SA – Dominic Cummings is Boris Johnson’s puppeteer, he will refuse to let the PM fire him as he should; the BBC and the press will support this total injustice as they always do. There was another really noteworthy guest who featured by the Andrew Marr show last Sunday that I wanted highlight. Dr. Soumya Swaminathan, the World Health Organization’s Chief Scientist is also a Paediatrician; she was invited to talk on the subject of children and Covid 19 and if we are going to have to live with Covid 19 for the rest of our lives? Marr reported that, “This week the WHO said we might have to live with this virus for five years or more.” He began by asking her if we were facing long term social changes as a result of that?
Dr. Swaminathan, “I think that’s what were all grappling with as people as well as, as Governments how do you get back to some degree of normalcy, without allowing this virus to get the upper hand, so it’s really maintaining that balance and you have to look at the number of interventions to be put in place as people as people start going back to work, going back to school. You know families want to meet again, we want to go shopping, we want to have social events, but at the same time we know now what is needed to keep this virus from spreading, you know the basics principals of maintaining physical distancing, of personal hygiene, respiration etiquette wearing masks when we’re out in crowded places or staying home when sick and so on. So that has to become the new normal, but I do believe that society has to, has to restart, we can’t wait.”
Marr remarked: “Now you’re the Chief Scientist, but I know in your own special area you’re a Paediatrician as well; can I ask you what the latest evidence is about children infecting each other?” Dr. Swaminathan responded, “Children don’t seem to be getting severely ill from this infection. We do know that children are capable of getting the infection so our own studies have shown that when children live in a house where an adult has the infection that they also have a risk of getting it just like the other adults, but there’s less data on how effectively they are able to spread it, to others.” This was sounding positive for the Tory agenda.
Marr must have felt encouraged as moving on she raised a point of specific relevance to children returning to school saying that, “What we have seen in countries where schools have remained open, is that there have not been big outbreaks in schools and where there have been, it’s been associated with events where a lot of people gather not in regular classrooms and it’s often been associated with an adult, whose had the infection and whose spread it. So it does seem from what we know now that children are less capable of spreading it, even if they get the infection and are certainly at very low risk of getting ill from the disease.”
Dr. Swaminathan cautioned about a small cohort of seriously concerning Paediatric cases saying, “Now very recently there’s been some reports of children getting admitted with a strange syndrome, an inflammatory syndrome something that looks like sepsis, something that looks like a disease called Kawasaki disease which causes inflammation in the blood vessels. Now it’s not very clear what the links are between Covid 19 and this syndrome. There are some children who have tested positive for the virus and some who haven’t and so the WHO has discussed with a group of international Paediatricians about how to approach this. And the need really to collect more data on this syndrome and what happens.”
The Doctor went on to outline the WHO course of action regarding monitoring and treating these cases. She said, “so we’ve put out a note, that just went up two days ago, which describes the case definitions of this syndrome and it’s requesting Doctors to actually provide information in a standardized format so that we can quickly learn as much as possible about this syndrome. But again to reemphasize that the risks for children are extremely low with this infection and there have not been many cases described of this, of children transmitting it to others, particularly in the school settings.”
Marr then homed in on the issue of the day, that scheduled return to the classroom for children in the UK; could he coax her into a headline grabbing endorsement of the need for an immediate return to school? He asked: “given all of that and the fact that some countries have reopened their schools already, is there any evidence from countries who have reopened schools or have nurseries open and so forth which should leave Governments still wondering about whether to open schools to have any second thoughts or misgivings about opening schools?” Marr obviously wanted the eminent Doctor to give the Government the green light on their June 1st school opening date, but her answer was a lot more pragmatic and nuanced.
Dr. Swaminathan, “I think that overall the data has been fairly reassuring, of course it’s only a few countries that have done that, but I think again the guidance set out by WHO clearly lays out the criteria that you would use, when you consider whether to reopen a school or not and very often it’s based at the local level at the community or at the city level and it’s based on of course epidemiology of the disease itself whether it’s still on the rise or whether it’s under control and going down and whether the measures that are needed to be put in place have there’s been enough time to do that in terms of rearranging classrooms making sure that there are hand washing facilities that teachers are trained.” The problem is that this Tory Government points to the successful return of children to school in countries where the infection rate is a lot lower than the UK, plus they have established test, track and trace to reduce risk.
Her well considered answer was far more in line with Labour Party, Teachers Unions and local community demands for adequate preparedness. Then Dr. Swaminathan brought up the key element that was conspicuously missing from all of the Government’s plans: greater transparency with more expansive engagement both with teachers, parents and local authorities. She continued by adding, “…it’s really important that all the stakeholders in this, the teachers the children themselves and the parents or care givers have had a chance to have a dialog and ask questions and be informed of what is being done to minimize the risk, and what they need to do and similar to what we were saying earlier that children who are infected do not go to school.”
This interview was not going in the direction Marr would have wanted, but he continued: “Because I’ve talked to some people in schools who say that in practical terms it’s almost impossible to explain to particularly young children about social distancing it just doesn’t happen in schools.” Dr. Swaminathan agreed that, “It’ true, but in classrooms can rearrange you know the tables and chairs so their children have at least a one metre distance between them and children learn, so hand washing of course and teachers would have to encourage and be a role model for children and so many of these basic things can be done.”
Then once again reinforcing the Labour and Union demand for getting test, track and trace properly established before school children are expected to return to class, the Doctor continued, “but then there also has to be a way of er, of doing some kind of checks in schools, of making sure that the infection isn’t spreading so that again is something that local Governments have to consider as schools reopen, what is the data that one is going to monitor and look at on a real-time basis so that you know you’re keeping track of what’s going on and you pick up anything really before it becomes unmanageable.” If Marr was hoping to pry a rash statement out of the good doctor to support the Governments fixed reopening of schools ready or not, he failed miserably!
That headline moment had evaporated so Marr moved on asking: “Dr. Swami Swaminathan, we’re hearing a lot at the moment about new antibody tests, is there any conclusive evidence that any of them actually work properly?” Marr should have know that it was too soon to tell with regard to this, but Dr. Swaminathan had to inform him, “We are still waiting for the longer-term data from people who have recovered from this illness, we know that a large majority of them develop antibodies, but how well it protects, and for how long it protects, from second infection is something that we’re not sure about at this point of time, but because of all the research that’s going on including the research to develop vaccines, I think we will learn more and more in the coming weeks and months about the antibody responses.”
If Marr wanted a line that supported the Government’s warped “Herd Immunity” eugenics program he was seriously out of luck; the reality, as the Doctor confirmed, is that we have no idea whether the antibodies produced by those who get infected will continue to be protected from a second exposure to the virus. She emphasized the data value of the antibody test saying, “At the moment its main use is really to check at the population level to see how many people have been exposed to the virus. So studies that have been done in many of the affected countries have shown that 5-10% of the population have been exposed to the virus. Now in countries like Spain, Italy, Germany, New York State and so on which again tells us that the vast majority of people are still susceptible to this virus and therefore we continue to need to be careful.”
Marr lurched in the direction of the stereotypical “fat shaming” prejudice of the Tory blame game as he asked, “Finally can I ask you about something there has been a lot of talk of in this country which is the link between obesity and a serious effect from Covid 19. What do you know about that at the WHO?” Dr. Swaminathan strategically avoided the potential toxicity of his targeting by saying, “again we are still finding out more about these risk factors and we have seen that obesity and with associated non-communicable chronic diseases. Obesity is very often associated with hypertension and diabetes in the same individual and those again are sometimes associated with poverty, with lower access to healthcare, with living in overcrowded conditions.” She wanted to direct the focus not just onto various known co-morbidities, but to the poverty that increased the incidence of such health conditions.
Dr. Swaminathan was so professional as she continued stressing the impact of poverty, “So many of these social and economic determinants of health go hand in hand and all of them increase the risk for severe illness and mortality for the data from many countries now shows that minority populations and those who have an access of these risk factors are actually doing much worse in terms of Hospitalization and death. So it’s a combination factors, obesity has been associated with worse outcomes in other respiratory illnesses including in acute respiratory distress syndrome due to other causes and that’s possibly because the lungs have to work harder in an obese individual especially when there’s a problem of an infection in the lungs, but we are still learning more about the pathophysiology of how obesity and other underlying risk factors actually have an impact on this illness.”
This WHO Doctor wasn’t going to facilitate Marr helping the Tories blame any Covid victims for getting sick; he asked one last question, “so people who have recovered, particularly younger people who have had Covid 19 and recovered, there seems to be some evidence of worrying longer-term effect beginning to emerge, particularly scaring on the lungs; have you done any research into that can you tell us anything about that?” Another “too soon to tell” redundant question; Dr. Swaminathan said, “Again this is an emerging area of research and we have to wait for some more time. I think what it really highlights is the need for scientists and researchers to work with Clinicians to who are seeing these patients in the Hospital and set up systematic long-term research studies to look at the clinical cause and also do properly conducted randomized clinical trials of interventions that are postulated to work that have some rational that they will work, but they need to be tested and properly conducted large randomized trials.”
The WHO implored us all to Test, Test, Test, but it has taken this wretched Tory Government several months of interminable delays to get testing underway, an unforgivable gross mismanagement of the crisis that cost many lives. During an emergency or a disaster the principal role of the WHO is not a very glamorous one; I witnessed this first hand after the Boxing Day tsunami. Other intrepid Medical volunteers arrived in the Aceh disaster zone to head out and treat victims, set up clinics, vaccination people or do emergency surgery as I did. I noticed that WHO functionaries had the crushingly boring task of collecting data and crunching the numbers; it was not a role for the disaster relief adrenaline junkie! We all reported back to WHO because an outbreak of any kind can quickly kill more people in an IDP camp than the disaster that forced them to take refuge in tents. British exceptionalism, complacency and zero data guesstimates represent the very antithesis of how the WHO facilitates the control of a global pandemic.
Social Distancing and Self Isolation may seem like newly devised restrictions, but the only thing new was this Tory Government’s ignorant resistance and late implementation of necessary public health measures. I remember “clearing quarantine” as a strictly controlled formality that prevented us from racing ashore for a cold pint after a long passage. “The word “Quarantine” comes from the Italian “quaranta,” meaning 40 – literally 40 days. It was adopted as an obligatory means of separating persons, animals, and goods that may have been exposed to a contagious disease. Since the fourteenth century, quarantine has been the cornerstone of a coordinated disease-control strategy, including isolation, sanitary cordons, bills of health issued to ships, fumigation, disinfection, and regulation of groups of persons who were believed to be responsible for spreading the infection.” (NCBI Website.)
The Government’s “still in testing” App for track and trace in new, but not really novel; most of the EU are relying on a more widely accepted and well tested App that accomplishes the same goal with better data security. There is nothing at all new about the track, trace and isolate strategy either as that has been a long established protocol for dealing with everything from contamination of water and food poisoning to controlling the spread of STDs and preventing an infectious disease outbreak like Covid 19. This comprehensive response is organized locally for a rapid targeted response and highly effective control in an emergency. In mid March this moronic Tory Government decided to stop community testing and abandon the established track, trace and isolate for the Dominic Cummings eugenics model of “Herd Immunity” and “take it on the chin” …forget the data, just wing it!
The abysmal Tory plan is to replace intensive localized contact tracing, that has worked effectively for decades, with a centralized system handled by one of their favourite private corporate entities with a long history of screwing things up. No wonder the WHO are shocked by our pathetic response to Covid 19 as we remain a global laughing stock. Dr. Soumya Swaminathan, the World Health Organization’s Chief Scientist, was both highly professional and very diplomatic in her efforts to avoid the trap of endorsing any aspect of reckless Tory policy. Tories never admit wrongdoing or failures and they never learn from their mistakes. Despite his blatantly flaunting the lockdown rules, Boris Johnson will refuse to fire Dominic Cummings because the Dom devised the plan for the Covert 2019 Rigged Election. The UK will suffer the ongoing corruption, failures and fatalities of this Government until the truth is exposed in an investigation that robs them of their legitimacy; only then can they be forcibly removed from office.