The Coronavirus inquiry. I’m an outlier – but I believe that following public opinion was a problem.

15 Mar

Coronavirus has disappeared from the headlines recently. The lifting of restrictions, the horrifying news from Ukraine, and our instinctive desire to quickly forget the dreadful means there is now a collective effort to never mention the dreaded C-word again.

But March 26th will mark the unhappy second anniversary of Britain entering lockdown: the biggest state-mandated change to our lives since the Second World War. With the terms of the Government’s inquiry into its handling of the pandemic announced last week, this is an opportunity to ask the fundamental question: was it all worth it?

The inquiry hopes to do this. The proposed terms of reference suggest that it shall assess all aspects of the government’s response: preparedness, the efficacy of interventions, the management of hospitals and care homes, the provision of essential equipment, and economic support. Under Baroness Hallett, the Chairwoman – a former High Court judge – it is hoped the inquiry will “reflect the importance of understanding the experiences of those most affected by the pandemic” and identify where the government got it wrong.

Like all inquiries, this will be a welcome opportunity for acts of confession and self-justification on the parts of ministers. That at least one Cabinet member has been keeping a diary for the last two years is unsurprising. This is a chance for ministers to show public contrition for any shortcomings, whilst aiming to guarantee that the eventual narrative presents them in the best possible light. Plus, Anthony Seldon and Tim Shipman must work from something.

The direct relationship between the size of an inquiry’s remit and the time it takes to conclude means it will be a while before we see Hallett’s final report. Moreover, inquiries tend largely to confirm lessons we have already learnt, providing only slaps on the wrist for politicians who have long since left office. By 2016, for example, we didn’t really need Lord Chilcot to tell us that invading the Middle East on a spurious pre-text was poor form, and that Tony Blair might have a slight messiah complex.

Nevertheless, we can get on with lesson-learning whilst the Baroness finishes dotting her Is and crossing her Ts. A report in the Lancet last week suggested the UK had a lower death toll than Italy, Portugal, and Spain – with no significant differences from those of France and Germany.

By looking at age-standardised avoidable mortality rates, the UK emerged as having the 29th worst mortality rate in Western Europe – largely, commentary suggested, due to our successful vaccine rollout. With cases currently hitting their highest numbers since early February alongside no drastic spike in hospitalisations, we really do appear to have triumphed over Covid.

140 million jabs and no restrictions is an achievement, even if returning to normality took longer than the “three weeks to flatten the curve” we were first promised. But if the vaccine rollout showed the British state at its best, the pandemic has also shown it at its worst. Billions chucked after a largely useless test-and-trace system, arrogant officials who genuinely believed Britain had a world-leading pandemic preparedness plan, and a health service as creaking as it is beloved: all hampered the fight. That tackling the virus was so expensive reflects the British state’s habitual cluelessness.

But surely that’s ancient history – who quibbles about timescales and costs when the pubs are open again? Nevertheless, there are real questions to ask about the fundamental problems of the government’s pandemic response. As a recovering student who spent his last year at university railing against restrictions, I almost respect those in Number 10 who dabbled in cakes and champers: they stuck two fingers up at rules so obviously grotesque even their very authors deemed them unreasonable. Saying such a thing makes me an outlier – but the trouble of following public opinion has been a problem of these last two years.

Think back to that mad, miserable March. The accepted narrative of events follows a government that began by nonchalantly dismissing the approaching threat being bounced by sensible scientists like Patrick Vallance, Chris Whitty, and Saint Ferguson of Lockdown into following the rest of the civilised world (basically European countries with skiing resorts, and those bits of America that like Hillary) into necessary restrictions. Ferguson famously claimed that locking down a weak earlier would have saved 20,000 lives. The allegation that nasty Tories pursued chimeric ‘herd immunity’ at the expense of innocent lives was potent.

The reality was rather different. Rather than rejecting ‘the science’ for political ends, the government studiously followed scientific advice. The crucial point was that that advice changed. Vallance, Whitty et al was began March claiming they wanted to squash the sombrero, that cancelling mass events and mandating face masks was pointless. They may have initially believed the virus was more like the flu, but, even so, the government hardly ignored them. Ferguson was the outlier in calling for restrictions.

What changed? Remember, officials initially openly scoffed at the concept of lockdown. They believed such an authoritarian measure was unworkable in as freedom-loving country such as Britain. Their minds were changed by a force that has done more to shape the government’s handling of this pandemic than any other: the almost-sadomasochistic partiality for restrictions on the part of the British public.

Professor Ferguson’s infamous model certainly had an impact on ministers, primarily because it showed the NHS being overwhelmed. A new Tory government, driven by Vote Leave’s obsession with polls and the health service, could never be seen to let our national religion buckle. As horrific scenes poured onto our television screens from Lombardy night after night, and as country after country entered a lockdown hitherto thought only possible under the CCP, the public mood changed.

Already by March 26th, travel by tube, rail, or bus was down by more than 80 per cent. Outcry at allowing events like the Cheltenham festival and St Patrick’s Day celebrations helped convince the government that Something Must Be DoneTM. We were bounced into lockdown.

And as the weeks drew on, and the public remained overwhelmingly in favour of being paid to sit at home and watch Netflix, removing restrictions became even harder. Not until jabs could be put in arms, providing levels of reassurance acceptable to even the most zealous mask-wearer, could the government finally turn the corner: it had to win against public opinion as much as the virus. We remained stuck under restrictions for so long not only because of the SAGE’s caution, but because the public’s instincts were usually more draconian than the government’s.

We have known since Public Heath England first reported on it in July 2020 that the measures imposed that March may have caused more deaths in the long-term than they saved. From domestic abuse and mental illness, to missed cancer screenings and two years of disrupted learning, the consequences of our national experiment in authoritarianism will still be being counted far beyond the end of even the most leisurely of inquiry timescales.

And as we have all chosen to conveniently forget just how popular the war in Iraq initially was, I suspect that, in years to come, as hospital backlogs and educational problems stack up and mountains of debt must be paid off by continuous tax rises, the British people will similarly choose to forget just how enthusiastic we were for lockdown. March 2020 was the cruellest month – and one day, in the not-too-distant future, none of us will be able to say why.

Sarah Ingham: The BBC licence fee makes no sense in our digital age

18 Feb

Sarah Ingham is author of The Military Covenant: its impact on civil-military relations in Britain.

Our small screens have had a good pandemic.

Ratings surged as house-bound Britain turned to box sets. Hovering around $330 at the start of 2020, Netflix shares went through the $700 barrier last autumn. Who didn’t want to escape the reality of being stuck at home with Chris Whitty for the scripted reality of luxury real estate, perfect teeth and power heels in Selling Sunset? Squid Game (Korea), Fauda (Israel) and Call My Agent (France) were glimpses of a world beyond a tepid staycation in Devon.

And for those who haven’t had enough of big pharma over the past two years, there is now Dopesick on Disney+. Over on Amazon Prime, Julian Fellowes’ The Gilded Age swaps Downton for New York’s Upper East Side and Burke’s Peerage for the Social Register.

We are undoubtedly living in a golden age of television. Or rather of content that would once have been watched on a television set, where we originally watched The Sopranos episode-by-weekly-episode, just as earlier generations thrilled to that other family drama with a high corpse count, I, Claudius.

The acclaimed togas’n’tunics series, made by the BBC in 1976, features in Time magazine’s 100 Best TV Shows of All Time. It can now be streamed via Apple TV. Those holding Apple stock in the past two years would have seen the price go from around $73 to almost $173.

Approaching its centenary, the British Broadcasting Corporation does not have to concern itself with matters like shareholder value. Like the old money oligarchs of The Gilded Age, the BBC is cushioned by vast unearned income. It can afford to look down on upstart start-ups, whether comparative minnows such as GB News and Times Radio, or mighty YouTube – from which about a quarter of US adults get their news, according to a 2020 survey by Pew Research Center.

Auntie Beeb and her cheerleaders will point to 2021 ratings as proof of her popularity. Aside from the 2020 Euros and the PM’s announcement of lockdown on January 4 – surely an unexpected winner – it had Top 10 hits with Strictly Come Dancing, Vigil and Line of Duty, whose final episode drew 15.2 million viewers.

It is perhaps the Strictly factor that makes the Government hesitate to kill off the licence fee, despite its almost 80-seat majority. Smashing the glitterball and unpicking the sequins would be a dismaying prospect to millions of viewers, who are also voters.

Last month, following the announcement that the licence fee would be frozen for two years, BBC boss Tim Davie implied the future of BBC2, BBC4 and Radio 5 Live could be in doubt. If he had wanted to engage Disgusted of Tunbridge Wells and the Indignants of other leafy constituencies, this was a far shrewder pick of stations-in-jeopardy than, say, Radio 1 or the soon-to-be revived BBC3.

Does the end of the current BBC funding model really mean the end of broadcasting Glasto/EastEnders/David Attenborough/Radios 3 and 6? Or of Wimbledon fortnight uninterrupted by ad breaks? Given the chasms which could apparently open in Britain’s cultural landscape, no wonder a minister even as doughty as Nadine Dorries backs off from any absolute commitment to abolish the licence fee.

The TV licence is, however, an analog anachronism in our digital age. It is time it was axed and the Corporation funded by subscription.

In 2020-21, the licence fee raised £3.75 billion, accounting for 74 per cent of the BBC’s £5.06 billion income. A recent You Gov/Times poll found that only one in 20 of those aged 18-30 watched any BBC channels live every day, compared with almost half of people aged 65 or above.

A television-set tax makes no sense in an era when millions of us are choosing to subscribe to streaming services and are watching what we like, when we like, on our mobile phones and tablets.

A public service broadcaster is the more creative branch of the Civil Service. Like most in Britain’s bloated public sector, it is great at splurging other people’s money. With no need to earn its keep, is it surprising that the £££s the Corporation fritters away on taxis and diversity officers are a tabloid staple?

Supporters claim the BBC represents brilliant value – 44p a day. They overlook the mutual dislike between the BBC and its paymasters, that is, the listening and viewing public. Many resent being legally coerced into funding a service whose worldview is completely at odds with their own.

The national broadcaster should aim to be a neutral in Britain’s cultural skirmishing. As Oliver Dowden stated in his recent speech to the Heritage Foundation, “There has always been a tendency among cultural and educational elite to serve their own interests rather than serve the public at large.”

If the BBC is really serving Middle Britain, it seems odd it lost Bake Off and turned down the revived All Creatures Great and Small, now a hit for Channel 5. Clarkson’s Farm has done more to entertain, educate and inform us about rural life than the clunkingly woke Countryfile or The Archers.

In 2013, the updated House of Cards became the gateway to Netflix for many. Three years later, The Crown pulled in even more new subscribers. Starting in 1997 as a DVD rental company, Netflix is now making Academy Award-winning films and is streaming in 190 countries. In 2020, it generated almost $25 billion in revenue and had an operating profit of $4.5 billion.

Meanwhile, over to the cultural blob that is our aged national broadcaster… In 2020, 55,061 of the nation’s citizens were prosecuted for TV licence evasion. Of the 52,477 convicted, 76 per cent were women, who were unlikely to have been among the most affluent members of the public.

And how absolutely fabulous is that, sweetie darling?

Omicron or no Omicron, high-income nations should have promoted a more equitable distribution of vaccines

29 Nov

After a fairly “relaxed” few months in the Coronavirus wars, many of us were dispirited last week to learn of the emergence of a highly transmissible new variant, Omicron, which was first identified by scientists in South Africa

In a joint press conference on Friday with Patrick Vallance, England’s Chief Scientific Adviser, and Chris Whitty, Chief Medical Officer, Boris Johnson levelled with the nation about its seriousness – and what measures the UK would take to combat it, from the re-introduction of compulsory mask wearing and a new PCR test requirement for people arriving at airports. Jonathan Van-Tam, Deputy Chief Medical Officer, has today expanded on the threat it poses.

Whether the Government’s steps are enough will be the subject of many questions over the next few weeks. But perhaps the most important is what Omicron symbolises for the international community; specifically around whether the distribution of vaccines has been as equitable as it could have been.

From the early stages of the crisis, prominent experts and the World Health Organization have warned of the importance of equitable vaccine distribution, first for moral reasons, but also because an imbalance could leave a vacuum for new variants to develop, and evade vaccines/ treatment. The emergence of Omicron has only added to that concern – due to the fact that it emerged in a part of the world with low inoculation rates (only 24 per cent of the population in South Africa has been inoculated).

That the variant was discovered in South Africa does not mean it is where it originated (rather, its scientists have some of the best detection tools); indeed, there are cases in Hong Kong, Canada and the UK. But it has nonetheless opened up the debate on whether more even vaccination rates around the globe could have made a difference, and how many new variants will take off elsewhere without better-protected communities. 

There are still shocking statistics on inoculation rates worldwide; only 2.5 per cent of the population in low income countries, for example, have received full protection, with 3.5 billion people across the globe waiting for their first dose of the vaccine. At the same time, 66 per cent of high-income countries have been vaccinated, with many onto their booster jabs and plans to inoculate children.

Could high-income countries do more? It’s worth saying that many have gone to extraordinary efforts to get vaccines out. In July this year, for instance, the UK began donating millions of vaccinations as part of the international Covax scheme, and has pledged to donate 100 million overseas by June 2022. 

As of September, the United States had donated approximately 140 million doses to around 83 countries, making it the highest donor, followed by China, Japan, India, the UK, France, Canada, Spain, Sweden and Poland

But even these staggering figures – Covax’s initial goal is to provide two billion doses of vaccines worldwide in 2021 and 1.8 billion doses to 92 poorer countries by early 2022 – may need to be improved upon. There will also be pressure on countries to be more flexible about vaccine patents; the European Union is being asked to share more information with others.

Furthermore, some countries may need help overcoming logistical challenges to rolling out their vaccines, from having difficulties with storage, to experiencing shortages in health workers who can administer inoculations. It is not a simple case of more jabs, job done; governments have to consider these additional barriers.

Either way, it’s clear that equitable distribution will become much more of a talking point with the new variant; it is a reminder that the world is in it “together” when it comes to beating the virus. This often seems to be forgotten in all the talk about booster jabs – and it’s a shame that it only gets brought up when growing variants hit home. Even before Omicron, developed nations had a duty to do more here.

Bella Wallersteiner: As a parliamentary staffer, I’m appalled by the double standards on who has to wear a mask

25 Jul

Bella Wallersteiner works as Senior Parliamentary Assistant for a Conservative MP.

After England moved to step four of the Government’s roadmap for lifting Covid restrictions, Lindsay Hoyle, the Speaker of the House of Commons, confirmed that face masks were no longer mandatory for Members of Parliament from July 19. Instead, MPs are being “encouraged” to wear face coverings while moving around the wider Parliamentary estate.

Unfortunately, the same discretionary freedom has not been afforded to parliamentary staff for whom mask-wearing remains compulsory. Unions have been quick to point out the unfair and divisive nature of one set of rules for MPs and another set of rules for people working in the engine room of our legislature.

Before the summer recess, a significant number of Conservative MPs celebrated “Freedom Day” by ditching face masks in the House of Commons for the final Prime Minister’s Questions. And who can blame them? Many of us are desperate to say good-riddance to masks, tear down the bossy and infantilising signs which remind us to practice good hygiene (like washing our hands), remove the pointless one-way systems (we all know how to maintain social distance after 16 months of practice) and dismantle the entire edifice which has given birth to a micro-industry of excuses for disruption “due to Covid”.

And, yes, I am aware that we have all been through a lot since the pandemic started, and need to respect personal choices as not everyone is ready to return to “normal”. If wearing a mask makes some people feel safer, then that is their right and I would not belittle “brainwashed sheeple” as some freedom crusaders have done.

My concern is that once again our legislators seem to think that it is acceptable to have one rule them, another for Parliamentary staffers who must continue to wear face coverings. Until now, the decision to wear a face covering has been a legal requirement, not a matter of personal choice.

All this changed when the Prime Minister told the public that they are no longer legally required to wear masks from July 19 (in spite of Professor Chris Whitty, Chief Medical Office for England, advising that masks should be worn as a “common courtesy”). A confusing miasma of different rules in different settings means that transport operators and some shops have decided to make face coverings mandatory which could bring them into conflict with equality legislation.

The Government has succeeded in making the face covering a daily battle ground between libertarians and those who believe that it is irresponsible to dispense with all protection at a time when nearly 50,000 people a day are testing positive for Coronavirus.

I have stopped wearing my mask in virtually every setting – but as a parliamentary staffer I will be required to carry on wearing one at work. This is just another example of how Covid “guidance” has broken down and become illogical. The Government needs to make up its mind – wearing a face mask should be either mandatory or discretionary, it cannot be both.

I drew attention to this contradiction on social media and Steve Baker, MP for High Wycombe, wrote to the Speaker about this blatant discrepancy in the rules. The Speaker confirmed the House of Commons’ position which is that the Speaker has “no power to prevent democratically elected members from coming on to the estate or in to the chamber when the House is sitting. As such, there is no meaningful way to enforce a requirement on members to wear a face covering.” Sadly, he would not be drawn on the issue of Parliamentary staff being required to wear face coverings at work. In solidarity with staffers, Baker will continue to wear a face mask around Parliament.

The next battleground in the fight for freedom and equality will be the so-called “vaccine passports” for domestic events. The Speaker has rejected the use of Covid passports for MPs around Parliament, but has made no mention of staffers. Vaccination passports will discriminate against people based on decisions they have freely made and threatens the foundations of our liberal society. I have been vaccinated against Covid-19, a personal choice, but I would never stigmatise anyone who is unable to be vaccinated to or chooses not to be vaccinated.

But rules are there to be interpreted in subjective ways as we saw when foreign VIPs were exempted from the burden of travel quarantine to attend the Euro 2020 finals. Who can forget the scenes from the G7 gathering in Cornwall where any pretence of following social distancing rules were dropped quicker than you can say “Build Back Better”.

Fortunately, there are MPs willing to stand up to this discrimination and unfairness. Rumours of a vaccine passport being a condition of entry for the annual Conservative Party Conference in Manchester in October have led to a number of Conservative MPs saying they will boycott the event. I have already confirmed publicly I will not attend conference if such discriminatory measures are in place.

The Government so far has presented the pandemic as an “all in it together” chapter of national solidarity. However, this has led to people being branded selfish for visiting family members living overseas or simply going abroad with their families for a summer break after 16 months of self-incarceration. This sort of intolerance is harming the UK’s reputation for nurturing a culture of individualism and self-regulation.

Ministers have enjoyed wide public support even from those horrified by a level of authoritarianism which has not been seen in this country since the time of Oliver Cromwell. It has been borne on the belief that it would be temporary and, once the vaccines were rolled out, dispensed with forever.

But now an “us vs them” dynamic has emerged which is threatening to upset public trust and Parliament is just a microcosm of this phenomenon.

Credibility and honesty will be critical in completing the immense effort we have all undertaken in response to this crisis. Dominic Cummings has shown us what happens to a government’s health message when those responsible for it fail to adhere to their own rules. We have stopped people from leaving their homes and seeing their dying loved ones in the name of being “all in this together”. The Government must restore confidence by pressing ahead with releasing all lockdown restrictions for everyone.

Freedom Day was supposed to be the moment when the country would be liberated from the tyranny of Covid. Instead, we are in danger of entering a two-tiered Orwellian society where “all animals are equal, but some are more equal than others.”

Andrew Murrison: There can now be no question about the Government’s timeline for opening up. June 21 must stand.

9 Jun

Rt Hon Dr Andrew Murrison MP has been leading military vaccination teams in London and the South West.

The vaccination programme has been truly awesome. It’s been a privilege to be involved at the coalface, leading military vaccination teams that have protected thousands of people. So successful has the national programme been, there can now be no question about the Government’s timeline for opening up. June 21 must stand.

It’s been a struggle reconciling Dominic Cummings’ select committee download with a series of NAO reports on the Government’s handling of the pandemic. God they’re dull, but there’s useful stuff between those beige pages for those that can be bothered to look. By the time the full public inquiry comes around workmanlike scrutineers like the NAO will have likely made all the learning points. Hopefully this government and the next will have actioned them. The only thing for the inquiry will be to send out the tumbrils. That’s what the media, opposition and some figures on the government benches are slavering over like Pavlov’s dogs.

Meanwhile government will be broadly content with the “learnings” published by the NAO last month in the latest of its pandemic handling series. But privately ministers will have been less pleased with the rusty old tool box they opened 15 months ago. On that at least – the absence of state preparedness in the UK and across the western world – Cummings is right. To their credit, ministers have been retooling public health institutions at pace to deal with infections – the old enemy that never went away.

Happily, I’ve spent 10 weeks well away from our barely functioning parliament giving and supervising thousands of jabs in London and the South West. I have some learnings of my own, none of which feature in the NAO report.

First, we need to decide what price in lives lost from a particular cause is societally acceptable before kicking off a war economy with all its downside in liberty, livelihood, health and the future of young people. What triggers future government intervention on the unprecedented scale endured since last March?

We have some figures that help frame the debate. Six years ago we lost over 28,000 to seasonal flu. Don’t remember? Me neither, and I can’t find any reference to it in Hansard for that year. We haven’t – at least up to now – locked down or even done the hands, face, space thing as seasonal flu sweeps through each winter.

There’s an even bigger figure that society is apparently willing to tolerate. As the Chief Medical Officer pointed out last month we lose in excess of 90,000 each year to smoking. That puts a huge, completely avoidable, burden on health services whose protection we were told was one of the prime imperatives at the start of this crisis.

Indeed, protecting the NHS was the reason for restrictions incalculably more onerous than a ban on the poison tobacco. Chris Whitty did not say, save lives, protect the NHS, ban smoking, but he might have done because that’s where his logic leads.

But we have closed down society for more than a year to save the same sort of numbers. Here’s where logic rubs up against political reality. In tackling the most agonising question, we don’t “follow the science” at all. No politician can possibly do so.

I love experts. I used to be one. But it’s in their nature, singularly and collectively, to lay it on thick. Their industry depends on it. They play it safe – none of them wants to be caught understating risk. Wider societal and economic downside is not their prime consideration and “could” is one of the most mutable words in the English language.

Chief among experts to be handled with care are behavioural scientists who have been second guessing how people might react to government interventions. Their product – project fear, nudging – verges on the sinister. Furthermore, empirically on the light side, it has a habit of misfiring. Not that there’s anything inherently wrong with anecdote, only that it has to be properly weighed and balanced.

Chatting with people while vaccinating in East London, for example, shaped my thinking about why some groups were proving harder to reach than others. A general scepticism of the State’s good intentions is in play mixed with distrust of the pharmaceutical industry – what readers of John le Carré’s novel set against medical trials in developing countries might call The Constant Gardener effect.

We need to harness the volunteer spirit that has been such a positive feature of this pandemic. The yellow vested volunteer stewards at test and vaccination centres putting themselves at risk and out in all weathers have been fantastic. I have seen medical students drafted in like it’s the 1940s and lay people – St John’s volunteers and combat soldiers – taught to vaccinate. But the crisis teaches us that above all we need trained medics held at readiness.

Armed Forces Reserves, the special constabulary and retained fire service offer models to pick from. I admire my colleague Alan Mak’s attempt through his private member’s bill to create a NHS reserve. I’d sign up in a heartbeat. We need to capture the recently retired and those clinicians currently in non-patient-facing roles whose skills need little updating.

Many of them tore their hair at a re-engagement process so achingly Sir Humphrey that many just gave up. Without too much drama we could have a light touch annual online check and update for those leaving frontline service so that they could quickly be drafted in when required.

NHS staff typically retire in their mid 50s with many workable years ahead. Many, and one hopes their professional and regulatory bodies – even their trade unions like the BMA that are not listed among the heroes of this crisis – would see continuing engagement as part of the duty that comes with membership of altruistic professions.

If we had had the framework and human resources to undertake proper old-style contact tracing and isolation, the sort of thing that dominated public health until antimicrobials and vaccination did for TB, we might have been able to mount the lockdown busting, intensely local early intervention seen in parts of East Asia but which we had to ditch almost before it started. Building that capacity has to be a priority in preparation for the next big one. For that you need a workforce that can be mobilised fast.

Mobilisation reserve service has bookended my parliamentary career – in Iraq in 2003 and in the pandemic Great Patriotic War. It has been a massive privilege to serve in uniform on the front line of the century’s biggest geopolitical events. The military has emerged from two starkly different engagements with its public reputation enhanced.

This time, much of the military’s work has been in communities where these days it is rarely seen, even regarded with suspicion. But the warmth of the public’s reaction to soldiers. sailors and airmen who have been truly awesome as vaccinators, porters and test site marshals has been humbling. Despite a deliberately low profile approach taken by the MoD, I suggest Operation Rescript has done more for civ-mil relations than any number of Armed Forces days.

In the breach whatever the threat, the Queen’s men and women belong to the public they serve. That sense of proprietorship is healthy in any democracy. There’s no doubt it’s been advanced during this crisis.

Chris Green: The narrative for vaccinating children and Covid passports is getting stronger. We need to stop and think.

28 May

Chris Green is MP for Bolton West and Atherton.

A narrative is being developed around Covid-19 that can have awful consequences. Fundamentally, it is that the only solution to the pandemic is to achieve a UK and then a global zero-Covid outcome. Obviously, this will require a vast amount of power to be transferred to governments for the foreseeable future.

Many people are “vaccine hesitant”, especially on behalf of their own children, so compulsion will be required to get the job done. Digital IDs, databases and other measures will be developed to enable a robust nudging operation and to ensure the smooth cross governmental working of complex systems.

The Health Secretary and Chief Medical Officer have already set out the right way to judge our performance in dealing with the pandemic. Matt Hancock and Chris Whitty have said that a key turning point will be achieved when the link between the transmission of the disease and death or hospitalisation has been severed. This will then begin to enable Covid-19 to be treated in a similar way to influenza.

I believe that the link has been severed so, while I would like the unwinding of lockdown to be quicker, I will accept waiting till June 21 but with no delay and no turning back.

Instead of a realistic understanding of our progress, the narrative for domestic vaccine passes, compulsory vaccination and even the vaccination of children is being developed and is getting stronger.

I am not too concerned with vaccination passports, in general, but I do worry that they are a Trojan Horse for a domestic pass. Initially, the domestic pass would be used for a small range of settings but could easily be expanded once established. My yellow fever vaccination came with a paper certificate that had all the necessary details but none of the civil liberty problems.

The decision on the domestic pass or Covid Status Certification is going to be made in early June. I rather hope that the Prime Minister would be as inclined to eat up this digital ID card as eagerly as he promised to eat a physical version. If he does, he will have ended the most likely enabler for compulsory vaccination.

If the CSC project goes ahead, and the narrative behind “zero Covid” grows ever louder propelled by the ever-present fear that the next variant will be so much more deadly, then the threat of compulsory vaccination looms larger.

The range of vaccines that we have are all considerably more effective than a typical influenza jab and they have maintained that high level of effectiveness from when they were first developed through a multitude of new variants that are either getting passed our leaky borders or are emerging domestically.

If fear drives the agenda the belief will take hold that we all must be vaccinated. The Covid Status Certification could rapidly evolve from just restricting access to large events controlling access to work, education and public transport.

Children rarely suffer from the disease but they are targeted by some as the living incubators of an ever-mutating pathogen. Children are not the problem and adults all have the option of a vaccination to assuage their fears.

We have had compulsory vaccination for children in the UK but that was to protect them from the dreadful smallpox rather than the vaccination of children to protect adults. Other countries do have systems of compulsory vaccination programmes and the Health Secretary has considered it in the past. He said, in reference to measles, “I think there’s a very strong argument for the movement to compulsory vaccination and I think the public would back us.”

Andy Burnham, the Mayor for Greater Manchester, has been calling for vaccinations for children as young as sixteen and trails are being run to approve vaccines for those as young as twelve.

Vaccines do carry health risks and it is possible for rare but extreme conditions to only emerge once many have already had the treatment. Is it moral to do this when the Covid-19 threat to children is known to be tiny?

Anyone looking at the Coronavirus dashboard should be reassured by the low level of deaths and number of Covid patients in hospital. The vaccines are working as they should but, with a hospital waiting list of 5,000,000, the NHS is not. Government priorities need to shift because we have a hard recovery ahead of us and we need to start as soon as possible.

This is no time for a permanent power grab by the State because a less free society is a less healthy society.

The vaccine roll out accelerates. But testing still remains a vital part of the Government’s strategy.

13 Jan

Now that vaccines are being administered across the UK at astonishing speed, with approximately 2.8 million doses given so far, it’s easy to believe the light at the end of the tunnel is here in the global battle with Coronavirus.

Ideally, it is. The best case scenario is that the vaccine quickly protects everyone who needs it, while reducing the virus’s transmission in the population. 

Even better would be if the vaccine provides long-lasting immunity, as opposed to people having to get inoculated on a regular basis (creating a health risk and huge logistical challenge, especially if the virus mutates and new vaccines are needed).

While we find out these details – and we should have some answers over the next few months – there’s been less talk about NHS Test and Trace, and mass testing, the systems the Government has spent enormous sums on to keep the virus at bay while there’s no vaccine.

Paradoxically, as the vaccine roll out gets under way, NHS Test and Trace has become stricter, updating its definition of “close contact” so that users have to log more details of who they’ve been within two metres of.

Not least because the system has been quietly improving, with a record figure of 493,573 contacts identified in the week ending December 30 – up from 407,685 the previous week. In short, this will lead to an increase in the number of people who need to self-isolate.

The Government is also devoting huge resources to mass testing, with Matt Hancock announcing on Sunday morning a programme of “lateral flow” devices to help detect asymptomatic cases. 

A total of 317 English local authorities will be able to deliver this, with the army deployed to Bolton to help next week. Pilot schemes are also being used by businesses, such as John Lewis and others in manufacturing, retail and food.

While these systems aren’t perfect – there are still lots of criticisms around their capabilities – the point is that they’re being developed and improved, in spite of the vaccine, which is celebrated as our get out option. So why is this the case?

The first explanation is simply that the Government needs every resource possible right now to fight the mutant variant of Coronavirus. Chris Whitty, England’s Chief Medical Officer, has warned that we’re about to go into the worst weeks for the NHS, so it’s no wonder that we’re readying multiple systems.

Then there are more depressing long-term considerations, such as whether the vaccine runs into trouble. Perhaps immunity does not last as long as we thought it would, or a new strain of the virus comes along for which there is no vaccine yet, and so forth. This is when Plan B, C, D, E and a whole alphabet of other options becomes vital.

Worse still, there could be another pandemic in the future. That’s why the Government can better justify spending eye-watering sums on this infrastructure, which we may be grateful for later.

The difficulty with all this is that the Government has had to build testing infrastructure while we’re in a pandemic, as opposed to before, so it has discovered flaws in its systems in the worst possible way, perhaps part of why test and trace has cost £22 billion.

No doubt there will eventually be questions about why it – along with many other governments – lacked preparedness in this area, unlike South Korea and Taiwan, who had contact tracing in place. Yes they built their systems in response to MERS and SARS, respectively, but the signs were there to the international community that this infrastructure was worth considering.

Either way, the focus on testing isn’t going away any time soon.

London’s Nightingale hospital comes off “standby” mode – as these sites face their biggest test yet

12 Jan

In recent months, the Government has been forced to defend itself over the Nightingale hospitals, the medical sites it set up in the spring to support the NHS through the Coronavirus crisis, which have been noticeably empty, and sometimes deactivated, across the pandemic.

While their emptiness should be a good thing, many have wondered – more so now that the NHS is under huge strain and with the emergence of the new Coronavirus variant – why this extra support has not been used much, if at all.

It is estimated that the Government spent £200 million in total on seven sites in England, but the most publicised Nightingale hospital (in London’s ExCel) closed a month after treating 57 patients. Inevitably there were questions about whether this was a good use of resources.

When Matt Hancock was grilled on this matter in December last year he said that these hospitals were never intended as the first port of call, and were in fact “there in case they’re needed.” Stephen Powis, NHS England Medical Director, has echoed this sentiment, calling them “our insurance policy, there as our last resort.”

So it is troubling that today the London Nightingale field hospital has been opened up again, albeit as a “rehab unit” to treat those recovering from Covid and other conditions.

The Nightingale in Exeter has been off “standby” mode since November, when it started taking patients from the Royal Devon and Exeter NHS Foundation Trust.

Nightingale hospitals in Manchester, Bristol and Harrogate have also been used for non-Covid patients.

And Northern Ireland is seeing a similar rise in demand, where the Nightingale Hospital in Belfast is being prepared for use as intensive care patients increase.

That being said, across all Nightingale hospitals there is no consistent snapshot of how they’ve been used, as so much is determined by the nature of the virus and how it spreads across the country.

At the other end of the spectrum is Sunderland’s Nightingale Hospital, a 460-bed facility, which has not treated a single patient and does not expect to as of yet.

It’s a similar story in Wales, where the health authorities decided to dismantle its 2,000-bed field hospital which was created at the beginning of the pandemic, instead moving to smaller sites, which are designed to support existing hospitals.

In England, however, the signs are there that this infrastructure will be more relied upon, particularly given the dire warnings from Chris Whitty, England’s Chief Medical Officer, about the challenges over the coming weeks as the NHS battles a much more transmittable version of the virus.

One of the biggest challenges ahead will be whether the Nightingales have enough staff to support the upscaled infrastructure. NHS professionals have complained that there simply aren’t enough nurses and doctors for them. Hancock has previously said the Government “built more capacity within the NHS” to cope with growing cases, but how this translates to reliance on the Nightingale hospitals remains to be seen. Tragically, the next few weeks are likely to be their crucial test.

Ryan Bourne: Ministers must speed up the pace of vaccination. Here are some ways of doing so.

6 Jan

Ryan Bourne is Chair in Public Understanding of Economics at the Cato Institute.

Back in May 2020, I wrote that a high-efficacy vaccine was the biggest economic stimulus available to us. Removing whatever barriers existed to its approval and rollout, so accelerating the end of the pandemic, was worth billions of pounds per week in GDP and hundreds of lives. Stock market reactions last year implied vaccines were potentially worth 5-15 per cent of global wealth. But it’s now clear there’s a need for even greater urgency in getting the UK vaccinated.

The disease outlook is grim. As of Sunday, the number of people hospitalised with Covid-19 in England was 32 percent higher than its April peak, with new daily admissions above those seen last Spring. In the South East, the number of Covid-19 patients in hospital is near double the 2020 peak. Chris Whitty explained yesterday how case curves are trending upwards in other regions. Given recent trends and mobility data less responsive so far than to lockdown one, things will get worse before they get better.

So a national lockdown was perhaps inevitable. To judge by Twitter, people were gearing up to revive their pro- and anti-lockdown talking points beforehand. But the armchair cost-benefit analysis from Spring 2020, or even November, is no longer valid. First, because we have vaccines already being rolled out that will, at the very least, mitigate against Covid’s worst effects. Second, because the new mutation appears more highly transmissible in the face of given suppression measures. Both realities strengthen the case for reducing interactions now. Both increase the urgency for rapid vaccination.

The benefits of measures that reduce transmission of the disease are more certain with vaccines available. Lockdown sceptics had a point when they said at least some “lives saved” from government mandates last year were deaths deferred until the next wave. Now, with only 20 million full vaccination courses required to inject demographic groups making up 97 per cent of cumulative deaths so far, avoiding infections today means avoiding Covid-19 deaths forever. That makes the case for breaking up social networks all the stronger, including through closing schools (evidence suggests children are seeding the virus into households).

The high transmissibility of the new strain supports this action. A more rapidly spreading virus increases the risk of “overshooting” ICU capacity. Such is the speed of spread (one in 50 people had the virus last week), each day of societal delay in reducing the transmission rate below one accelerates the crunch. So quickly are we becoming infected, herd immunity may even come this year. The choice before us is whether we achieve it through the route strewn with significant deaths and bad illnesses, or via a path where injections eliminate almost all severe cases.

It feels almost lame to say it—as if nobody ever thought of it—but both the public health and economic consequences suggest we must do everything possible to speed up the vaccination process. We are in a straight race between vaccinations and the virus, and I fear even Boris Johnson’s revised timetable is too slow.

In an ideal world, with plentiful vaccines, logistics ready, and vaccines preventing transmission, the best path to herd immunity would be to vaccinate high transmitters first in a geographically concentrated way. However, we do not know whether the vaccines actually reduce transmission yet, and Chris Whitty contends that there will be supply shortages for months. If that is true, prioritising those at highest personal risk, as the government is doing, makes sense.

The UK regulator was admirably swift in vaccine approval. But doses available have been revised down massively since November and it’s not obvious why things aren’t moving faster. Reported vaccinations in week two (through 27 December) were not even half the number of those in week 1. Sure, this was Christmas week, but why not have longer working hours on other days to compensate? With a spreading virus, delay costs lives. Oxford/AstraZeneca’s vaccine was approved last Wednesday. It was not rolled out until Monday. Why? The virus doesn’t take time off to celebrate New Year’s Eve and a bank holiday.

Yesterday, Johnson said that 1.3 million vaccinations had now been undertaken. That’s only around 350,000 in the past eight days – nowhere near fast enough given the balance of costs and benefits. By mid-February, he hopes that 13.4 million first doses will be achieved. That requires two million per week from now until then. Yet even that seems tardy given the costs of lockdowns.

We must be pulling every lever here. Constraints to early roll-outs should have been foreseen. And if there are unforeseen roadblocks, economists would advise that raising the price you are willing to pay encourages supply. If, as reported elsewhere, a lack of vials is really the problem, what incentives are being given to ensure manufacturers work round the clock, seven days per week? Making the activity more profitable increases the willingness to pay overtime, train new workers, and run machines hot. If not vials, identify the production or staffing bottleneck and apply the same logic.

Eliminating barriers to vaccinator volunteers is a no brainer. So it’s heartening that the government is “reviewing” red tape that says vaccinators must be diversity, terrorism, and fire-safety trained. But financial incentives could help too. The NHS is giving GPs an extra £10 for every care home resident they vaccinate this month, which makes sense given 36 per cent of deaths have been in homes. Yet what about financial inducements for extended hours, weekend work, and more?

This would not only help in getting more vaccinations delivered, but potentially space them out a bit too. So prevalent is the virus right now, hordes of people packed into waiting rooms could lead to infections even prior to vaccines being administered. Is anyone establishing drive-through or outdoor sites, as seen in Israel?

Nor can we afford wasted vaccines. The zero out-of-pocket price means no penalty for people or providers for missed shots. With the possibility of vaccines wasted or appointments missed, GPs, hospital workers, and (hopefully) pharmacies should have the decentralised authority to administer them to “ineligible” individuals without the threats of repercussions to avoid waste. A vaccine dose to someone is better than no one. Let’s not sacrifice lives on the altar of “fairness.”

The Government’s “first doses first” policy shows that Ministers understand inoculating more people sooner is essential, even with a potential efficacy trade-off. But this strategy only helps in the medium-term if the supply is ramped up. The economy and the public health effort require getting the manufacture, logistics, and physical delivery expanded in the swiftest time possible. It’s not easy, but the language from government sometimes treats the stated constraints fatalistically, rather than seeing them as an economic problem that prices, incentives, and regulations could affect.