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I am getting well behind with my reporting as this was meant to go up days ago covering interesting interviews on last Sunday’s Marr show. Andrew Marr and his guests tried to make sense of the Boris Johnson’s new messaging as the Government no longer wants all of the plebs to “Stay at Home.” The change to “Stay Alert” is a bit vague to say the least. Normally a person is considered to be alert and oriented once they are awake, but this suggests a far wider connotation regarding the need to “stay alert to potential danger.” Stay Alert is all about compelling people to take responsibility for their own safety even if they are expected to return to an unsafe working environment. This is totally unacceptable and all of the major Trade Unions have said they will not advise any of their people to go back to work unless reasonable safety standards are met. The Government hasn’t exactly formed a great track record with regard to keeping our NHS staff and Carers safe while heavily reliant on them to keep on working.
The Tories have ditched the sheer hypocrisy of telling the public to “Protect the NHS” during a period where the Government has repeatedly abandoned their responsibility to provide a reliable, ongoing supply of adequate PPE, to reduce the risk to staff, and to organize timely testing of all Healthcare providers in Hospitals, Care Homes and GP Practices. The new buzz words are “Control the Virus;” once again this implies that this duty is entirely under our control and conveniently removed from the Government’s remit. What is even more worrying is that it would seem to indicate that the Tory agenda is not the total eradication of this disease, but a plan to maintain the disease at a manageable level of infection and mortality for the foreseeable future.
This “turning on of the tap” is the next phase of the eugenics “Herd Immunity” plan that the Tories never really abandoned because a “Slaughter the Sheeple” to cull the “Economically Inactive Scavengers” will save the Government a lot of money moving forward. “Save Lives” remains unchanged, but we should ask, whose lives are the Tories intent on saving? The poor and disadvantaged are becoming infected and dying at twice the rate of the privileged while the BME community has been hit particularly hard. Several days ago there were reports that over 40 of London’s bus and MTA workers had died of Covid 19; there are legitimate fears over going back to work that might derail the Tory plan. Sadly, the only lives that really matter to them are the wealthy Tory elite; just the fittest and strongest of the expendable slave labour force, those forced to work lengthy hours for pittance wages, will be spared.
With two right wing pro Tory guests to review the papers, Jo Cobern from the BBC and Frazer Nelson Editor of the Spectator, there was no pretence at any political balance as the BBC continues its lurch to the far right. Most of the above realities were readily glossed over without too much scrutiny during the Paper Review, but there were juicy rumours that Mat Hancock was about to become the fall guy after seven days of not meeting his own 100,000 test target while 50,000 tests were shipped off to the US for processing! Other matters raised were the Unions recommending no return to work until there were safety guarantees and that the schools potentially going back may also present a problem. The impending imposition of a fourteen day quarantine on those entering the UK was also discussed, but all of these measures remain a matter of speculation awaiting Johnson’s dictates later on.
Marr interviewed Professor Peter Horby, chair of NERVTAG to ascertain what we might expect from Medical science to help combat Covid 19. A Professor of Emerging Infectious Diseases and Global Health he is on an expert committee of the Department of Health (DH), and the Group Leader Epidemic diseases Research Group Oxford (ERGO). Marr said, “He is also running the world’s largest clinical trial of potential treatments for Covid 19” and when they spoke he asked “whether we will get an effective treatment for Covid and when?”
Horby replied that, “Treatments in many ways are easier as we are looking at drugs that are already used.” He explained how, “these repurposed drugs are already on the shelf in the pharmacy, if we can test those and show that they work we can give them immediately to everyone.” He went on to say that, “with vaccines you are giving them to a much wider population and you are giving them to people who are not yet sick, so the risk-benefit balance is very different… you need to be a lot more careful with new vaccines. He felt there was a reasonable chance we could find drugs that work, ‘perhaps even this year’.”
Marr asked about the drug Remdesivir that had been approved for emergency use in the United States. This broad-spectrum antiviral drug, that was originally developed by the pharmaceutical company Gilead as a treatment for Ebola, could potentially be used in the treatment of Covid 19. Horby said that there had been a small Chinese trial had not shown significant results, but announced on the same day, a US trial “had shown that the drug was capable of reducing the duration of Hospital stays by five days.” Horby said “they hadn’t yet seen any benefit on mortality” further results are yet to be seen. Personally, I remain sceptical of “Big Pharma” in the US with their huge profit driven agenda. Marr commented about the drugs “being made widely available if they work, but Remdesivir is not widely available,” noting that Horby was unable to get sufficient supplies of Remdesivir for his own trial.
Horby said that, “there are two sorts of drugs the repurposed drugs and then there’s the experimental drugs. Remdesivir is not yet properly licensed for anything so it is not yet available on the shelves.” Marr said “can you just explain to us how your trial works?” “The recovery trial is a national effort,” Horby sounded hopeful in his reply, “here in the UK we’re in an excellent position, probably better than anywhere else, because we’ve got the NHS and we’ve also got a national research infrastructure, so we managed to open the trial across the whole of the UK, it’s open in all the devolved Nations… in 117 Hospitals… it means we can get very big numbers so we’ve now enrolled 9500 patients… we believe is the biggest trial anywhere in the world, it puts us in a very good position to get some very clear answers about whether these drugs are beneficial.”
Marr bought up Hydroxychloroquine that had unfortunately gained a really dangerous rap due to the incredibly reckless intervention of Donald Trump. Horby decried the President’s dangerous intervention, insisting there was no reliable evidence. Criticizing the “anecdotes we hear from small studies aren’t good enough,” he said “this has well known side effects… you have cases of people poisoning themselves with this drug.” However, he failed to inform us that this very affordable drug is still included in the trials as a potential treatment for Covid. Hydroxychloroquine is not an experimental new drug and it doesn’t have significant side effects when properly administered; it has a reasonable safety profile and is currently widely used overseas for the treatment of Malaria.
Horby said that people seeking treatment should sign up for the trials. Marr switched back to Remdesivir and valid concerns, “the company would ramp the price up, it becomes hard to get and incredibly pricey.” That is their business model! He wanted to know if the pharmaceutical companies were going to make it unaffordable. Horby shared the concern saying, “it is incredibly important that there’s a global solidarity around these issues, there should be no opportunity for these companies making vast profits from these drugs; everyone across the world no matter what their income including the poorest countries should have access to drugs like this. If they work they need to be licensed out for generic produced so that they can be made available to everyone at cost price.” I was left wondering what kind of happy pills he had consumed before the interview!
Marr asked, “from what you have seen so far is it more likely to be a combo of two or even three drugs that are being used widely?” Horby elaborated, “Covid has two aspects to it, you have got the virus and the viral replication… the antiviral drugs kill the virus and stop it replicating, but there is also a lot of inflammation, so we have other drugs to target the inflammation.” He said you will need both and the best approach was with a combination, “one or more antivirals plus something that dampens down the immune response to the virus.” Marr turned to focus or Professor Horby’s role as the chairman of NERVTAG, quoting one paper that warned of 100,000 deaths if we got the release from lockdown wrong. Horby said we could very easily be back in a situation of crisis.
Marr asked about the “R” number that we have all been hearing so much about. Horby admitted it was an estimate based on all sorts of data sources that are imperfect. From what I have learned so far about the missing data from lack of testing I would say that “imperfect” was a major understatement! Horby deftly papered over the cracks saying, “we need to improve the information streams that will allow us to have a more precise idea of what’s happening and then we can calibrate the public Health response so that we keep it under control:” more doublespeak! I couldn’t help noting the emphasis on controlling the virus rather than irradiating Covid 19. Questioned on regional differences, Horby said that “the “R” number is a composite… lots of small epidemics and we are so interconnected that it may not make sense to different restrictions in different parts of the country.”
Marr said, “your committee advised the Government to stockpile gowns and they didn’t” Horby stumbled after he had to admit to problems with PPE, but he tried to cover for Government’s mistakes saying “a lot of their early planning was based on Pandemic influenza” saying it had been “more extensive than any of us were expecting.” On the one hand stating there was now “no excuse,” but then following with the standard excuse of global shortages. I couldn’t help thinking that if it were bullets there would be no supply issues…
Marr said that, “Richard Horton who’s the Editor of the Lancet, had a bit of a go at committees like NERVETAG he said that most of the participants in SAGE… are actually Government scientists that are on the payroll of the Government, we did not have truly independent scientific advice; this is a system that is corrupted we do not have people who are truly able to give truth to power.” Horby was asked if he could give truth to power. More prevarication followed, but I noted that Dominic Cummings’s presence at meetings and the potential for his unscientific input was not mentioned by Marr – last week’s news…
Horby asserted that Marr was mistaken as he tried to justify the people participating in these influential committees in a profuse defence, concluding that they were, “completely independent and not influenced by politicians.” Marr said NERVTAG had been criticized too, he was asked why initially they had assessed the disease as only a “moderate risk?” Horby claimed that this was misunderstood, “the risk assessment was, what was the actual risk right then to the people in the UK at the time” according to him “it was not used as a trigger for any action.” Immediate risk, not impending risk: did that justify negligent inaction? Why wouldn’t they want to fully anticipate and plan for the worst and be fully prepared; this made no sense, a very questionable response at best. Horby must have been extremely relieved that the interview was over as, in my opinion, he did not equipped himself well.
Marr interviewed Jonathan Ashworth, the Labour Shadow Health Secretary asking his opinion of the new messaging. Ashworth was not impressed with the vague instruction to “Stay Alert.” He questioned the clarity of the message, saying “this virus really does exploit ambivalence and thrive on ambiguity.” Marr pressed him for a definition, but Ashworth just emphasized how deadly the virus was and our disgraceful UK standing with the highest death toll in Europe. He was particularly concerned for those from poorer backgrounds and those in the BME community who were extremely vulnerable; he said many who survive will have long-term health problems. This uncovered a serious concern as we are all acutely aware of how the total lack of empathy from the Tory Government has impacted our disabled population in the past: the future is bleak for those crippled by Covid.
“We always knew that getting out of lockdown was going to be a difficult and complicated process” Marr said, “Labour has been calling again, and again, and again for a path out of the lockdown” he wanted to know if they felt any responsibility for the confused messaging at the moment? Typical ploy to target Labour, who aren’t in Government, for blunders that the Tories are never held responsible for. Ashworth didn’t take the bait, saying “we have seen different briefings for different newspapers… at the same time I don’t think it is unreasonable to ask the Government what the strategy is.” He kept the focus on the Government’s responsibility saying, “we know we need more testing… we abandoned our contact tracing…”
Marr interrupted saying, “I’m sorry to jump in” and claiming there was a contradiction between asking for clarity now and wanting to know what will happen in the weeks ahead; he was determined to call out Labour for scrutinizing and demanding clear instructions from the Government. Ashworth remained unruffled saying, “we must treat the public like they’re grownups” Labour wanted a general strategy offering more clarity, not a fixed date like what was briefed to the papers. It must be noted that the vague Sunday briefing was expected to take effect the very next day! Labour were asking for “a route map… the lockdown is a blunt tool it is not a strategy in itself.” Ashworth was concerned for those whose cancer treatment was on hold and he said, “taking children out of school for so long has huge implications for our young people as well.” Ashworth didn’t think his questions were unreasonable.
Marr said “can I ask your view on ending the lockdown differently in different parts of the country…” He reeled off numbers London has 86 deaths per 100,000 and he offered other areas in comparison like Norwich with only 5 per 100,000, but all were treated the same. Ashworth went to the heart of the matter saying he thought there was “a case for targeted testing and tracing regimes.” He was not in favour of the Tory, “just pick a big number approach.” He wanted to target deprived areas, BME communities, but also certain cohorts of within the workforce, all healthcare workers and care homes. However he considered releasing restriction by area was a mistake as wealthy people could afford to relocate so it was not a good policy.
Marr asked about a Labour policy that people in rent arrears should be given two years to pay it back, but many in the Labour Party considered this far too cautions and think that, “arrears accrued during Covid 19 should be written off completely.” Ashworth said “as we come out of this crisis society cannot be the same again it shows that we need more public investment, investment in our public services, we need strong infrastructure in this country.” He said “we need to build our economy so it’s not based on low pay and zero hours contracts.” He wanted a debate on, “how we rebuild the country after we come through this, but in the meantime we need the support to get through this.” Ashworth noted that, “a lot of people will be worse off because of this crisis.” I wouldn’t count on the most severely deprived getting a bail out from the Tories any time soon!
Statistician Professor Sir David Spiegelhalter from the University of Cambridge was described by Marr as, “an advisor to the SAGE committee on Covid 19, much quoted by ministers about the difficulties making international death comparisons.” Strange how that unusual name had been mentioned so often over the past week, I was really curious to see how fiercely he would defend his much quoted article. Marr started by asking him, “how many people are infected in the UK?” This was a prompt for the professor tp reel of a string of mind boggling numbers and he obliged. Spiegelhalter started that with, “some very rough back of the envelope sums” we’ve had maybe 35,000 deaths from Covid 19…” In reality it is becoming widely accepted as being far higher than that.
He elaborated further saying, “the infection fatality rate, the proportion of people that get infected who go on to die, is on average less than 1%, multiply that up, you get 3½ million infected with the virus but it could be much higher than that…The infection fatality rate could be half that… 7 million in this country at least infected.” He said it was, “extraordinary that we don’t know the basic facts yet. We have heard from Sir Ian Diamond, the Head of the Office for National Statistics that they had finally got asked to do a proper survey; April 17th they finally got asked and they will start getting the results this week, of how many people have got it and how many people have had it.” Spiegelhalter said it was “the one bit of criticism he was prepared to make about the Government is the fact that the testing the development of the testing has been so delayed.” Just ONE!
Marr asked about the number of excess deaths per week or month at the moment, he wanted to know what he could tell us about that. Spiegelhalter said, “That is the most useful figure to look at. If we look over the last four weeks of the data from the Office of National Statistics, which is the most reliable source of information it goes up to just April 24th so it is still 2 week old data, we can see that instead of over those four weeks the 42,000 deaths we would normally expect at this time of year instead we had 79,000! That’s nearly double, that’s 37,000 extra deaths, but only 2700 of those had Covid 19 on the death certificate. That leaves about 10,000… which are kind of unexplained. What has caused these extra deaths?”
Spiegelhalter tried to account for the unexplained deaths, “…the spike in non Covid excess deaths… some of them will be under-diagnosis, but Ian Diamond was attributing them to indirect deaths or collateral damage, the damage caused by the disruption to the Health Service.” He said this, “was clear looking at the data from Care Homes and people’s homes. There’s been a massive shift from deaths in Hospitals into deaths in Care Homes and homes, not necessarily a bad thing for people to die in more familiar circumstances, but a lot of death happening out of Hospitals that we wouldn’t have expected at this time of year. More than half the deaths in Care Homes, running at three times the normal rate are not being labelled as Covid. This is unbelievably important due to people not going to Hospital and not calling the ambulance when they are ill.” He said, “it didn’t even take into account the damage in the longer term due to lack of chemotherapy, elective surgery and so on, that is also a massive issue.”
Marr highlighted how Spiegelhalter had had a slight run in with the Prime Minister when he criticized him for, “quoting you in terms of the uselessness of international comparisons.” Spiegelhalter did appear somewhat annoyed at the way his recent article in the Guardian had been misconstrued and he had criticized the PM over statements on international comparisons. He said that he was motivated to write the article because he was, “sick of the media based who’s top or doing the worst.” He added that, ”because of the enormously different ways that different countries were reporting their data it was a completely fatuous exercise to do a sort of Eurovision between who’s the worst in Europe, but I should have made myself clearer.”
Spiegelhalter went on to explain that what he was talking about was, “look at the bad countries in Europe, UK, Belgium, France, Spain, Italy; I was not saying that we can’t make any comparisons at all because clearly it’s important to note that we as a member of that group is way above in terms of their mortality above Germany, Austria, Portugal, Denmark, Norway who have low fatality rates. If only to say what’s happened in this country is not inevitable, it doesn’t mean it had to happen.” He admitted he had not been very clear and that, “then I found my paper was being quoted by ministers to support the claim that we cannot make any of international comparison.”
Spiegelhalter said he, “thought it would go away, but finally Boris Johnson used it in a response in parliamentary questions I felt forced and my colleagues encouraged me to actually go public and say please don’t do this, it’s not what I meant, don’t use this to make the claim that we can’t make any comparisons. I tweeted that out at it’s my one and possibly my only viral tweet with over 10.000 re-tweets.” Marr responded, “you said it wasn’t inevitable that we had that number of deaths and that finally leads to are we talking about policy or are we talking about clustering of people in London and other issues?”
Spiegelhalter replied that there were, “so many reasons why countries can differ let alone the policy… the age distribution,” he said he, “hadn’t realized that in Ireland 6% of the population is over 75 and in England it is literally double that 12% of the population are over 75. This is a disease of the over 75s almost completely. There are many comparisons, we are a densely populated country they are still making… these fine comparisons are extremely difficult indeed. However, when you see massive differences between countries, then they it is really worth trying to investigate why.” Marr picked up on his point that it was a disease of the over 75s and wanted to ask, “how scared should most of us be of dying of Covid 19?”
Spiegelhalter said it was, “an interesting question because as lockdown was released we are going to be turning from a societal threat into risk management. I think it’s very important that we are aware of what the risks are… people’s anxiety should be roughly proportional to the actual risks that they face.” Spiegelhalter offers more numbers, “the ONS reported nearly 30,000 Covid deaths up to April 24th. People are worried about children, let’s look at the young group… among the young, children under 15, only 2 have died out of 10 million. This is the tiniest risk, people talk about protecting our children this is bit of a delusion, but we have to think of the potential for spreading the virus.”
“If you look at personal risk for young people it’s staggeringly low. If you look at under 25s, there’s 17 million of them in the country and we have had 26 deaths among the under 25, they may have had other complications, but that is one or two per million that’s about the same as the risk from accidents or sudden deaths over a couple of days. Let’s compare it with the over 90s, more than 1% of the over 90 have so far died from Covid just in four weeks, that’s 10,000 times the risk of the younger people. It is very difficult to communicate that staggering gradient in risk… the risk doubles every 6 or 7 years.”
Marr pitched in, “so we’re talking about the over 70s and over 75s? He asks how well are these press briefings communicating the situation?” Spiegelhalter was scathing in his reply, admitting that he had watched the previous day’s broadcast and quite frankly he said he had, “found it completely embarrassing. We get told lots of big numbers, the precise numbers of test done, 96,978, well that’s not how many tests were done it includes ones that were posted out. We are told 31,587 people have died; no they haven’t its far more than that. This is not trustworthy communication of statistics and it’s such a missed opportunity.”
Spiegelhalter concluded the interview by saying that, “the public out there are broadly very supportive of the measures and they are hungry for details for facts, genuine information and yet they get fed this what I call ‘number theatre’ which seems to be coordinated by a number ten communications team rather than genuinely trying to inform people about what is going on. I just wish that the data had been brought together and presented by people who really knew its strengths and limitations and could treat the audience with some respect.”
The Communities Secretary, Robert Jenrick was next up, asked by Marr what the Prime Minister meant by “Stay Alert?” Jenrick said that, “at ten o’clock tonight the Prime Minister will lay out a roadmap for the next phase of the virus, we’ve passed the peak and so we do think this is the right moment to update and broaden the message.” So Stay Alert will mean stay alert by staying home as much as possible, but stay alert when you do go out by maintaining social distancing, washing your hands, respecting others in the workplace and the other settings that you’ll go to. This will be a cautious message because the rate of infection is still high and the public are understandably anxious.” There was a hint of more people being expected to return to work, but Jenrick’s blind confidence in the shambolic new messaging and the full implications of the Governments instructions remained vague until much later in the day.
What most people were told at ten o’clock, literally just hours before they might be expected to head back at work, was that “Stay Alert” meant navigating the close proximity danger on crammed public transport to get to their totally unprepared workplaces where maintaining social distancing would be impossible. The total lack of warning or any consideration of preparedness for the ongoing health and safety risks obviously did not concern the Government at all. Just keep washing your hands – the Tory Government is washing their hands of all responsibility for the inevitable second wave spike in Covid 19 cases.