- Forget the blame game and focus on avoiding another Great Depression
- Lockdown is only a “placeholder” and, in the long run, could lead to ruin
- Without a vaccine, herd immunity may be the only answer to end lockdowns
- Tough decisions are needed soon, in weeks, not months
It is important to remember from the outset that the protection of the vulnerable (old and young) is a major objective in dealing with the Covid-19(CV) crisis. A lockdown helps save lives, and also protects the NHS. Otherwise, a lockdown only buys time and does not solve the CV issues.
THE BLAME GAME MUST END NOW
On 3rd April both the Times and the Guardian included references to a future full public enquiry into mistakes that may have been made in the CV crisis, in articles by Ian Martin and Simon Jenkins respectively. The latter referred to “the mother of all enquiries”. They may be right, as that is how typically the UK parks an issue and moves on while the media acts as judge and jury. However, it is sad that now, in the midst of the storm which in good faith those in charge are seeking to navigate, commentators look forward to an investigation into what went wrong, which , usually for the media, is about who can be blamed, sacked , persecuted or prosecuted. These pages have earlier referred to the start of the blame game and that expression is appearing in the media more regularly. The mere threat of an enquiry will now bring fear in the hearts of those involved, close off open discussion of what to fix (in case someone imputes guilt), lead the weaker , and some politically minded, to build the backside covering case, at a time when all energies should be directed at one single goal, controlling CV and avoiding a Great Depression. Perhaps now the UK influencers could resolve that the blame culture of Britain be finally discarded.
Sherbhert has previously recommended before Matthew Syed’s book “Black Box Thinking”, the fundamental basis of which is to compare the responses of the NHS and other healthcare services to errors with that of the aerospace/airline industry. The latter uses data, including mistakes, to learn and improve by open admission and discussion of them, to avoid repetition: whereas healthcare does not. Apt to compare as both involve preserving lives.
If a person makes an error or just could have done better, for whatever reason, and anticipates blame and recrimination, fearing humiliation or the sack, they will be less likely to fess up, discuss transparently how things could be done better, retreating into blame- shifting or sharing. Worse too, in such an environment, such people may hesitate to take responsibility and important decisions, procrastinate, and avoid change, infecting others with the same malaise. Great businesses do not make scapegoats but encourage openness and learning instead to avoid the errors of the past.
THE SAGA OF PERSONAL PROTECTIVE EQUIPMENT
Day after day, UK journalists question the UK Government (UKGOV) and its advisers at the daily press briefing about the provision of Personal Protective Equipment (PPE) to health and care workers: “why does not everyone have what they need by now?”. A BBC Breakfast presenter interviewing Susan Masters, Senior Nurse at the Royal College, asks numerous questions like “How well cared for do nurses feel?” All these questions are designed to get answers which can lead to a story to find fault and blame within UKGOV when it is clear the PPE roll out has been beset by difficulty.
There has never been a suggestion that there is a material shortage of PPE in the UK, on the contrary. It is perhaps fairly clear that the management in charge of distribution have not delivered PPE to the right places on time. It seems that Public Health England (PHE) assuming they have a significant involvement, or even other executives in charge of logistics, have for some as yet unknown reason failed to ensure the supply chain has worked as it should. Is it bad management? Is it a shortage of transport? Is there a turf war? It is evidently not the fault of Ministers – but they must shoulder the blame and, in fairness to them, they have resisted the temptation to vilify those responsible, at least publicly.
However, what should happen is that those responsible should feel able to describe the errors and fix things for tomorrow: but if they do that, they will probably suffer damage at media hands. So, one wonders if the fixes will happen. It is notable that distribution of PPE picked up it seems when the army became involved. This seems to be an example of the healthcare system, the NHS and/or PHE as it is to be expected they work hand in hand, failing its staff. While applause for the healthcare workers who work tirelessly for the benefit of their patients is welcome, this crisis must not embed even more the damaging religion which is growing up around an NHS which has much room for improvement, without a blaming tone.
CV IS AN UNKNOWN QUANTITY – THE SCRIPT IS BEING MADE UP WHILE THE PLAY IS BEING ACTED OUT
It is “very unclear whether any country’s strategy has been better or worse than any other’s” said the Times on 3rd April. The reason is that the play is still going on and the ending is unknown to anyone. It is not known whether CV is weaker in warm conditions; why children seem less damaged by it; what is safe distancing; whether a vaccine can be found; whether a test may exist to measure immunity, and so on. Governments rely on scientists’ modelling and experts’ advice, but different scientists and experts favour different models and draw different conclusions and make predictions which vary enormously. Experience with other coronavirus types may educate or may mislead. Nobody in reality has the right answer. That is the problem when trying to find solutions without the right information. Just like economists’ models, the medical models will all be wrong, but one will be more right than others – but only hindsight will tell us, and it may be down more to luck than judgement.
And so, with that background, it is reasonable to say that all Governments, administrators, medics, scientists and researchers are working hard around the world, in some cases cooperatively, to find remedies to combat CV. And UKGOV has to make decisions guided by science as best it can. Some may turn out to be good, some bad. Meanwhile those without responsibility or involvement continue to snipe. On 3rd April Sir Paul Nurse of the Francis Crick Institute is reported to have said “The country was not prepared as it should have been”. John Ashton, ex regional director of public health in NW England is reported to describe PHE’s handling of things as “a fiasco”. On 4thApril Juliet Samuel wrote a piece in the Daily Telegraph including a scathing rant at UKGOV and institutions (by which it is assumed she means medical and scientific) and the mess of everything made so far.
The fact is that, in the major economies of Europe and in the U.S., millions are getting infected and thousands are dying, and in many developing countries the virus is taking hold with consequences far more dire potentially than in the richer world. Nobody has a strategy with the way out. In the UK too, the fact is that there is no diagnostic industry to speak of. No real manufacture of chemicals and kits required, let alone ventilators, and no real facilities to make the remedies such as vaccines of tomorrow, relying almost entirely on other countries. This is the product of globalisation, so warmly and perhaps properly embraced in the good times, but dangerous in the bad. Maybe those who propound the panacea of globalisation will also be major critics of unpreparedness for a CV pandemic? Reliance on China for future anything seems worth reconsidering. There is little point harking back, but lessons for the future and risk assessment will be needed. Perhaps the UK should now start building a diagnostic capability to help meet a need which is imminent. Bill Gates has suggested that countries such as the UK start now to build facilities to produce the vaccines when discovered, which will be needed by the billions of doses. Are Governments, including UKGOV, thinking in such ways in partnership with the huge pharmaceutical industry?
LOCKDOWNS MUST STOP SOON TO AVOID RISK OF A GREAT DEPRESSION
The most pressing, more and more are saying, is to find a strategy to stop the lockdowns. These are only deferral tactics, not a long-term answer, and will probably quickly lead to meltdown, socially as well as economically. Economists and analysts and other commentators are all contemplating openly a great depression on the way unless a global alternative approach is adopted. Graham Medley, the UKGOV chief pandemic modeller, is reported to warn that a prolonged lockdown risks causing more suffering than the virus itself and that the country needed to face the trade-off between harming the young versus the old. He describes lockdown as a placeholder. The lockdown may buy time to prevent health care systems collapsing: but if that leads to a depression then that certainly will seriously damage not just the health service but the whole planet indefinitely. Repeating a paragraph in Sherbhert article “Covid-19 – A Balancing Act for Government and All Citizens – Part 1”:
“Like it or not, it is necessary to weigh the degree of loss of life and suffering against the disruption (in wealth, health, mental and physical, and social cost) of emergency measures. This balancing act occurs all the time in our normal lives – for example the UK tolerates some 2000 deaths and 160,000 injuries a year on the roads because it thinks the benefits of vehicle travel outweigh such disadvantages. So, the measures to protect life must be balanced against other things – an invidious task for UKGOV and its leaders and they should be thanked for shouldering this burden on behalf of all citizens.”
Unless the heat of Africa, India and Asia restrain CV, its consequences in human and economic loss in those regions may be catastrophic, far worse than in developed nations. If those developed nations are also bankrupt and in disarray, looking only to self-protection, how will the necessary resources ever be available to those regions? Do not the G7 and G20 need to combine and devise a non-lockdown strategy for common implementation rapidly?
If, having seen a depression on the horizon, countries of the world simply walk into it, it will not be a public enquiry that will be of interest. That UKGOV may even allow the country to come near that has to be unthinkable. Unless in short order real medical and science answers are found which can be quickly implemented within weeks, that trade off of the future for the young versus the longevity of the old becomes real. If regrettably that trade off cannot be avoided, someone with courage may have to make life and death decisions and must not be pilloried for it.
It may be that, if the only scientific answer is that, without a vaccine, people need to get infected with CV to build immunity, perhaps the UK should get on with it within a matter of weeks, while protecting the vulnerable as best can be done. One thing presumably the NHS can get plenty of is samples of CV itself. In addition to an active testing programme, maybe an active programme of consensual organised infection of minimal dosage (different to vaccination) needs to be on the table, if scientifically possible. The public will need to be brought along and a process of perhaps having to face that reality needs to start now. A version of the “chicken pox children’s party” may need invention. Maybe herd immunity is the only right answer, just a question of timing.
