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Showing posts with label corona. Show all posts
Showing posts with label corona. Show all posts

Tuesday 1 June 2021

If the Wuhan lab-leak hypothesis is true, expect a political earthquake

 Thomas Frank in The Guardian


‘My own complacency on the matter was dynamited by the lab-leak essay that ran in the Bulletin of the Atomic Scientists earlier this month.’
‘My own complacency on the matter was dynamited by the lab-leak essay that ran in the Bulletin of the Atomic Scientists earlier this month.’ Photograph: Thomas Peter/Reuters
 

There was a time when the Covid pandemic seemed to confirm so many of our assumptions. It cast down the people we regarded as villains. It raised up those we thought were heroes. It prospered people who could shift easily to working from home even as it problematized the lives of those Trump voters living in the old economy.

Like all plagues, Covid often felt like the hand of God on earth, scourging the people for their sins against higher learning and visibly sorting the righteous from the unmasked wicked. “Respect science,” admonished our yard signs. And lo!, Covid came and forced us to do so, elevating our scientists to the highest seats of social authority, from where they banned assembly, commerce, and all the rest.

We cast blame so innocently in those days. We scolded at will. We knew who was right and we shook our heads to behold those in the wrong playing in their swimming pools and on the beach. It made perfect sense to us that Donald Trump, a politician we despised, could not grasp the situation, that he suggested people inject bleach, and that he was personally responsible for more than one super-spreading event. Reality itself punished leaders like him who refused to bow to expertise. The prestige news media even figured out a way to blame the worst death tolls on a system of organized ignorance they called “populism.”

But these days the consensus doesn’t consense quite as well as it used to. Now the media is filled with disturbing stories suggesting that Covid might have come — not from “populism” at all, but from a laboratory screw-up in Wuhan, China. You can feel the moral convulsions beginning as the question sets in: What if science itself is in some way culpable for all this?

*

I am no expert on epidemics. Like everyone else I know, I spent the pandemic doing as I was told. A few months ago I even tried to talk a Fox News viewer out of believing in the lab-leak theory of Covid’s origins. The reason I did that is because the newspapers I read and the TV shows I watched had assured me on many occasions that the lab-leak theory wasn’t true, that it was a racist conspiracy theory, that only deluded Trumpists believed it, that it got infinite pants-on-fire ratings from the fact-checkers, and because (despite all my cynicism) I am the sort who has always trusted the mainstream news media.

My own complacency on the matter was dynamited by the lab-leak essay that ran in the Bulletin of the Atomic Scientists earlier this month; a few weeks later everyone from Doctor Fauci to President Biden is acknowledging that the lab-accident hypothesis might have some merit. We don’t know the real answer yet, and we probably will never know, but this is the moment to anticipate what such a finding might ultimately mean. What if this crazy story turns out to be true?

The answer is that this is the kind of thing that could obliterate the faith of millions. The last global disaster, the financial crisis of 2008, smashed people’s trust in the institutions of capitalism, in the myths of free trade and the New Economy, and eventually in the elites who ran both American political parties. 

In the years since (and for complicated reasons), liberal leaders have labored to remake themselves into defenders of professional rectitude and established legitimacy in nearly every field. In reaction to the fool Trump, liberalism made a sort of cult out of science, expertise, the university system, executive-branch “norms,” the “intelligence community,” the State Department, NGOs, the legacy news media, and the hierarchy of credentialed achievement in general.

Now here we are in the waning days of Disastrous Global Crisis #2. Covid is of course worse by many orders of magnitude than the mortgage meltdown — it has killed millions and ruined lives and disrupted the world economy far more extensively. Should it turn out that scientists and experts and NGOs, etc. are villains rather than heroes of this story, we may very well see the expert-worshiping values of modern liberalism go up in a fireball of public anger.

Consider the details of the story as we have learned them in the last few weeks:

  • Lab leaks happen. They aren’t the result of conspiracies: “a lab accident is an accident,” as Nathan Robinson points out; they happen all the time, in this country and in others, and people die from them.
  • There is evidence that the lab in question, which studies bat coronaviruses, may have been conducting what is called “gain of function” research, a dangerous innovation in which diseases are deliberately made more virulent. By the way, right-wingers didn’t dream up “gain of function”: all the cool virologists have been doing it (in this country and in others) even as the squares have been warning against it for years.
  • There are strong hints that some of the bat-virus research at the Wuhan lab was funded in part by the American national-medical establishment — which is to say, the lab-leak hypothesis doesn’t implicate China alone.
  • There seem to have been astonishing conflicts of interest among the people assigned to get to the bottom of it all, and (as we know from Enron and the housing bubble) conflicts of interest are always what trip up the well-credentialed professionals whom liberals insist we must all heed, honor, and obey.
  • The news media, in its zealous policing of the boundaries of the permissible, insisted that Russiagate was ever so true but that the lab-leak hypothesis was false false false, and woe unto anyone who dared disagree. Reporters gulped down whatever line was most flattering to the experts they were quoting and then insisted that it was 100% right and absolutely incontrovertible — that anything else was only unhinged Trumpist folly, that democracy dies when unbelievers get to speak, and so on.
  • The social media monopolies actually censored posts about the lab-leak hypothesis. Of course they did! Because we’re at war with misinformation, you know, and people need to be brought back to the true and correct faith — as agreed upon by experts.
*

“Let us pray, now, for science,” intoned a New York Times columnist back at the beginning of the Covid pandemic. The title of his article laid down the foundational faith of Trump-era liberalism: “Coronavirus is What You Get When You Ignore Science.”

Ten months later, at the end of a scary article about the history of “gain of function” research and its possible role in the still ongoing Covid pandemic, Nicholson Baker wrote as follows: “This may be the great scientific meta-experiment of the 21st century. Could a world full of scientists do all kinds of reckless recombinant things with viral diseases for many years and successfully avoid a serious outbreak? The hypothesis was that, yes, it was doable. The risk was worth taking. There would be no pandemic.”

Except there was. If it does indeed turn out that the lab-leak hypothesis is the right explanation for how it began — that the common people of the world have been forced into a real-life lab experiment, at tremendous cost — there is a moral earthquake on the way.

Because if the hypothesis is right, it will soon start to dawn on people that our mistake was not insufficient reverence for scientists, or inadequate respect for expertise, or not enough censorship on Facebook. It was a failure to think critically about all of the above, to understand that there is no such thing as absolute expertise. Think of all the disasters of recent years: economic neoliberalism, destructive trade policies, the Iraq War, the housing bubble, banks that are “too big to fail,” mortgage-backed securities, the Hillary Clinton campaign of 2016 — all of these disasters brought to you by the total, self-assured unanimity of the highly educated people who are supposed to know what they’re doing, plus the total complacency of the highly educated people who are supposed to be supervising them.

Then again, maybe I am wrong to roll out all this speculation. Maybe the lab-leak hypothesis will be convincingly disproven. I certainly hope it is.

But even if it inches closer to being confirmed, we can guess what the next turn of the narrative will be. It was a “perfect storm,” the experts will say. Who coulda known? And besides (they will say), the origins of the pandemic don’t matter any more. Go back to sleep.

Monday 17 May 2021

Why the suspicion on China’s Wuhan lab virus is growing

 Tara Kartha in The Print


Members of the World Health Organization (WHO) team at the Wuhan Institute of Virology | Photographer: Hector Retamal/AFP/Getty Images via Bloomberg
 

It’s been nearly eighteen months since the coronavirus brought the world on its knees, with India in the middle of a deadly second wave that is claiming 4,000 lives daily on an average. No one can tell when this will end. But it is possible to probe how this catastrophe began, and China’s role in it. Fortunately, even as cover ups go on. Several reports are out in the public domain and anybody who isn’t afraid of speaking the truth should be able to connect the dots.

One report out is that of the Independent Panel, set up by a resolution of the 73rd World Health Assembly. The specific mission of the committee was to review the response of the World Health Organization (WHO) to the Covid outbreak and the timelines relevant. In other words, it was never meant to be an inquisition on China. And it wasn’t. Not by a long chalk. It went around the core question of the origin of the virus, even while indulging in what seems to be pure speculation. Then there are two recent publications investigating the origin of the virus, which are worthy of note. Neither are written by sage scientists, but by analysts viewing the whole sequence of events through the prism of intelligence. Which means that these efforts skip the big words, and get to the facts. Collate all these different sources, add a little more of the background colour, and you start to get the big picture. 

Is this biological warfare?

The need to find out the truth becomes urgent as the situation worsens, for instance with dangerously high death rates in Aligarh Muslim University, where there is now speculation whether the deaths could be linked to a separate strain. There are arguments that India’s second wave could be a deliberate one, especially since the ‘double mutant’ has not hit any of its neighbours. Such speculation is likely to rise, given that China has now effectively closed any possibility of withdrawal from Ladakh, and the Chinese economy goes from strength to strength, growing a record 18.3 per cent in the first quarter of the new financial year. Unsurprisingly, even world leaders, like Brazil’s President Jair Bolsonaro, have linked the pandemic to biological warfare.

Arising from this is the biggest potential danger: someone may decide to respond in kind in a bid to fix Beijing. That’s how intelligence operations work. After all, major countries haven’t been funding their top secret labs for nothing. In any scenario, there’s some serious trouble ahead, especially since the Narendra Modi government seems to be more intent on playing down the crisis than addressing it. 

The Independent Panel 

The panel’s mandate is set out clearly in the May 2020 resolution, which calls for “a stepwise process of impartial, independent and comprehensive evaluation…to review experience gained and lessons learned from the WHO-coordinated international health response to COVID-19…” and thereafter provide recommendations. This the panel undoubtedly did.

The 13-member panel included former Prime Minister of New Zealand Helen Clark, former President of Liberia who has core expertise in setting up health care after Ebola, an award winning feminist, a former WHO bureaucrat, and a former Indian health secretary, who had six months experience in handling the first Covid wave, was on innumerable panels on health, and in the manner of civil servants in this country, also did a stint in the Ministry of Defence, not to mention the World Bank. The Indian representative certainly gives the whole exercise the imprimatur of legality, given hostile India-China relations. And finally, Zhong Nanshan who was advisor to the Chinese government during the Wuhan outbreak, and who received the highest State honour of the Medal of the Republic from his President—Xinhua describes him as a “brave and outspoken” doctor.

The WHO also lists Peng Liyuan as a Goodwill Ambassador, describing her as a famous opera singer. She is the wife of President Xi Jinping. It’s,therefore, entirely unsurprising that while the panel diligently shows WHO the sources of early warning, it makes a vague case on the origins of the virus, noting that while a species of bat was “probably” the host, the intermediate cycle is unknown. Most astonishingly, the committee states that the virus “may already have been in circulation outside China in the last months of 2019”. No evidence for that either. The overall tenor of the report is that it would take years to sort all this out.

There is only one paragraph of note from the point of view of those seeking the truth.

The panel’s report states that less than 55–60 per cent of early cases had been exposed to the wet markets, and that the area merely “amplified” the virus. In other words, the market, with its hundreds of exotic wildlife, could not have been the source. It, however, carefully notes that the Wuhan Institute of Virology (WIV) sequenced the entire genome of the virus almost within weeks, and later provided this to a public access source. The report praises the diligence of clinicians who managed to isolate the virus within a short time. That’s wonderful all right. No question. But it doesn’t at all address the question whether those diligent researchers were also experimenting on the virus. 

That troubling question

These assessments by the Independent Panel are now, however, being questioned, leading to bits of intelligence being pieced together from within a country that would put the term ‘Iron curtain’ to shame. An earlier WHO study on the virus’ origin was roundly condemned by a group of countries,including the US, Australia, Canada and others (not India) as being duplicitous in the extreme.

In January 2021, the US Department of State released a Fact Sheet on activity of WIV, which is entirely based on intelligence. That factsheet is damning, indicating that several researchers at the institute had fallen ill with characteristics of the Covid virus, thus showing up senior Chinese researcher Shi Zhengli’s claim that there was “zero infection” in the lab. The lab was the centre of research of the SARS virus since its first outbreak, including on ‘RaTG13’ virus found in bats, and which is 96 per cent similar to the present virus SARS-COV-2. Worst, it also pointed out that “the United States has determined that the WIV has collaborated on publications and secret projects with China’s military. The WIV has engaged in classified research, including laboratory animal experiments, on behalf of the Chinese military since at least 2017”.

That’s intelligence. Now for the analysis — the two recent publications probing the virus’ origin. 

Disaggregating the facts 

One analytical article is published in the prestigious Bulletin of the Atomic Scientists. Another is a paper by the equally reputed Begin Sadat Centre for Strategic Studies. Both are a careful collation of facts, and establish the following.

The paper by Begin Sadat Centre brings out additional information that bolsters the US Fact Sheet. It appears that the US had been able to get a ‘source’ from WIV directly, and that another Chinese scientist had defected to an unknown European country. That led directly to information on the military side of the programme. The study also quotes David Asher, who led the Department of State investigation. Asher observes that the WIV had two campuses, not one, as popularly believed. This was known by the Indian authorities for years, but does not seem to have been put about. Asher also adds that all mention of the SARS virus was dropped from the institute’s publicly admitted biological “defence programmes” by 2017 at the same time when the Level 4 lab kicked off operations.

Even more surprising was that an adjacent facility had already administered vaccines to its senior faculty in March 2020 itself. That doesn’t suggest an accident. That suggests a program that was designed to kill, and for which vaccines were already under research. Then there damning studies stated: “There are plenty of indications in the sequence itself that [the initial pandemic virus] may have been synthetically altered. It has the backbone of a bat [coronavirus], combined with a pangolin receptor binder, combined with some sort of humanized mice transceptor. These things don’t actually make sense (and) …..the odds this could be natural are very low… [but this is attainable] through deliberate scientific ‘gain of function research” that was going on at the WIV.

There is no doubt that ‘gain of function’ research is practised in biological research labs world over, resulting in, sometimes, dangerous incidents. This type of research involves in-crossing viruses, ostensibly to gain knowledge on how to battle the disease from within. In these cases, it’s almost impossible to decide where the ‘defence’ aspect leaches into an offensive capability. That these findings were from US scientists who were ‘fearful’ of being quoted shows not just the extent of Beijing’s clout in university research and funding, but also a high degree of restraint. Biological research is almost never talked about. 

The denials begin

Biological research and the secrecy around it is the aspect of focus in Nicholas Wade’s article published in Bulletin of the Atomic Scientists. As he writes, from the beginning, there was denial at the highest levels from some unexpected quarters. The first was in The Lancet— one of the oldest journals of medical research—by a group of authors in March 2020, when the pandemic had just broken out. Even to a layman, it would have seemed that it was far too early for the group of authors to contemptuously dismiss ‘conspiracy theories’ that the virus was not of a natural origin.

It turns out that The Lancet letter was drafted by Peter Daszak, President of the EcoHealth Alliance of New York, who’s organisation funded corona virus research at the Wuhan lab. As is pointed out in Wade’s article, any revelation of such a connection would have been criminal to say the least, if it was proved that the virus did escape from the lab. Unsurprisingly, Daszak was also part of the WHO team investigating the origins of the virus.

Another burst of outrage came from a group of professors who also hurried to disprove, in an article, the ‘lab created’ theory on the grounds – simply put – that it was not of the most probably calculated design. The lead author Kristian G Anderson is from the Scripps Research Institute, La Jolla, which specialises in biomedical research. It also has partnerships with Chinese labs and pharma companies. None of that is criminal. Especially when Scrippsis already in financial distress at the time.  Besides, such collaborations are not restricted to just US labs. See, for instance, an account of Australian doctor Dominic Dwyer, who was part of the first WHO study, and who dismissed without any evidence presented that the virus had leaked from a lab.

Dwyer’s claim that the Wuhan lab seems to have been run well, and that nobody from the facility seemed to have fallen sick has now been disputed. Evidence of a dangerous virus escaping a lab – as it has in the past on what he calls “rare” occasions – would mean a death blow to labs everywhere. Funding is, after all, hard to come by. Then there is the nice hard cash involved. The Harvard professor Dr Charles Leiber who was arrested, together with two other Chinese, for collaborating quietly with the Wuhan University of Technology (WUT), was being paid roughly $50,000 per month, living expenses of up to 1,000,000 Chinese Yuan (approximately $158,000) and awarded $1.5 million to establish a research lab at WUT.  He was also asked to ‘cultivate’ young teachers and Ph.D. students by organising international conferences.

It’s all very pally and friendly, and a lot of money is involved. The end result? A virus out of hell, that seems not to affect the Chinese as its economy powers ahead and shifts its weight more comfortably into its rising position in the global order.

Monday 6 July 2020

A 'Mild Attack' of Corona could be Dangerously Misleading

Otherwise healthy people who thought they recovered from coronavirus are reporting persistent and strange symptoms - including strokes writes Adrienne Matei in The Guardian 


 
‘It’s important to keep in mind how little we truly know about this vastly complicated disease.’ Photograph: Yara Nardi/Reuters


Conventional wisdom suggests that when a sickness is mild, it’s not too much to worry about. But if you’re taking comfort in World Health Organization reports that over 80% of global Covid-19 cases are mild or asymptomatic, think again. As virologists race to understand the biomechanics of Sars-CoV-2, one thing is becoming increasingly clear: even “mild” cases can be more complicated, dangerous and harder to shake than many first thought.

Throughout the pandemic, a notion has persevered that people who have “mild” cases of Covid-19 and do not require an ICU stay or the use of a ventilator are spared from serious health repercussions. Just last week, Mike Pence, the US vice-president, claimed it’s “a good thing” that nearly half of the new Covid-19 cases surging in 16 states are young Americans, who are at less risk of becoming severely ill than their older counterparts. This kind of rhetoric would lead you to believe that the ordeal of “mildly infected” patients ends within two weeks of becoming ill, at which point they recover and everything goes back to normal.

While that may be the case for some people who get Covid-19, emerging medical research as well as anecdotal evidence from recovery support groups suggest that many survivors of “mild” Covid-19 are not so lucky. They experience lasting side-effects, and doctors are still trying to understand the ramifications.

Some of these side effects can be fatal. According to Dr Christopher Kellner, a professor of neurosurgery at Mount Sinai hospital in New York, “mild” cases of Covid-19 in which the patient was not hospitalized for the virus have been linked to blood clotting and severe strokes in people as young as 30. In May, Keller told Healthline that Mount Sinai had implemented a plan to give anticoagulant drugs to people with Covid-19 to prevent the strokes they were seeing in “younger patients with no or mild symptoms”.

Doctors now know that Covid-19 not only affects the lungs and blood, but kidneys, liver and brain – the latter potentially resulting in chronic fatigue and depression, among other symptoms. Although the virus is not yet old enough for long-term effects on those organs to be well understood, they may manifest regardless of whether a patient ever required hospitalization, hindering their recovery process.

Another troubling phenomenon now coming into focus is that of “long-haul” Covid-19 sufferers – people whose experience of the illness has lasted months. For a Dutch report published earlier this month (an excerpt is translated here) researchers surveyed 1,622 Covid-19 patients with an average age of 53, who reported a number of enduring symptoms, including intense fatigue (88%) persistent shortness of breath (75%) and chest pressure (45%). Ninety-one per cent of the patients weren’t hospitalized, suggesting they suffered these side-effects despite their cases of Covid-19 qualifying as “mild”. While 85% of the surveyed patients considered themselves generally healthy before having Covid-19, only 6% still did so one month or more after getting the virus.

After being diagnosed with Covid-19, 26-year-old Fiona Lowenstein experienced a long, difficult and nonlinear recovery first-hand. Lowenstein became sick on 17 March, and was briefly hospitalized for fever, cough and shortness of breath. Doctors advised she return to the hospital if those symptoms worsened – but something else happened instead. “I experienced this whole slew of new symptoms: sinus pain, sore throat, really severe gastrointestinal issues,” she told me. “I was having diarrhea every time I ate. I lost a lot of weight, which made me weak, a lot of fatigue, headaches, loss of sense of smell …”

By the time she felt mostly better, it was mid-May, although some of her symptoms still routinely re-emerge, she says.

“It’s almost like a blow to your ego to be in your 20s and healthy and active, and get hit with this thing and think you’re going to get better and you’re going to be OK. And then have it really not pan out that way,” says Lowenstein.

Unable to find information about what she was experiencing, and wondering if more people were going through a similarly prolonged recovery, Lowenstein created The Body Politic Slack-channel support group, a forum that now counts more than 5,600 members – most of whom were not hospitalized for their illness, yet have been feeling sick for months after their initial flu-like respiratory symptoms subsided. According to an internal survey within the group, members – the vast majority of whom are under 50 – have experienced symptoms including facial paralysis, seizures, hearing and vision loss, headaches, memory loss, diarrhea, serious weight loss and more.

“To me, and I think most people, the definition of ‘mild’, passed down from the WHO and other authorities, meant any case that didn’t require hospitalization at all, that anyone who wasn’t hospitalized was just going to have a small cold and could take care of it at home,” Hannah Davis, the author of a patient-led survey of Body Politic members, told me. “From my point of view, this has been a really harmful narrative and absolutely has misinformed the public. It both prohibits people from taking relevant information into account when deciding their personal risk levels, and it prevents the long-haulers from getting the help they need.”

At this stage, when medical professionals and the public alike are learning about Covid-19 as the pandemic unfolds, it’s important to keep in mind how little we truly know about this vastly complicated disease – and to listen to the experiences of survivors, especially those whose recoveries have been neither quick nor straightforward.

It may be reassuring to describe the majority of Covid-19 cases as “mild” – but perhaps that term isn’t as accurate as we hoped.

Thursday 25 June 2020

60 is the new 80 thanks to Corona

 Patti Waldmeir in The FT

“Better be safe than sorry.” I have never believed that. 


I have lived my first 65 years often turning a blind eye to risk. I lived in China for eight years, enduring some of the worst industrial pollution on earth, despite having asthma. I risked damaging the lungs of my then small children by raising them in a place where their school often locked them in air-purified classrooms to protect them from the smog. 

Before that, I lived for 20 years in Africa, refusing to boil water in areas where it needed boiling, eating bushmeat at roadside stalls — not to mention the escapades that I got up to as a young woman in the pre-Aids era. 

But now, as I peer over the precipice into life as a senior citizen, coronavirus has finally introduced me to the concept of risk. Part of it is the whole “60 is the new 80” paradigm that the pandemic has forced on us — but most of it is that, whether I like it or not, I fit squarely in the category of “at risk” for severe illness or death if I catch Covid-19. 

I have diabetes, asthma and am finishing my 65th year. I don’t live in a nursing home, a jail, a monastery or a convent (as does one close friend with Covid-19), but according to the US Centers for Disease Control and Prevention (CDC), I still qualify as high risk because of my underlying conditions and age. 

So what do I — and people like me, I am far from alone — do now that the world is reopening without us? I’ve got some big decisions to make in the next few days. My youngest child is moving back to our flat outside Chicago after a month living elsewhere: does one of us need to be locked in the bedroom? Do I have to eat on the balcony for two weeks? 

There is no shortage of people, not least President Donald Trump, telling me that all this is simple: vulnerable people should just stay home. But what if they live with other people? What if those people have jobs? And what about our dogs? Our two old mutts are overdue for a rabies shot because the vet was only seeing emergencies. Is it safe for me to take them in now? Can my kids go to the dentist, and then come home to live at close quarters with me? 

I asked several medical experts these questions, and they all offered versions of “we haven’t got a clue”. Robert Gabbay, incoming chief scientific and medical officer of the American Diabetes Association, was the most helpful: “Individuals with diabetes are all in the higher-risk category but even within that category, those who are older and with co-morbidities are at more risk — and control of blood glucose seems to matter. 

“You are probably somewhere in the middle” of the high-risk category, he decided. My diabetes is well controlled and I don’t have many other illnesses. “But your age is a factor,” he added. Up to now, I’ve thought I was in the “60 is the new 40 crowd”: now I know there is no such crowd. 

The head of the Illinois Department of Public Health underlined this at the weekend when she gave her personal list of Covid dos and don’ts, including don’t visit a parent who is over 65 with pre-existing conditions for at least a year, or until there is a cure. Dr Ngozi Ezike also said she would not attend a wedding or a dinner party for a year and would avoid indoor restaurants for three months to a year — despite the fact that Chicago’s indoor restaurants reopen on Friday. 

I turned to the CDC, which initially said it would issue new guidance for “at risk” people last week, but didn’t. This would be the same CDC that I trusted when it said not to wear a mask — though 1.3 billion people in China were masking up. Today China, which is 100 times larger by population than my home state of Illinois, has less than three-quarters as many total pandemic deaths. (Yes, I know China has been accused of undercounting cases, but so has the US.) Masks aren’t the only reason; but they are enough of a reason to erode my trust in what the CDC thinks I should do now. 

It doesn’t help that the CDC website lists “moderate to severe asthma” as one of the primary risk factors for poor coronavirus outcomes — while the American Academy of Allergy Asthma and Immunology says “there are no published data to support this determination”, adding that there is “no evidence” that those with asthma are more at risk. Who’s right? 

I need to know: this weekend is the one-year anniversary of the death of my eldest sibling. I’ve chosen not to make the trip to visit his grave in Michigan. Next month, I turn 65, and I want to spend that day with my 89-year-old father: should we rent a camper van, so we don’t infect his household? I thought about a porta potty for the journey, since public toilets are apparently a coronavirus hotspot. When I started searching for “female urination devices” online, I knew it was time to ditch this new “better safe than sorry” persona I’ve assumed under lockdown. 

Maybe it’s time to remind myself of a fact that I once knew: that life is a risky business, and there is only so much I can do about that. I’ll die when it’s my time — probably not a day before or after, coronavirus or no coronavirus.

Wednesday 20 May 2020

Returning to work in the coronavirus crisis: what are your rights?

Hilary Osborne in The Guardian 


 
Some people may be concerned about returning to work during the coronavirus crisis. Photograph: Matthew Horwood/Getty Images


As the lockdown restrictions begin to be eased across the UK, more workers are being asked to return to the workplace.

The government has said that employees should only be asked to go back if they cannot do their job from home, so if you can, your employer should not be asking you to travel in to work.

If you do need to go to your workplace, your employer is obliged to make sure you will be safe there. Employment lawyer Matt Gingell says: “Employers have a general duty to ensure, as far as reasonably practicable, the health, safety and welfare of all of their employees.”

Here’s a guide to your rights if your employer wants you back in the workplace.

How much notice should I be given that I have to return?

“If employees are unable to work from home, employers can ask employees to return to work and, technically, no notice is required,” says Gingell.

Solicitor and consumer law expert Gary Rycroft says there is no notice period written into law “but giving at least 48 hours’ notice should allow either side to have discussions and air any concerns or even official ‘grievances’”.

The advisory group Acas says employers need to check if there are any arrangements in place with unions or similar about notice. It advises: “Employees and workers should be ready to return to work at short notice, but employers should be flexible where possible.”

So while your employer could ask you to return straight away, a good employer would understand if there were things you needed to put in place first, and give you chance to do so.

What if I was furloughed?

When you were furloughed your employer should have outlined what would happen when it wanted you to go back to work, and this may have a clause saying that you have to return as soon as you are asked.

“The termination of the furlough agreement and when an employee will be expected to return to work will depend on the provisions of the agreement,” says Gingell. Again, though, even if there is no notice period, a good employer should realise that you may need some time to prepare.

If you have been furloughed under the government’s job retention scheme, your employer can’t ask you to go in and do ad hoc days, or work part-time. They would need to take you off furlough and renegotiate your contract with you.

Can they ask me to go back in part-time?

Not, currently, if you have been furloughed and they are using the government scheme to pay you. It only allows companies to furlough people for all of their normal hours, and bans them from asking you to do any work while you are off.

But if your company has not claimed government money to cover your wages, it can ask you to resume work part-time. Make sure you understand the terms of the request – your employer cannot adjust your contract without your permission, so if it is asking you to change your hours you should get advice.

Can they ask me to take a pay cut?

“The law here is the same as it would be if an employer made the same request in the normal course of an employee’s employment. Reducing hours and/or pay are deemed to be such fundamental changes to an employee’s terms and conditions that the employee concerned should be consulted and then agree in writing,” says Rycroft.

He points out that for some employers “this may be the only economically viable option”, and the alternative, if people refuse, could be redundancies. To make more than 20 people redundant there will need to be collective consultation.

What if I am in a vulnerable group or live with someone who is?

No special rules have been put in place to protect people in these groups who are asked to go into work but some already exist – if you are disabled or pregnant, for example, your employer has extra obligations.

Rycroft says some employees may be able to argue that it will be discriminatory to force them to attend work outside the home. “It is all a question of degrees, in terms of how the employer can show that they have listened to legitimate concerns and made reasonable adjustments,” he says.

If you are pregnant your employer is obliged to make sure you can do your job safely. This can mean allowing you to do your job from home, or giving you a new role which can be done remotely. If your employer refuses either of these options, and you do not feel safe going into work you should take advice. Employmentsolicitor.com says that you could be able to argue for a medical suspension on full pay, which will allow you to stay at home.

Living with someone who is vulnerable or especially at risk is not necessarily a reason an employee can refuse to return to work, says Rycroft. “However, you can, as an employee raise a grievance and ask to be listened to and hopefully a compromise may be agreed, such as unpaid leave or using up annual holiday. But if an employer can show that a workplace is safe, the employer may insist on an employee attending.”
What if I have childcare to worry about?

Legally, you can take time off to look after any dependants – these could be children, or older relatives. This time is typically unpaid. If you are currently furloughed and your employer does not have enough work for everyone to go back full-time, they may agree to leave you on furlough so you can continue to earn 80% of your normal pay.

What information should they give me in advance?

Rycroft says there is no law saying that employers should provide information before you return, but the government guidance to employers recommends that they do. He says this information – written or verbal – should cover how they are making your workplace safe in light of the pandemic. So you should be told what is happening to ensure social distancing and hygiene. “This will allow employees to understand how their health and safety at work is being addressed.

Can I refuse to go back?

Yes, if you believe there is a real danger to going to work. “If an employee refuses to return to the workplace due to the employee reasonably believing imminent and serious danger and is then dismissed for that reason the employee could, depending on the circumstances, have a claim for unfair dismissal,” Gingell says.

“The requirement that the employee has to believe that there is imminent and serious danger, does limit the right.”

Otherwise, you cannot refuse. “If someone refuses to attend work without a valid reason, it could result in disciplinary action,” says Acas. But you may be able to make other arrangements with your employer – perhaps you can use holiday or take unpaid leave, or if you have concerns about something like travelling at peak time, they may be willing to accommodate different shifts. Your employer does not have to agree to this, but it is worth asking.

What if I am worried when I see my workplace?

Rycroft says that under section 100 of the Employment Rights Act 1996 employees may leave a place of work where there is an imminent health and safety danger. So if, for example, you return to find social distancing is impossible, you could argue that this is a reason to leave your workplace.

But in the first instance you should try to resolve the issue with your boss. Gingell says: “Employers ought to to listen to the concerns of individuals and be sympathetic and understanding.”


If you do not get anywhere with this, you should take advice. If you are in a union, it should have a helpline you can call if there is no rep to speak to on site. Acas is another port of call, as is Citizens Advice.

“If the employer has breached the implied obligation to provide a safe working environment and/or trust and confidence an employee could, again, depending on the circumstances, resign swiftly as a result and claim constructive unfair dismissal,” says Gingell. But he says you should get advice before taking this action.

“Another option for employees to consider is contactIng the Health and Safety Executive, which enforces health and safety legislation,” he says.

Friday 15 May 2020

Under cover of coronavirus, the world's bad guys are wreaking havoc

The pandemic has allowed strongmen and tyrants to get away with murder and mayhem while we look the other way writes Jonathan Freedland in The Guardian 

 
‘Viktor Orbán has long sought to rule Hungary as an autocrat, but the pandemic gave him his chance, allowing him to brand anyone standing in his way as unwilling to help the leader fight a mortal threat.’ Photograph: Tamás Kovács/AFP via Getty Images


Under the cover of coronavirus, all kinds of wickedness are happening. Where you and I see a global health crisis, the world’s leading authoritarians, fearmongers and populist strongmen have spotted an opportunity – and they are seizing it.

Of course, neither left nor right has a monopoly on the truism that one should never let a good crisis go to waste. Plenty of progressives share that conviction, firm that the pandemic offers a rare chance to reset the way we organise our unequal societies, our clogged cities, our warped relationship to the natural world. But there are others – and they tend to be in power – who see this opening very differently. For them, the virus suddenly makes possible action that in normal times would exact a heavy cost. Now they can strike while the world looks the other way.

For some, Covid-19 itself is the weapon of choice. Witness the emerging evidence that Bashar al-Assad in Damascus and Xi Jinping in Beijing are allowing the disease to wreak havoc among those groups whom the rulers have deemed to be unpersons, their lives unworthy of basic protection. Assad is deliberately leaving Syrians in opposition-held areas more vulnerable to the pandemic, according to Will Todman of the Center for Strategic and International Studies. As he puts it: “Covid-19 has provided Assad a new opportunity to instrumentalize suffering.”

Meanwhile, China continues to hold 1 million Uighur Muslims in internment camps, where they contend now not only with inhuman conditions but also a coronavirus outbreak. Those camps are cramped, lack adequate sanitation and have poor medical facilities: the virus couldn’t ask for a better breeding ground. What’s more, Uighur Muslims are reportedly being forced to work as labourers, filling in for non-Muslims who are allowed to stay home and protect themselves. That, according to one observer, “is reflective of how the Republic of China views [Uighur Muslims] as nothing but disposable commodities”.

Elsewhere, the pandemic has allowed would-be dictators an excuse to seize yet more power. Enter Viktor Orbán of Hungary, whose response to coronavirus was immediate: he persuaded his pliant parliament to grant him the right to rule by decree. Orbán said he needed emergency powers to fight the dreaded disease, but there is no time limit on them; they will remain his even once the threat has passed. They include the power to jail those who “spread false information”. Naturally, that’s already led to a crackdown on individuals guilty of nothing more than posting criticism of the government on Facebook. Orbán has long sought to rule Hungary as an autocrat, but the pandemic gave him his chance, allowing him to brand anyone standing in his way as unwilling to help the leader fight a mortal threat.

Xi has not missed that same trick, using coronavirus to intensify his imposition of China’s Orwellian “social credit” system, whereby citizens are tracked, monitored and rated for their compliance. Now that system can include health and, thanks to the virus, much of the public ambivalence that previously existed towards it is likely to melt away. After all, runs the logic, good citizens are surely obliged to give up even more of their autonomy if it helps save lives.

For many of the world’s strongmen, though, coronavirus doesn’t even need to be an excuse. Its chief value is the global distraction it has created, allowing unprincipled rulers to make mischief when natural critics at home and abroad are preoccupied with the urgent business of life and death.

Donald Trump gets plenty of criticism for his botched handling of the virus, but while everyone is staring at the mayhem he’s creating with one hand, the other is free to commit acts of vandalism that go all but undetected. This week the Guardian reported how the pandemic has not slowed the Trump administration’s steady and deliberate erosion of environmental protections. During the lockdown, Trump has eased fuel-efficiency standards for new cars, frozen rules for soot air pollution, continued to lease public property to oil and gas companies, and advanced a proposal on mercury pollution from power plants that could make that easier too. Oh, and he’s also relaxed reporting rules for polluters.
Trump’s Brazilian mini-me, Jair Bolsonaro, has outstripped his mentor. Not content with mere changes to the rulebook, he’s pushed aside the expert environmental agencies and sent in the military to “protect” the Amazon rainforest. I say “protect” because, as NBC News reported this week, satellite imagery shows “deforestation of the Amazon has soared under cover of the coronavirus”. Destruction in April was up by 64% from the same month a year ago. The images reveal an area of land equivalent to 448 football fields, stripped bare of trees – this in the place that serves as the lungs of the earth. If the world were not consumed with fighting coronavirus, there would have been an outcry. Instead, and in our distraction, those trees have fallen without making a sound.

Another Trump admirer, India’s Narendra Modi, has seen the same opportunity identified by his fellow ultra-nationalists. Indian police have been using the lockdown to crack down on Muslim citizens and their leaders “indiscriminately”, according to activists. Those arrested or detained struggle to get access to a lawyer, given the restrictions on movement. Modi calculates that majority opinion will back him, as rightist Hindu politicians brand the virus a “Muslim disease” and pro-Modi TV stations declare the nation to be facing a “corona jihad”.

In Israel, Benjamin Netanyahu – who can claim to have been Trumpist before Trump – has been handed a political lifeline by the virus, luring part of the main opposition party into a government of national unity that will keep him in power and, he hopes, out of the dock on corruption charges. His new coalition is committed to a programme that would see Israel annex major parts of the West Bank, permanently absorbing into itself territory that should belong to a future Palestinian state, with the process starting in early July. Now, the smart money suggests we should be cautious: that it suits Netanyahu to promise/threaten annexation more than it does for him to actually do it. Even so, in normal times the mere prospect of such an indefensible move would represent an epochal shift, high on the global diplomatic agenda. In these abnormal times, it barely makes the news.

Robin Niblett, director of Chatham House, argues that many of the global bad guys are, in fact, “demonstrating their weakness rather than strength” – that they are all too aware that if they fail to keep their citizens alive, their authority will be shot. He notes Vladimir Putin’s forced postponement of the referendum that would have kept him in power in Russia at least until 2036. When that vote eventually comes, says Niblett, Putin will go into it diminished by his failure to smother the virus.

Still, for now, the pandemic has been a boon to the world’s authoritarians, tyrants and bigots. It has given them what they crave most: fear and the cover of darkness.

Thursday 14 May 2020

The coronavirus slayer! How Kerala's rock star health minister helped save it from Covid-19

KK Shailaja has been hailed as the reason a state of 35 million people has only lost four to the virus. Here’s how the former teacher did it writes Laura Spinney in The Guardian 


 
‘Our clinics for respiratory disease meant we could look out for community transmission’: KK Shailaja, health minister.


On 20 January, KK Shailaja phoned one of her medically trained deputies. She had read online about a dangerous new virus spreading in China. “Will it come to us?” she asked. “Definitely, Madam,” he replied. And so the health minister of the Indian state of Kerala began her preparations.

Four months later, Kerala has reported only 524 cases of Covid-19, four deaths and – according to Shailaja – no community transmission. The state has a population of about 35 million and a GDP per capita of only £2,200. By contrast, the UK (double the population, GDP per capita of £40,400) has reported more than 40,000 deaths, while the US (10 times the population, GDP per capita of £51,000) has reported more than 82,000 deaths; both countries have rampant community transmission.

As such, Shailaja Teacher, as the 63-year-old minister is affectionately known, has attracted some new nicknames in recent weeks – Coronavirus Slayer and Rockstar Health Minister among them. The names sit oddly with the merry, bespectacled former secondary school science teacher, but they reflect the widespread admiration she has drawn for demonstrating that effective disease containment is possible not only in a democracy, but in a poor one. 

How has this been achieved? Three days after reading about the new virus in China, and before Kerala had its first case of Covid-19, Shailaja held the first meeting of her rapid response team. The next day, 24 January, the team set up a control room and instructed the medical officers in Kerala’s 14 districts to do the same at their level. By the time the first case arrived, on 27 January, via a plane from Wuhan, the state had already adopted the World Health Organization’s protocol of test, trace, isolate and support.

As the passengers filed off the Chinese flight, they had their temperatures checked. Three who were found to be running a fever were isolated in a nearby hospital. The remaining passengers were placed in home quarantine – sent there with information pamphlets about Covid-19 that had already been printed in the local language, Malayalam. The hospitalised patients tested positive for Covid-19, but the disease had been contained. “The first part was a victory,” says Shailaja. “But the virus continued to spread beyond China and soon it was everywhere.”

In late February, encountering one of Shailaja’s surveillance teams at the airport, a Malayali family returning from Venice was evasive about its travel history and went home without submitting to the now-standard controls. By the time medical personnel detected a case of Covid-19 and traced it back to them, their contacts were in the hundreds. Contact tracers tracked them all down, with the help of advertisements and social media, and they were placed in quarantine. Six developed Covid-19.

Another cluster had been contained, but by now large numbers of overseas workers were heading home to Kerala from infected Gulf states, some of them carrying the virus. On 23 March, all flights into the state’s four international airports were stopped. Two days later, India entered a nationwide lockdown.


FacebookTwitterPinterest Indian citizens arriving from the Gulf states are bussed to a quarantine centre. Photograph: Arunchandra Bose/AFP via Getty Images

At the height of the virus in Kerala, 170,000 people were quarantined and placed under strict surveillance by visiting health workers, with those who lacked an inside bathroom housed in improvised isolation units at the state government’s expense. That number has shrunk to 21,000. “We have also been accommodating and feeding 150,000 migrant workers from neighbouring states who were trapped here by the lockdown,” she says. “We fed them properly – three meals a day for six weeks.” Those workers are now being sent home on charter trains.

Shailaja was already a celebrity of sorts in India before Covid-19. Last year, a movie called Virus was released, inspired by her handling of an outbreak of an even deadlier viral disease, Nipah, in 2018. (She found the character who played her a little too worried-looking; in reality, she has said, she couldn’t afford to show fear.) She was praised not only for her proactive response, but also for visiting the village at the centre of the outbreak.

The villagers were terrified and ready to flee, because they did not understand how the disease was spreading. “I rushed there with my doctors, we organised a meeting in the panchayat [village council] office and I explained that there was no need to leave, because the virus could only spread through direct contact,” she says. “If you kept at least a metre from a coughing person, it couldn’t travel. When we explained that, they became calm – and stayed.”

Nipah prepared Shailaja for Covid-19, she says, because it taught her that a highly contagious disease for which there is no treatment or vaccine should be taken seriously. In a way, though, she had been preparing for both outbreaks all her life.

The Communist Party of India (Marxist), of which she is a member, has been prominent in Kerala’s governments since 1957, the year after her birth. (It was part of the Communist Party of India until 1964, when it broke away.) Born into a family of activists and freedom fighters – her grandmother campaigned against untouchability – she watched the so-called “Kerala model” be assembled from the ground up; when we speak, this is what she wants to talk about.

The foundations of the model are land reform – enacted via legislation that capped how much land a family could own and increased land ownership among tenant farmers – a decentralised public health system and investment in public education. Every village has a primary health centre and there are hospitals at each level of its administration, as well as 10 medical colleges.

This is true of other states, too, says MP Cariappa, a public health expert based in Pune, Maharashtra state, but nowhere else are people so invested in their primary health system. Kerala enjoys the highest life expectancy and the lowest infant mortality of any state in India; it is also the most literate state. “With widespread access to education, there is a definite understanding of health being important to the wellbeing of people,” says Cariappa.

Shailaja says: “I heard about those struggles – the agricultural movement and the freedom fight – from my grandma. She was a very good storyteller.” Although emergency measures such as the lockdown are the preserve of the national government, each Indian state sets its own health policy. If the Kerala model had not been in place, she insists, her government’s response to Covid-19 would not have been possible.


FacebookTwitterPinterest A walk-in test centre in Ernakulam, Kerala. Photograph: Reuters

That said, the state’s primary health centres had started to show signs of age. When Shailaja’s party came to power in 2016, it undertook a modernisation programme. One pre-pandemic innovation was to create clinics and a registry for respiratory disease – a big problem in India. “That meant we could spot conversion to Covid-19 and look out for community transmission,” Shailaja says. “It helped us very much.”

When the outbreak started, each district was asked to dedicate two hospitals to Covid-19, while each medical college set aside 500 beds. Separate entrances and exits were designated. Diagnostic tests were in short supply, especially after the disease reached wealthier western countries, so they were reserved for patients with symptoms and their close contacts, as well as for random sampling of asymptomatic people and those in the most exposed groups: health workers, police and volunteers.

Shailaja says a test in Kerala produces a result within 48 hours. “In the Gulf, as in the US and UK – all technologically fit countries – they are having to wait seven days,” she says. “What is happening there?” She doesn’t want to judge, she says, but she has been mystified by the large death tolls in those countries: “I think testing is very important – also quarantining and hospital surveillance – and people in those countries are not getting that.” She knows, because Malayalis living in those countries have phoned her to say so.

Places of worship were closed under the rules of lockdown, resulting in protests in some Indian states, but resistance has been noticeably absent in Kerala – in part, perhaps, because its chief minister, Pinarayi Vijayan, consulted with local faith leaders about the closures. Shailaja says Kerala’s high literacy level is another factor: “People understand why they must stay at home. You can explain it to them.”

The Indian government plans to lift the lockdown on 17 May (the date has been extended twice). After that, she predicts, there will be a huge influx of Malayalis to Kerala from the heavily infected Gulf region. “It will be a great challenge, but we are preparing for it,” she says. There are plans A, B and C, with plan C – the worst-case scenario – involving the requisitioning of hotels, hostels and conference centres to provide 165,000 beds. If they need more than 5,000 ventilators, they will struggle – although more are on order – but the real limiting factor will be manpower, especially when it comes to contact tracing. “We are training up schoolteachers,” Shailaja says.

Once the second wave has passed – if, indeed, there is a second wave – these teachers will return to schools. She hopes to do the same, eventually, because her ministerial term will finish with the state elections a year from now. Since she does not think the threat of Covid-19 will subside any time soon, what secret would she like to pass on to her successor? She laughs her infectious laugh, because the secret is no secret: “Proper planning.”

Sunday 19 April 2020

How did Britain get its response to Coronavirus so wrong?

As the warnings grew louder, the government was distracted by Brexit. On testing, contact tracing and equipment supply, there was a failure to prepare by Toby Helm, Emma Graham-Harrison & Robin McKie in The Guardian



By late December last year, doctors in the central Chinese city of Wuhan were starting to worry about patients quarantined in their hospitals suffering from an unusual type of pneumonia.

As the mystery illness spread in one of China’s major industrial hubs, some tried to warn their colleagues to take extra care at work, because the disease resembled Sars (severe acute respiratory syndrome), the deadly respiratory disease that had killed hundreds of people across the region in 2002-03 after a government cover-up.

One of those who tried to raise the alarm, though only among a few medical school classmates, was a 33-year-old Chinese ophthalmologist, Li Wenliang. Seven people were in isolation at his hospital, he said, and the disease appeared to be a coronavirus, from the same family as Sars.

In early January he was called in by police, reprimanded for “spreading rumours online”, and forced to sign a paper acknowledging his “misdemeanour” and promising not to repeat it.

Many early cases were linked to the city’s Huanan seafood and fresh produce market, which also sold wildlife, suggesting that the first cases were contracted there.


FacebookTwitterPinterest The Wuhan hygiene emergency response team leave the closed Huanan seafood wholesale market on 11 January. Photograph: Noel Celis/AFP via Getty Images

Scientists would discover the disease had probably originated in bats and had then passed through a second species – in all likelihood, but not certainly, pangolins, a type of scaly anteater – before infecting humans.

But the infections were soon spreading directly between patients, so fast that on 23 January the government announced an unprecedented lockdown of Wuhan city and the surrounding Hubei province.

Two weeks later, on 7 February, Li, who had contracted coronavirus himself, died in hospital from the condition about which he had tried to raise the alarm. He had no known underlying conditions and left behind a wife and young child.

Li became the face of the mysterious new disease. The story of his death and pictures of him in a hospital bed wearing an oxygen mask made media headlines across the globe, including in the UK.

The world, it seemed, was slowly becoming more aware of how lethal coronavirus could be, that it was not just another form of flu with fairly mild symptoms.

But while UK scientists and medical researchers were becoming more concerned, and studying the evidence from China, those among them who were most worried were not getting their messages through to high places.


Distracted by Brexit and reshuffles

The Conservative government of Boris Johnson had other more immediate preoccupations at the start of this year.

Johnson was still basking in his general election success last December. After he returned from a celebratory Caribbean holiday with his fiancee, Carrie Symonds, the political weather for the prime minister seemed to be set fair. It was honeymoon time.

Three and a half years on from the Brexit referendum, the UK was finally about to leave the EU on 31 January. The fireworks and parties for the big night were being planned, the celebratory 50p coins minted.

Minds were certainly not on a developing health emergency far away, as Johnson prepared to exploit the moment of the UK’s departure from the European Union for all it was worth. “I think there was some over-confidence,” admitted one very senior Tory last week.

The prime minister and his chief adviser, Dominic Cummings, wanted to make an early impression at home in other ways too, as domestic reformers. Cummings was waging a war on civil servants in Whitehall, throwing his weight around and deliberately upsetting the Westminster applecart.

While he made the headlines, briefing about his iconoclastic ambitions, Johnson was preparing a big Cabinet reshuffle to assert his own authority in other areas now Brexit was done and dusted.

With Labour effectively leaderless after its fourth consecutive election defeat, there was little opposition to trouble Johnson on any front at all – and certainly no-one of note asking tough questions about coronavirus.

The prime minister duly recast his cabinet team on 13 February – five days after Li’s death in Wuhan. He made big changes but unsurprisingly retained the hitherto safe pair of hands of Matt Hancock as his health secretary.


FacebookTwitterPinterest Boris Johnson speaking about the EU on 3 February. Photograph: Reuters

In a sign of where priorities lay – and the lack of concern that a potential crisis might be heading our way from the east – Hancock wasted no time recording a video of himself grinning with delight on reshuffle day.

He smacked his right fist into his left palm saying he could not wait to “get cracking” and that he relished the chance to deliver the Tories’ manifesto promises, reform social care and improve life sciences. And lastly, in a more sombre voice, he spoke of “dealing with coronavirus and keeping the public safe” before adding, as the grin returned: “Now let’s get back to work!”

It is perhaps too early to conclude for sure that Johnson, Hancock and the government’s entire team of scientific and medical advisers were caught asleep at the wheel. But the fact that Johnson and Hancock themselves, in common with much of the Downing Street staff, would go on to contract the virus or suffer symptoms, further suggests that people at the top had not been sufficiently on their guard.

Now, 11 weeks on from the first cases being confirmed in the UK on 31 January – a period during which more than 14,000 people (and probably several thousands more once care home fatalities are counted) in the UK have died from Covid-19 – and with the country in lockdown, the economy facing prolonged recession as a result, schools closed, and no sign of an end in sight – hard questions have to be asked.

We already know with some certainty that other countries, such as Germany, South Korea, Taiwan and New Zealand, will emerge from this crisis having performed far better than the UK. A few weeks ago the government’s advisers crassly said that fewer than 20,000 deaths would be “a very good result” for the UK.

As we fast approach that grim tally, many experts now believe the UK may come out of this crisis, whenever that may be, with one of the worst records on fighting coronavirus of any European nation. Once the full tally is counted, few expect the number of deaths to be below 20,000.

By contrast, on Friday, Germany was saying it thought it had brought coronavirus largely under control. It had had 3,868 deaths, less a third of the total in the UK (and Germany’s population, at 83 million, is far higher), having conducted widespread testing for Covid-19 from early on, precisely as the UK has failed to do.

How, then, did it come to this? How did coronavirus spread across the globe, prompting different responses in different countries? Did the UK simply fail to heed the warnings? Or did it just decide to take different decisions, while others settled on alternative actions to save lives?


The warnings grow louder

David Nabarro, professor of global health at Imperial College, London, and an envoy for the World Health Organization on Covid-19, says one thing is for sure. All governments were warned how serious the situation was likely to become as early as the end of January. Ignorance of the danger that was coming can be no excuse. Yet it would not be until late March – later than many other countries – that Johnson would announce a complete lockdown.

“WHO had been following the outbreak since the end of December and within a few weeks it called a meeting of its emergency committee to decide if this outbreak was a ‘public health emergency of international concern’,” said Nabarro.

“That is the highest level of alert that WHO can issue, and it issued it on January 30. It made it very clear then – to every country in the world – that we were facing something very serious indeed.”

Well before the end of January, the WHO had been tracking the growing threat minutely: 14 January was a key day in the spread of the disease that would become known as Covid-19. The first case was confirmed outside China, with a woman hospitalised in Thailand.

A WHO official warned then that it was possible that human-to-human transmission had occurred in families of victims – a sign that the disease had potential to spread far and fast – and, inside China, officials were quietly told to prepare for a pandemic.

There was little international attention on the day, though, because Beijing’s dire warnings about a pandemic were made in secret, and a WHO spokesman rowed back from his colleague’s claim.

Officially, China had not seen a new case of the coronavirus for over a week; the outbreak appeared to be fading. It took another six days for China to publicly acknowledge the gravity of the threat, time that scientists believed meant a further 3,000 people were infected.

But on 20 January, officials announced more than 100 new cases and admitted the virus was spreading between humans, a red flag for concern to anyone who works on infectious diseases. The virus could no longer be contained by finding the animal source of the infection and destroying it.

Two days later, the scale of the challenge was made clear to the general public when Beijing locked down millions of people. All transport into and out of the metropolis of Wuhan was cut off, an unprecedented modern quarantine that would come at huge human and economic cost.

On 29 January, the UK would have its first two confirmed cases of the disease. There was little sense that China’s dilemma and its approach – shut down life as we know it or watch the death toll spiral out of control – might have to be our nightmare within weeks.

In early February, Donald Trump announced a ban on travellers who had passed through China in the previous 14 days. Europe began focused testing of people with symptoms and travel histories that linked them to the disease, but little else. 

Johnson, it seemed, still had Brexit and free trade much more on his mind. Any hint of draconian action to fight coronavirus that might hurt the economy was the last thing he was entertaining.

In a speech on Brexit in Greenwich on 3 February, he made clear his views on Wuhan-style lockdowns. “We are starting to hear some bizarre autarkic rhetoric,” he said.


”Humanity needs some government somewhere that is willing at least to make the case powerfully for freedom of exchange, some country ready to take off its Clark Kent spectacles and leap into the phone booth and emerge with its cloak flowing as the supercharged champion of the right of the populations of the Earth to buy and sell freely among each other.”


‘Herd immunity’: UK goes it alone

By early March it was abundantly clear to many academics and scientists that the approach being adopted by the UK was markedly different from those followed by other countries. From South Korea to Germany, governments had invested heavily in expanding testing capacity from the first weeks of the epidemic.

Hong Kong, Taiwan and Singapore had brought in controls on travellers from infected regions and strict contact tracing to help understand who could have been exposed, inform them and require self isolation. Face masks became widespread in east Asia, long before it was recommended elsewhere.

Testing and contact tracing has been at the heart of the approach advocated by the WHO, so that countries can establish how transmission chains were occurring, in order to break them.

Many also brought in some social distancing measures, banning large gatherings, closing schools or extending holidays, and encouraged those who could do to work from home. None were as extreme as China’s shutdown, or the European and American lockdowns that would follow.

Writing in the Observer last month, Devi Sridhar, chair of global public health at the University of Ediburgh, noted the distinct UK approach. “Rather than learning from other countries and following the WHO advice, which comes from experts with decades of experience in tackling outbreaks across the world, the UK has decided to follow its own path. This seems to accept that the virus is unstoppable and will probably become an annual, seasonal infection.

“The plan, as explained by the chief science adviser, is to work towards ‘herd immunity’, which is to have the majority of the population contract the virus, develop antibodies and then become immune to it.
This theory has been widely used to advocate for mass vaccination for measles, mumps and rubella. The thinking is that, if most of the population is vaccinated, a small percentage can go unvaccinated without cases emerging.”

It was not just the UK whose politicians and scientific advisers were, arguably, slow to act in the early stages. Others countries, including Spain and France, were caught out too, but it was Italy’s tragedy that alerted Europe to the scale of the threat it faced.

European governments and citizens were forced to reckon with the reality that in an age of global travel, the thousands of miles separating them from China meant almost nothing at all. Thousands of Britons were holidaying in Italy the week that it shut down. They were advised to go into self-quarantine on return, but were not registered by the health authorities, nor were their contacts tracked.

Italy and the UK had both had had their first case a day apart at the end of January, but cases rose faster in Italy. The country may just have been unlucky that carriers of the disease flew to its northern cities and ski resorts rather than to other European capitals.

Whatever the reason, cases and then deaths started climbing sharply in northern Italy in late February. Dozens of towns were locked down from the 21st, but in the rest of the country life carried on as normal.

It was soon clear that the problem had not been contained. On 8 March, the prime minister, Guiseppe Conti, quarantined 16 million people across the north of the country, and the next day extended the lockdown to all of Italy.


FacebookTwitterPinterest Russian biological warfare troops, called in by the Italian authorities, disinfect the Pope John Paul I care home near Bergamo. Photograph: Russian Defence Ministry/TASS

The measures saved lives, but came too late for thousands of Italians. The death toll outstripped China, and the world looked on horrified as hospitals were overwhelmed, doctors forced to choose who should have a chance on a ventilator and who should die. On 11 March, the WHO declared a global pandemic. On 14 March, Spain went into lockdown, and three days later France did the same.

But in the UK there appeared to be greater reluctance to act decisively with lockdowns: the banning of mass gatherings and the closure of pubs and restaurants. The government’s scientific and behavioural science advisers were warning ministers that the public might react badly to draconian measures and would not tolerate them for long.

In an apparent show of defiance against the lockdowners, Johnson and Symonds attended the England v Ireland rugby match at Twickenham on 7 March. The Cheltenham Festival, attended over three days to 13 March by 250,000 racegoers, was allowed to go ahead.


Shutdown: Johnson changes tack

The tone was about to change. In a Downing Street press conference on 12 March, Johnson, who had said a few days before the first UK death that the disease was “likely to spread a bit more” suddenly became the deliverer of grave warnings.

Previous talk by his advisers of avoiding lockdowns and developing “herd immunity” had been banished and replaced by a brutal honesty. “I must level with you,” Johnson told reporters. “More families, many more families, are going to lose loved ones before their time.” On 18 March – just days after Downing Street had suggested it was not on the cards – the government announced the closure of all schools until further noticed. Pubs and restaurants were ordered to shut on 20 March. The UK had come late into line.

One former cabinet minister last week described the change of approach as a “screeching U-turn”. Johnson and his ministers were now, even more than before, taking cover behind, and advice from, their scientific and medical advisers. Many of these advisers had become increasingly concerned that the UK had become out of step with other countries because of political resistance from ministers to measures that would hit the economy. The Observer has been told that at least two senior government advisers were on the brink of of quitting before Johnson switched his approach.

The government has found itself unable to escape the consequences of a wider failure to prepare. As hospitals threatened to be overwhelmed before orders were given to massively expand capacity, ministers came under intense criticism over the lack of protective equipment for frontline NHS staff, over the lack of ventilators for patients in intensive care, and for a failure to test more widely for Covid-19, particularly among NHS workers.

The lack of preparedness and instances of chaotic planning has shocked many in and outside the NHS.

Last week, Dr Alison Pittard, the dean of the Faculty of Intensive Care Medicine, the professional body for intensive care practitioners, said the minimum specifications for the government’s own homegrown ventilator scheme would produce machines that would only treat patients “for a few hours”. “If we had been told that that was the case… we’d have said: ‘Don’t bother, you’re wasting your time. That’s of no use’,” she told the Financial Times.

Last month the government missed an EU procurement deadline for ventilators because, minister said, an email went unnoticed. The NHS had said 30,000 more would be needed, Hancock reduced this to 18,000. Pittard said her faculty had been warning for years about a shortage of intensive care capacity and intensive care nurses in hospitals.


FacebookTwitterPinterest Boris Johnson and partner Carrie Symonds with the England captain Owen Farrell at Twickenham on 7 March. Photograph: Facundo Arrizabalaga/EPA

Normally each intensive care patient would have one intensive care nurse in attendance all the time, she said. Now there was one nurse to six patients, although other staff had been redeployed to intensive care units to plug the gaps and the new system was working because of heroic efforts. Although she was reluctant to criticise the government, she said that if the faculty had been listened to, “we wouldn’t be starting from this place”. Germany, she pointed out, has 29 intensive care beds per 100,000 people, compared with six in the UK.

The Tory MP and former health minister Dan Poulter, who works part-time in the NHS, said that given the enormity of the challenge facing government “it almost seems wrong to be critical”.

But he believes part of the problem is that insufficient advice has been sought from experienced NHS clinicians who would have warned of problems with PPE early on, of the shortage of ventilators and would have told ministers of the urgent need to test NHS staff.

“An early over-reliance on academic modelling also resulted in a lack of experienced frontline NHS clinicians – in other words, the people who really understand the day-to-day challenges our hospitals and health service face – from feeding into the initial Covid-19 action plan,” he said. “This has manifested itself amongst other things in the slowness of providing adequate PPE for frontline NHS staff and in the lack of virus testing for healthcare staff in the earlier part of the outbreak.”


How the scientists reacted

When the investigations into the UK’s response to Covid-19 come to be written, there is widespread recognition among experts that this lack of long-term strategic planning will be at the centre of it. So too should be the need to ensure that the views of experts are fed into government more efficiently and widely. The prospect of a previously unknown disease spreading catastrophically around the globe and infecting millions is, after all, not a new one.

Indeed, many warnings have been given in the past about the viral dangers facing humanity. “Given the continual emergence of new pathogens ... and the ever-increasing connectedness of our world, there is a significant probability that a large and lethal pandemic will occur in our lifetime,” Bill Gates predicted several years ago. “And it will have the impact of a nuclear war,” he warned, while urging nations to start stockpiling antiviral drugs and therapies. If only.

For its part, the WHO prepared – several years ago – a list of viruses with no known treatments or vaccines, illnesses that could one day trigger that pandemic and kill hundreds of thousands. Prospective killers included nipah disease and lassa fever as well as an ailment it simply called “disease X” – “a serious international epidemic caused by a pathogen currently unknown”.

As to the most likely nature of that mysterious virus, most modelling assumed that disease X would be flu-like in behaviour, says Dr Josie Golding, the epidemics lead at the Wellcome Trust. After all, influenza had caused so many deadly global outbreaks in the past. As a result, a lot of investment went into making influenza vaccines in preparation, she says. “But have we been thinking about diseases other than influenza that might become pandemics? I don’t think we have. There has been a real gap in our thinking.”

Then came the appearance of Covid-19 – caused not by a strain of influenza but by a coronavirus – in November. Initially, only a few cases were highlighted, a trend that began to change early this year with a rise in numbers of infected ill people.

“The report that really grabbed my attention came out in mid-January,” says epidemiologist Professor Mark Woolhouse at Edinburgh University. “It said 41 cases of this new respiratory illness had now been diagnosed in one small area of China, around Wuhan. And that set the alarm bells ringing for me.”

For Woolhouse, the cluster of cases in one place showed this was not a matter of a few people scattered around China picking up an occasional infection from an animal such as a bat or a chicken. “Forty-one cases in one small area at the same time could not be explained that way. People are not picking this up from animals, I realised. They are actually spreading it to each other. It was already heading out of control.

Ewan Birney, head of the European Bioinfomatics Institute in Cambridgeshire, also noted the significance of the new disease at the time. “I presumed, at first, that this one would also burn itself out, probably somewhere in Asia,” he says.

His reasoning was straightforward. The outbreak of Sars that appeared in 2003 in China was caused by a coronavirus and killed more than 10% of those it infected. “In fact, it killed or hospitalised so many of those it infected the chain of transmission from one person to others was cut. It was too lethal for its own good. So I thought this might happen with this new disease. But it turns out Covid-19 is much milder and incapacitates fewer individuals, so there is no cut in its transmission. When that became apparent – around mid-January – I became very worried.”

Then there was the infectiousness of the new virus. A person with Sars generally starts to display symptoms before they infect other people. That makes it much easier to contain. But this was not the case with Covid-19. Early data from China – again released in January – showed the virus was being spread from people who were displaying only the mildest symptoms, or in some cases no symptoms. This was making the condition very difficult to track, says virologist Professor Jonathan Ball of Nottingham University.


FacebookTwitterPinterest The County Oak Medical Centre in Brighton was closed on 10 February after a member of staff was infected with coronavirus. Photograph: Glyn Kirk/AFP via Getty Images

“At that point I realised this outbreak was going to be very serious,” he added. “I sent a tweet to a colleague in Australia. It simply said: ‘This one is out of the bag properly’. He sent one back agreeing with me.”

Around this time, Paul Nurse, Nobel laureate and head of the Francis Crick Institute, recalls attending a conference where he met Mark Wolpert, head of UK Research and Innovation, the organisation that funds a vast slice of British scientific research.

“He had just received a text message from a colleague about the outbreak and we started to discuss the implications,” Nurse recalls. “It did not take us long for us both to realise this was going to be very significant. It took another two or three weeks to confirm these worst fears – by mid-February.”

By this time, Birney had realised the virus had a real sting in its tail and could cause serious illness among the elderly and those with other underlying serious ailments. “It was half-term and I was on holiday with my parents. All I wanted to do was to get the holiday over and then get them back to their house in the country where they could keep themselves isolated.”

In February, sporadic cases of Covid-19 were appearing round the country, recalls Tom Wingfield, a clinician and infectious disease expert based at the Liverpool School of Tropical Medicine. “These were cases that had been brought into the country, mainly from China or Italy. Then there was an outbreak in Brighton and I realised that the virus had established itself in a community there. It was a turning point.”

Britain was still doing quite well in containing the disease by testing, tracing contact and setting up quarantine for those suspected of being infected with Covid-19 at this time. “Then, in March, the government decided to abandon this approach and shift from containing the disease to delaying its progress,” says Wingfield. “I would really like to know why the decision to give up testing and contact tracing was taken.”

Many other researchers also question why the government took so long to react to their warnings. “Part of the trouble was there were other virologists who were saying this was going to be like Sars or flu and there was not too much to worry about,” says Ball. “But Sars happened in 2003. The world is much more connected now than it was then. More to the point, Covid-19 was also much more infectious than Sars. And so it started appearing in lots of other countries. 

“Perhaps some of us should have got up in front of BBC News and said you lot ought to be petrified because this is going to be a pandemic that will kill hundreds of thousands of people,” adds Ball. “None of us thought this was a particularly constructive thing to do, but maybe with hindsight we should have. If there had been more voices, maybe politicians would have taken this a bit more seriously.”

“There is no question that we were insufficiently prepared,” Nurse says. “We had been warned a few years ago when reports made it clear that the UK was not ready to combat a major flu pandemic and we did not take up that warning. As a result, we were caught out.”

He and many others say an inquiry into Britain’s Covid-19 preparedness will have to be held at some point but stress that this should not be started until the crisis has been dealt with in the UK.

Professor Ian Boyd, a former chief scientific adviser at the Department for Environment, Food and Rural Affairs, agrees. “There is a great danger there will be a lot of looking back with the benefits of hindsight and poking fingers of blame,” warns Boyd. “But when you are in the middle of things you have to make a lot of very hard 50-50 decisions, and sometimes you make the wrong call. On the other hand, there is no harm in making sure that we learn as many lessons as we can.”


The lessons from the rest of the world …

Boris Johnson, after his own brush with death at the hands of Covid-19, will presumably no longer take the gung-ho attitude to illness that he has always has. A former Tory minister said: “If Boris had any sense he would take control of the inquiry and lead it.”
One conclusion that experts are already drawing is that it was those countries close to China, with memories of Sars, or cultural ties to their neighbour, which were much faster to act in response to Covid-19. Perhaps most notable in its success was Taiwan. Closely linked by economic and cultural ties to mainland China, Taiwan could have been at high risk of a major Covid-19 epidemic. Tourists and business people travelled regularly back and forth.

But helped perhaps by having an epidemiologist as vice-president, the government set up a gold standard regime of testing and contact tracing that means that nearly three months on from its first confirmed infection, it has registered fewer than 400 cases and six deaths.

Taiwan’s extensive testing and thorough contact tracing are precisely the kind of action that the former health secretary Jeremy Hunt is demanding before the UK lockdown is lifted. Hunt points out that it is one of the essential conditions set by the WHO to avoid a second wave resulting from an easing of restrictions.

Hong Kong, which also suffered from the Sars crisis, also moved early to enforce quarantine and social distancing, as well as widespread mask wearing, and today has registered just over 1,000 cases and only four deaths.


FacebookTwitterPinterest A man in Wuhan on 10 February, the 19th day of the transport lockdown. Photograph: Getty Images

In late February, South Korea looked like it was on a trajectory to disaster, with the highest number of confirmed cases outside China, and numbers rising rapidly. But after the country’s first infection, the government met medical companies and urged them to start developing coronavirus test kits on a massive scale.

The results were impressive. When the epidemic hit, it was ready to deploy largescale testing. Its measures allowed South Korea to become the second country to flatten its coronavirus curve, without the sweeping shutdowns of society and economic activity that China had pioneered and the west would be forced to adopt.

China’s experience should have provided a grim template for western countries to use to prepare. The speed with which Wuhan’s crisis had intensified showed that a relatively advanced medical system could be swamped. Within three weeks there were over 64,000 people infected and 1,000 dead.

The pleas for help from Wuhan’s residents and doctors were to be echoed by those from Italy a few weeks later, and soon after the UK.

Look back three months, and in China there were not enough tests to work out who had coronavirus, there was not enough protective equipment for medical staff treating patients, and then, soon, tragically there were not enough hospital beds and ventilators for sick patients. These are exactly the challenges faced by authorities from New York to Rome, London to Madrid.


… and the other country that didn’t listen

If the UK has serious questions to answer, the country that so far has seen the worst of the outbreak, the United States, was slowest of all to act. Trump for months ignored, played down or lied about the threat posed by coronavirus, leaving individual states to act unilaterally as it became clear it had already taken hold on US soil.

On 17 March parts of California issued “shelter in place” orders, effectively a lockdown. By the end of that week New York City had also shut down, along with a dozen states, and the majority of the rest of the country had put some restrictions in place. Only five states had few or no controls.

There have now been nearly 700,000 confirmed cases in the US and over 33,000 deaths; actual numbers are likely to be higher for both. The economy has also been devastated, with more than 22 million out of work as businesses collapse or shrink under the strain.


The US was slowest of all to act, but Donald Trump is preparing to lift restrictions already. Photograph: Alex Brandon/AP

Trump insists the US is turning a corner, and has tried to blame – among other targets – the WHO for failing to fully raise the alarm, and has stripped it of its US funding.

There have certainly been questions about the organisation’s strong praise for China and the exclusion of Taiwan, which may have contributed to the delay in recognising human-to-human transmission was occurring. But it began daily briefings on 22 January and had declared a global health emergency by the end of that month.

While initially sceptical about China’s distancing measures, it urged other countries to adopt them once there was evidence they were working. It warned about shortages of PPE over a month ago, and since the beginning of the outbreak has urged countries, including the UK, to “test, test, test” to contain the virus – a strategy followed by almost all countries that have managed to suppress it.  

A senior Whitehall source with detailed knowledge of the UK’s response and those of other countries said: “The fact is that those countries who knew a lot about Sars quickly saw the danger. But in the UK the attitude among politicians and also scientists was that it was really just some form of a flu. All the government’s pandemic planning was based on a flu scenario. And then it turned out to be something different and far, far worse and the response was completely inadequate.”

And we are going to be living with the consequences for a long time. Don’t expect a vaccine to come to the rescue in the short term, says Nabarro. “For the foreseeable future, we are going to have to find ways to go about our lives with this virus as a constant threat to our lives. That means isolating those who show signs of the disease and also their contacts. Older people will have to be protected. That is going to be the new normal for us all.”