Coronavirus: for want of revolution

25/03/2020

The picture (above) of Army trucks (Austrian-built, by the German firm MAN) crossing a deserted Westminster Bridge in broad daylight, depicts the sort of scene one might associate with a military coup.

But it is not the military who have overtaken this country but a microscopic organism, turning our society on its head in a way that we could not even have begun to predict a few short weeks ago. With the first two cases being reported at the end of January, less than two months later we had reached 8,077 by yesterday, with 422 dead – results produced by a woefully inadequate system which is massively under-reporting the true case load.

As it stands, despite guesses from a variety of sources, we can have no real idea of the extent to which coronavirus has penetrated the UK population, although it is probably fair to say that the distribution is probably patchy and that the main hotspot is London.

It is just as well therefore, that the authorities have finally reacted to set up an emergency treatment centre in the London's ExCel conference centre, although this action should have been taken weeks ago. If the need was obvious to me two weeks ago, sitting in Bradford relying on open source material, then it should have been obvious to the authorities some weeks earlier.

Now that we are seeing warnings that NHS hospitals could run out of beds in a fortnight, this development has come not a moment too soon, with the centre expected to be handling cases within a week.

We have also learned that the National Exhibition Centre in Birmingham has also been offered as an emergency treatment centre – another huge venue which could be converted to take thousands of new cases.

The great pity is that this wasn't thought of earlier, using such centres as the main treatment resource, rather than employing the existing NHS hospital network, and thus shutting down much of the routine health care for the nation. Part of the grisly death toll of this epidemic, therefore, will have to be measured in the untreated illness in people who could no longer get the help that they needed.

When we finally get through this, as we undoubtedly will, there will need to be not one but several searching inquiries into the management of the epidemic response, and such factors should feature high in any deliberations.

And since we cannot (or must not) assume that the Covid-19 epidemic is a one-off, the like of which will never be repeated in our lifetimes, we must use the experience gained to re-configure our public health systems to ensure that we are better equipped to deal with the challenges that the future might bring us.

With that, I must admit that I am getting a little tired of the "shock-horror-probe" denouements by sundry, wise-after-the-event journalists, keen to show how different aspects of the response led to the situation in which we find ourselves.

Much as I detest Johnson – and have little respect for the team of experts around him – given the deterioration of the public health systems over the decades, it is likely that the initial response would not have been much better, regardless of who was in charge.

The same, however, does not go for the more recent responses, and it is of some interest that Johnson received a call from Chinese president Xi Jinping about measures to prevent and control the Covid-19 epidemic.

It seems that, rather than mobilising resources, the prime minister frittered away his time – and his declining credibility – in giving health education lectures on personal hygiene. The current shape of the epidemic curve is mute testimony as to how fruitless those efforts were, with his actions being condemned internationally as "confused, dangerous and flippant".

Now we are in a partial lockdown, the effects of which are patchy, with confusion in many quarters, it is up to the police to take on an enforcement role where there are so many exemptions that it is hard to see how the law can be applied.

That much is evident from the police response, with police "chiefs" demanding urgent clarification from government as to what their precise duties should be.

Martin Hewitt, chairman of the National Police Chiefs' Council, says that police would have to use persuasion until new enforcement powers were made available under emergency legislation. "These are new rules. They are trying to be as clear as they can but it will take a while, I think, for everybody to get that understanding", he says.

In other areas, though, police leaders are saying that the lockdown may be impossible to enforce through lack of resources, not least because about ten percent of police officers are already off sick or self-isolating because of the virus.

Once the enforcement system is in place, though – with initial penalties of £30 being discussed, with provision for unlimited amounts – there will doubtless be plenty of jobsworths willing to come forward to impose fixed penalty tickets on the unwary. With hordes of under-employed parking wardens at large, there is a ready-made recruitment pool and you can bet that the authorities will be quick to exploit such an easy opportunity to top up their depleted coffers.

In the first days, however, it seems there will be little need for firm action. According to a YouGov poll, there is overwhelming support for the new measures, with 93 percent of Britons backing them, including 76 percent who say they "strongly support" them.

How people will feel after three weeks of "lockdown", especially if the measures are intensified, remains to be seen. One might expect a few localised incidents, and there is the ever-present threat of a repeat of the 2011 riots.

This cannot be dismissed as a possibility when there will be a large number of unemployed, extremely short of money as time goes on, unable to pay their bills and willing to loot supermarkets in order to feed themselves. Warnings that the epidemic could bring out the worst in humanity should not be ignored.

It is perhaps significant that Italy's unions are threatening a general strike over its government's definition of "essential" activities that would be allowed to continue working through the crisis. This is an issue which the Johnson administration has yet fully to tackle.

Furthermore, while there are some limited signs in Italy that the increase in cases might be slackening, there are as yet no firm signs that the epidemic is under control.

Much will thus depend on the ability of the UK government to contain the epidemic in Britain, allowing the restrictions progressively to be reduced, but the auguries are not encouraging. Not least is the growing scandal of the shortage of protective equipment for medical staff, hampering them from carrying out their tasks and putting them at risk.

As the crisis reaches what is expected to be its most dangerous period, we are told that doctors' and nurses' groups are complaining that their members are being expected to take unacceptable risks.

Dr Rinesh Parmar, chair of the Doctors' Association UK, warns that, where PPE continues to be in short supply, some doctors may feel they have no choice but to withdraw their services. The inability of the NHS properly to supply its staff with the necessary equipment, says a great deal for the overall failure to plan for a large-scale epidemic.

More to the point, when doctors at the height of an epidemic are even thinking of withdrawing their services, this is almost revolutionary talk. Perhaps the next time we see Army lorries crossing Westminster Bridge, it will be for real.