Ready When You Are, CB!*

The area around Leicester affected by the spike in COVID cases

For those who haven’t heard, the city of Leicester is back in lockdown after having experienced a spike in Coronavirus cases. The city currently has three times the number of cases as the next highest city and 10% of all cases in Britain, with only about a half a percent of the British population. Non-essential shops, which opened on June 15, are asked to close for 2 weeks, when there will be a review of the data. The further opening of restaurants, pubs, etc., scheduled for July 4, is now on hold for Leicester.

This approach is, in theory, the best way to deal with coming out of lockdown. If you have the data, quickly, you can lock down hot spots while allowing the rest of the country to go on with its business. But “quickly” is the important word here. On the BBC News this morning, the mayor of Leicester, Sir Peter Soulsbury, complained of the government’s slowness to impart information about the spike to the appropriate people in Leicester. He says they’d been asking for numbers and had only received the report on Thursday, June 25. It was a little difficult to find dates for when the government knew there was a spike, but Sky News is reporting that the spike first appeared in the two weeks ending June 16. Since Public Health England subsequently reported data for the period to June 26, or three days before the story, it seems likely that the government knew of the spike by, say, June 20 at the latest. And probably, since most data are reported weekly, they could already see the start of the trend the week before. This is important, because that means that Leicester could have contained the threat by not opening non-essential shops on June 15 and putting more measures in place immediately. This is not the first time the government dithered, and each time it does (and then issues “guidelines” instead of “rules”), it makes it less likely that they will be able to contain new outbreaks—and less likely that the public will take the next set of “guidelines” seriously.

A friend of mine asked me last week why I thought China has contained the virus so much more quickly and completely than, particularly, the US and the UK. We need only look at their response to the recent Beijing outbreak to get some clues. China, of course, would have done the whole world a favor, and may have been able to obviate the entire pandemic, if they’d been more honest more quickly. That doesn’t mean, however, that we can’t learn some lessons from them. In Beijing, there were 36 cases reported on Monday, June 15, bringing the total to 79 in four days. This was the first outbreak in 2 months, so Beijing went into immediate lockdown. They traced the outbreak to a market (with a good track and trace system), so they immediately shut down the market. They rolled out mass testing and put rules in place to control movement. The government ordered—rather than asking nicely—anyone who’d been to the market to quarantine for two weeks.

Obviously, it’s easier in a communist regime to put rather draconian measures in place, but we go too far in the other direction and risk confusing people with the “maybe this would be a good idea, but we know there are exceptions” approach. I’ve seen people on Facebook who have been diligent and vocal in following the guidelines suddenly posing for photos hugging family members in other households, etc., and it seems they think they’re still following advice. Everyone just seems to be a little confused.

In order for the whole country to start to open, we need a few things in place. First is the quick access to data about outbreaks. Second is a truly reliable testing and tracking system. By now, the government has been trialling its tracking app for a few months, but just last week, they announced that they will be joining forces with Apple and Google to create a new app. But even without the app, we could do a much better job than we have been at tracing the old-fashioned way. According to the former chief scientific adviser, Sir David King, the government’s (particularly Dominic Cummings’s) decision to hire the Serco group to perform tracking and tracing was a huge mistake. Certainly, there have been multiple accounts of people hired to make the tracking phone calls who sit home with nothing to do while they’re collecting their £9 an hour. It’s King’s contention, and it seems to make sense, that the tracking should be done at the local level, within the NHS, with GPs controlling the process. Instead of looking at “4,000 a day,” you’re looking at a smaller, much more readily handled number of cases. These, of course, can be aggregated, and we still need some sort of decent system to do that, but right now, we have very little to go on. Testing is the second part of this. We have no way of knowing, in the UK or the US, what the infection rate actually is. President Trump is right to say that more testing means more people testing positive. (Where he goes off the rails is in suggesting that testing should be slowed down.) Right now, we have no real way of knowing what the numbers are, we have no reliable way of tracing people who have been in contact with people who test positive, and we seem to have no teeth to enforce any rules, if the beaches  are a good indication. Crossing your fingers and hoping for rain on the weekend is not a good government plan. Waiting a month for a low-level functionary to put together numbers that were available 72 hours after a peak started makes it impossible to contain outbreaks. And all of this leads to very low confidence that the government knows more than the average person relying on emotion and anecdote.

And who better to deliver that mix than Victoria Derbyshire, who has been one of two news readers on the BBC morning news but is more at home in her chat show slot, finding the stories designed to tug at the heartstrings with a minimum of information. This morning, after interviewing the mayor of Leicester, she interviewed boutique owner Arinder Bhullar. One of Derbyshire’s standard questions is “How do you feel about that?” She asked Bhullar about the lockdown. There were a lot of interesting points that could have been made. Because of the government’s slowness, plans had already been in place to open on July 4, staff had been brought off furlough, etc. Or maybe she might complain that more information was needed about exactly where the spike originated. But no, Bhullar said she was “angry and upset” and thought Leicester was being punished, singled out, for this treatment. She thought if Leicester had to go into further lockdown, the entire country should follow suit. And no one responded by saying, “But Leicester is being ‘singled out’ because it’s the place with the spike. This is the way to avoid further spikes. In the long run, it means you will be able to open sooner with more confidence.” Except me, shouting at the television.

*For those of you under 50 who may never have heard the joke to which my title refers, Cecil B. DeMille was filming one of his epics. He had a very complicated scene that he was amazed took only one take. Everything was perfect. He grabbed his megaphone and shouted to the camera operator, “Did you get all that?” To which the man replied, “Ready when you are, CB!”

One thought on “Ready When You Are, CB!*

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