Saturday 24 October 2020

Taking the right decisions


On the whole, Mark Drakeford has come out rather well for his handling of the pandemic in Wales, with his clear, open, and honest attempts to do what’s right to protect public health and to explain what he’s doing and why. That’s not to say he’s got everything right or that he should be immune from criticism for some of the details, but compared with the bumble and bluster of our next door neighbour he has, quite rightly, enjoyed a large degree of popular support. And I’m sure that, looking at what’s happening over the border, moving to a second lockdown before things get completely out of control is better than the English approach of doing too little, too late. I’m not alone in suspecting that Johnson will be forced to follow suit eventually, but will preside over many more hospitalisations and deaths before that happens. Until that happens, Drakeford may be facing a bit of a bumpy ride from some quarters, asking why something is OK on one side of the border but not on the other. But the ‘Welsh’ Conservatives should be a bit more careful about criticising Drakeford – their words may well come back to haunt them.

The logic of making a distinction between essential and non-essential goods is clear enough. He’s not saying that buying food is safe whilst buying electrical goods, for instance, is not; it’s more a question of trying to ensure that as few people as possible make as few shopping trips as possible, and keep those visits as short as possible – it’s that reduction in contact which will have the required effect, not what people buy when they go into a shop. It might have been better had he explained it simply in those terms. His point about trying to be fair to the smaller shops which can’t open at all by not allowing the supermarkets to hoover up all their custom is also fair and logical, although it rather overlooks the fact that companies like Amazon fill the gap and that both the smaller shops and the supermarkets lose as a result. On-line purchases are better from a disease control point of view than shop purchases, but he may not be doing as much to protect those smaller retailers as he might wish to believe. Another problem is that the definition of ‘essential’ is not at all as straightforward as it appears. Different people in different circumstances will have different needs, and a blanket categorisation doesn’t allow for that.

Sometimes logic isn’t enough or, rather, a different kind of logic needs to be applied. Allowing supermarkets to sell anything and everything that they currently sell would, no doubt, carry a higher level of risk of the disease spreading than curtailing the range of goods sold. But there might be a benefit overall in controlling the spread if it maintained a greater buy-in from the public at large – losing that support carries a real danger as well. It’s a tough call, and somebody has to make it. I’m not entirely convinced that Drakeford has got this one right, but it’s easy for those of us not faced with the decision to criticise it. The thought that up to an extra 1,000 people could die between now and the end of the year if he gets it wrong is clearly weighing heavily on his mind. We should be grateful for that, given the insouciance with which the UK’s PM seems to regard the lives of the old and vulnerable.


Jonathan said...

My UK home is in N.Pembs but I run an office with 4 staff in Liverpool 1. So I cross the border (the famous Pant to Llanymynech) a lot including the famous roadsign "Welsh Covid Rules Apply" with lorries thundering past it. So I see both sides. Wales - I think its valuable simply to remind ourselves and others that we have a border. I like a Welsh 1st Minister taking a different path from England and can put aside other (party) differences and cut him some slack. But the Wales position (I think) is all based on taking the position that science and other political factors point to a lockdown (in whatever form). I do not agree with this position and have signed the Great Barrington Declaration. It is allowed, you know. I have left Wales to its self-destructive lockdown and nonsensical legal distinctions and will carry on as normally as possible - pretty much 100%. The Liverpool view is interesting. I attended a rally at St.George's Hall yesterday, the point being to protest against the lockdown in Liverpool. Young crowd, left wing as you'd kind of expect. I was tipped off about this by the staff in the office who like working normally in the office and are furious about lockdowns. I'm starting to think that Liverpool might revive its Independent Liverpool campaign and maybe end up like Hansestadt Bremen (another port) and Hansestadt Hamburg (yet another port) as "States" in the Republic of Germany. The Welsh have had centuries of child-like subservience to authority, sadly. The Welsh people should at least progress to being stroppy teenagers and start to find their own feet, not necessarily following the Crwban from Cardiff West at all.

John Dixon said...


"...the Wales position (I think) is all based on taking the position that science and other political factors point to a lockdown" I think that's fair comment, and it's also true that the majority of scientific opinion supports the policy being pursued.

"I do not agree with this position and have signed the Great Barrington Declaration. It is allowed, you know." Of course it is allowed to sign the declaration, just as it is allowed to disagree with the scientific consensus about either the danger posed by the virus or the measures being taken against it. And I'll even accept that there is at least a possibility that the majority of scientists are wrong and that the minority are right. 'Science' is not about a majority vote, it's about facts and evidence, and those are things whch can and do change. It will be months - possibly years - before we have a definitive answer to that. The question facing Drakeford et al, though, is this, and it's one that they have to answer now on the basis of what facts and evidence they have in their possession: what are the consequenes of following the majority view and being proved wrong compared to following the minority view and being proved wrong? It isn't a simple question about lives vs the economy - if we follow a path which leads to many thousands more deaths and a lot of long term sickness, that also has an economic cost.

On the infamous declaration itself, even if the authors are right in playing down the degree to which the virus threatens the livs of most of the population, there are a few blindingly obvious flaws in their assumptions. Specifically:

1. They assume that people who have had the virus will develop immunity. As yet, there is no firm scientific basis for that assumption, let alone for any assumption about the duration of that immunity. Whilst we know that Covid follows most other viruses in that the human body creates antibodies, we do not yet know how effective those antibodies are, nor for how long. And if it doesn't create the assumed immunity, the consequences of following their policy are significantly different to those which they project.

2. They assume that it is possible to protect the most vulnerable, but they don't explain how. There's a good reason for that - protecting the vulnerable isn't at all straightforward, and I doubt that it's possible. It doesn't just involve isolating the vulnerable, it also involves isolating those who come into contact with them, and their families, and so on and so on.

3. They assume that those who get the disease and don't die will recover. There's enough evidence already to dispute the validity of that assumption. There are some long-lasting effects about which too little is currently known.

It is, of course, valid for you or anyone else to argue that we should simply accept that the virus is here to stay, and that the 'cure' in terms of the actions required to control it is worse than the disease. But an honest argument along those lines does involve an admission that it is based on accepting a certain (probably large) number of premature deaths. Coming up with alternative science is an attempt to avoid facing up to that.

Spirit of BME said...

The First Minister`s title on Wikipedia is ‘The Right Honourable Professor Mark Drakeford MS’, or in short Mr TRHPMDMS and pursuing a different course to England ,he has made a stella job in getting publicity for Wales on a world stage- well done that man!!!
He has introduced the circuit-breaker shut- down rather than a regional one and the idea came from a leaked SAGE paper created by a mathematics professor in an English University , who when questioned about it stated, that it was only an illustration of an extreme situation and rowed back on its effectiveness, as his view now was that it would only hold off the in-coming tide for a short time.
So, Lab-rats were called for to test this theory, as no one has declared that they know what the outcome will be apart from wreaking the economy, more suicides and delayed medical treatments adding to future avoidable death toll.
I hope and trust that Mr TRHPMDMS has negotiated a fat sum from HM Treasury to compensate for this experiment.

John Dixon said...

Spirit (Part 1),

”… the idea came from a leaked SAGE paper created by a mathematics professor in an English University…” I’m not sure that this is an entirely accurate description of what happened – I had thought that it was in a bundle of papers released by SAGE. But what is true, without doubt, is that, on the basis of modelling papers which they received, whether published formally or not, SAGE as a whole (and not just one individual member or adviser) has been recommending for some time that a fire-break or circuit-breaker be implemented for the whole UK.

” … [who] stated, that it was only an illustration of an extreme situation…” Well, yes, any modelling is only based (and can only be based) on the assumptions used, and the numbers can only ever be illustrations of possible outcomes based on those assumptions.
” … [and added], his view now was that it would only hold off the in-coming tide for a short time.” I don’t believe anyone would disagree with that; the question is about what it means in real terms. The firebreak instituted by Drakeford will not, in itself, solve anything. What it will do (and we can be reasonably certain about this given the experience of lock down earlier this year) is reduce the rate of transmission in the short term, buying time for other actions to be taken. But if other actions are not then taken, then it will merely have temporarily delayed the progress of the pandemic in Wales. That has been the problem of the lockdown – the time so expensively bought was not used to put effective other strategies in place.

”… as no one has declared that they know what the outcome will be…” That’s true, I agree. But neither does anyone know what the outcome will be without the firebreak. Faced with two unknown outcomes, we have to make a choice, and it isn’t an easy one.

”… more suicides…” People often refer to suicides as one cost of a lockdown, but if economic hardship pushes people into suicide is that ultimately a health problem or a financial one? If government fully protected the income of those impacted by the virus, would that not make a difference? (And it would also help virus control by incentivising isolation rather than de-incentivising it.)

”… delayed medical treatments adding to future avoidable death toll.” It is true that many other medical treatments got delayed during the previous lockdown. But was it really the lockdown which caused the delays? I think it was actually that doctors, nurses, beds and other resources were diverted into caring for the victims of COVID. If there isn’t a lockdown, and cases rise faster as a result, doesn’t that make the situation worse rather than better?

John Dixon said...

Spirit (Part 2),

Here’s what I think we do know, with a reasonable degree of certainty:

1. Left unchecked, the virus will prematurely kill many thousands of people in Wales / UK – anything up to around 1% of the population. This will be mostly (but not exclusively) the old and the vulnerable. When people talk about naturally developing herd immunity, what they usually don’t mention is that the way that nature achieves herd immunity is precisely by killing off the most vulnerable.

2. At this stage, we don’t even know whether having had the virus leads to immunity, nor how long that immunity lasts. It’s at least possible that we’ll face an annual repeat if the virus is not controlled.

3. A firebreak in itself will merely delay the progress of the virus; without a serious and effective operation to trace, track and isolate carriers (or the availability of an effective vaccine), the virus will simply continue to spread through the population after the firebreak ends.

4. The firebreak (or any other form of lockdown) will be costly in financial terms, but so would simply allowing the virus to spread.

You refer to the firebreak as an ‘experiment’. I agree that it is. Letting the virus run freely would also be an experiment. Any action taken in response to a new and unique set of circumstances is going to be an experiment to an extent at least. The question is – which experiment do you want to be part of?

Spirit of BME said...

Your summing up is a balanced view of things.
You and I are experiencing our third pandemic and taking those experiences into mind the hard truth is (to put politely) this fire will always seek dry tinder until it is staved of it .So going ‘unchecked’ is not an unknown.
Herd immunity can come from a vaccine, which I do not think will happen soon, or the natural build-up of the virus in society, or the virus mutates and gets less aggressive.
The great unknown is what level of immunity we are at, as Sage states 7% (when I last looked ) others say 30% and some state that the coronavirus we already have from past flues could make it as high as 60%,although this has not been proven.
I am told when it hits 60% it is in dramatic decline.
The one great certainty is, if you and I knew the answers we could make a fortune.