Showing posts with label infection. Show all posts
Showing posts with label infection. Show all posts

Saturday, 11 July 2020

What is wrong with this Government? Can it not get anything right?

I was writing this as Johnson announced further relaxations...

At the outset I have to confess a serious distrust of all Tories and a horror of corruption in high places. So there is no chance I shall be soft in my criticism of Johnson and co. Still less when they have committed the cardinal sin of allowing a special adviser to take such extraordinary control over governmental affairs.
And of course panic causes strange effects. And there has never been more reason for panic than the onset of a killer virus that is a global pandemic. And one for which there is no obvious treatment and as yet no real sign of a vaccine.
But frankly events of the past few months go much further than mere failure to come up to scratch in the extraordinarily tough environment of a global catastrophe.
It all started with the utterly insane idea of 'herd immunity'. For that you need 60-70% of your sample to have had the disease AND be guaranteed immune. That might be OK for the common cold but this things kills and leaves others virtually disabled for life. And while spread is uncomfortably fast it is also too slow to wait that long. The man who said it should have been removed as far from the levers of power as possible. The Isle of Rockall for example. But instead they invited him in... and he is still here!

At my age and with my experience of emergency planning I am utterly astonished at the mess we have got ourselves in. Until, that is, I consider the previous decade of austerity.
Emergencies are planned for. That is a given, or should be. They always happen. Usually at the worst possible time. But this is what you have a Civil Service for. Complete with scientific and medical and technological and logistical expertise to look into the future, judge the need, and provide the essentials.
But the Tories are notoriously bad at planning ahead. And even worse at spending in advance of need. And worse still at laying the foundations of a public and welfare state.
So in the years of austerity they have cut and cut again. And those cuts have more than decimated our levels of preparedness. Made far worse by an accountancy juggle called Just In Time. And another called Current Cost Accounting.

Let me explain a little. Under older regimes you bought in advance what you needed for say one year's production, generation, activity, emergency. And stockpiled it. This was, the bean counters considered too costly. Expensive warehouses, armies of men with clip boards checking date, lifetime etc.
How much better they said to make it when you need it. So empty the warehouses, sack the checkers. Calculate your costs on the real costs, not cost plus storage and maintenance. Prices will come down. Prices did not come down. You may have noticed a steady rise.

And then there was the cost of building stuff. Depreciation. Build a hospital for £100m and calculate that it would lose value at say £5m a year, reaching zero at 20 years when replacement needed to be considered. But wait. That might be OK for Government but businesses need assets. So value the hospital at the cost of replacement RIGHT NOW. That way the asset would grow year on year and you could borrow squillions against the assets. Privatise those state businesses and guess what? They all use CCA instead of Historic Cost Accounting. They all have inflated asset books and vast debts, protected by assets that are actually not worth much at all.

How does this affect Government and emergency planning? Well for emergencies you need hospitals bigger than you do for day by day activity. So some wards were maintained but kept empty against sudden need. Some Intensive Care Units (or HDUs or whatever) ditto. And a score or two of big stuff like ventilators. If you do not have them when the crisis comes you have to build Nightingale units Just In Time.. too late!

And PPE? Yes of course, millions of items in store, kept under review and replaced as time wore on. Hand it all to the private sector and guess what? They dump it, fail to replace, argue for Just in Time (while actually CCA-ing the stuff!). And yes they did. So no PPE when it is needed. And you are not in the buying club either so a scramble to find it when you need it. People die.
And arrangements to use private services? Not kept up to date so not available at time of need. And so thousands of elderly crisis patients are sent back to care home to make space in the hospitals for the crisis you failed to plan for. And thousands die in agony, killing many of their carers.
And now we read of vast millions of contracts placed with unqualified and even insolvent companies to supply critical equipment. And without any safeguarding procedures. And often with mates of cabinet members.

And the much-vaunted Civil Service, who know about all these things and have done for years? Retired, redundant, too costly, austerity.... replaced with unskilled, incompetent special advisers with agendas and secret deals.

You can only blame Johnson and his bunch of buffoons. They were picked for their enthusiasm for Brexit, not their intelligence, experience or proven skills. They are incompetent and inept. They listen too willingly to their backers and their special advisers, fooled into believing these people know best.

Meanwhile the relatively few Tories with real public service ethics have been sidelined or left to grow old and go fallow. There is no way back for a generation. This cadre of clowns has been given five years (FIVE YEARS) to govern by another crackpot decision. They are praying that two things will happen: 1 - we will all forget what utter idiots they were and 2 - that in time they will get the hang of it.
Meanwhile people die, people go hungry, children miss school, families collapse, suicides happen, jobs vanish, food fails to reach the shelves, prices soar, medicines disappear, prices soar, theatre and halls close, libraries vanish, museums get dusty, HS2 never appears but costs squillions, Trident gets replaced but still isn't any use...
Can we really let this go on for another four years?


Monday, 18 May 2020

Has coronavirus murdered the bucket list?

HOW likely are you to go jetting around the world after we finally escape from coronavirus? Will you really want to spend 10 or more hours in an aircraft with 2-300 other people, all breathing very much the same air just to say 'been there, done that'? Really?
If we examine first what turned a Wuhan epidemic into a world wide pandemic killing hundreds of thousands of innocent people we find it was aviation what dunnit.
China is not the place it was a few decades ago. No way. Today it is as highly connected as any other country.
And the people of Wuhan – all umpty-ump millions – are just like us. They have bucket lists and reasons to fly far and wide.
So when sometime in December 2019 the first few people got infected with coronavirus they had not the foggiest idea it had happened. Neither did anyone else at first. So they got on their planes and flew far and wide. And into Wuhan came many thousands more who sampled the delights and set off home, with more souvenirs than they realised.
It is no good blaming China for this part of the disaster – they knew no more in the first few days than anyone else. Forget where the virus started – once it was travelling it was inevitably going to be a pandemic. Days would pass before any symptoms raised alarm bells.

Looking back at the great influenza pandemic of the post WWI decade and which killed in the multi-millions, what spread that was soldiers going home. It originated maybe in Spain but it took the armies of the suddenly peaceful world to get it world-wide.
So here at Wuhan. And we know it and the airlines of the world are virtually grounded. Or should be. And the cost of this disaster, which their profitable activities took to the world, is so great that they will never be the same again. No really, never.
For even when they begin to fly again they will be a shadow of their former selves. And I believe we, their customers, will be harder to find. Much harder.
For not only will we all be a lot more cautious but two economic realities will bite hard. We will all have less money to spend, recovering individually and nationally, and the cost of flying will never be as low as it was 2019.

We all know more
today about the reality of what happens on board. At 30,000 feet the air is thin as Everest and bitterly cold – sub-zero. Aircraft cannot carry oxygen for their passengers so they use what they have in the cabin and draw in and heat up extra – about 25-30%. They operate the cabin at about 9lbs per sq in instead of the 14.8lbs at ground level.
To be fair this gives them a complete air change every few minutes. But pretty much all of it will have passed through pretty well all of the lungs on board by then...
And while on the ground the air is mostly still and most viruses fall harmlessly down, in the cabin it is different. Your mouth throws air and virus-laden droplets forward. They are heavy and affected by air resistance so they fall down and six feet is safe. In the air they fall into the back of the seat in front and hair of the occupant. And your nose points down, for a reason. A sneeze generates droplets at 200 mph. Should you sneeze (and who does not at 500 knots in dry cabin air?) those droplets will fall in your lap or on you magazine or tray. The cabin air is on the move all the time. Those droplets could be anywhere in a few seconds.
Of course in a full load of say 250 passengers your average 757 or A380 the manifest will include only a few coronavirus carriers. Say back in Wuhan there were four on each flight out. The re-infection number (R) back then was high, maybe 3-4. So in the first hour say the four infected 12-16. They in turn hit 36-48 in the next hour and they got say 120 in the next... by the time they landed practically everyone on board, including crew, could be infected.
Life is never quite that cruel but even if only 50 stepped off with the virus the outlook was already pretty grim. And that was one aircraft.

When the airlines get flying again is an open question and what rules they will have to follow is unknown as yet. But one thing I suggest is certain. And leads to another:
  • Unless we have a vaccine the rules will be draconian.
  • And even if we do, only those WITH immunity will get free, unfettered travel.
I suggest the first real casualty in the travel industry will be the bucket list.