Reply To: SARS cov2 and Covid 19

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The article is useful as Clark says in pointing out that backward tracing is probably more important than forward tracing. But R0 is not fixed in time and is merely a crude mathematical tool used for guidance and should never be handed to politicians. The superspreaders and the different rates of transmission in different situations may skew the data but nevertheless there are still lots of basic facts that need to be worked out with this virus. Spread amongst politicians seems high anecdotally because it goes with the job, they have to interact with many people. Superspreaders therefore are in a large part, not biologically determined to be so but are just social butterflies more likely to spread disease than someone who is a recluse.
As to why our governments are not succeeding, it is simply because there is no will to carry out two basic actions. A robust test and trace system is still not in place, because it has been politicised and instead of being handed over to MHPs became a capitalist opportunity to throw money at their cronies. Ideally it also involves local networks, something the Tories went into a lot of trouble to demolish over the last 10 years. Local councils are mainly now impoverished and inadequate in effecting large scale coordinating emergency measures. The second point never seriously discussed is the issue of ‘self isolation’ which is a completely different concept from medical isolation. Self isolation is necessarily a voluntary process. And it is so deliberately because it takes away all responsibility from the government and blames individuals. If you self isolate you have to do so in your own family space, and the majority of family spaces do not have the luxury of two bathrooms and toilets, let alone sometimes enough bedrooms or space to have effective isolation. Secondly self isolation means also self care and self catering in supplies and also in earning. The cycle breaks down because many are unable to survive if they rigorously self isolate. This creates a social unrest and feeling of resentment against all government measures including now the wearing of masks, adopted as a form of defiance through non-observation. True medical isolation removes much of this by infected individuals being cared for until they are non-infectious. This is the secret of the success of many ‘authoritarian’ countries, especially when there is still strong social and medical universal support as a payoff. Nobody now talks of China, despite their success. The secret of China and others is the combination of an authoritarian regime, a fairly compliant, accepting and obedient population with a modicum of respect for elders, and as a payoff, a major state backing for looking after the health and well being of the population as a whole.