Covid#13 – Saving The Planet (24 June 2020)

I saw a movie last week. A friend recommended it. His cinematic tastes are more sophisticated than mine, but Mars Attacks delivered exactly what the title promised, and more. Mars didn’t just attack; its inhabitants annihilated almost everyone in the cast. Pierce Brosnan was decapitated and Sarah Jessica Parker’s head was transplanted onto a chihuahua. When President Dale (Jack Nicholson) pleaded for peace, a Martian hand of friendship impaled him through the rectum. All that stood between earth and oblivion was, inexplicably, the music of Slim Whitman. The aliens disliked it so much that (spoiler alert!) their brains exploded. As a result, humanity prevailed.

It would be an exaggeration to call the film good. Dumbing down is its own reward though, and I had my reasons for watching it. An excuse, at least. I’d been thinking about the apocalyptic atmosphere that descended as COVID-19 spread out of Wuhan and Milan, and a story Mikhail Gorbachev had once told about Ronald Reagan. In November 1985, during a nuclear arms control summit in Geneva, the American president apparently ended an afternoon session early and invited his Soviet counterpart on a lakeside stroll. Accompanied only by interpreters, Reagan then raised a subject that was playing on his mind. If extra-terrestrials were to invade, he wondered, would the USSR help defend earth? ‘Without a doubt’, said Gorbachev.

The very idea of a US president who dreams of global cooperation is almost poignant in 2020, and Reagan’s sunny personality couldn’t be more different from the dark presence glowering out of the White House today. But Reagan trod a fine line between ludicrous and bellicose, playing up to his cowboy image in an era that teetered on armageddon. President Dale’s unhappy fate in Mars Attacks was a reminder that not every threat can be negotiated away, but the casting of Jack Nicholson as a reasonable man also hints at an unexpectedly serious point. The gravity of a global crisis is no guarantee against ridiculous or inadequate political leadership.

High-flown rhetoric about the scale of the COVID-19 threat was widespread outside the United States when this pandemic began. In March, the World Health Organisation and Chinese government both urged the international community to take concerted action for humanity’s sake. By early April, no less a figure than Matt Hancock was rallying the human race. It was ‘in the midst of a war’, he said, and history proved ‘that when the world unites against a common foe, we will prevail.’ A couple of days later, the Queen pitched in. She recalled a more divisive conflict – the Second World War – but ‘this time’, she reassured viewers, ‘we join with all nations across the globe in a common endeavour.’

That almost sounded convincing. As I counted emergency vehicles and hearses on my rides around lockdown London, ominous developments far away felt strangely familiar. A friend who’s been working on a book about life in an isolated Peruvian village told me that the virus was somehow spreading through the Amazonian rainforest. An aid worker I know described its effects in the world’s largest refugee camp: the residents of Bangladesh’s Cox’s Bazar had been doubly confined, and they were worrying not just about COVID-19, but also rumours that anyone showing symptoms would be murdered in quarantine. Hardships were often worse elsewhere, but the sense of menace was ubiquitous. It seemed to be touching everyone, in ways more shareable than ever before.

That’s changed, in that people are now angry and sceptical as well as distressed, and the prospects for inter-governmental collaboration look even worse. As if hankering for a War on Terror to call his own, Donald Trump’s only crisis strategy has been to conjure more adversaries into existence. Two days after Benjamin Netanyahu became the first world leader to call COVID-19 an ‘invisible enemy’, the president borrowed the phrase to declare war on it. In the three months since, his tweets, interviews, press briefings and speeches have attacked the ‘invisible enemy’ (along with the ‘Wuhan virus’, the ‘Chinese plague’ and ‘kung flu’) more than a hundred times. Under cover of the verbal barrage, he’s withdrawn United States from the World Health Organisation and escalated political assaults on not just China, but Canada and Europe too. The only fears he hasn’t whipped up are those he senses might be his fault. Asked on 20 March what he’d say to Americans ‘who are scared’, Trump told NBC’s Peter Alexander, ‘I say that you’re a terrible reporter, that’s what I say. I think that’s a very nasty question.’

Contemplating the violent vocabulary of Donald Trump for long never did anyone any good. But the language has echoes closer to home that deserve notice. Boris Johnson first mentioned the ‘invisible enemy’ just two days after Trump, and when the prime minister announced his own ‘wartime government’ on 17 March, he was deliberately evoking the alliance against Hitler. ‘Incredible’, an astute American friend observed at the time. ‘He’s dreamed of being Churchill in the wilderness for years. Now it’s all come true, and you can’t even complain about the war he’s chosen to fight.’ Three months on, her cynicism’s redundant. Winston Churchill, for all his flaws, rose heroically to the moment. Johnson, having targeted a morally indefensible foe, has been ceding ground throughout.

Caricatures notwithstanding, the prime minister is quick-witted and eloquent, and the difficulty he’s had in articulating this pandemic’s enormity is correspondingly telling. His first effort on 12 March – a sombre warning that many families would ‘lose loved ones before their time’ – was so surprising that it was impressive. But Johnson reflected a lot more anxiety than he soothed, and after COVID-19 came close to killing him, he seemed hostage to his own clichés. Speaking after his hospitalisation, he said that: ‘If this virus were a physical assailant, an unexpected and invisible mugger, which I can tell you from personal experience it is, then this is the moment we have begun together to wrestle it to the floor.’ Ostensibly heartfelt, the reduction of a brush with death to a supernatural street crime casts doubt on whether Johnson saw beyond his lucky escape at all. Even as an expression of optimism, the statement rang false. Since the day the coronavirus was supposedly wrestled to the floor, the number of lives it’s claimed has almost doubled.

Johnson’s inadequacy is so apparent that his approval ratings have plummeted, and since his dependence on Dominic Cummings was exposed last month, it’s become common to hear that he’s lost the psychological plot too. Rumours are circulating that late fatherhood is proving stressful or that post-intensive care syndrome has set in; my favourite fantasy is that shame is belatedly gnawing at his soul. Chances are he’s just finding hard work a chore though. And though his inner demons are probably awful to behold – more terrible than any invisible mugger – only one misfortune would definitely instil shame. Deserting the metaphorical battlefield would be an admission of real defeat.

My own bet’s on a prime ministerial offensive. Now that Johnson has announced a major dismantling of the lockdown on 4 July, he’s bound to try and switch attention to more comfortable political arguments – including Brexit – so as to recover his footing. That could make the next few weeks particularly dangerous. His lurch to liberation clearly owes more to calculations of political advantage than it does to serious assessments of practical readiness. Though Johnson told parliament on 20 May that the UK would have a ‘world-beating’ test-and-trace operation in place by the beginning of this month, recently released official statistics show that a quarter of those who’ve so far tested positive for COVID-19 haven’t been traced at all. That puts all the talk of invisible enemies into its proper context. If the government was focused on eradicating an unseen virus, a more efficient system to identify carriers would have been developed long ago.

I’m keener than ever to mix and mingle, but the prime minister’s claim to parliament yesterday that ‘at every stage, caution will remain our watchword’ inspires no confidence at all. With tattered military ambitions in mind, Boris Johnson’s performance reminded me of advice urged on Lyndon Johnson at a pivotal moment during the build-up of US troops in Vietnam: ‘Declare victory and go home’. That would have been a sensible strategy back in 1966 – countless lives would have been saved – but it would be a disastrous course of action today. That’s not to say risks shouldn’t be taken; they’re unavoidable. But this pandemic is a lot more complicated than the war Boris Johnson had in mind when it began – and its political challenges are only going to get tougher.

Covid#12 – Herd Fantasies (13 June 2020)

I was invited to a dinner party a week ago. The host was an old friend, now a senior doctor at a busy London hospital. When this pandemic started, he feared the worst. Though he didn’t say so, he thought his own number might be up. Over the next few weeks, as he and his colleagues battled to save lives, the surge in admissions threatened to overwhelm his hospital’s critical care units. By early April, fears of the virus were so intense that some victims were dying in isolation. Staff lent mobile phones to patients on their deathbeds, so they could say goodbye to people they loved.

Last weekend couldn’t have felt more different. As we traded lockdown tales in the garden – a conversational bargain, from my point of view – it became almost possible to forget that a cataclysm’s still in progress. And when I wondered what the coronavirus was going to do next, my friend, who always seems pretty buoyant, looked elated. He’s recently had an antibody test, and though he doesn’t recall suffering any illness worse than a chill this year, it showed he’d had COVID-19. As if astonishing himself, he held out clenched fists and opened them slowly. ‘Obviously it’s not just me’, he said. ‘Who knows exactly what it means? But in London, I’m pretty sure herd immunity’s been achieved.’

That says a lot more about my friend’s confidence than demonstrable reality. Though government serology testing suggests that at least 17% of the capital’s residents had COVID-19 antibodies by mid May (compared to 5% elsewhere), it’s not clear yet how – or if – they protect against re-infection. Insofar as there might be heightened resistance in London, it’s certainly not total. But the exchange got me recalling how contentious the hope for universal immunity has become – and how weird that is.

The controversies began with an appearance by Boris Johnson on ITV’s This Morning on 5 March. The prime minister told Holly and Phil that all the scientists he was talking to were ‘brilliant’, and that one of their many clever suggestions was that the population could maximise its resistance to COVID-19 by ‘taking it on the chin’. That was enough to convince some critics that the Tories were cooking up a plan to cull the weak and murder the old. But in the uneasy, apprehensive days of early March, a more common reaction was stunned surprise. A prime minister who’d built his career on levity was wondering whether the best way of tackling a lethal pathogen might be to spread it around. Many foreigners were just amazed, unsure if Britain under Bojo was more sacrificial or suicidal. My favourite response was a popular joke on the Chinese social media site Weibo: ‘After leaving Europe, they now want to leave the world.’

I was definitely among the stunned. Call me an apologist for genocide, but the hidden agenda struck me even then as more panic-stricken than sinister. Ministers and advisers weren’t being ruthless; they were in disarray. When Johnson took control of pandemic management at a COBRA meeting on 2 March – after delegating the job to Health Secretary Matt Hancock for a month – his priority was apparently to cling to boffins: claims to be ‘guided by the science’ quickly become a mantra among ministers. And though the government’s chief scientific adviser Patrick Vallance said on 13 March that ‘herd immunity’ was one of ‘our aims’, the prime minister promptly lurched in favour of a strict lockdown – again, ‘on scientific advice’ – after a team of Imperial College epidemiologists under Professor Neil Ferguson published an urgent forecast. It warned that a failure to check COVID-19 would probably lead to hundreds of thousands of deaths.

That’s all history (except insofar as the machinations will one day be evidence in an inquiry) but neither the science nor the politics is settled. Ferguson proposed last week that locking down a week earlier would have halved this country’s death toll. The Swedish scientist most closely associated with an alternative policy, who advised his government to go easy on restrictions, has just said that in hindsight he’d have favoured stricter measures. Neither Patrick Vallance nor the government’s chief medical officer, Chris Whitty, are prepared to admit past mistakes, but both insisted on Wednesday that they were monitoring events carefully, because we’re ‘not at the end of this pandemic, not by a long shot’. And with shops and zoos preparing to open, school gates staying closed, and political protests multiplying, there’ll be plenty of events to monitor. While the scientists gather data, we’re living the experiment.

And even if government interventions should have been earlier or firmer, an alternative argument remains strong. In the absence of a vaccine, widespread immunity offers many countries their best hope of getting through this pandemic. Though right-wing extremists like Brazilian president Jair Bolsonaro have yoked cynical political agendas to this claim, credible science also justifies it. The reasoning has been vocalised best by an academic who co-authored a paper published at Oxford University a week after Ferguson’s Imperial report. Professor Sunetra Gupta maintains that at least half the British population are already immune to COVID-19, and that the coronavirus is ‘on the way out’. Natural resistance or antibody acquisition explains why the disease has ‘grown, turned around and died away’ all over the world, ‘almost like clockwork’.

Gupta isn’t a fascist any more than Neil Ferguson is a snowflake. She objects to the ‘libertarian harangue’ that’s been ‘hitched’ to the scientific modelling of her Oxford team, she firmly supports enhanced protection for vulnerable people, and (as befits a scientist who’s also a prize-winning novelist) her stance is both nuanced and empathetic. Lockdowns aren’t just hindering the acquisition of immunity, in her view. ‘The truth is that lockdown is a luxury. And it’s a luxury that the middle classes are enjoying, and higher income countries are enjoying, at the expense of the poor, the vulnerable and less developed countries. To think of it simply in terms of “is this epidemic going to be over or not?” is really unconscionable.’ Personal factors might also explain her differences with Imperial – but if they do, Gupta isn’t entirely at fault. Her career was almost nobbled by false allegations in 1999 that she was sleeping her way up the career ladder – and though the man who slandered her duly lost his Oxford professorship, Roy Anderson took a team of 70 loyal epidemiologists with him to Imperial College. One of them was Neil Ferguson, who relied directly on a recent Lancet article by Anderson for the structure of the Imperial lockdown paper.

Scientists’ likeability and their rivalries don’t say much about the reliability of any particular piece of work, but the contrasting approaches of the Imperial and Oxford analyses still illustrate an important truth. Data is meaningless until it’s interpreted, and no one yet knows which interpretations of COVID-19’s spread are going to end up most accurate. Every epidemiological model in use at the moment draws heavily on what happened during the Spanish Flu pandemic a century ago (Neil Ferguson, like Anthony Fauci in the United States, has written influentially about what it might teach), but history only offers signposts. Though social distancing, school closures and the prevention of mass gatherings reduced fatalities back then, many deaths were delayed by months, not staved off for years – and that’s bound to be even truer of a coronavirus that disproportionately hits the old and sick. Spanish Flu also mutated far faster than COVID-19, and its vicious second spike can’t say much about what recurrent waves of infections will do today. In any event, lowering casualties by slowing down the world threatens collateral damage that’s simply unknowable. According to one guesstimate, global lockdowns could cause 1.4 million extra deaths before 2025 from tuberculosis alone.

No one’s necessarily to blame if epidemiological guidance turns out to be wrong: science does that sometimes, and politicians are elected to decide between options and put advice into practice. But judgments aren’t immune from criticism either – and even as I’ve been writing this post, a strategy to pretend otherwise has been on show. At last Wednesday’s Downing Street press briefing, Patrick Vallance and Chris Whitty flanked the prime minister, and all three batted away journalists’ questions about whether they had made any mistakes. The scientists said it was too early to know, while Johnson deferred to their expertise. It was a smooth circle of excuses, for fixed decisions with final consequences. Key workers and health professionals were lethally under-supplied when they needed protective equipment most. Broken promises to ‘cocoon’ and ‘shield’ the vulnerable contributed to a care home catastrophe and a per capita death rate that might well end up the highest in the world. Though everyone’s able to shift responsibility for now, there’ll come a time when the political buck won’t be as easy to pass around . . .

Along with quite a few people I know, I’m vacillating between optimism and despondency at the moment, and last week’s dinner party kept me teetering. My upbeat friend was echoing hopes I share, but the risks from COVID-19 still feel very real. Holding back from an instinctive hug and handshake, he was entirely sympathetic. ‘You’re sensible’, he nodded. ‘That’s wise. Completely understandable. You’ve got mild panphobia.’ That came as news to me, and I turned over the diagnosis in my mouth as I cycled homewards. When I reached Battersea Bridge, curiosity got the better of me. Pausing to look at the river and absorb the nocturnal hush that’ll soon become unimaginable again, I keyed ‘panphobia’ into my phone. It turned out I’d been displaying symptoms of an ‘abnormal, vague, persistent dread of everything’. That sounded about right. But as I wobbled on, a tinge of irrational exuberance was added to the dread. Doctors know their stuff. Perhaps antibodies really are widespread? Even I might have picked up a few. I definitely remember a cough in February.

Covid#11 – Black Lives Matter (5 June 2020)

As usual these days, London’s on edge. Plenty of people look relaxed, almost carefree, but few conversations steer clear of COVID-19 for long. Others are wilfully careless: a recent Yougov poll suggests that the government’s indulgence of Dominic Cummings has caused 7% of the population to observe lockdown rules less strictly than before. There are probably serene corners of the capital somewhere, but the prevailing mood feels odd: impatient but also bewildered, touched by fears that a second wave of infections is already on the way.

Uncertainties on the ground are intensified by gnawing political doubts on high. Even The Spectator tentatively proposed last week that Boris Johnson ‘is not up to the job’, and on Wednesday, the Leader of the Opposition nailed the ominous implications. Keir Starmer has had Johnson’s measure for years – ever since they both worked within metres of each other in Doughty Street – and he was spot on when he accused the prime minister of ‘winging it’. The government started without a plan, and as Starmer said, it’s now trying to ‘exit without a strategy’.

Curious to see if one particular aspect of the lockdown might be weakening, I revisited Speaker’s Corner last Sunday. It wasn’t long before I found a preacher: the first returnee since March. Dr Banda had strong views about the nature of angels, the power of prophecy and Star Trek, and he claimed to have met a million people and not lost a single argument. As he explained how he’d predicted the miracle of the mobile phone, I grew tempted to take him on – at which point, coincidentally enough, my dad called. Was I at the protest, he wondered? A TV report from Trafalgar Square had just shown hundreds of demonstrators demanding justice for George Floyd, the black man asphyxiated on 25 May by a white police officer in Minneapolis.

Within minutes, I was there. The crowd had dispersed, but it hadn’t gone home. Placards multiplied when I got to Westminster, and by the time I crossed the Thames, pedestrians were streaming along the pavement at pre-lockdown rush-hour levels. Wobbling along the road, I became part of the march, and soon found myself beneath the Stars and Stripes outside the US Embassy at Vauxhall. Accompanied by boos and supportive car horns, people yelled a slogan that’s become almost traditional since Donald Trump’s election – ‘your pres-ident’s a wan-ker’ – along with a chant unheard in this country until last week. Again and again, the crowd repeated three words spoken by George Floyd as he lay dying under a policeman’s knee: ‘I can’t breathe.’

The suffocation of a defenceless black man so powerfully epitomises what’s rotten in the United States under its current ruler that it barely crossed my mind not to protest. But the thought of being elsewhere wasn’t unthinkable. Far from it. As the crowd grew, I kept recalling the anti-vaxxer protest I went to last month, and a remark I’d made soon afterwards that ‘gathering en masse during a pandemic is inherently dumb’. Vauxhall could hardly have felt more different – COVID-19 deniers and 5G fantasists were nowhere to be seen, while many participants were making obvious efforts to keep apart – but that’s only half an answer to charges of recklessness. The risk of a disease spreading through a crowd is determined by probabilities, not good intentions.

The reason I was prepared to take a chance is obvious: the protest felt important. And, subjective as that is, the sentiment reflects an attitude to risk that’s almost universal. Even my dad, a shielded 83-year-old who assumes the worst of COVID-19, expected me to demonstrate against George Floyd’s murder and was pleased when I did. Those who’d disapprove of that particular mass gathering might make greater allowance for others: a beachful of sunbathers, perhaps, or reopened schools. Tory legislators thought it sensible last week to oblige elderly and vulnerable MPs to swarm in to the House of Commons in person if they want to vote. Actions taken and precautions foregone during this pandemic are affected not just by science, but by passions and varied beliefs about the public interest.

Observations like that skirt around the trickiest issue of all: whether more mass action is desirable. No one seems more torn on that point than Black Lives Matter UK itself. Last weekend, it unhappily disavowed Sunday’s protest by referring to ‘the implications of calling a mass march in the middle of a pandemic that is killing us the most’; it’s now tweeting legal advice about what to do in the event of arrest. And confrontations are certainly possible. A head of steam is building behind plans for a second rally outside the US Embassy on Sunday afternoon . . .

My support for demonstrations so far has been informed by another subjective factor: one so complicatedly personal that I still can’t really work out where rational thought ends and wishful thinking begins. My perception of risk has been changing. I’ve come to suspect that immunity to COVID-19 exists, and that it’s widespread and durable enough to be significantly reducing the likelihood of the virus’s spread. The opinion’s not provable – but it’s not based on utter ignorance either, and the precautionary principle that’s often invoked to justify stricter regulations doesn’t defeat it. To explain why, I’d have to unpack a controversy over herd immunity that would distract from the theme of this post – but a point tangentially connected to my tentative argument is directly relevant.

As most people know by now, COVID-19 has a discriminatory impact. Black and Asian key workers have been exceptionally likely to fall victim (at least three-fifths of all health care staff killed by the coronavirus in the UK have come from these communities) and the greater vulnerability of non-white people was confirmed by a Public Health England report last week. As an analysis, the study was useless – hundreds of informed opinions canvassed during its preparation were suppressed, and it didn’t even pretend to explain the disparities it described – but one fact buried deep within its pages was striking, all the same. Deaths from all causes are up at the moment – in large part, because people are neglecting very serious health problems – and black men are more vulnerable than anyone else. Confirmed COVID-19 deaths in this group haven’t been immensely higher by comparison to white men (just 10%), and yet black men were more than twice as likely to die in the six weeks after the lockdown began. Set against mortality rates at comparable periods between 2014 and 2018, they’re dying nearly four times as often as normal.

The PHE report’s methodology is dubious, not least because it assumes all COVID-19 deaths were properly recorded as such, but this finding is still remarkable – especially because all non-white minorities, women as well as men, seem to be dying of non-COVID-19 causes at considerably greater rates than the white population. A convincing explanation of these excess mortality levels would have to look into all sorts of variables, including poverty levels, occupation choices and genetic predispositions, but one conclusion is already crystal clear. Non-white people, above all black men, are suffering a great number of avoidable deaths as a consequence of not just COVID-19, but the lockdown too. That’s no reason to be complacent about this coronavirus – it’s a racially selective killer in its own right – but it illustrates complexities that shouldn’t be ignored when discussing health precautions. Black lives matter.