Reply To: Corona virus: Government takes the St Augustine approach.

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Thank you so much for such a comprehensive round up of events. I missed the Andrew Marr show and now I have a good update and also of the 5 o’clock propaganda broadcast.

Taking up some points: Jenny Harris and Apples and Oranges is of course true, but not in the sense she means. It is not that of demographics or ethnic mix or susceptibilities, but it is true that Germany has not deindustrialised unlike UK, where we cannot manufacture anything anymore, and we are unable to be self-dependent in many fronts. Germany has also paid much more attention in maintaining higher spending on healthcare, higher beds, and doctors per 100000 population, higher ITU beds and higher ability to manufacture testing kits for example.

But in all this crisis the Tories have believed on our exceptionalism. After all we managed to have our sovereignty back after Brexit and we must make full use of it. To start with we must have an exceptionally incompetent government, unfit to deal with anything unexpected, like international crises, flooding and now this Covid-19 pandemic. The MO is to declare that we are the best, to declare that we are going to do this and that, and then as you say, to blame everyone else when these plans do not materialize. It’s as if they believe that the moment they have wished something to happen, they are exonerated.

But another amazing revelation that has now become apparent is that the so called scientific advisor posts within the government, appear to be thinly veiled political appointments, in the sense is that they are not really “guided by the science”, as they keep reminding us, as subjugating the science to their political will. This was so clear from the outset when the herd immunity red herring was floated when there was so little understanding of immunity to this virus. Yes, it revealed that the government understood herd instincts, but had very poor grasp of the concept of immunity. I do not understand how these government appointed scientific staff can sleep at night knowing how they must act against all they have been trained to do.

But here are also some of the crazy ideas that have become part of the propaganda.

Preventative measures: for what is essentially a respiratory virus transmitted by droplets and aerosols and perhaps other bodily fluids, the government advocated the ritual of the 20 seconds handwasher. To this day there are still discussions as to whether face masks, are protective. I have to say that the doubt has also been sown by the WHO, and their advice is ambivalent about their usefulness in slowing the epidemic by widespread use in the population. In fact, the most laughable thing I heard, and this time by respectable medics, is that face masks can cause more harm than good if it makes you touch your face! I am not saying that hand hygiene is not important, but it is not the sole way of prevention in a respiratory virus. These same scientific advisers also said at the outset that cancelling mass gatherings would have minimal effects on slowing the infection rate, and decided to allow the importation of 3000 Spanish fans for a match in Liverpool at a time the infections in Spain were at a high level.

The other insanity is the whole abandonment of the basic tenets of dealing with an epidemic, widespread testing, isolation of case and contact tracing. Although this was started at the outset, it was abandoned when the government decided to adopt the strategy of herd immunity. This should really be the highest priority now as a prerequisite to easing the ‘lockdown’. But there is no chance of that happening soon as the government is failing all targets to ramp up testing on both the logistical and organizational level.

The rather early major focus, to belatedly encourage local industries to produce ventilators, fell also on many stumbling blocks and instead of concentrating on sourcing tested ventilators from known sources, the government wasted precious time on this rather difficult to achieve endeavor but also without appropriate structural commitment. In any case, it is not just ventilators that are needed, industries cannot just conjure up trained staff to run them especially in the post austerity NHS.

But what has caused me some alarm is that now the Blood transfusion service would like to collect serum from individuals who have recovered from covid-19 in order to attempt to try and see if this can help those who have the disease to recover quicker and possibly to avoid fatalities. But has this project really passed critical scrutiny? What is known about immunity to SARS cov2? The current state of knowledge is incomplete. What has been suggested so far is that there is slow and weak development of a humoral immune response, as outlined above by Kim from the interview of Prof Sarah Gilbert with Marr. But also from what I understand about the pathology that the virus causes in certain individuals, the major lethal complication in this disease is the ARDS which is not a direct result of virus multiplication, and does not occur in in the acute phase but usually a week or more after the start of the infection, and is possibly related to uncontrolled stimulation of the immune system. What would a little bit of convalescent serum do to treat a ‘cytokine storm’?

So, in all of this it seems that headlines are more important than details and I am afraid this is a result of politicizing a very medical problem.