Wednesday 15th April 2020

Daily Diary: What An Oddly Mundane Catastrophe!

It was a cold, clear night last night. Looking north from our bedroom at the top of the house, across Galleons Reach that just catches the buildings and streetlights from East London and reflects them in lines of white, yellow and amber, I can see out to the Essex hills. The lights are so noticeably clear, like bright stars, free from haze that would fuzz them. Each house, each streetlight a bright point. The once never ending hum from the city is quieter, so quiet in fact that I can hear our central heating gas boiler’s exhaust. Normally there’s a 24/7 hum, from subsonic to mid-range, reassuring me that all is well with the engine of human activity.

This morning, waking up at half past seven, I make a point of revisiting the view. There is a little inversion haze, but it is white, untainted by the purple-brown of motor vehicle exhaust pollution. Up here on the common the air is pretty good for London, but now it is even cleaner. Purer.

The cuttings are making mixed progress. One is rooting for sure. It was always the strongest. The weakest is not progressing and I’m worried that the threads on the base of the cut stem are actually filamentous bacteria. Emily brought us a tray of sweet peas to plant out but I need to find sticks for them to climb up. Maybe tomorrow.

A month has passed and the corona story is bigger than I’d ever imagined. It’s still growing, with all its ramifications and it is becoming a several hours a day effort keeping up with it. I try to include at least one other activity each day so I don’t get too obsessed, too wrapped up, but I fear that that’s going to be a losing battle.

The postman arrives with a collection of letters and packages. It’s decontamination time. I have a diluted bleach solution in a plant sprayer, and everything gets sprayed, plastic as well as paper. What comes into the house has to be treated as potentially contaminated. The conservatory smells like the municipal baths and all ventilation options are set to GO!

Then the young woman from the pharmacy arrives. We have a small lobby at the front of the house that acts as an ‘air lock.’ She drops off the bag of medicines in the lobby and picks up the envelope with the money in it. I then pick up the pharmacy bag once she’s outside again, so there is no proximity and always a door between us. The pharmacy bag is sprayed with methylated spirit because it evaporates faster than bleach.

We have a long chat with Emily, who’s chosen not to continue with the special school. She was assigned to an autistic girl called Amelie, but Amelie is now at home, so going in is optional. There’s a lot of uncertainty. Tom would have begun his Berlin posting this week, but that’s on hold as his skills have been harnessed in Whitehall. If there are any money issues arising from the decision, we’re not spending anything on holidays this year, so we can help out if necessary. Families are the cornerstone of society. Families see each other right.

Back in the seventies, when I was in my early twenties, I bought a book called ‘The Limits to Growth.’ Written by an international team of scientists, economists and politicians. The premise was that human civilisation couldn’t continue growing in number and prosperity. Resources would increasingly be consumed. Waste would increasingly be produced. It’s a key principle known to every biologist. It’s called the sigmoid curve If all goes well, like a child growing into an adult, the curve is a graceful S-shape, but it need not be. Sometimes it levels. Sometimes, like yeast cells poisoned by its own waste product – ethanol – it crashes. We simply don’t know what the human population growth curve will do, or when it levels, how exactly that comes about.

It’s certainly true that the same principles apply to economic growth. The world simply can’t carry on getting richer forever. Something has to check it. The rich are far too greedy to give up the system that feeds their wealth, so something has to give. It’s become increasingly clear that things weren’t going to evolve in some benign and decent way – there are far too many Trumpoids out there believing there is a virtue in selfishness and humanity has been in this bind since records began. The coronavirus pandemic is as much a consequence of how our civilisation functions as it is about anything else.

So will the change going to take the form of a René Thom catastrophe? Will the old world order be tipped over by events rather than respond to human wisdom?

Would it happen suddenly?

Perhaps it already has.

And it was so mundane we barely noticed it.

The Bigger Picture: When Knowledge Is An Option

It’s hard to hide the truth while searching for it at the same time. If science had progressed that way, the Age of Enlightenment would never have happened, and we’d still be performing alchemy, necromancy and attributing magical powers to mathematics. It’s only by pure coincidence that the truth and the most desired narrative ever come into alignment.

Politicians know that in the same way that engineers know about gravity. If truth and the narrative don’t align there are three choices – come clean and take a pin to the delicate bubbles of people’s confidence, allow a false narrative to roll on, repeating and emphasising it along the way, or say nothing?

China chose the third option. For six days after senior Chinese officials had secretly come to the conclusion that they were facing a pandemic from a novel coronavirus they said nothing to warn the public. So it was that the city of Wuhan at the epicentre of the disease hosted a mass banquet for tens of thousands of people and millions began travelling home for the Lunar New Year celebrations. Saving face was more important than saving lives.

It’s likely that the culture of secrecy has also made it very difficult and maybe impossible to identify patient zero, the first person to have been diagnosed with Covid-19. Effectively it means that a choice has been made that knowledge is an option rather than a necessity when it comes to uncomfortable and unpalatable truths.

So we don’t know how Covid-19 started. We don’t know where it came from. We don’t know if it jumped species in the Huanan seafood market in Wuhan or whether it came via stray dogs eating bat meat. Indeed, nearly 30 per cent of Americans, encouraged by their president, believe that the coronavirus escaped from a Wuhan laboratory, despite a complete lack of evidence. Rumours, conspiracies and theories abound, and that suits an authoritarian regime just fine, as it can’t be pinned down. It’s the same government that backs unproven treatments for Covid-19. Traditional medicine is not just a placebo, it claims.

It’s easy to China-bash in the circumstances. The UK government, preoccupied with celebrating Brexit, its casual leader taking holidays and ignoring scientific counsel rather than preparing the nation’s defences preparing the nation’s defences against the inexorably approaching pandemic in January and February, when those in the know were well aware of the dangers, chose not to know, or at least advertise the fact that they might.

America too.

It was known to those who wished to know. On January 21st the US Centres for Disease Control and Prevention (CDC) today confirmed the first case of in Washington state and that the patient concerned had travelled from Wuhan on January 15th. The first alert had gone out from the CDC to physicians on January 8th, about a week after details about Covid-19 had been declared by the Chinese authorities (a day after it had leaked out of China online).

On January 28th Dr Carter Mecher, a senior medical adviser at the Department of Veteran Affairs, emailed a group of public health experts scattered around government and universities, “Any way you cut this, it is going to be bad. The projected size of the outbreak already seems hard to believe.”

There was no way Trump couldn’t have known, and he admitted as much on tape in an interview with veteran reporter of Watergate fame, Bob Woodward.

But knowledge, at least widespread knowledge, was an option to be declined. The president focussed instead on controlling the message, protecting gains in the economy and batting away warnings from senior officials. It was a problem, he chose to tell the nation, that had come out of nowhere and couldn’t have been foreseen.

But it could. There was a Pandemic Playbook. The CDC did have a pandemic plan. And Crimson Contagion – a joint exercise conducted from January to August 2019, in which numerous national, state and local, private and public organizations in the US participated, in order to test the capacity of the federal government and twelve states to respond to a severe pandemic of influenza originating in China.

It wasn’t just knowledge of the fact, but knowledge of the extent of the fact. In the absence of systematic test and trace, in many places no one is quite sure about how far the disease has spread. It’s like we’re flying through fog with a faulty altimeter. So attributing deaths to Covid-19 is hit and miss, particularly in the case of the stricken who never made it to hospital. Pneumonia is pneumonia and it has carried the elderly off so much so it has long travelled as ‘the old person’s friend.’

New York City death toll soars past 10,000 in a revised virus count, adding more than 3,700 additional people who were presumed to have died from the virus but had never tested positive.

In England too, Covid deaths could be 15 per cent higher than government estimates. The head of the charity Age UK warned that elderly people in nursing homes have been ‘airbrushed out’ of the official Covid-19 figures, and carers are being overlooked in the fight against the disease. There are fears of a virus running wild in adult social care and ministers have promised to ramp up testing for care home residents and staff, as fears grow that the virus is ‘running wild.’

The NHS Confederation, which represents organisations across the healthcare sector, said the welcomed the promise but said that the country’s testing capacity is “far from where it needs to be.”

President Trump says some states could reopen by May 1st. Dr Fauci doesn’t agree, saying that the US is “not there yet,” and floating the concept of a “floating re-entry” under which areas with fewer cases that are easier to track and quarantine will be able to resume normal life sooner. “It is not going to be a light switch,” he said on CNN’s State of The Union. “It is going to be depending on where you are in the country, the nature of the outbreak you’ve already experienced, and the threat of an outbreak you have not yet experienced. New York is going to be very different from Arkansas.”

The United States is now the global epicentre of the virus with more than 557,000 confirmed cases and more than 220,000 deaths.

There is friction between the president and a number of governors who are more cautious about lifting restrictions. Trump tries to be bullish and attempts to assert ‘total’ authority to overrule them. But the authority to make such decisions lies with individual states, not the president, and some governors, such as Andrew Cuomo of New York, say they’re prepared to resist such orders.

There’s also friction between Trump and the rest of the world. His move cut WHO funding at the height of a pandemic is criticised worldwide. Many Russians say it’s selfish. Bill Gates says it’s dangerous. Diplomats use the word “regrettable,” but it’s a very mild representation of the anger felt and expressed in dozens of other countries large and small.

Eliot Engel, Chair of the US House of Representatives Foreign Affairs Committee summed up the frustration at such an ill-considered move.

“With each passing day of this worsening crisis, the president is showing us his political playbook: Blame the WHO, blame China, blame his political opponents, blame his predecessors – do whatever it takes to deflect from the fact that his administration mismanaged this crisis and it‘s now costing thousands of American lives,”

Trump’s response is to play a campaign-style video defending his Covid-19 response at a press briefing.

The virus is also disrupting the workings of the country. The Census Bureau announces a delay in the 2020 count, saying it would extend the deadlines for collecting census data, and would ask Congress for a delay in providing final counts used for congressional restructuring.

And in a closing chapter of the outbreak on the aircraft carrier USS Theodore Roosevelt, a sailor who had the virus died two weeks after Captain Crozier fateful request for help.

Since the 1960s there has been a growing idea that economics would somehow be constrained by the limitations of the global environment, The economist Kenneth Boulding coined the term ‘Spaceship Earth.’ It would take over five decades for that concept to enter a wider grasp of how economics worked. Where humanity collided with their environment, such as in environmental damage or zoonosis – diseases jumping species – economics would suffer.

The consequences of climate change, notably in forest fires and the consequence of more frequent storm events, were beginning to have serious impacts, but set against the scale of the whole planet it was hard to build up a global picture at any one point in time. Economic damage was largely localised, in line with environmental damage. It’s taken the pandemic to cause widespread economic damage.

When people become sick on any large scale, so do economies.

In Britain the impact of Covid-19 is said by some, including the Office for Budget Responsibility (OBR) to be the biggest economic shock since 1709. Two million people could lose their jobs through the virus, as Chancellor Rishi Sunak warns “more tough times” lay ahead and declares health to be the top priority. GDP could fall by 35 per cent in the second quarter according to the OBR, although they add it could bounce back quickly, and banks have more resilience than they had in 2009.

There are winners and losers too.

On the winning side Amazon hired 100,000 people last month. Now it’s hiring another 75,000. The emerging demand in PPE, where demand far outstrips supply, creates an army of disaster profiteers and price-gougers.

While the Trump administration tries to assist some of the losers when they reach an agreement in principle with major US airlines over a $25 billion bailout to prop up the struggling industry.

Treating Covid-19 at present can be best described as climbing a steep learning curve:

  • At the moment it’s largely immediate problem solving. Such as who gets the last available ventilator?  What are the criteria? How can it be fair, if in practice it’s an unthinkable choice. But it’s real in both European and American hospitals.
  • We receive a letter from Cancer Research UK telling supporters it’s turning its efforts temporarily to Covid-19.
  • Plasma therapy, the transfer of blood plasma from those recovering to those suffering. It’s a method going back to the nineteenth century, but it’s being seriously considered to help treat Covid-19 patients.
  • The development of vaccines has been going on since January, well before most political leaders grasped what was going on. Sanofi and GlaxoSmithKline collaborate to speed up vaccine development as the EU eyes mass investment through its next long term budget to restart growth.

Elsewhere, different countries had different stories to tell:

  • France is to stay in strict lockdown for another month. Emmanuel Macron admits failings and tells the nation that the end to the crisis is not yet in sight. A year after the blaze, Notre Dame restoration is halted by the virus. And the Tour de France postponed as Macron extends a ban on public gatherings until July.
  • In Italy, coronavirus books rush to publication.
  • Italy and Spain ease lockdown restrictions. Others watch out for the repercussions.
  • In Austria some shops are reopening after a month of restrictions. Austria has seen a relatively low death toll, the latest being 384.
  • Portugal has not been hit as hard by Covid-19 as neighbouring Spain. Only 535 against 18,000. Two key factors seem to apply. The first is that Portugal was about 3 weeks behind Italy and a week and half behind Spain. This gave the country  time to get hospitals ready and increase capacity in intensive care units. The second reason being given is that Portuguese citizens are in general prone to be more compliant and obedient of the authorities, particularly in the light of Spain’s recent unsettled politics.
  • Putin makes a rare and bleak Covid-19 admission. “We don’t have much to brag about.” Russia’s president acknowledged that his country risks being overwhelmed by Covid-19.
  • To me it struck a chord – a primary mover of the virus has been relative wealth and mobility, along with a lack of respect for the age-old way of dealing with a plague – social distancing.

About social distancing:

  • A new study from the Harvard School of Public Health shows that some social distancing may be needed into 2022 to keep Covid-19 in check.
  • There is a lack of clarity about whether we should be wearing face masks. Different countries have different takes on this. Even within countries there are deep divisions. So much so that it breeds mask tribalism for the whole duration of the pandemic. In America mask-defiance for the extreme right becomes a political statement, which seems bizarre, bearing in mind all it does is filter virus-containing particles and droplets out of the air we breathe. I have worn a mask since early March. It’s prophylactic. It’s the precautionary principle, no different for why I always paraglide with a reserve parachute. It’s nothing to do with fear. It’s simply common sense. The British Government responds with predictable fudging – a review on whether face masks should be recommended for more widespread use is ongoing.
  • There is also a lack of clarity about how far apart we should be from each other. Some say two metres, some say one and a half and others say one is fine. No one has fully explained how far air can carry coronaviruses or even the difference between indoors and outdoors, or well ventilated and less well ventilated spaces.
  • Prisons, with all the confinement and close proximity issues present significant social distancing problems. Decarceration can reduce Covid-19 spread and in a number of US states prison governors start to ‘quietly’ release hundreds of prisoners convicted of non-violent, non-sexual crimes.

It’s all part of a new reality. A reality we often take to describing with the language of war. It might not be correct to do so, but there are many parallels. Nested in this ‘world on tilt’ come the following day’s stories describing a locked down world.

  • Thousands of rough sleepers are still not safely housed, charities say.
  • Greedy cats are the big losers for the Covid-19 community WhatsApp groups. New neighbours are now connecting and cat owners are learning that their pets are cheating on them.
  • People adapting to online dating during lockdown. The pros and cons, but Tinder has increased take-up considerably.
  • More people are considering switching to electric vehicles thanks to improved air conditions during the pandemic.
  • Drinking alcohol doesn’t kill Covid-19, but it does increase the risk of lockdown violence, says WHO. “Fear and misinformation have created a dangerous myth that consuming high-strength alcohol can kill of the Covid-19 virus. It does not.”
  • Designers in Vietnam are creating hand-embroidered and stylish face masks, hoping to convince people to don protective gear in the fight against coronavirus.
  • Theatre costumiers turn their hand to PPE. Costumes from the TV series ‘Chernobyl’ are donated to the Covid-19 fight.
  • England women footballers donate to #PlayersTogether to help the NHS during the coronavirus crisis.
  • Two are arrested over false Covid-19 tests.

Finally there are the personal stories:

A devoted husband using a ‘cherrypicker’ to pay his wife of 61 years a visit after the couple were separated for more than a month due to the pandemic. A daughter who having lost her nurse mother vows to buy more PPE for the hospital. And a doctor describing the anguish of the front line:

“The hardest part of treating coronavirus patients is letting them die without their loved ones. My job as a doctor includes giving people a comfortable, dignified and peaceful death. Covid-19 has made this harder than ever.”

Let us never forget.

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