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Eliminating the virus, not learning to live with it

 

Our Covid carnage – why it was avoidable and how it can be prevented in the future

 

Why anti-lockdown views have been wrong and deeply damaging

 

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Thoughts on …                                                              30 June 2021

 

Eliminating the virus, not learning to live with it

 

A letter to the new Secretary of State for Health and Social Care  

 

Rt Honourable Sajid Javid, MP                                                                                                                                            

Secretary of State for Health and Social Care

Dear Mr Javid – Sajid     

                                                                          

How to destroy the virus

 

There is only one way to achieve your ambition of restoring life to more normality and it is not by learning to live with the virus. It is by destroying it to the point of virtual elimination. There is no other way that the UK or the rest of the world can be confident that the carnage will end.

 

This has been my view, and the view of others, since the beginning of the pandemic and if it had been the strategy the government had adopted would have saved tens of thousands of lives. Your duty as Health Secretary is to protect people’s lives and health and I am sure you have the strength of character to ignore party political considerations as well as the siren voices who are arguing that we must learn to live with the virus.

 

Your predecessor tried hard, and was clearly successful with regard to the vaccine rollout, but it is impossible to disregard his horrific and unimaginably tragic legacy of well over 150,000 lost lives – the vast majority being wholly avoidable.

 

I have always believed, and argued in the many representations I have made to various people, that the guiding principle in the government’s response to Covid must be lives before livelihoods – livelihoods can be restored but lost lives cannot. Nor In my view is there a balance to be struck between maintaining a certain level of economic activity and a certain level of acceptable mortalities. I have not yet heard anyone put a precise number on what the latter would be.

 

I have also been saddened and shocked by some of the comments of your colleagues in the Covid recovery group about individual freedoms being lost because of lockdowns. They clearly do not understand the meaning of freedom in a caring and interdependent society. Their use of the term freedom day has been deeply insensitive – there is no freedom on the horizon for the 150,000 people who have lost their most basic freedom of all.

The strategy of lockdowns has been correct and they have proved to be effective. If they had been watertight “shutdowns” for a shorter period they would, however, have saved countless more lives.

 

There is no doubt at all that once again the virus is out of control. I suspect the reasons for this is are a mix of casual or careless behaviour by many people, and a lack of discipline by some. There seems to be a widespread view, now that many restrictions have been lifted, that the pandemic is almost over and life can return to normal. It is lax behaviour more than the characteristics of the Delta variant that is more likely to be the cause of the latest surge in infections.

 

Regrettably the idea that the pandemic is coming to an end is far removed from reality. Globally the virus is rampant and in the UK hospitalisations and mortalities are rising, including amongst those who have received both doses of the vaccine. And there are still too many people across all age groups who have not been vaccinated.

 

It is clear that the vaccine rollout will not be sufficient in itself to eliminate the virus and will probably not be as fully effective as we all hoped. It is, however, the key to the virtual elimination of Covid that must be pursued. This is not difficult to do and can be achieved with the following measures:

  • As close to 100% vaccination as possible
  • Continuing with the test, trace and isolate programme
  • The retention of sensible restrictions
  • Localised shutdowns
  • Border controls
  • Impeccable behaviour by everyone at all times – including no unnecessary shouting or chanting at sporting events, not having too much to drink, and maintaining the 2 metre rule
  • Very firm and frequent messages about behaviour and about the pandemic not being over
  • Putting an end to tribal politics and making a determined national effort headed by a government of national unity
  • Bringing in new advisors with fresh thinking on eliminating the virus
  • Kindness all round

 

A few weeks ago we were very close to eliminating the virus in the UK with low infections, hospitalisations and mortalities. Other countries such as New Zealand, Australia, Singapore, Taiwan and China have kept death rates to a minimum by adopting an elimination strategy. (see note)

 

We can, and must, do the same. We are in the middle of the most unique event in human history and it is ridiculous to pretend that life will suddenly become normal by learning to live with the virus. It has also been ridiculous to compare it with flu.

 

None of us, of course, is immortal but it is a basic human instinct to preserve life and protect our health and do all we can to that end – hence the NHS.

I am sure, Sajid, that as for most of us, Winston Churchill is one your great heroes from history. “We shall never surrender” he said. And nor must we surrender to Coronavirus.

 

I wish you well in your new post and hope you will be able to adopt a new strategy along the lines many of us are seeking.

 

Yours sincerely.

 

Alan Kerr

 

Note: It is regrettable that some sections of the media, including the BBC, are attempting to denigrate the incredible achievement of Australia in keeping its death toll so low, now that it has had a further outbreak. It also needs to be said that it most definitely has not closed its borders in terms of trade, only in terms of air travel.

 

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Thoughts on ...                                                                          6/5/21

 

Our Covid carnage – why it was avoidable and how it can be prevented in the future

 

The past year has seen incredible heroism from our key workers in health and social care, in food provision, and in essential public services. We can never repay them enough. The past year has also seen great acts of kindness from volunteers and neighbours. It has seen resilience in the face of adversity in many forms – the virus itself, lockdown restrictions, and the anxieties of lost income and financial hardship. It has seen a willingness from the majority of people to comply with legislation and advice from the government in order to reduce the spread of infection. And it has seen outstanding endeavours from those working to produce new treatments for the virus and, of course, the different vaccines to inoculate us against it.

 

But our death toll from Covid has been appalling. It has brought the most unimaginable carnage which in turn has brought unimaginable suffering and grief. As members of society we must all share responsibility for this through our actions and inactions. Our political leaders have let us down badly with horrific and tragic consequences and by allowing them to do this we have let ourselves down.

 

The high death toll has, in my view, been completely avoidable and a different strategy would have kept mortalities to the similar low levels seen in Australia, Singapore, Taiwan and China. Clearly the government took the virus seriously by implementing the lockdown restrictions and providing financial support to individuals and businesses but it massively underestimated how lethal it was and how rapidly it could spread.

 

The government and its advisers, along with Members of Parliament, the right wing press, spokespersons for many sectors of the economy and individual members of the public, felt it was possible to strike a balance between saving lives on the one hand and economic activity and normal everyday life on the other. These people felt, and mistakenly still feel, that it was possible to suppress the virus to a level which we could live with rather than try to eliminate it.

 

My view has always been that there was, and is, no balance to be struck. It must be lives before livelihoods and the morality of the “balance to be struck” argument should be seen as highly questionable. Moreover, as well as having profound ethical limitations, aiming to return to economic and social normality by lifting restrictions too soon has been a wholly misguided strategy. 

 

It has resulted in the government not being completely focussed on measures to eliminate the virus with the result that the general public has not been completely focused either. It has encouraged the right wing press and a small group of MPs to pursue unfeeling and irrational arguments against restrictions and it has probably heartened those who, for various reasons, are in denial about the magnitude of the disaster.

 

Not with the benefit of hindsight but from the start of the pandemic some of us have been urging the government to show leadership to fight the virus not surrender to it. We should have had immediate, and much tighter, national and local lockdowns which were properly enforced by using the military as kindly but firm Covid marshals. We should have had a government of national unity which would have generated the right spirit of shared endeavour. In this way non-compliance with the restrictions would have been seen as completely anti-social and unacceptable.

 

The government and MPs across the political spectrum should have listened to those of us who were arguing that the only way to defeat the virus was to virtually eliminate it, and that the individual and collective virtues required to achieve this were large quantities of discipline, patience, caution, determination, compassion and kindness. 

 

Tens of thousands of lives would have been saved if the government and decision-makers had led the country with a much more committed and determined attitude. From the outset it should have been fully committed to resolutely defending against the virus and determined in its strategy to destroy it. This could possibly have kept the death toll to under five thousand and it would not have had such a disruptive effect on economic and social activity.

 

Despite the resilience and unselfishness that most people have shown over the past year there has been a lack of discipline from far too many. Large private gatherings should not have taken place, nor should protest marches, and nor should footballers have been hugging each other at the end of a match or when a goal was scored.

 

Sadly, as well as a lack of discipline, there has been some extremely unpleasant innuendo from certain people about the relative value of older and younger lives. I have raised this with those concerned but I am not confident it has had any effect - see open letter.

 

I bear no malice towards the government or our political classes. I am grateful, as everyone should be, for their tireless efforts on our behalf especially in organising lockdowns and, of cousre, rolling out the vaccines. But their overall strategy has been flawed and ill-judged. They have not led us well and in due course must consider their positions. Above all, they, and all of us, must learn from our mistakes as we go forward. We must be determined to eradicate the virus and not learn to live with it. We must be committed to reducing mortalities to single figures in any given week or better still to zero.

 

This must be our future direction. Further national lockdowns should not be necessary but localised restrictions will probably be required for some time to come. We can bring infections right down by introducing Covid certification; having no foreign travel and no arrivals from abroad unless there are urgent personal reasons; continuing with test and trace and monitoring self-isolation; and aiming to vaccinate everyone who is medically fit to be vaccinated. It should go without saying that everyone must comply fully with all restrictions and regulations and meticulously follow guidance on hygiene, social distancing, masks and fresh air.

 

There will be many more unnecessary deaths and no return to normal life until the virus is virtually eliminated from the UK and the rest of the world. It is utterly defeatist to say we must learn to live with it. This deadly enemy of humankind must be chased down and destroyed whenever and wherever it appears. This can and must be done.

 

And it can be done with large quantities of the virtues mentioned above which I will restate: discipline, patience, caution, determination, compassion and kindness.

 

May I suggest to the government, in all humility, that those of us who for the most part were correct in arguing for the strategies that were necessary, must be listened to this time.

 

 

For Coronavirus comments made since the start of the pandemic click here

 

For building back better see: Quercus Manifesto

 

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Thoughts on ...                                                                        23/3/21

 

Why anti-lockdown views have been wrong and deeply damaging

 

An open letter to one opponent of lockdown measures who recently aired his views on the radio, and to all other opponents of lockdown

 

Dear fellow citizen

 

I was concerned to hear on the radio the views you expressed about the restrictions placed on society by the government. I thought I would respond to your points in the hope that you, and those who share your views, will seriously consider what I say and perhaps rethink your position.


You begin by at least acknowledging that the epidemic is serious. You then go on to ask, “is it so serious that it’s worth having the worst recession for 300 years”? This frequently repeated, and empirically unprovable, comparison is unhelpful as it instantly creates a subliminal, alarmist impression that we have to go back 300 years to find our economy in good shape. This is clearly manifest nonsense since our modern economy and standard of living are nothing like they were in the eighteenth century. The UK economy has obviously been seriously damaged as a result of the Covid restrictions but it has been supported by the extensive mitigation strategies put in place. It is impossible to predict the future but there can be some hope that the downturn is temporary. 

 

Your next rhetorical question is whether it is worth “closing the job market to a whole generation of young people emerging from education”. (I take this to mean that there will be no jobs for them rather than that their education has been so blighted they are unemployable.) I can see no reason whatsoever why there will not be a huge job market when there is a return to more or less normal economic activity. In fact there is every likelihood that the range of employment opportunities in this country will be greater than it has ever been with a compelling need for clean energy, more self-sufficiency and the proper funding of social care.

 

Exaggerated and scare-mongering predictions and generalisations about the future which are not evidence based have no place in a rational discussion about the effects of the pandemic on society.

 

Similarly, I find your third rhetorical question a deliberately distorted exaggeration of the present situation. You ask, “Is it worth turning our society into a state where the smallest item of daily life has to be justified potentially before a policeman?” Without wishing to attempt to identify what constitute the smallest items of daily life, and accepting that not complying with legal restrictions, is unlawful, I simply cannot agree with your premise that our society has been turned into a police state.

 

It has not. We have temporary restrictions in place which are essential to stop the spread of infection and protect human life. They have been agreed by parliament and surveys have shown they are supported by a clear majority of the population – about 75% I believe. As you well know restricting people’s liberty to do what they want is the best way of preserving the liberty of everyone – the liberty not to be harmed by the actions of others. It is, again as you well know, the only way any society can function.

 

I cannot support your assertion that “history will look back on this as an utterly disproportionate response”. It will be future historians, not history, who will look back on the government’s and society’s response to the pandemic. I think it is highly probable that many of them will reach the same conclusion that I have, namely that if much tighter restrictions had been implemented much more quickly for both the first and second waves of infection, tens of thousands of lives would have been saved.

 

You go on to say that the fact is that this is a disease which “kills considerably less than 1% of those who are infected”. Like a number of statistics that have been used to support the anti-lockdown argument it is both incorrect and misleading. It is incorrect, according to my maths, because the number of known mortalities, using the low official number (126,000) not the more realistic higher one, as a percentage of the official number of known infections (4.3 million) is 2.9%. It is completely misleading because mortalities are not spread evenly across the whole population which requires the only meaningful statistics to be those that relate to mortalities in different age groups. The percentage of mortalities to infections is a lot higher than 2.9 in older sections of the population.

 

You continue by stating that “it’s a disease from which people die at about 82.4 years old according to the statisticians which is not very different from the age they die from anything else.” Unfortunately statistics such as this give a totally false impression of the realities of any given situation. This one draws attention away from the fact, invariably unacknowledged, that since it is the mean figure there will clearly be a large number of people who live longer than 82.4 and a large number who die younger than this age. The latter fact has, in my view, been given insufficient coverage in the media and has resulted in a false sense of security among younger age groups.

 

It is, however, your comparison of the average age of death from Covid with our overall average death rate that I find deeply disturbing and have done so since the beginning of the pandemic whenever the comparison has been made. It is disturbing because it appears to lend credibility to an argument that is both irrational and seemingly lacks compassion.

 

It is irrational because it is not based upon society’s ethical norms and mores. To my knowledge, society has not yet decreed that human life should begin to draw to a close at around the age of 82 and therefore, irrespective of this being a wholly abhorrent notion, there can actually be no logical reason why it should be a reference point for mortality from any cause.

 

Nor has society, or science, decreed that the quality or value of life is greater when one is younger than 82 because one can do more, be more fulfilled or contribute more. I know many people who are leading full lives and contributing to society over the age of 82 and I am sure you do too. There are many people in public life who are doing the same, amongst them being the Queen, the Pope and David Attenborough. With regard to the value of life it could be argued that it becomes more, not less, precious the fewer the years ahead of us.

 

As for arguments that because one is nearing the end of a normal lifespan it is somehow wrong to expect more, or it is unfair because the elderly are a drain on society’s collective resources, we have devised a system of public expenditure which, so far, has been widely accepted as being necessary to accommodate an ageing population.

 

The same reasons as those above can also be advanced to counter any repugnant beliefs people may have about the value of the lives of those who are disabled in any way or suffering serious illness.

 

Although I fully understand the severe anxiety and distress that many people have suffered over the past year and share your desire for a return to normal in terms of family life, employment and leisure activities, it seems to me that your acceptance that lives should be sacrificed in the interests of normality appears not to reach a sufficiently high level of compassion. The fact is that compassion and love for each other underpins our common humanity. It is a basic human instinct to care for each other especially when we are unable to care for ourselves. It is the great triumph of our species that this instinct has become cemented in society’s structures especially in the areas of health and social care provision.

 

You conclude your opening remarks by saying “It is not worth completely wrecking the future of our children’s generation in order to save that many lives”. Such exaggerated and emotive terms as “completely wrecking” have no place in rational discourse and the fact that the numerical scale of the mortalities is not mentioned hides the enormity of the death toll.

 

You refer to scientists warning from the outset against a stop-go lockdown because this merely shifted deaths from one period to a slightly later period. I don’t know who these scientists were, as I cannot recall this comment being made, but the strategy of lockdowns has dramatically reduced infections and death rates. There has been no scientific reason why a surge in infections should necessarily follow a lockdown. This has not occurred with lockdowns in Australia, New Zealand and Singapore and would not have occurred here if everyone had exercised discipline and caution.

 

You say we should have adhered to an existing plan which involved trying to ensure that life should continue as normally as possible and which also involved isolating the sick and infectious. I imagine on the latter point you are referring to protecting the vulnerable. Leaving aside the fact that isolating millions of people is hardly consistent with the idea of life as normal such a strategy would have led to a vastly increased number of infections, followed by mortalities, in the rest of the population.  This is why lockdowns for everyone were essential.

 

If as human beings we have an instinctive behavioural response to care for each other, as I have suggested, it follows that we should all be willing to  participate in that caring by doing everything we can to protect those around us – our families, loved ones, friends, acquaintances and the billions of people we do not know. Our finest instinct becomes a moral imperative and a social duty.  In present circumstances this requires all of us individually to do our utmost to comply with restrictions for the good of others. We all understand how painful this is in different ways for different people but it is a duty we need to accept.

 

You say we are being coerced into this. You may feel this but I do not believe that most people do. As stated above there has been consistently high support for lockdown according to opinion polls. Some of us have argued for faster and harder lockdowns from the beginning of the pandemic – at the time, not with the benefit of hindsight. I am firmly of the belief that this strategy, properly explained, would also have commanded the support of the vast majority of the British people. It would undoubtedly have saved tens of thousands of lives, possibly as many as 120,000.

 

I feel strongly that your views and those of the small minority who share them, have been deeply damaging in our fight against the virus by undermining our collective determination to defeat it. I accept, of course, that the vaccination programme has been excellent and hopefully in due course will restore some normality to our daily lives. However, for the reasons of which you will be well aware, we need to be cautious about the longer term efficacy of vaccines and should therefore strive for zero Covid here in the UK and globally.

 

As I have said many times in the past year the only way to defeat the virus is to be disciplined, patient, determined, kind and caring. I’m sure you are kind and caring, as are others who share your views, and so I urge you to reconsider your beliefs and join those of us who do not accept we should be defeated by the disease.

 

Yours sincerely

 

Alan Kerr