Thoughts from Pontevedra, Galicia, Spain: 6.7.21

Night’s candles are burnt out, and jocund day stands tiptoe on the misty mountain tops.

Spanish life is not always likeable but it is compellingly loveable.  

– Christopher Howse: ‘A Pilgrim in Spain’

Cosas de España/Galiza

Good news: Despite the increase in virus cases, Galicia’s tourism sector has succeeded in gaining bookings and occupation rates of 70 and 80% are expected for July and August, respectively.  Those who’ve come in the last week will have learned of the vagaries of our weather. But I’m sure they’ll all have brought rainwear, given our reputation for 24 hour rain, 365 days a year.

Bad news: Despite the price-reduction measures announced by the government, increases won’t stop and are expected to total €139 over the rest of the year. For the average family, I guess 

Just news: The more successful of our (many) narcotraficantes have decided to muscle in on the rich pickings of the hash trade down South. Should lead to a few battles.

The UK

Covid: Below is the latest – shocking – review of the governments’s failures, from the medical correspondent of Private Eye. Will Boris Johnson ever pay the price for his poor leadership? Very probably, as “All political lives end in failure”. The only question is When.

A propos . . . Failures of State: The Inside Story of Britain’s Battle with Coronavirus.

Quote of the Day

As restrictions ease. . . The great mask debate isn’t really about clinical efficacy or the coherence of the rules. It’s about signalling the sort of person you are. Are you freedom-loving and rational, or socially responsible and selfless?  

The Way of the World

More than a third of Brits aged 30 to 49 have stopped talking to someone over a political stance but less than 20% of people aged 50 to 64 have done so. The study found that “wokeness” and “cancel culture” were becoming a dividing line in the UK. 

Finally  . . .

In the crazy world of fashion, an ounce of ostrich feathers was once – in the 19th century – worth more than an ounce of gold.

Note: If you’ve arrived here looking for info on Galicia or Pontevedra, try this.  


Cock and bull 

Dominic Cummings’ 7-hour confession to the joint inquiry of the health and social care committee and science and technology committee upped the ante on prime minister Boris Johnson and health secretary Matt Hancock by alleging one to be “totally unfit to govern” and the other “a serial liar”. 

Whether he has the data to back up his claims remains to be seen. But another Covid wave would play into his fantasy of pinning the blame on two people (one of whom he helped install in power). We already know tens of thousands of people might still be alive if the government had made different decisions, but that applies to many governments. Indeed, according to an international independent inquiry, the whole pandemic was a huge failure of global governance and an avoidable tragedy to boot. 

We’re doomed . . . 

The UK advisers’ view at the pandemic outset was that we were doomed, nothing would work and we could only hope to spread out the inevitable high death toll. Boris Johnson’s view at the outset was that it was no worse than 

swine flu and it was OK to shake hands with people in hospitals when advised not to. MD’s view at the outset was that a pandemic would be prevented by swift global action, as it was with SARS-CoV-1 in 2003. We were all wrong. 

Persistent bollocks 

Many ministers and advisers have persisted with a party line they know is bollocks. Anyone who says any of the following is either lying or woefully misinformed . . ,. 

I. We were well prepared for the pandemic 

2. Herd immunity was never the plan 

3. We put a protective ring around care homes 

4. There were no PPE shortages 

5. We protected the NHS 

The best chance of stopping the pandemic was at source. In the unlikely event of China having a public inquiry, we might finally discover whether the virus came from a bat cave or a laboratory, and what early opportunities to contain it were squandered. Once it reached our borders, via Europe, we had a defeatist pandemic plan based on influenza to guide us until more evidence emerged. Countries that had experienced the horrors of SARS-CoV-1 in 2002 were guided by the urgent need to keep it out at any cost. 

That expert advice in full . . .

2011 UK flu plan: In January 2020, the UK used its pandemic flu planning as the default for Covid, and waved the white flag. The 2011 advice stated: “It will not be possible to halt the spread of a new pandemic influenza virus, and it would be a waste of public health resources and capacity to attempt to do so.” 

2014 UK flu plan: “International travel restrictions are highly unlikely to interrupt the spread of an epidemic significantly.” 

2016 Exercise Cygnus: In 2016, Exercise Cygnus, aka Exercise Sittng Duck, modelled for a “swan flu pandemic” and concluded: “The UK’s preparedness and response, in terms of its plans, policies and capability, is currently not sufficient to cope with the extreme demands of a severe pandemic that will have a nationwide impact across all sectors.” 

We had 4 years to put it right, but the government opted for more austerity before the Treasury miraculously found £372bn to bail us out of the pandemic. We didn’t improve our preparation. Our stockpile of essential PPE was inadequate and in some cases out of date. We didn’t have a plan for mass testing. And with our overloaded health services and shocking levels of obesity and chronic disease, we truly were sitting ducks. 

2017 risk register: The 2017 UK national risk register estimated that 20,000-750,000 people could die in the event of a pandemic flu-like illness. It prompted no action. 

Following the science . . .

21 January 2020: The UK’s NERVTAG (New and Emerging Respiratory Virus Threats Advisory Group} estimates that closing the border to 50%of passengers – its toughest sanction – should not be recommended as this would “only delay an epidemic in the UK, not prevent one”. So we kept borders open and imported the virus on at least 1,536 occasions from Spain, Italy and France in February and March 2020. 

22 Jan: SAGE agrees with NERVTAG that border screening would be ineffective, and says we should hand out leaflets and posters asking any sick passengers to come forward instead. 

30 Jan: The World Health Organization raises the risk of the coronavirus outbreak to its highest level, a public health emergency of international concern (PHEIC}. It warns that “all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread”. However, it does not recommend face masks or border controls. 

3 February: The government’s Scientific Pandemic Influenza Group on Modelling, Operational sub-group (SPI-M-O) is less optimistic: “It is unclear whether outbreaks can be contained by isolation and contract tracing. If a high proportion of asymptomatic cases are infectious, then containment is unlikely via these policies.” 

11 Feb: SPI-M-O recommends the government should not close down mass gatherings. 

18 Feb: SAGE advises that “when there is sustained transmission in the UK, contact tracing will no longer be useful”. Which is just as well, as it only has contract tracing capacity for 5 cases per week (requiring 800 contacts). At a push it could manage 50 cases a week. 

25 Feb: Public Health England (PHE) issues guidance for care homes that says it is “very unlikely that people receiving care in a care home or the community will become infected”. Staff are told they need not wear masks, because they “do 

not provide protection from respiratory viruses”. 

The same day, “herd immunity” appears in SAGE minutes based on an Imperial College paper, which declares that measures that are “too effective” merely delay transmission. It postulates allowing the disease to spread and “fine-tuning” infections until the UK population has reached herd immunity. 

26 Feb: SAGE suggests that suppressing Covid like in Hong Kong and China “would result in a large second epidemic once measures were lifted”. The “preferred outcome for the NHS” might be to allow some disease to spread while reducing the peak. 

3 March: SAGE writes: “There was agreement that Government should advise against greetings such as shaking hands and hugging, given existing evidence about the importance of hand hygiene.” Boris Johnson tells a televised press conference: “I was at a hospital the other night where I think there were a few coronavirus patients and I shook hands with everybody, you will be pleased to know, and I continue to shake hands.” 

The government launches the “contain” phase of its corona virus action plan, described as “detect early cases, follow up close contacts, and prevent the disease taking hold in this country for as long as is reasonably possible”. 

4 March: Adverts promoting face masks as protection from Covid are banned in the UK. PHE says masks are ineffective and instead urges more hand-washing to delay the spread of the virus. SAGE advises that introducing social distancing measures could potentially decrease the total number of deaths by around 20-25%, and substantially reduce the peak of the infection. It still believes that cancelling large-scale public events wouldn’t contain the outbreak. 

Herd it all before . . . 

5 March: SAGE again refers to a herd immunity strategy, allowing healthier people to gradually catch the virus and develop immunity while “cocooning” those more likely to die if infected. The UK “optimal policy” is to avoid strong measures to suppress the virus early on, allowing infections to develop over the summer months while suppressing the peak to 4,500 deaths per day, and reaching herd immunity by September. Modelling assumes that suppression measures can be sustained for a maximum of 3-4 months, so introducing early lockdown-style measures to stop the disease is judged likely to lead only to a more deadly resurgence later on when they are lifted. 

6 March: Care home workers are still operating under February guidance that “face masks do not provide protection from respiratory viruses such as Covid-19 and do not need to be worn by staff”, NERVTAG reports that much of the UK’s limited stockpile of high grade respirators is being used up and “there are concerns that there may not be enough FFP3 stock for use later on when it may be needed”. NERVTAG explains why masks are discouraged for the public but recommended for healthcare staff. Unlike the public, trained healthcare staff “know when to change the masks when they become soggy”. 

l2 March: The government announces that it will stop all community testing for SARSCoV-2 infections and focus instead on testing people in hospitals as it moves from the “contain” phase to the “delay” phase (aka Operation Sitting Duck). 

16 March: The UK strategy of “herd immunity” (aka “mitigation” or “single peak”) aims to reach population immunity in one surge before September, with 40m lower-risk citizens taking it on the chin while the higher-risk citizens hide. Alas, a new SAGE model predicts 259,000 deaths would result, with NHS intensive care capacity overwhelmed eightfold. 

17 March: First use of the word “lockdown” in SAGE minutes. We lock down six days later. 

2 April: The government publishes advice to care homes. It states that some patients “may have Covid-19, whether symptomatic or asymptomatic. All of these patients can be safely cared for in care homes if the guidance is followed.” It also states that “negative tests are not required prior to transfers/admissions into the care home”. 

5 April: Boris Johnson is admitted to hospital with Covid. 

I5 April: Prior testing before discharge to a care home becomes mandatory* (*er, where available). 

Testing truths 

Government advice on testing and tracing has flip-flopped from “no point” to “can’t be done” to “essential for those with symptoms” to “test the whole country, symptoms or not”. We could have done as the WHO advised on 

30 January 2020 and massively ramped up our test and trace capacity early. Taiwan and Germany did. We didn’t. 

Protecting the NHS 

Ww did not protect the NHS or patients. We didn’t have sufficient PPE or tests. Tens of thousands caught the virus inside hospitals and many died. ITU just about coped by dangerously understaffing its units and pushing staff to the point of exhaustion. Many now have crippling long Covid. Many patients have suffered and died because they couldn’t access non-Covid care. Waiting times will take years to come down. General practice is in meltdown. In hindsight, and now, stopping the virus at our borders is a much better plan. 

Freedom postponed? 

No one  knows what will happen after 21 June. The government needs to treat us as adults and share all the data and modelling that informs whatever decision it makes. As with any treatment, there is no guarantee. But we need to know the benefits, risks, alternatives and unknowns of any decision, and what the safety net is if shit happens again. 

The government should also revisit its pandemic management, admit to errors and apologise for them. Many scientists at the time raised concerns that delayed lockdowns would cause thousands of needless deaths. For the millions of people harmed by Covid, Dominic Cummings’ recent allegations merely add to the pain, and 5 years is- a long time to wait for the public inquiry’s verdict. The government needs to grow up and ‘fess up now. With evolving variants, herd immunity may never be fully achieved, even with global vaccination. But it remains our best shot at freedom . . .