Robert Halfon: The levelling-up ladder risks being knocked away by Covid-inspired decisions on education

13 Jan

Robert Halfon is MP for Harlow, a former Conservative Party Deputy Chairman, Chair of the Education Select Committee and President of Conservative Workers and Trade Unionists.

Last week, having previously advised that schools would remain open – that the risk to children was low, that classrooms were safe and that closures had a marginal effect on transmission – the Government decided to reach a consensus with the education unions and shut school doors. At the same time, the decision to go ahead with exams was scrapped and pupils will now, for the second year in a row, be under a system of centre-assessed grades.

As pointed out by Department for Education (DfE) Ministers on a call with MPs just two weeks ago, one of the most senior CMO officials said:

“There is no evidence younger children transmit the new strain of the virus at the same rate as adults, and there is no evidence the new strain of the virus causes more serious illness in either children or adults” .

A statement on January 2 from the Royal College of Paediatricians and Child Health (RCPCH) noted:

“Children’s wards are usually busy in winter. As of now, we are not seeing significant pressure from Covid-19 in paediatrics across the UK. As cases in the community rise there will be a small increase in the number of children we see with Covid-19, but the overwhelming majority of children and young people have no symptoms or very mild illness only. The new variant appears to affect all ages and, as yet, we are not seeing any greater severity amongst children and young people.”

Conservative MPs were also told by the DfE about a recent study by Public Health England, which concluded that:

“School closures would have only a minor and temporary effect on transmission rates, and the wider impact of this on children’s social, physical, educational and emotional development would be significant.”

If the science has changed, and the new variant represents a serious threat to children, teachers and support staff, then the Chief Scientific Adviser and the Chief Medical Officer should, at the very least, set out the evidence explaining this, and why everything they had said about the need to keep schools open has now changed.

Whether or not a risk assessment was carried out as to the impact of school closures on pupils’ educational attainment, mental health and wellbeing is unknown. If it hasn’t, it should have been, and if it has, it should be published.

What we do know, according to a report by the IFS and Nuffield Foundation, is that education inequalities have been exacerbated by the pandemic, and the gap between disadvantaged pupils and their better-off peers has widened significantly. Since September, disadvantaged children have missed more school than others. They are also less likely to return to schooling, even when given the chance to do so. The IFS state that the pandemic will halt or reverse the closing of the attainment gap – undermining much of the work the Government has done since 2010.

The RCPCH and the Royal Society of Psychiatrists (RSoP) have also highlighted the damage to pupils’ mental health and well-being of school closures. A few months ago, 1,500 members of the RCPCH signed an open letter warning of the “scarring” harm to children’s life chances. Last week, Dr Karen Street, an Officer of the RSoP, wrote harrowingly about the 400 per cent increase in eating disorders amongst young people – partly due to social isolation. On Saturday, in The Daily Telegraph, Dr Bernadka Dubicka, Chair of the Royal College of Psychiatrists Child Faculty, reminded readers of the:

“NHS digital data published in October which found one in six five-to-16-year-olds living with a mental health problem, up from one in nine just three years ago.”

She warned that:

“Inequalities will widen, life chances will diminish, and the mental health crisis already running rife in our young people could plague this generation for years to come – that is unless the Government urgently prioritises children and young people and places them at the centre of policy making”

For our younger generation, it looks pretty bleak.

Of course, there is remote learning, but there are still hundreds of thousands of students on the wrong side of the digital divide. The Government is trying to address this, with one million laptops being provided and free mobile data, thanks to an agreement reached with phone operators. However, for all the laptops in the world, it still isn’t enough. We know that online learning can be extremely varied. Moreover, it requires a student to open the computer and to study independently or for parents to provide constant support. School closures put enormous pressures on parents, many of whom are balancing their own work commitments, while trying to help educate their children.

The Government has made its decision on schools and we are where we are. So what should happen now?

First, everything should be done to try and get schools open. If this means ensuring that teachers and support staff are a priority for vaccination (not because one group of workers are favoured over another – but to get pupils back into the classroom and learning again), then so be it. The end of half-term re-opening should be a reality, not just an aspiration.

Second, the DfE must rocket-boost the £1 billion catch-up tuition fund to focus it on disadvantaged areas so that extra assistance can be given to pupils at risk of being left-behind. Mental health support should be provided in schools so that children, parents and teachers who are struggling can access counselling and advice when they need it.

Above all, the Government needs to set out a long-term plan for education – focused on addressing the attainment chasm between the disadvantaged and the better-off and, perhaps, look at the role and effectiveness of the £2.5 billion pupil premium, for starters.

Children, parents, teachers and support staff need an educational route map out of the Covid-19 swamp. Without it, many could be stuck in the mire of an epidemic of educational poverty and a crisis of mental health, long after the pandemic has passed. The levelling-up ladder of opportunity for the coming generation, will have been knocked away.

Rob Sutton: Government needs advisers. But advisers need competition – not their present monopoly. As this pandemic has proved.

13 Dec

Rob Sutton is an incoming junior doctor in Wales and a former Parliamentary staffer. He is a recent graduate of the University of Oxford Medical School.

The combined effect of emergency measures which allow legislation to bypass parliamentary scrutiny, and a viral pandemic which requires the rapid interpretation of ever-changing and highly technical data, has exposed a troubling weakness at the heart of government: that our expert advisers, however talented and hard-working they might be as individuals, have left much to be desired.

This is not entirely due to the advisers themselves, but the internal structures and incentives which Number 10 relies upon to provide advice. Those organisations which Johnson’s administration turns to for expert opinion (SAGE, Public Health England, the Department of Health, and the Government Office for Science), hold effective monopolies within their own niches.

Despite the breadth of talent these groups pull from, and the impression of depth of available opinion, there is relatively little overlap of their briefs, and they are ultimately machines of consensus: built to produce a unified position, rather than competing proposals.

From a political communications perspective, this is ideal. Presenting a position drawn from the interpretation of ambiguous (and unstable) data as being scientific consensus gives some degree of protection from criticism.

Yet this is hardly a good approach to building policy. These problems, though longstanding, were dramatically exposed by the Covid-19 pandemic and the corresponding increase in the government’s reliance on expert advice. The natural monopoly of ideas held by these bodies of experts has led to a predictably narrow scope for policy debate.

This is a concern which has riled many in Parliament, who feel increasingly marginalised in favour of unelected experts who face no public scrutiny or internal competition. Steve Baker, ever the prolific organiser and influencer, has been among those leading calls for reform of expert advice in government, arguing that this should be addressed as a matter of priority in a letter to the Prime Minister.

A government which retreats from parliamentary scrutiny and has been defined by a vision of centralised control hardly encourages open discussion. Yet the importance of balancing contrasting advice has become, more than ever before, a critical requirement for effective policymaking. At the root of the problem is the question of what expert advisers should be doing. Is it their job to dispassionately report the available evidence? Or to interpret it in a broader societal and political context?

This uncertainty has been, in part, a problem of the Government’s own making. The unwavering fixation on the “following the science” assumes “the science” to be an immutable corpus of knowledge.

This is an untrue and unhelpful representation. The scientific method demands a narrow and well-defined hypothesis, from which it follows that any interpretation should have a narrow and well-defined applicability. To test that hypothesis, metrics will be proposed to observe and quantify the phenomenon under investigation.

These metrics, being a representation, not the phenomenon itself, moves us a degree away from reality (for instance, positive results does not mean number of infections; it is a proxy). Data analysis and statistical methods move us a further degree away, as does one’s ultimate interpretation of what, if anything, that analysis tells us.

The power of the scientific method is therefore also its weakness – that we get results with narrow applicability, have to apply human biases to interpret them and then apply those findings to real world situations, with all their intractable messiness.

Add predictive methods such as modelling, which are extremely sensitive to both initial parameters and the specific model used, and the problems are compounded. To assume that there is a single fountain of scientific knowledge from which the answers to all our policy queries must unambiguously flow is a political fiction. And it is designed, rather cynically, to place those answers beyond reproach from the scientific laity.

We therefore have two issues which combine to limit the effectiveness of expert advice in government: an exclusive inner circle of advisers who hold an effective monopoly on policy proposals (even to the exclusion of parliament itself), relying on research data which inevitably has a narrow scope of applicability and is subject to differing interpretations. Science can tell us much about the world as it is; it is a powerful means of answering “what,” but on questions of “should” it is silent.

Under normal conditions, Parliamentary scrutiny would serve as a means of tempering the most extreme of Government policy suggestions. But under the emergency legislation enacted in March, we no longer enjoy this luxury. This has exposed the fragility of the Government’s market on expert policy suggestions.

Without internally competitive processes to broaden the conversation and provide alternative options, there is a worrisome absence of incentives to encourage policymakers to stray from the consensus. With an effective monopoly on advice, there is little reason for ideas to be good, or even workable, as long as they are presented with an air of agreement.

This is the reason why interdisciplinary and intradisciplinary competition for policy proposals is so vital. Interdisciplinary competition would allow us to balance the public health implications of Covid-19 against broader considerations of, for instance, the economy and mental health. intradisciplinary competition would allow conflicting interpretations of data to be debated in a rigorous manner.

Yet capturing this kind of competition, which comes so naturally to the private sector, is notoriously difficult to embed within the public. There are ways this might be built into the current organisational structure. “Red teams,” groups whose primary purpose is to play devil’s advocate, and thereby exposing weaknesses and unforeseen complications would be a step in the right direction.

Baker and, ironically, Dominic Cummings (who has frequently been a source of frustration amongst those lamenting the Government’s overreliance on a small number of expert voices) are among those who have argued for their implementation.

There are few who would, I suspect, attempt to make the case that the expert advice this Government has so heavily relied upon during the Coronavirus pandemic has been an overwhelming success. But the current parliamentary term is young, and if reforms in the procurement of expert advice were implemented with determination, we should quickly see them paying off.

Edward Davies: Work and relationships are the core components of mental health. The lockdown has damaged both.

4 Nov

Edward Davies is Director of Policy at the Centre for Social Justice

The Coronavirus crisis will have many knock-on effects, but one of the biggest – the decline in the nation’s mental health – is already daily headline fodder.

Research published in the British Journal of Psychiatry found that recent suicidal thoughts had increased from one in 13 to one in 10 respondents since March: that’s the equivalent of an extra 830,000 adults thinking of ending their life.

A mega-survey conducted by Mind, the mental health charity, found that more than half the adult population reported a deterioration in their mental state during lockdown. Even six months on from telling us all to ‘stay at home’ ONS analysis finds almost four in 10 adults reporting high levels of anxiety in October.

The Department of Health in England has said, predictably, that it is increasing investment in mental health services in response. But maybe it shouldn’t. We need to learn from the last few months that addressing the mental health needs of the country is not about an ever-increasing spiral of public service spending.

Child and Adolescent Mental Health Services (CAMHS) are overwhelmed, and the knee-jerk response to expand them is understandable. But by the time a child gets there they are already likely to be suicidal. We must go much further upstream.

The last six months have reminded us that good public services, important though they are, are not at the root of mental wellbeing. In fact, the two core components have little to do with public services or government at all, and were profoundly undermined by the lockdown: our work and our relationships.

First, on work, there are few more important things to a person’s mental health than having a reason to get up in the morning. The Royal College of Psychiatrists is unequivocal about the importance of employment for people with mental health problems, they say it is “central to personal identity; provides structure and purpose to the day; gives opportunities for socialisation and friendship; and increases social networks – a core component of social capital”.

And secondly, on relationships, the evidence is even stronger. The Grant Study, a landmark 75-year longitudinal study of Harvard students, is utterly unequivocal about the importance of our relationships to mental and physical health:

“So what have we learned? What are the lessons that come from the tens of thousands of pages of information that we’ve generated on these lives? Well, the lessons aren’t about wealth or fame or working harder and harder. The clearest message that we get from this 75-year study is this: good relationships keep us happier and healthier. Period.”

The quality of our close relationships is fundamental to child mental health, too. Family instability is the single biggest reason that children report attending CAMHS. But, deeper than that, NHS data shows the very structure of our family relationships has a fundamental impact on the mental health of our children.

A primary school child with married parents has a six per cent chance of a mental disorder. It rises to 12 per cent for cohabiting parents and 18 per cent for lone parents.

This overwhelming evidence on work and relationships is reflected in the “happiness data” initiated by David Cameron and still quietly being collated by the ONS. After our health itself, the two most significant factors in an individual reporting that they are satisfied with their life is their marital status and employment status – way more important than other items we might assume, such as housing or income.

So what does that mean coming out of this crisis? It means that whenever policy talk turns to mental health, we need to remember the lessons of both this recent pandemic and thousands of years of history and evidence.

Public services are hugely important, but we will not prevent this problem by constantly pouring water on the fire.

If we want to truly tackle mental health problems in this country, we need to go deeper. We need to ask why, if close relationships are so important, we have allowed the most stable relationship form – marriage – to collapse to a quarter of the rate of a generation ago.

Why do our homes get smaller, our commutes get longer, and more people than ever live completely alone? As a start we should invest in greater relationship support in the early years of children’s lives and revive the Government’s Family Test to ensure housing and economic policy supports rather than hinders families’ wellbeing.

The Government has committed (but not spent) £2.5 million to conduct research into family hubs; this shouldn’t be a dry exercise, but should be done quickly enough to provide a road map to the delivery of family hubs in every part of the country.

Rev-up family support at pivotal moments like the birth of a first child. Birth registration should be a gateway into family support at the very moment parents need it most. Simply fire-fighting this problem with well-intentioned hoses of ever more school counsellors and spiralling public services will never prevent it in the first place.

John Redwood: Covid-19 – and the hard questions that must be asked about forecasts, numbers, data and treatments

3 Nov

Sir John Redwood is MP for Wokingham, and is a former Secretary of State for Wales.

Throughout this pandemic, I have been dismayed by the poor data and the misleading forecasts produced by some of  the official advisers to the government.

On Saturday evening, like many people, I was left trying to read graphs purporting to give the reasons to justify a major curtailment of personal and business freedom, only to be unable to see the varying scales, the sources of the data or the relevant dates. There were as often glaring omissions. Why, for example, are we never given up to date figures of bed occupancies for the NHS either nationally or regionally?

Over the last six months, we have been shown some gloomy forecasts that proved wrong, regular changes in the way figures like the numbers of deaths are computed, misleading international comparisons with countries that compile data differently and a refusal by the advisers to engage in public with legitimate professional concerns of other medical and scientific experts who take a different view.

We hear a stupid mantra that we must follow the science. There is no single agreed scientific view of this disease because it is new and talented scientists and medics are wrestling to understand  it and to work out how best to treat it. There are healthy disagreements between them as they seek  better knowledge.

It is the worst kind of talking down to tell us there is one perfect settled scientific view which leads to one simple policy prescription of lock down. When I asked about the forecast of four thousand future daily deaths and the huge range in estimates for both deaths and cases into December, there was no convincing answer. The truth is that the government advisers do not know how many cases or deaths there will be next week or month.

I fully accept that for a minority this is a dangerous and potentially lethal disease.  For most, it is at worst a flu-like illness; for others, there are no symptoms at all. I am seeking changes to the way that the fovernment responds to the pandemic. I wish them to do all that a government can to save lives, and to help the vulnerable find the protection they need and want from the disease.

I also wish to see the Government avoid measures which do substantial damage to jobs and livelihoods. As we saw,  the last national lockdown was unable to stop the virus spreading again come the autumn. The Government’s own advisers who think the lockdown itself brought down case numbers and deaths substantially accept that a tough national lockdown does not solve the problem. They recommend continuing with various lockdown measures as long as we have no cure or preventative vaccine. Others think the virus had peaked at the point where the lockdown was imposed, and maybe the weather and other factors played a part in its temporary demise.

I am urging the government to work closely with medics and pharmaceutical researchers to identify more treatments to cut the death rates. There are various steroids, anti-virals, clot busters and antibody treatments that have now been found to help, or may emerge from trials as useful additions to treatment.

Health professionals have also now discovered using non invasive ways of administering extra oxygen are often best. There are also issues about whether Vitamin D and zinc supplements can help. I have urged more emphasis on qualified people seeking new ways of treating and preventing. There is much medical and pharmaceutical talent in the UK, and it may well make more breakthroughs, as it did with the introduction of steroid treatment.

I have urged better data.  The basis of defining a death has been changed several times during the pandemic, and there are issues about whether Covid-19 deaths have been overstated whilst understating other lung infections and serious co morbidities in the mainly elderly people dying. In the early stages, the authorities boosted death numbers from Covid-19  by directing its inclusion on a death certificate even if there was no confirmatory test for its presence, based on reported symptoms.

There was also a wish to ascribe all deaths to Covid-19 where it was present, even though the elderly person concerned muay have died from one or more of several other bad conditions they had. Some of the most common tests for the disease may also report false positives, which needs to  be taken into account when examining  figures for deaths and cases.  The latest forecasts for cases and deaths take the form of very wide ranges where the upper figure is three times the lower figure, making them meaningless as planning forecasts.

There is an absence of reliable public data on hospital bed occupancy, which seems to be the main worry of NHS management and the scientific advisers. We must not close the economy down to save the NHS if it can now cope thanks to the building of the Nightingales, greatly expanding intensive care facilities and recruiting many more staff. Why are we not using some hospitals as isolation hospitals specialising in Covid-19, and leaving the rest of the system free of the disease to reassure patients needing many other treatments?

What we do know is a lockdown is very damaging to jobs and business. The first national lock down took around a quarter off our national income and output – an unprecedented fall. We cannot afford to do that again, as government rightly spent a fortune on subsidising public services and private sector employment to cushion the blow.

I am pressing for substantial changes to lockdown plans. I see no need to close outdoor sports facilities. I think a range of specialist retailers should stay open with suitable measures to cut risks of infection spreading. Pubs and restaurants should be allowed to sell drink as well as food for take away. Government should work with business and offer help to improve air extraction so more can function safely indoors.

I do support the schools staying open as this is important to the development and future prospects of children and teenagers. This disease is usually very mild in young people. I have urged the resumption of non Covid-19 work by the NHS as Ministers seek, as many more people die of causes other than Covid-19 every day.

In order to reduce, the spread of the virus everyone needs to reduce the number of social contacts they have in enclosed spaces with poor air. This requires buy-in by the public. There is no agreed set of laws and controls on our everyday movements that will guarantee success. Government needs to persuade people to reduce social contacts rather than try to find  a set of laws they can enforce against the wishes of a significant minority. It could also help by assisting more people and businesses to live with the virus for all the time we have no cures and vaccines.

Can we have more UV sanitising systems deployed in public places? Can we have more assistance to adapt air systems in commercial premises to extract dirty air promptly to make them safer? Can we have some better understanding from government that we need all the small businesses that serve us, and they are the ones that are in danger of being hounded out of work by clumsy generalised lockdowns.

We can adapt our lives to living with the virus by many small steps of a practical nature. This battle cannot be won by taking too many liberties away, and lecturing people to stop their social and business lives. My constituents want the government to work with them to help protect the vulnerable and make normal life safer for the rest. There is no silver bullet or single answer. We all need to help, and that requires a general spirit of collaboration, tolerance and commonsense.

John Redwood: Covid-19 – and the hard questions that must be asked about forecasts, numbers, data and treatments

3 Nov

Sir John Redwood is MP for Wokingham, and is a former Secretary of State for Wales.

Throughout this pandemic, I have been dismayed by the poor data and the misleading forecasts produced by some of  the official advisers to the government.

On Saturday evening, like many people, I was left trying to read graphs purporting to give the reasons to justify a major curtailment of personal and business freedom, only to be unable to see the varying scales, the sources of the data or the relevant dates. There were as often glaring omissions. Why, for example, are we never given up to date figures of bed occupancies for the NHS either nationally or regionally?

Over the last six months, we have been shown some gloomy forecasts that proved wrong, regular changes in the way figures like the numbers of deaths are computed, misleading international comparisons with countries that compile data differently and a refusal by the advisers to engage in public with legitimate professional concerns of other medical and scientific experts who take a different view.

We hear a stupid mantra that we must follow the science. There is no single agreed scientific view of this disease because it is new and talented scientists and medics are wrestling to understand  it and to work out how best to treat it. There are healthy disagreements between them as they seek  better knowledge.

It is the worst kind of talking down to tell us there is one perfect settled scientific view which leads to one simple policy prescription of lock down. When I asked about the forecast of four thousand future daily deaths and the huge range in estimates for both deaths and cases into December, there was no convincing answer. The truth is that the government advisers do not know how many cases or deaths there will be next week or month.

I fully accept that for a minority this is a dangerous and potentially lethal disease.  For most, it is at worst a flu-like illness; for others, there are no symptoms at all. I am seeking changes to the way that the fovernment responds to the pandemic. I wish them to do all that a government can to save lives, and to help the vulnerable find the protection they need and want from the disease.

I also wish to see the Government avoid measures which do substantial damage to jobs and livelihoods. As we saw,  the last national lockdown was unable to stop the virus spreading again come the autumn. The Government’s own advisers who think the lockdown itself brought down case numbers and deaths substantially accept that a tough national lockdown does not solve the problem. They recommend continuing with various lockdown measures as long as we have no cure or preventative vaccine. Others think the virus had peaked at the point where the lockdown was imposed, and maybe the weather and other factors played a part in its temporary demise.

I am urging the government to work closely with medics and pharmaceutical researchers to identify more treatments to cut the death rates. There are various steroids, anti-virals, clot busters and antibody treatments that have now been found to help, or may emerge from trials as useful additions to treatment.

Health professionals have also now discovered using non invasive ways of administering extra oxygen are often best. There are also issues about whether Vitamin D and zinc supplements can help. I have urged more emphasis on qualified people seeking new ways of treating and preventing. There is much medical and pharmaceutical talent in the UK, and it may well make more breakthroughs, as it did with the introduction of steroid treatment.

I have urged better data.  The basis of defining a death has been changed several times during the pandemic, and there are issues about whether Covid-19 deaths have been overstated whilst understating other lung infections and serious co morbidities in the mainly elderly people dying. In the early stages, the authorities boosted death numbers from Covid-19  by directing its inclusion on a death certificate even if there was no confirmatory test for its presence, based on reported symptoms.

There was also a wish to ascribe all deaths to Covid-19 where it was present, even though the elderly person concerned muay have died from one or more of several other bad conditions they had. Some of the most common tests for the disease may also report false positives, which needs to  be taken into account when examining  figures for deaths and cases.  The latest forecasts for cases and deaths take the form of very wide ranges where the upper figure is three times the lower figure, making them meaningless as planning forecasts.

There is an absence of reliable public data on hospital bed occupancy, which seems to be the main worry of NHS management and the scientific advisers. We must not close the economy down to save the NHS if it can now cope thanks to the building of the Nightingales, greatly expanding intensive care facilities and recruiting many more staff. Why are we not using some hospitals as isolation hospitals specialising in Covid-19, and leaving the rest of the system free of the disease to reassure patients needing many other treatments?

What we do know is a lockdown is very damaging to jobs and business. The first national lock down took around a quarter off our national income and output – an unprecedented fall. We cannot afford to do that again, as government rightly spent a fortune on subsidising public services and private sector employment to cushion the blow.

I am pressing for substantial changes to lockdown plans. I see no need to close outdoor sports facilities. I think a range of specialist retailers should stay open with suitable measures to cut risks of infection spreading. Pubs and restaurants should be allowed to sell drink as well as food for take away. Government should work with business and offer help to improve air extraction so more can function safely indoors.

I do support the schools staying open as this is important to the development and future prospects of children and teenagers. This disease is usually very mild in young people. I have urged the resumption of non Covid-19 work by the NHS as Ministers seek, as many more people die of causes other than Covid-19 every day.

In order to reduce, the spread of the virus everyone needs to reduce the number of social contacts they have in enclosed spaces with poor air. This requires buy-in by the public. There is no agreed set of laws and controls on our everyday movements that will guarantee success. Government needs to persuade people to reduce social contacts rather than try to find  a set of laws they can enforce against the wishes of a significant minority. It could also help by assisting more people and businesses to live with the virus for all the time we have no cures and vaccines.

Can we have more UV sanitising systems deployed in public places? Can we have more assistance to adapt air systems in commercial premises to extract dirty air promptly to make them safer? Can we have some better understanding from government that we need all the small businesses that serve us, and they are the ones that are in danger of being hounded out of work by clumsy generalised lockdowns.

We can adapt our lives to living with the virus by many small steps of a practical nature. This battle cannot be won by taking too many liberties away, and lecturing people to stop their social and business lives. My constituents want the government to work with them to help protect the vulnerable and make normal life safer for the rest. There is no silver bullet or single answer. We all need to help, and that requires a general spirit of collaboration, tolerance and commonsense.

David Davis: My prescription for a Covid Plan B? A strategic dose of vitamin D.

26 Oct

David Davis is a former Secretary of State for Exiting the European Union, and is MP for Haltemprice and Howden.

Remdesivir, the much-touted anti-Covid drug, has failed its tests, and has been shown not to prevent any deaths. Vaccines, touted for September, are now delayed at least until the second half of the winter, will be rationed, and are expected to be only partially effective.

Meanwhile, the various lockdown strategies tried by the government are of variable effectiveness, somewhere between partial and zero in their impact. The Government’s scientific advisers are recommending temporary lockdowns without hard evidence of their effectiveness. Only last week they admitted that the evidence base for the so called non-pharmaceutical strategies are “weak”, but that urgency requires their use.

Lockdowns have enormous economic cost, and have deadly side effects on the general health of the nation. Indeed if the lockdown strategy were a drug, it would have failed to meet the criteria that have now led to the rejection of remdesivir, hydrochlorquine, and countless other more or less promising medicines.

And the trouble with the “temporary” lockdown is that, without a very fast and effective test, track and trace system, backed up by a rapid isolation strategy, the lockdown will go on for months. The harm to lives and livelihoods will be enormous.

So what now? Is there an escape from this nightmare? Is there a game changer available to us that will allow us to create an effective plan B? I believe that there is.

In early May, I wrote to the Health Secretary pointing to two studies showing a strong association between the incidence and severity of Covid-19 with vitamin D deficiencies in the patients.

Vadim Backman, one of the authors of one of those studies, said about healthy levels of vitamin D that “Our analysis shows that it might be as high as cutting the mortality rate in half”.

Now I am a sceptic when it comes to vitamins and supplements. The supplements industry has a few too many salesmen too willing to make bogus or overblown claims for products that have are mostly harmless – but also mostly useless.

But this was a little different. The claims were, and are, coming from highly respected scientists, the vast majority of whom had no commercial interest. And the arguments were scientifically plausible.

Most of us learned in our GCSE science courses that vitamin D was important to calcium uptake for building healthy bones. Deficiency led to rickets and other bone diseases.

But less well known is that since the mid 1980s there have been a series of scientific discoveries that showed that the the role of vitamin D was massively greater than had previously been understood. Every cell in the body had a vitamin D receptor. At sufficient concentrations, the vitamin switches on thousands of genes.

In particular the immune system seemed to be hugely dependent on the availability of the vitamin. It enhances both innate immunity – the original primitive immune system that is the primary defence of young children – and adaptive immunity, the system that creates antibodies to kill pathogens.

Every year that passes sees more and more scientific insight into the role of vitamin D in resisting disease and controlling inflammation. There is hard evidence in particular in the role of vitamin D supplementation in resisting respiratory diseases. It can help suppress colds, influenza and pneumonia, which fact I also highlighted in my letter to Matt Hancock.

When the Secretary of State referred my letter to NICE, the Government’s body that assesses drug effectiveness, they essentially rejected it on the grounds of insufficient evidence. The evidence was, of course, stronger than for there so called “non-pharmaceutical strategies”, but that was not a matter for NICE. And since then, there has been a non-stop stream of supportive evidence.

Before we get to the hard science, there is already a vast amount of circumstantial evidence. Everyone is well aware that the risk of dying from Covid-19 is significantly increased if you are elderly, obese, come from a black or minority ethnic background or have a pre-existing health conditions such as diabetes.

A very large proportion of all those groups are people with Vitamin D deficiency. Of itself, that implies that vitamin D deficiency may be the common cause.

There are clear correlations with latitude and seasonality in the severity of the disease. Basically, the more sunshine, the more vitamin D, the fewer deaths. The exceptions are countries like Spain and Italy, whose cultural traditions (of covering up) lead to very low vitamin D levels, and to higher death rates. The example the other way is the Nordic countries, who are very northerly, but whose diet is either naturally or artificially rich in vitamin D.

So the physiology and biochemistry implies that there is an immunological effect. The evidence all around us implies that there is an effect. But for the scientists we need hard data.

When I wrote to the Health Secretary, I laid out observational studies that had shown a significant reduction in infections, and a dramatic drop in the death rate above a certain blood level of vitamin D.

Since then, the evidence showing that vitamin D might help prevent Covid turning serious in some people continues to grow.

The gold standard of medical research is the randomised control trial. At the start of the pandemic we did not have such evidence, and NICE highlighted this in their June review.

However, since the review, researchers in Spain have published the results of the world’s first randomised control trial on vitamin D and Covid.

The results are startling and clear-cut.

The trial, which took place at the Reina Sofía University Hospital in Cordoba, involved 76 patients suffering from Covid-19. 50 of those patients were given vitamin D. The remaining 26 were not. Half of those not given Vitamin D became so sick that they needed to be put on intensive care. By comparison, only one person who was given Vitamin D requiring ICU admission.

To put it another way, the use of Vitamin D reduced a patient’s risk of needing intensive care 25-fold.

Two patients who did not receive Vitamin D died. None of those on vitamin D died. While the sample size is too small to conclude that Vitamin D abolishes the risk of death in Covid patients, it is nonetheless an astonishing result. Again, it is consistent with earlier studies showing large reductions in mortality.

This is just one element of the growing body of evidence showing a link between Vitamin D and Covid-19 outcomes. Recent analysis by Ben Gurion University suggests supplementation can cut the risk of infection from Covid-19 in half in some of the most at-risk groups. This 1.3 million person study backed up the conclusions of a previous 190,000 person research project in America. The mass of evidence is building and building.

Thankfully, the Government at last appears to be acting on this.

Last week, the Health Secretary confirmed his Department would be looking again at the evidence. He also confirmed that the Government would be increasing the public messaging around Vitamin D supplements. Crucially, he confirmed there are no downsides to taking supplements.

The vitamin D levels in the blood of the British population halve over the winter, which is one reason we catch so many colds then. They started going down in September. So this announcement is long overdue. Nevertheless we still have just enough time to act on this.

Vitamin D is readily available and – at a penny per pill – it is incredibly cheap. Providing supplements to those at risk due to pre-existing conductions, such as diabetes, would cost £45 million: to these, plus to every ethnic minority citizen, about £200 million.

For a little more, we could do what the Nordic countries do, and fortify some basic foods with vitamin D. And for tiny amounts of money, we could repeat the Spanish experiment in every British hospital, elevating vitamin D levels in Covid patients on arrival, cutting down the demand for ICU treatments.

These expenditures are trivial amounts compared to the £12 billion spent on test and trace and the billions being pumped into the NHS to help it through the crisis.

Furthermore, providing supplements for those at most risk would also help reduce other pressures on the NHS through the winter months, as we know Vitamin D can reduce the likelihood and severity of other acute respiratory illnesses, which flare up annually around this time. Imagine the thousands of lives that could be saved even if we just made prescription mandatory for care homes?

If we were really ambitious, we could fortify our food with it. Sweden puts it in milk as a matter of course, as do some of their Nordic neighbours.

In summary, correcting vitamin D deficiency could halve the infection rates in vulnerable groups: in addition it could more than halve the death rate for those who do get infected. At a time when we are considering yet another lockdown, with all the damage that that could cause, this could be a game changer.

Add this to the better techniques in medical handling of serious cases, and the availability of dexamethasone for the most severe. These are already cutting death rates in ICU from about 50 per cent to nearer 30 per cent. Combine it with the better organisation of hospital care which is now underway, and perhaps reinforce that with use of the Nightingales to isolate more infected people (rather than just as overspill capacity).

The pandemic mortality rate, properly managed, would begin to approach the severity of a serious flu outbreak. At that level, we would no longer need the massive economic self harm of national lockdowns. And as that pressure comes off, there may be a chance of the track and trace getting ahead of the disease, and controlling it further with a hyper-localised strategy, similar to the successful German and South Korean ones.

So while the review of the evidence is underway the Government must take the first step towards addressing the issue.

The Government must at very least provide free supplementation to the at-risk groups. This will no doubt save thousands of lives across the winter months and, in Matt Hancock’s own words, supplementation has “no downsides”. The odds of success are seriously better than the government’s existing strategy. Accordingly, the precautionary principle makes this a no-brainer.

Pressure rises on Ministers to publish assessments of the impact of lockdowns, restrictions – and Covid itself

20 Oct

Last week, ConservativeHome called for the Government to broaden and deepen the national conversation about Covid-19 – or at least try to as best it can.

It is essential to see the disease in the round by understanding the consequences of lockdowns, restrictions and the virus itself on both lives and livelihoods.

For livelihoods, read what’s usually called the economy, a dry term, but is actually a human story of lost jobs, lower living standards, higher poverty, damaged schooling and vulnerable sectors, including hospitality and retail.

For lives, read healthcare outcomes other than Covid-related ones.  In other words, cancelled operations and fewer treatments, as well as (for example) worse heart disease, cancer, mental health and domestic abuse outcomes.

This is why we urged the Goverment to publish –

  • A regular Treasury report that calculates the economic cost of the lockdown.
  • A rolling Department of Health assessment of the human cost of the shutdown.
  • The creation of an economic counterweight to SAGE.

We also suggested that some think-tanks have the capacity to issue comprehensive reports.

This site originally urged this course during the spring, and is far from alone in having done so.  On which point, congratulations to the Daily Mail, which today publishes a four-page investigation into health outcomes. It finds –

  • 25,000 more people died at home during pandemic, since they didn’t go to hospital as it continued.
  • There is set to be a 20 per cent rise in cancer patient deaths because of treatment backlogs.
  • Organ transplant operations fell by two thirds while waiting list deaths doubled. More than 50,000 operations for children were cancelled.

It’s worth pointing out that some of these outcomes will have been a consequence of Covid-19 itself rather than restrictions – for example, people not going to A & E departments in order to reduce the risk of catching the virus.

The line Matt Hancock took yesterday in the Commons is that suppressing the virus is integral to better health outcomes, because the more NHS resources the virus demands the fewer there will be for other conditions.

But a question that obviously follows is whether or not the Government’s strategy, which is dependent at present on big lockdowns, is the best means of protecting the NHS.

It’s worth noting that a Department of Health analysis has said that “in the long-term, the health impacts of the two month lockdown and lockdown-induced recession are greater than those of the direct Covid-19 deaths”.

The Mail is not alone in trying to get its readers to look at the Coronavirus in a more full context.  Yesterday, the Daily Telegraph reported that the ‘Protect the NHS’ message led to 90 per cent drop in hospital admissions.

The Times last Friday urged the Government to be “more transparent about the economic and health costs – the same day that we took much the same view.

And a wide range of Conservative MPs are increasingly calling for the kind of action we have outlined.  Theresa May has called for more formal economic advice.  Steve Baker, writing on this site yesterday, urged Ministers to publish “serious analysis of the costs of the options they face”.

Downing Street will be reluctant to take this course, and thus indicate that the Government might change its strategy, while it is doubling down on the present one.

In political terms, that’s what our report yesterday about new LAMP and lateral flow tests signified.  Number Ten believes that these can deliver where track and trace has not (though it is not abandoning the latter).

So it is trying to persuade Tory backbenchers not to abandon the testing strategy, and transfer their support either to lockdowns and a permanent suppression plan, or to loosening and a more voluntarist approach.

We shall see whether this push pays off – and if this planned massive scaling-up of new tests works.  ConservativeHome’s understanding is that the Treasury hasn’t ruled out a big report on economic costs.

However, Government sources pointed out that much of the required data is already available (i.e: unemployment figures), and that it would be hard to disentangle the effects of restrictions from those of the virus more widely.

We also detect a concern about the consequences of publishing bad economic news: on the one hand, the Treasury has an interest in alerting voters to the scale of the economic challenge, but none in alarming them.

Steve Baker: Ministers should reject a second lockdown and prepare for Plan B

19 Oct

Steve Baker is MP for Wycombe, and served as a Minister in the former Department for Exiting the European Union.

“We have not overthrown the divine right of kings to fall down for the divine right of experts” – Harold Macmillan

The public are rightly concerned. Daily, they are warned of disaster. “Coronavirus is deadly and it is now spreading exponentially in the UK,” said Matt Hancock last week.  No wonder poll after poll shows consistent public support for stricter measures, even as the economy tanks and mental health sinks.

The omniscient SAGE has spoken. The Government drags along. The language of fear cows the public. Cases soar. Truly, we have fallen down for the divine right of experts.

But this is not working. We need experts and expertise, but we must beware of experts with counterproductive incentives, and of the structural problem of the division of expertise among fields and individuals.

Ministers and experts have worked hard in good faith, but the pandemic has asked the impossible of them. We must not blindly follow whatever strategy is put forward by scientists with a monopoly on advice. We now know that SAGE has suggested another national lockdown, but calling it a “circuit breaker” cannot make it costless. The immense economic, social and non-Coronavirus health damage that the first lockdown caused means that we cannot allow another.

Many of the problems we are experiencing boil down to fundamental issues in how we use experts to inform social policy. We need a better system of expert influence on social policy without tearing down the edifice, but we must avoid the monopoly rule of experts. Thankfully, there is a literature of expert failure showing how government can more safely and effectively take advice.

Scientists respond to incentives like everyone one. Pressures bear on even the most sober, scientific and impartial person. Knowledge in a pandemic is incomplete and uncertain. Suppose an epidemiologist provides the Prime Minister with a low estimate of the number of deaths, and there is no lockdown. Perhaps there are many more deaths than predicted. The epidemiologist will be blamed as a bad scientist. Shame and guilt will follow: a bad outcome.

Suppose our expert provides a high number and there is lockdown. However many people die, it can always be said it would have been worse without lockdown. A high estimate therefore implies credit for saving lives. Praise, pride and innocence follow: a good outcome.

Expert failure also arises when incentives create uniformity of opinion. Professionals earn livings from the official recognition of their profession’s knowledge, enforcing orthodoxy. We think experts do not disagree over “the science” so we are quick to follow their advice.

Moreover, all experts only give a partial perspective. We must recognise that epidemiologists are not economists, GPs, mental health practitioners, cancer specialists or social workers. Their narrow expertise must be complemented, and not at the ministerial level.

Furthermore, since the start of the outbreak, scientists, politicians and the media have treated untested and uncertain theories as certain. When scientists speak of the risks of coronavirus, they do not speak of certain knowledge. Risk is not certainty – as Professor Neil Ferguson’s now infamous record of predictions illustrates. Confusing the two is damaging.

Government expert advice requires four important reforms.

First, we must simulate a market for expert advice using competing expert groups in the same field.

Second, ministers should require three independent expert opinions on critical policy.

Third, the partial perspective of experts should be exposed by bringing together complementary fields.

Finally, employing “red teams” (advocati diaboli) is a good way to challenge and test prevailing expert opinion.

Meanwhile, a Department of Health and Social Care report has shown the lockdown leading to more cancer deaths, deteriorating mental health and many other social harms that can make the cure worse than the disease.

Breast Cancer Now has estimated that around 986,000 women have missed mammograms in the UK after screening services were paused because of coronavirus. The charity has also estimated that around 8,600 women could be living with undetected breast cancer.

Earlier this month, 66 GPs wrote to the Health Secretary to urge him to consider non-Coronavirus harms and deaths with equal standing beside coronavirus deaths. This complex optimisation problem of saving the most lives deserves more public debate.

Dr Raghib Ali, an epidemiologist and consultant in acute medicine, recently highlighted on this site that lockdowns can need to be repeated until a vaccine or fully effective treatment is found. They postpone rather than prevent infection, and a vaccine may not come.

Even if it does, it may not be as effective as people hope. A vaccine may take longer to be rolled out than people wish. No wonder in response to my question last week on when the vulnerable may be vaccinated, the Prime Minister stated that he cannot say by when he expects a vaccine to be produced. He admitted that a vaccine may never come.

But the Government’s strategy remains to supress the virus until vaccination. That has petrified sections of our economy, propped up by £745 billion of quantitative easing and ultra-cheap credit. In evidence to the Treasury Select Committee, the Bank of England has made it clear that such extraordinary monetary policy is only possible because of the independence of the Monetary Policy Committee, and that it is not its job to fund government.

The implication is clear: if inflation were to rise above target, then the Bank would have to act under its mandate. With QE at about the level of Government borrowing today, that could have the effect of pulling the plug on public spending.

The Government’s finances and our broader economy are in a precarious position. Even without an inflation, such extraordinary monetary policy is bound to create misallocation of resources: the longer we prop up our economy like this, the deeper the distortions and the longer and harder our economic recovery will be.

The economy is, of course, closely related to the health of the nation: poverty shortens lives. That’s why Ministers must move now to reform the structure of expert advice, publish serious analysis of the costs of the options they face and prepare for plan B. It is time for Conservatives to relieve experts of unreasonable burdens and reject a second national lockdown.

Iain Dale: The number of people who tell me that they would ignore the rules of any new national lockdown is troubling

16 Oct

Iain Dale presents the evening show on LBC Radio and the For the Many podcast with Jacqui Smith.

The number of people who tell me they would ignore the rules of any new national lockdown is troubling indeed. Despite YouGov reporting that 68 per cent of the nation support such an initiative, were to be in any way successful it would need the full co-operation of the British people, and I now wonder whether that would be forthcoming.

Dominic Cummings’ trip to Barnard Castle back in the spring did an enormous amount of damage. It allowed people to say: “well, if it’s one rule for them and another for us, that’s it. I’ve done my bit’.

However ludicrous the logic might appear, it’s a view many people take. The story of Matt Hancock drinking in a bar after 10pm didn’t help either, no matter what the truth of it was.

It was a clever move by Keir Starmer to break with the Government and side with the scientists who want a circuit breaker lockdown. Clever politically – though perhaps not from any other standpoint.

For as Boris Johnson pointed out at PMQs, SAGE recognised, in the minutes of the meeting in September, that although it recommended a so-called ‘circuit-breaker’ lockdown, it also that recognised the Prime Minister has to weigh this up with other considerations, not least economic and behavioural.

On the face of it, it seems more logical to adopt a regional and local approach to lockdowns. That’s the one that the Opposition leader wants to adopt on test and trace – yet otherwise he’s set on a national lockdown, even for areas with comparatively few cases.

No Labour spokesperson I have interviewed has been able to tell me how to explain to a business in North Norfolk why it should close, when in the whole of the area there are only 19 cases as I write.

Sometimes, we are led to believe that we’re the only country going through this. We hear very little in the media about what’s happening elsewhere in the world, apart from the United States.

Virtually every other country in Europe is introducing new restrictions and experiencing high rates of new infections – yes, even the sainted Germany.

As I write, France has hit 26,000 new infections. Emmanuel Macron has announced a curfew from 9pm to 6am in nine cities, including Paris. He has admitted that many of the country’s biggest hospitals are on the verge of being overwhelmed. Its test and trace system has been even more shambolic than ours, and has been largely abandoned. Where in the British media do you hear about that (apart from on my LBC show, natch)?

It’s as if every failing in the UK system is leapt upon as a further sign of both Johnson’s incompetence and deliberate spite towards a population that he clearly wants to die. It’s preposterous, of course. No one denies that there have been massive failings in all parts of the response to Coronavirus, but why is it that the failings in Scotland, Wales and Northern Ireland aren’t highlighted in the same way?

The figures in Scotland in many areas are worse than in England yet, because she does a press conference every day, Nicola Sturgeon is given a largely free pass by a supine Scottish media.

Holding a press conference in which you repeat yourself each day, but talk a good game, is no substitute for effective policy. And in most areas, Scottish government policy towards Coronavirus has been just as ineffective as that applied in other parts of the UK.

– – – – – – – – – –

On my Cross Question programme on Wednesday night, Richard Burgon’s answer to every question on Covid was to trot out a mantra of blaming Boris Johnson for every single failing.

Well, it’s a point of view, but to then rely on New Zealand as proof of the Prime Minister’s incompetence strikes one as incongruous to say the very least. He kept saying that New Zealand has done everything right, and if only we had followed its lead we’d have been OK.

Sometimes, you have to shake your head at the ignorance of some people. How is it possible to compare a country with a population density of 16 per square kilometre with another country which a density of 255 per square kilometre? How is it possible to compare a country whose biggest city’s population is 1.6 million, with one whose capital city has a population of nine million?

I could go on. The challenges of fighting a virus in a country like the UK is very different to that of New Zealand. Having said that, no one can deny the New Zealand government has done a brilliant job, and I am sure there are things we could learn from their experience.

Similarly, we can learn from other European countries, and you’d hope that there’s a lot of learning going on in the Department of Health. Sometimes, one has to wonder, though.

Take test and trace. Three months ago, I interviewed the Mayor of Blackburn. Because the National test and trace scheme was failing to trace people in Blackburn and the R rate was increasingly at a worrying pace, the Mayor and his local council decided to use its own public health people to set up a local test and trace system.

Contrary to some media outlets reported at the time, this was not set up in opposition to the Dido Harding system, it was designed to complement it. If the national system failed to trace someone in 48 hours, details were handed over to the local public health department. It worked like a dream.

‘This is the way forward,’ I thought to myself after the interview. And I assumed that arrangement this would be replicated across the country.

Not a bit of it. Only now is it beginning to happen – with the Department of Health, PHE and National Test and Trace finally working out that more local input is needed. Why has it taken so long for the penny to drop? Ask me another.

What we are seeing in so many areas is a failure of the machinery of government. This will be one of main areas for a public inquiry to delve into.

How can it be right for example, for Boston Consulting to be paid £7,340 per day for each of its consultants who have been hired to advise on test and trace? I do hope there’s a performance element to the contract…if so, they ought to be handing the money back

Obviously, a private company has to make a profit, but £7,340 per day equates to an annual rate of £1.8 million per consultant. There’s taking the piss, and taking the piss. And this qualifies on both counts. Whichever civil servant or minister signed this off has some very serious questions to answer.

And don’t get me started on the EU and the trade talks. I’d better leave that until next week, I think. If only for my own sanity and your blood pressure.

Chris Green: We are following a failing Covid strategy and its costs are too high. That’s why I quit the Government.

16 Oct

Chris Green is MP for Bolton West and Atherton.

Resigning from a position of Parliamentary Private Secretary is, in practice, like taking a small step down from the lowest rung of the Parliamentary career ladder. It is not momentous, but is still enormously difficult and you better have a good reason for it. I think I did.

The impact of the Coronavirus pandemic has been a shock to the political system as much as it has for the country. The ambitions of the Prime Minister, following his stunning election victory, have been made more difficult. They are perhaps even more pressing today than they were in December. The greatest focus is in tackling Covid-19, which is an event we had not prepared for and barely understood – at the beginning.

We now know so much more and, especially over the summer when the virus had been suppressed, we had the opportunity to pivot to a different approach from that of the first six months, or to set out why the price of carrying on in the same way outweighed the cost.

The national circuit breaker which lasted three months should have been enough to control the disease and enable a focused and highly able track, trace and isolate system to work. It has clearly failed – otherwise we would not now be speculating on what the patchwork of the new tiering system will look like. I am anticipating a comprehensive series of regional circuit breakers that may have the characteristics of a national lockdown in all but name.

Greater Manchester has had a ten week ‘local lockdown’ and Bolton has had three weeks of a more extreme economic lockdown on top. The latter has meant the closure of bowling alleys and close contact beauticians, whilst pubs, restaurants and cafes can only sell takeaways, which has effectively shut most of them down too. This lockdown was far tougher than the top tier of the new lockdown regime.

From the beginning to end of this period, reported positive test results have rocketed up as though the virus had no care for the rules. The lockdown has failed in its own terms, but has had wider impacts that we have yet to realise the extent of.

There have been 20,000 fewer GP referrals to hospital in Bolton when compared to the last year. We can only imagine what the national figure is. The Department for Health should do a comprehensive assessment of which treatments have not been carried out. Health Ministers should explain to the Commons the impact that this has had for each medical category.

We know the extraordinary financial cost of Covid but when will we know the full health cost of missed medical treatment? We are beginning to find out, but many will be suffering for years to come. By sharing data, the Government will have the opportunity to win people to their course of action. The experience of my constituents in Bolton made me realise that we are following a failing strategy and that its costs are too high.

Is there an alternative? Yes, I think there is and, when I could not make any headway with it privately, I resigned. dThe principal points are:

  • The understanding of the disease and how to treat it has advanced since the pandemic first hit us. Existing safe drugs and medical techniques are now being used to treat people in hospital effectively, which means that the threat of the NHS being overwhelmed has diminished.
  • Some of the data being used is not as clear as it should be. For example, we are now doing twenty or more times as many daily tests than during the peak of the pandemic and, had we done this number of tests then, we would expect to see 100,000 positive outcomes. The official graphical presentation does not reflect the massive increase in testing.
  • Society has changed – people accept ‘low density socialising’, the use of hand sanitiser, social distancing and the wearing of masks. These measures dramatically reduce the rate of transmission.
  • We are now in a better position to judge the threat from Covid-19, and a far better place to understand the threat to our health and wealth from the lockdown. We had to make difficult decisions in a certain ignorance at the beginning, but we can now reflect on our own experience and that of other countries.
  • Conservatives believe in a free society. We are better placed to assess our own risks, and this is now true with Covid-19. Is it morally right to keep a man or woman isolated from their children and grandchildren for months or years? To have them waste away in misery during their final years as we wait for a vaccine to come to the rescue. A vaccine that cannot be given to babies, is likely to be relatively ineffective for the elderly and may not be that good anyway. Some vulnerable people will want to shield, and we should do all we can to support them but let others enjoy their lives with their friends and family.

We need to start trusting the people or the people will lose trust in the politicians and their advisors. There is another way, and it is not about letting the virus rip.