Why not do today what was possible yesterday?

The UK government is faced with the most serious problem with one arm tied behind its back – it is trying to manage a pandemic, but it has no sight of the underlying infection rate. Until very recently, there were no reliable immunological tests. There is a test for viral RNA, but it has shortcomings. Viruses are notoriously hard to sample for, not least because they degrade very fast in sunlight and open air unless kept cold and damp. There are complex issues in sampling the air, surfaces, waste and food. There are emerging protocols for sampling surfaces for SARS-COV-19 which will be improved rapidly.

So we could know a lot about who has the virus, where it is, how it spreads and what to avoid. Yet we, in the UK don’t.

In the UK, we don’t seem to have adopted mass disinfection, nor the wearing of masks, yet China found them both helpful. The Czech Republic has shown that masks reduce the rate of spread.

There are things it could do, but would not appear to be doing yet at any real scale, and I must wonder why. Not out of a sense of conspiracy, but a genuine scientific curiosity as to what they believe the more effective answers. There is no doubt that knowing these things will save lives.

That’s go through some of the options by which the UK could at least know what the spread and concentration of virus is today:

  1. sample recent blood tests taken in hospitals for any reasons for the presence of live virus
  2. offer mass blood tests at home
  3. sample the air coming out of tube stations for viral DNA of each ventilation.
  4. randomly sample the population using the best possible statistical sampling methods with the tests that they do have
  5. have everybody self-report their health every day using some sort of online app

While each of those would have faults, if enough different methods are used, it might be possible to compare them to the hospital tests that are currently being done on those showing symptoms, and from there get a much better view of the prevalence of the live virus in the human population.

There is no doubt that knowing these things will save lives. We know that there is a polymerase chain reaction test available for the viral RNA, and we are aware that this test can show. Positives for some days after infection because they are in a is still present even after the virus particles have been destroyed and can no longer be spread. However, this can be adjusted for when analysing the results.

We could, for instance, learn whether to shut tube lines, or train lines, or to isolate small towns or regions (because they are uninfected or badly affected, as required. Yes, the town of Eyam is the model we need to think about)

All the other things are being promoted by various groups and are well within the current technological and biochemical expertise of the United Kingdom. The basic tests have been available for years, and the specific tests for this virus have been available for weeks or months.

So why are government not already doing these things?

Perhaps, they already have, and they have the answers. If they do have the answers, then my hypothesis is that the answers are either:

  • very good (in which case they will make everything out to be a crisis, then claim credit for solving the crisis when it doesn’t happen.)
  • very bad (in which case they would plan for the very worst, isolate themselves and the governmental structures of the United Kingdom, moves the army away from many centres of human population, institute war level emergency measures to protect the vital infrastructure of government and the military, and so on).

We cannot tell from what we know today.

Alternatively, perhaps they don’t want to know. This would, for instance, be the case if they were ideological committed to allowing the population to become sick, accepting any number of casualties, any amount of damage to the National Health Service (as doctors will be to the most common casualties), and then convinced by ideology that the United Kingdom will be able to emerge from the pandemic with a largely immune population faster than any other nation in the Western world.

This is a cruel, but effective strategy. Any country that proceed it would pay an enormous price in human life but would dominate its local region for several years after the pandemic passed. Neighbouring states would face extended disruption as anyone who instead chose to pursue isolation, social distancing, and “flattening the curve” strategies would take longer to recover and build an immunologically competent population.

The choice of ‘mass immunity’ v ‘flattening the curve’ rapidly becomes a sort of very high stakes Prisoners Dilemma between nations once it is understood. If everyone in the Western world pursues a quarantine-based strategy while they develop adequate high volume test and trace protocols and technologies, then they all benefit from protecting the population and their health services at a significant financial cost, but gain a tremendous amount of loyalty from the population so protected. If one defects, its people die in droves, but it emerges first and grabs the prize.

The risk of pursuing this strategy is compounded by having no vaccine yet (although trials are starting in the UK and the USA). If the vaccine is available quickly, those that flattened the curve win. If it takes 2 or more years, the ‘mass immunity’ group gets a bigger advantage. Historically, vaccines can take 10 to 15 years to develop and deploy at a global scale. Fortunately, the consensus is that a vaccine to SARS-COV-2 might only take 2 years to develop as there is a lot of basic work on other related beta-Coronavirus diseases to start with (and a HUGE incentive to complete the process). The bad news is that even very large companies can only make 100,000,000 doses a year, so entire industries would have to divert production of all other vaccines to deliver to the approximately 1 billion people most at risk (20%) let alone the 7 billion people who would be make mildy sick and spread the virus. Then, for ever afterwards, we would need to immunize around 200,000 people every year (at current birth rate).

Of course, each time the virus mutates, the process must go back to a mid-point and start again. The beta-Coronavirus family is notoriously good at mutating: SARS-HKU1 had 22 varieties. SARS-COV-2 is showing about 250 varieties so far. Any vaccine has to provide immunity to all of the common dangerous disease-causing versions.

Alternatively, those that pursue the “take it on the chin” strategy whether overtly or covertly, risk a ferocious backlash from the population as the death toll – especially of senior doctors – begins to mount up. Without strict authoritarian controls, including but not limited to police action and military enforcement, it is unlikely that any Western government could survive such a strategy. If they can create enough systems of authoritarian control then, coupled with the rapid bounce back in economic and military strength, governments may feel emboldened to behave in ways which have previously been an acceptable in the Western world.

There is some evidence that Russia was pursuing this strategy. It had taken no steps, other than closing its borders to foreigners, to control or contain the infection. Accordingly, the disease would double every 2 1/2 to 3 1/2 days, and burn through the population in around six months leaving millions dead. One would expect the death rate in Russia to be substantially higher because of the lack of social infrastructure, advanced medical care (except for the most privileged in the large city) and generally low standards of health because of such factors as alcoholism, smoking, and a systemic blindness to the human cost of other government policies.

It is also clear that some nations have deployed every gram of their strength to follow a scientific process of contain, test, trace, treat. Where this behaviour has been coupled with the wearing of masks in public, automatic social distancing (as in the countries which already had experience of SARS and MERS). And is also clear that these countries have dramatically flattened the infection curve and prevented exponential growth of infection.

Next up we would have the advanced Western European nations, especially Germany, Holland, and the Baltics. They reached “case number 10” relatively late and had a good time to prepare while watching what was happening in Italy, Spain, and elsewhere. They have relatively small populations, albeit they don’t have the automatic social distancing or a habit of wearing cough masks in public. They do benefit from deep scientific infrastructure which can be rapidly deployed to new purposes (universities and research hospitals being very valuable in this situation).

Those that are suffering the most, when they need not to do so, are all those where governmental structures have been eroded by right-wing libertarian ideologies of austerity and a cult of individualism. These countries include the UK, Spain, USA, and Italy have responded very poorly. They also allowed a toxic right-wing media to make any possible coordinated activity by the state unpleasant or unpalatable to most of their more gullible & infantilised population. Even if they had tried, they would be been unable to respond correctly because of the penalty of 20 years or more of carving up the apparatuses of the State so they could be privatised, and a habit of deliberately setting government departments against each other in competitive fiefdoms. The population has been primed to accept any constraint on its behaviour as some sort of assault on a concept of “freedom”.

So, back to the original question: why is the UK government not already doing simple and possible things that are very likely to find information that would be very important to the strategic planning system and which would reduce the number of deaths from a known disease?

Qui bono?