Friday, 19 June 2020

The Johnson effect.

I try to keep politics at bay during these posts; there is enough science around to keep any health blogger busy - however, politics and the pandemic are interwoven. 

On the one hand, I keep hearing about how we in the UK are "world beaters". The most recent claim focused on testing and tracing, this is despite our system yet to be properly up and running and already beset with technical and human problems. It lags well behind many others. Im afraid the bullshitometer has gone well into the red!

On the other hand, it does sadly seem that in one sense we are truly leading the world -  in our rates of death from COVID19.  The graphic below sadly displays our 'world beating' performance. 



Only Belgium has more deaths per head, but they have counted deaths in the community when COVID was suspected, so have overinflated their figures. I'm not sure why Johns Hopkins missed out Spain from this graphic, but they slightly lag behind us.

If the figures for Scotland and Wales are removed, English deaths per head of the population look even worse.

So listening to Boris Johnson and his merry team describe our response to the pandemic as world beating had driven me to put down in words how we have indeed achieved our status as a world leader. In COVID related deaths.

So, on the basis of what we have learned, let me describe:

10 tips to create a bigger, longer pandemic! 


1. Make sure the population is as unhealthy as possible

FOOD. First, ensure as many people are eating as much highly processed low quality food as possible. This will ensure that most people are overweight or obese, and we know already that people poisoned in this way fight infection less well and indeed spread viruses further.

Work towards future trade agreements with the USA, the undoubted world leaders in the production of low quality food. This will ensure even more people become overweight and metabolically compromised as well as getting rid of our smaller mixed farms which produce healthier food. Planning for the next world beating pandemic already.

POVERTY. Increase poverty to the point where as many people as possible can only afford to buy said cheap ultra-processed food. Poverty also increases stress which makes people think they needs "treats" and "rewards" to alleviate the anxiety of day to day life.

SMOKING AND ALCOHOL Cut funding for smoking cessation clinics to ensure that a significant chunk of the most vulnerable sections of the population continue to smoke. Make alcohol as available and as cheap as possible. 

AIR POLLUTION Don't do anything to reduce air pollution as this increases susceptibility to infection and absolutely ignore any improvements to health resulting from lockdown induced reductions in the amount of poisonous air people have to breathe.

VITAMIN D Make sure most people spend as much time indoors as possible. Low pay and having to work long hours to make ends meet will also compromise immunity. Warehouse and call centre jobs are ideal for this and will be much in demand during the pandemic. 

Low population levels of Vitamin D will also help the pandemic along. So its essential not to mention Vitamin D at all, especially when it becomes clear that people with low levels are dying more, and keep well clear of any suggestion that taking Vitamin D supplements might help avoid these needless deaths until it is too late to make any difference. 

PUBLIC HEALTH ADVICE In press briefings make sure not to mention anything that might give people a clue how to get healthier. Avoid all mention of sugar, tobacco, sugar or alcohol or lifestyle at all. 

People who smoke are overweight, lack exercise, drink to much alcohol and eat a poor diet are 20 times more at risk of becoming ill, even before COVID19 came along. 

PR Hint - Call this Individual Choice.

2. Increase social inequality


Increasing social inequality also ensures the population as a whole is less pandemic-ready. High levels of stress and day to day financial worries reduce individuals resistance to infection. Keep wages as low as possible for as many people as possible and destroy ways of mitigating this, like Sure Start for kids, and youth clubs for young adults.

The appropriation of the nations wealth by a small number of people with will help the virus get a hold.  As you said in Febuary, the pandemic offers a golden opportunity to cash in.

PR Hint - Call this Opportunity


When it becomes clear that the underprivileged and in particular BAME groups are hit harder by the pandemic, promise to commission reports which report back only when it's too late to do anything. Make sure to redact the reports before they are published to ensure nothing needs to be done. Ensure more reports are recommended and agree to do listen to what they say at some unspecified time way into the future.

PR Hint - Call this Anti-Racism.

3. Create a weak public sector


Slim down Local Councils, public health departments and community health teams, ideally to the point of extinction. Make it impossible for primary health care teams, health visitors, social workers and district nurses to work effectively together. Make sure also that local public health departments have no input whatsoever to anything at all.

Create multifaceted staffing crises my making training expensive for medical, nursing and even midwifery students. Reduce pay for staff, and increase the workload of clinical staff while at the same time paying for more management needed to administer complex contracting systems. Duplicate this wherever possible. 

In particular, a recruitment crisis in primary care would make effective responses less likely and ensure that primary care staff spend as much time on admin tasks as possible. This has already been achieved.

PR Hint - Call this Modernisation.


Making sure European doctors and nurses are made to feel unwelcome and return to their countries of origin. Make it difficult for overseas staff to work in the NHS by charging them for the services they provide, whether they use them or not - and try to stop them coming here in the first place. Setting income requirements above that generally paid in the NHS or care sector would help achieve this. Extend this charge to every member of their family and make it annual.

PR Hint - Call this Patriotism.


Ensure that social and health care systems operate with completely different and highly strained funding streams. Keep promising to sort this out, but never ever do.

Fragmentation, poor communication across the sector, no structural leadership, administrative chaos and variable quality will ensure the sector is always one step behind. Ensure also that as many of the profits from care homes as possible are sequestered offshore by equity companies to ensure they are not simply taxed recycled and reused. 

PR Hint - Call this Competition.

4. Get rid of any spare capacity in health care


Make sure that there is no slack, no spare capacity, no contingency whatsoever in hospitals. Ensure everyone is already working flat out and that there are no spare beds at all before the pandemic hits. Reduce ITU beds to the absolute minimum.

Make sure that the care privatised, fragmented, leaderless care home sector are desperate to maintain the high occupancy levels needed to make a profit. Reassure them that taking COVID19 will be fine and that there is no evidence that this will cause a problem. When the evidence of harm pours in, simply state that it is now time to move on. 

PR Hint - Call this Rationalisation


Shelve any pandemic planning that might suggest money is spent on resources like PPE that just sit there doing nothing until an emergency comes along. To back this up, get rid of any stored PPE. 
Reduce capacity in NHS or public health laboratories by centralising and privatising so we are not ready for widespread testing for months. This will ensure the pandemic gets off to a world beating start. 

PR Hint - Call this Efficiency.

5. Show personal leadership


Be unfit - Demonstrate the difference obesity makes by weighing in at 17st 7lb and 5ft 9in, with a BMI was of 36.2. This is well into the obese category. (BMI over 30). This is known to impair the immune system ability to counter COVID as well as creating other illnesses along the way which also make the outcome worse

Get infected early. -  Make sure you visit a big hospital and shake as many hands as you can.
Prime Minister Boris Johnson shakes hands with nurses during a visit to Addenbrooke’s Hospital in Cambridge (Alastair Grant/PA)

This not only ensures that you pick up the infection yourself, but also that you spread it around as many of the front like staff as you can.

Make an announcement:

“I am shaking hands. I was at a hospital the other night where I think there were coronavirus patients and I was shaking hands with everybody, you will be pleased to know, and I continue to shake hands"

Any ensuing infections will cause staff to isolate, putting pressure on those still working and means that staff have to be brought in from other wards and agencies to fill gaps, thus further increasing the chance of spread the infections.

Ensure you have the best treatment available though do not mention that such care is beyond the capability of the private sector.

Spread the infection

Make sure you visit places where you can meet as many people as possible. Shake lots of hands and don't be shy with the hugs. Sport provides an ideal seeding ground and if possible import spectators from hot spots like Madrid if you can. Ideal for this would be a four day festival where 250,000 people share as small a space as possible and chummy up to as many of them as possible.

Big up Herd Immunity.

And then deny you did any such thing


PR Hint - Call this the British Bulldog spirit

6. Delay decision making


Make sure that ongoing decisions are made as late as possible, are totally centralised and don't involve local authorities, GP's, NHS trusts or anyone else with their feet on the ground prior to announcements.

Don't attend COBRA meetings. COBRA meetings are so called because they refer to Cabinet Office Briefing Room A meetings, and no doubt because its a catchy title. Their purpose, according to the Institute of Government, is to co-ordinate decision making in the event of high level emergencies and civil disruption. Like a pandemic. Avoid them like the um, plague. 

Have swish American Style daily party political broadcasts. Call them press briefings and make them as paternal, chummy and friendly as possible. At all times thanks everyone for everything and keep manners on full throttle. Appear to be very nice and speak calmly and slowly. Allow friendly questioning from hand picked media. Defer to the scientists at all times and imply that everything that goes wrong is their fault.

Travel freely while telling people not to and issue fines for people who flout ill defined regulations as long as they are not chums.

Make special advisors special - Make sure that public health messages are compromised by supporting rule-breaking by special advisors who do what they like. Forgive them for doing exactly what you are telling everyone else not to do. That is why they are special.

At all times state that you have made the right decisions at the right time based on world beating advice and that you are proud of everything. Look exasperated when asked if there are lessons to be learned.

PR hint - Call this certainty

7. Privatise the public health response.


Make sure that the potential for developing permanent public health expertise is not achieved. Thus usual method of contracts with chums who will keep costs low will suffice and ensure the NHS misses the chance to develop this capacity with well trained better paid staff.

  SERCO     

The private sector will guarantee poor or even no communication with existing public health services, keep training and pay to a minimum, as well as giving lots of contracts and cash to the usual chums. At all times prioritise Conservative party donors who excel at avoiding tax. 

8. Make the economy work for you


Behind the scenes, prepare to turn our backs on our neighbours. Start agreeing to trade deals with America making sure at all times to not mention their effect on health or agriculture and most important of all, ignore the effects on climate change.

This will preserve the cascade of wealth from the bulk of the population to most wealthy and ensure chums in the corporations are not fettered by rules and regulations related to health, food quality, safety or the environment. 

Borrow lots of money from chums in pension funds, investment banks, and insurance companies who will get generous risk free returns paid for by the taxpayer. Rather like the debt recently paid off for the abolishment of slavery.




PR Hint - Call this prudence
 

9. Play the Blame Game


Claim all successes as your own and simultaneously ensure that all failures are placed where they belong - elsewhere. 

Compromise every good idea by delay, prevarication and underfunding. 

At all times tell people that we are leading the world in whatever the subject matter is at that moment in time.

10. Repeat the whole thing during the next pandemic


Ensure the whole system can evaporate into thin air and local expertise is not developed before the next pandemic, when we can go back to number one and start all over again.

The real lessons to be learned are how to shift more money from the taxpayer to the expanded private sector, which after all, is the whole point of being in government.


These measures and more will ensure that in the UK we sit at the top table of COVID19 infected nations and have a world beating pandemic!



 












3 comments:

  1. That just about sums it up .... and is why I have pulled up the drawbridge! :-(

    ReplyDelete

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