure during business as usual,’ and that in the event of a pandemic staff absenteeism through illness combined with widespread infection of the vulnerable ‘could be very challenging’.

The report’s recommendations included further modelling to understand the capacity of the care sector, further work to understand how the public would react to the crisis, and the creation of a ‘joint-level tactical plan’ to help different organisations cooperate more effectively.

The National Audit Office (NAO) said Covid-19 had focused attention on social care in England ‘as never before’, highlighting pre-existing shortcomings in services as well as major gaps in the government’s understanding and oversight of the care system.

The NAO report supports’ the recommendation and findings of ‘Cygnus’, i.e. fragmented services unable to meet the rapidly growing need for care, at risk of staffing shortages, and exposed to constant financial uncertainty, leaving them unable to plan properly or invest in new facilities.
 

‘years of funding cuts, repeated failure to fix workforce shortages, and a lack of central oversight and understanding’

 
The NAO report found that once we were in lockdown, the lack of a long-term social care strategy highlighted the years of funding cuts, repeated failure to fix workforce shortages, and a lack of central oversight and understanding of the sector’s problems.

As ‘Cygnus’ found the sector is dominated by private care providers, around 76% of residential care is provided by commercial operators, many of whom carry significant debts as part of their funding structure, meaning that their balance sheets are fragile, and the falls in occupancy caused by the pandemic left many requiring financial support from the government.

Underfunding of local authorities has led to a 6% fall in over-65s receiving council care over the past five years. A quarter of over-65s reported that, whilst they received no help, they needed help with daily living activities such as washing and dressing.

Social care directors in England said last year thousands of people had lost their lives prematurely because care homes were ‘ill-equipped and under-resourced’ to deal with Covid because of years of underinvestment in social care. A cross-party group of MPs called in October for a £7bn-a-year funding boost by 2023.
 

‘last year thousands of people had lost their lives prematurely because care homes were ‘ill-equipped and under-resourced’’

 
Successive governments have promised and failed to deliver reform of adult social care for years, despite cross-party support. Johnson himself said he had a ‘clear plan’ to do so when he became prime minister in 2019 but has yet to deliver one.

The austerity legacy of the Cameron/Osborne years left the NHS woefully underfunded and therefore unable to respond fully, despite the efforts of their staff ⁽³⁾. Nearly half of staff say underfunding stops them doing their job properly, many say it’s the worst situation they have seen.
 

• 2009-2019 the NHS budgets rose on average just 1.4% per year, compared to 3.7% average rises since the NHS was established.
• The whole NHS budget has not been protected and the result is cuts to frontline services, especially in public health.
• There is a crisis in the recruitment of staff across the NHS – including too few doctors, midwives, paramedics and nurses.
• Per head the government spends less on the NHS than many other comparable countries.
• We have less beds and doctors per head than many comparable countries.
• Large cuts to social care and mental health have added huge pressure on the NHS as there are not enough services outside of hospital.

 
Two-weeks ago it was reported that between 1 August 2020 and 21 March more than 40,600 people have likely been infected with C-19 while being treated in hospital in England for another reason, raising concerns about the NHS’s inability to protect them. Across England 15% of all patients treated for the virus caught it while in hospital.

Doctors and hospitals claim that many of the infections were caused by the NHS’s lack of beds and limitations posed by some hospitals being old, cramped and poorly ventilated, as well as health service bosses’ decision that hospitals should keep providing normal care while the second wave of Covid was unfolding, despite the potential danger to those receiving non-Covid care.

‘These heart-breaking figures show how patients and NHS staff have been abysmally let down by the failure to suppress the virus ahead of and during the second wave,’ said Layla Moran MP, the chair of the all-party parliamentary group on coronavirus.
 

‘15% of all patients treated for the virus caught it while in hospital’

 
What has become clear is that a successful response to C-19 depended on more than a country’s wealth, scientific prowess, and history of public health successes.

The U.K. enjoys all these advantages but mounted one of the worst responses to the pandemic. Often countries faltered during the second or third surge of infections, because their governments and people grew tired of implementing effective strategies, whilst in many Asian countries, it has long been common for people to wear masks when feeling ill, so they adopted masks early and widely.

One of the issues we struggled with was constantly being behind the curve, whereas countries such as Taiwan who had C.1 reported Covid-19 death per 3.4m people reacted quickly and positively.

They were among the first country to react to the news from China in December 2019, and immediately started screening travelers from Wuhan.

From late January, Taiwan closed its borders to travelers from China, then as Covid spread around the world it tightened controls to require two weeks’ strict hotel quarantine for all arrivals.

At the same they activated the Central Epidemic Command Centre that brought together government, academia, the medical system and the private sector in a unified fight, among other actions they rationed masks, so everyone in the country could access them, while stepping up production, and launching strong public communication campaigns about new controls and why they were necessary.
 

‘early actions were pivotal in keeping Taiwan to under 800 cases all year, while avoiding lockdowns’

 
In addition, Taiwan also provided intensive support, including stipends, to patients with Covid-19 and people with whom they had come into contact, helping to increase adherence to public health recommendations. These early actions were pivotal in keeping Taiwan to under 800 cases all year, while avoiding lockdowns.

After a two-week extension of holidays last spring, Taiwanese schools have largely opened as normal (with a few localised, temporary closures after cases were identified). Restaurants, cafes, cinemas and theatres, beaches, and hotels, have continued to trade. As a result, whilst the economy was initially hit it rebounded to grow 5% in the last quarter of 2020 and is forecast to expand at a similar rate this year.

Even the intrusive data collection measures authorised temporarily for disease control, including using phone data for electronic ‘fencing’ of people isolating after possible Covid-19 contact, have been widely accepted by the public. Their digital minister, Audrey Tang, explained that this was due to the government clarity and transparency, said Chen. ‘You have to let the people know what the government is trying to do.’

Taiwan success shows how Britain’s tragedy was never inevitable, and how lives and livelihoods might have been spared if the outbreak had been handled better by the UK government.

They never resorted to a lockdown because they acted quickly on a collection of effective policies including border controls, efficient track, trace and isolate systems, and widespread mask-wearing.
 

‘lives and livelihoods might have been spared if the outbreak had been handled better by the UK government’

 
Once the virus is prevalent in a country, the key is ‘crushing the curve’: New Zealand with C. 1 reported Covid-19 death per 205k people were amongst the most successful at this.

As with Taiwan, New Zealand is an island, which makes it far easier to enforce travel bans.

In response to models that showed the countries health care system being overwhelmed by the virus, they began implementing their pandemic influenza plan in February, including preparing hospitals and instituting border control policies.

Because New Zealand lacked sufficient testing and contact tracing capacity, national leadership implemented a countrywide lockdown in late March with the goal of eliminating Covid-19 entirely.

By June, the pandemic was declared over in New Zealand, with the country reporting one of the lowest coronavirus-related mortality rates among all 37 OECD nations. Later cases were all from international travelers, who were kept in isolation for two weeks post-arrival, and not from community spread.

In addition, their PM, Jacinda Arden, exemplified empathetic, clear communication, which greatly increased people’s willingness to cooperate and was essential to the country’s success.

Testing was another area we failed to exploit unlike South Korea, who had C. 1 reported Covid-19 death per 64k people. They conducted more than twice as many tests per capita as other countries in the pandemic’s first weeks. Along with other measures, including extensive and highly effective contact tracing and quarantine, this kept cases from increasing rapidly.

The countries that performed best have learned from their mistakes and used data to continuously improve.

It would be fair to say that countries such as Taiwan had the ‘benefit’ learned much for the SARS virus, however their planning was based on learning from this, their research was published extensively, therefore there was nothing stopping our government, or others, learning from this.
 

‘We chose not to, perhaps because of British exceptionalism’

 
We chose not to, perhaps because of British exceptionalism, perhaps because other coronavirus epidemics, such as SARS, had been contained far from Europe, the UK.

Where we have excelled is in the roll-out of the vaccine. As a result, we can know, hopefully look forward to where we go next.

Perhaps the most illuminating indication of where comes from Johnson himself, who said that people have had enough ‘days off’ and must get ‘back into the office’ immediately!  I wonder how many parents working from home, trying to hold down a job while providing home-schooling saw it as ‘days off’?

Many who were ‘forced’ to go out to work, especially the low paid, took risks that saw large numbers infected. Covid deepened the economic divide, with poorer earners falling into debt while the high paid amassed monumental savings. Over 60% of business leaders were personally ‘thriving’, while over half the workforce felt over-worked, according to the Work Trend Index.
 

‘poorer earners falling into debt while the high paid amassed monumental savings’

 
Then there is the use of webcam surveillance for employers to spy on home, looking for breaches of rules, for staff ‘missing from desk’ or ‘detecting an idle user’.

The Amazon-style treatment of warehouse staff, or of time-bullied delivery drivers having to pee in bottles, is spreading to more workplaces. Care workers are told that their all-night shifts sleeping-in with patients don’t deserve the minimum wage.

The lowest paid always suffer the most, and yet they are the ones that have no other options.

When the current furlough ends, unemployment will rise, handing more ‘power’ to employers. ‘Fire and rehire is spreading like wildfire,’ says Andy McDonald, Labour’s shadow secretary for employment rights, who notes wryly that he shadows nothing: tellingly, this government has no such ministry. ‘Precarious work has taken off in the last decade,’ he says.

Under the cloak of Covid, one in 10 workers face losing their jobs and being rehired on worse terms. Examples of this include:
 

• British Gas considering sacking hundreds of long-serving boiler-servicing engineers for refusing longer hours and poorer terms and conditions, their employer tearing up contracts unilaterally.
• Tesco, despite making mega profits in the pandemic, tried stripping between £4,000 and £19,000 off staff wages, until a Scottish court last month imposed a temporary injunction.

 
It is reported that working-class employees were ‘nearly twice as likely’ to face fire and rehire as ‘those from higher socio-economic groups’. The words used are straight from business school, such as Network Rail which is ‘modernising’ terms and conditions across all services.

Aside from the economic casualties, we are at what could transpire to be a pivotal moment for both our democracy, and the relationship between the state and society. This is a subject this column has highlighted previously, as the government continues evading scrutiny, and meaningful constraints.

This can be seen in Johnson’s relationship with the ‘technology entrepreneur’ Jennifer Arcuri and her access to public funds and favours, David Cameron’s lobbying on behalf of disgraced financier Lex Greensill, and the cronyism in handing Covid-related contracts and jobs to associates of senior Tories.
 

‘we are at what could transpire to be a pivotal moment for both our democracy, and the relationship between the state and society’

 
The side-lining of parliament has been an on-going feature of Johnson’s government, from his attempt to suspend it in 2019, the pitiful levels of debate, the lack of scrutiny allowed on coronavirus rules and legislation, and the rushing-through of the new police, crime, sentencing and courts bill.

The latter has led to numerous demonstrations which have provoked a reckless and violent response from the police, and a similar reaction from Tory ministers. Power, if unchecked, allows people to do what they want because they know they can.

The governments arrogance and tendency to turn nasty and authoritarian isn’t new, but it has been given new life by the pandemic. Whilst the lockdowns and restrictions have been necessary, they have been railroaded through, and precedents have been set.

There has been a laudable collective sacrifice of individual wants and needs for the collective good, which has led us to accept extensions of the state’s reach that may have gone a step too far.
 

‘power, if unchecked, allows people to do what they want because they know they can’

 
As the high-profile human rights lawyer Adam Wagner, said: ‘Come the next great threat, we have set the marker: parliament will not have a say and will hardly raise a whimper; decisions will be made on a whim by whichever person, however capricious, happens to be behind a particular ministerial desk.’

As with the ‘war on terror’, powers that were initially presented as temporary look set to become lasting. As the civil rights pressure group Liberty puts it, the restrictions on protest in the police, crime, sentencing and courts bill amount to a brazen quest to ‘use this public health crisis as cover to make emergency measures permanent’.

The same issues are why people are reticent to embrace a ‘Covid certification scheme’ which is proposed as a help to returning to normality, but could itself become normal, providing the basis to restrict certain people’s participation in everyday life.

The scheme has provoked Labour back into life, as their leadership switches from abstaining on the bill to voting against it. This is the sort of legislation the former backbench libertarian Johnson would have been against, seeing it as a means of subjecting us to back-door surveillance.

As PM, whilst Johnson has turned from poacher to gamekeeper, he continues to regard rules as applying to lesser people.

He has relied for so long on his knack for persuading people to exempt him from ordinary standards of decent behaviour, that he knows no difference.

It is the same with his lack of affinity to the truth, no one is now surprised when he lies, therefore he continually gets away with it. As he does with his ongoing negligence and incompetence. Failures that would have finished other PM’s simply wash over him, it as if we accept and embrace his fallibility.
 

‘no one is now surprised when he lies, therefore he continually gets away with it’

 
This all has the effect of lowering our defences He governs by force of character, with a casual display of power, both informal, and unchecked, which is far more dangerous than the overt arrogance and hostility of a Trump.

This stealthy takeover of parliament threatens the very essence of our democracy. Allied to the culture war this weakens both the state and civil liberties.

The decline of the Liberal Democrats, the smallness of the Green party, and, in an age when ‘liberal’ has connotations of the despised trendy elite, any semblance of progressive politics is too easily dismissed.

Have we really come through the last 12-months, 127,000 deaths, to see us ruled over by a regressive, authoritarian government paying lip-service to our long-cherished democracy?
 

‘Jung the foreman prayed at work,

Neither hands nor limbs would burst,

It’s hard enough to keep formation with this fall out saturation..’

 
Notes:

1. https://www.statista.com/statistics/1104709/coronavirus-deaths-worldwide-per-million-inhabitants/

https://www.worldometers.info/coronavirus/?utm_campaign=homeAdvegas1?

2. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/927770/exercise-cygnus-report.pdf
3. https://nhsfunding.info/nhs-crisis-making/#:~:text=The%20NHS%20has%20experienced%20a,since%20the%20NHS%20was%20established.

 
In lieu of any formal investigation into the UK’s – and specifically Boris’ – handling of the pandemic, Philip’s ‘Covid Special’ leaves few in credit, and points to ways in which existing shortcomings may have been exacerbated to leave an even more concerning future.

His conclusion that the pandemic has ‘exacerbated the wealth gap, highlighting just how much richer and secure the wealthy have become while the poor have become poorer and less secure’ is hard to dodge, but given that Exercise Cygnus highlighted problems to be addressed in a war game flu pandemic simulation in 2016, it rather smacks of failing because of a failure to prepare.

Austerity can only have made things worse as hospitals and the care home system were already weakened before the Beast from the Feast arrived.

However, what follows is a ‘worst-of-breed’ response that apparently took no account of information and expertise gleaned from the SARS outbreak, and failed to take advantage of at least one of the benefits of being an island; where Taiwan and New Zealand closed their borders and strangled the virus we just kept on proffering the chicken or the beef.

The fact that the Times this week reported that an estimated 8,000 tourists a day are entering the UK is so nonsensical, particularly where those making outbound journeys would attract a £5,000 fine, that it will need to be ascertained whether Tory cronyism stretched to the department headed by Grant ‘Two Planes’ Shapps.

Other than that, it is a litany of cock-ups, obfuscation and missed opportunities that is very explicitly evidenced by the death toll; mixed messages, indecision and an apparent inability to learn the lessons of history resulted in a disastrous result that does indeed look as though it was ‘far from inevitable’. 

Few of those that will suffer from economic long-Covid will have taken any comfort from the government’s announcement of a traffic light system to open up international travel or Mr Shapps’ pledge to tackle the ‘inequality’ created by the high costs of the required testing; those that have been ‘fired and rehired’, forced to wee in bottles or desperately trying to keep a roof over their heads will not be heading to an airport anytime soon.

Maybe those with immaculate gardens and plump bank balances, carping about being restricted from traveling to countries that are almost inevitably behind the UK in terms of vaccinations, should spare a thought for those they were applauding a few months ago, but won’t be joining them in the departure lounge on account of their pay cut.

If that is thoughtlessness in action, this government’s attack on democracy and liberty feels more contrived and with long-term consequences; with David Cameron just the latest to be found snout-deep brazen Tory cronyism may be a result of the administration’s bomb-proof status, but it would be an ugly stain on this country’s reputation, if anyone cared. 

Philip’s column delivers a stark summary of the key factors that led to the UK suffering the 6th highest death toll per million and the structural changes that have been imposed that will see the gap between the haves and the have-nots continue to widen; as a backdrop there are scenes of destruction in Belfast as shelves have emptied and tensions have spilled – yet another eruption that speaks of the simmering frustrations that could lead to an ugly summer in the absence of empathetic and honest leadership.

Two tracks this week, purely for fun – The Germs with ‘Forming’ (I know, me neither) and David Bowie with ‘Drive-in Saturday’. Enjoy!
 

 
 

Philip Gilbert is a city-based corporate financier, and former investment banker.

Philip is a great believer in meritocracy, and in the belief that if you want something enough you can make it happen. These beliefs were formed in his formative years, of the late 1970s and 80s

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