SARS-CoV-2 COVID-19 update 3

Rookwood, Going Postal
Halifax, Canada – Empty shelves with no toilet paper
Indrid__Cold – Licence CC BY-SA 2.0

I had a very disturbing phone call today. A good friend of mine, with an IQ and integrity reaching the outer stratosphere, touched base with me regarding the current SARS-CoV-2 situation. A very considered, thoughtful and honest man, I never believed I would experience what I did during our exchange. He was clearly scared, and quite rightly so. I will not say what business sector he works in, but let’s just say you need a high level of government clearance to do so. The reason he was so scared is simple, and I will share why.

Maybe, just maybe, some of the country gets it. I’m not talking about SARS-CoV-2 or COVID-19 here, nor the various and countless other issues that have broken the back of this nation – immigration, debt, lack of social mobility and cohesion or a growing underclass to name but a few. What I am talking about are individuals who have not bought in to the big lie, those that are of independent mind and have cut their own path through the hard rock of life, rather than following on the backs and efforts of others. Such people are invaluable in times of crisis such as now, as they are able to see clearly over the event horizon and help us understand the truth, no matter how unpalatable. The truth is COVID-19 is the least of our worries right now. If you don’t have it, do your best to protect yourself and others and don’t catch it. (Males 80+ with cardiovascular disease are most at risk [5]). Now, more than ever, is a time where we need to be looking out for each other, going that extra mile, making that additional sacrifice. It is not the time for petty politics, finger pointing or bullshit. We need to look out for our loved ones, our friends, our families, ourselves. Maybe even our enemies, if we have a big enough heart. If you thought Brexit was divisive, see what the next few weeks and months will bring.

The rats are finally out of the traps, and as always, I use the technique of reading between the media lines, in parallel with as much background research and material as I can absorb in the interim to write these articles. Full marks go to Boris Johnson and his candour concerning COVID-19. Admitting that a percentage of your population will inevitably die in the wake of this pandemic takes considerable courage and integrity. Unlike certain disease “Experts” I have seen wheeled out, not only has he gained my respect, but my empathy as well. The stress is clearly beginning to show, and I genuinely believe he has the nation’s best interests at heart, even if he will get some things wrong. It is tremendously difficult to lead under such circumstances, and with siren voices everywhere, it is challenging to isolate those with a less than pure motive. As a leader, it is often difficult to separate the “Yes men” from the sage or indeed the fool. Hindsight, as always, has 20-20 vision.

So I am not going to pull any punches here. Yes, the media is milking this for all it is worth. Yes, there are those that are going to capitalise on the misery and suffering of others. Yes, you may have to make some very difficult personal decisions. No, this is not the Black Death or Ebola. No, this is not an extinction level event. The truth is less straightforward, more difficult and far less palatable. Irrespective of the healthcare system in your country, COVID-19 the disease, will overwhelm it unless strict measures are taken to prevent the spread of the virus, SARS-CoV-2. This is proven, scientific fact. Most Western nations have now failed in this regard. The thinking, unspoken, yet loitering in the air like a fetid droplet, is that the economy and infrastructure are more important concerns, at least initially. This stance will crumble as the virus takes a tighter hold of the nation’s jugular. Demand for mechanical ventilation has reached 30 times the daily norm in the UK, and as COVID-19 patients require extensive periods of assistance breathing, we cannot be far from saturation point where critically ill patients will be left to die due to lack of resource [1]. This already is happening in Italy [2]. With ~ 30% of patients presenting at hospital requiring either oxygen or mechanical ventilation, and with the rule of thumb epidemiologists use, that is for every known case of disease there are 99 behind it, the math is both daunting and unequivocal.

The big problem now is that the remainder of UK PLC are waking up and smelling the coffee. Rudely awaking from their deep slumber, they have had a shocking overdose of reality. Panic is everywhere, and like the clinically cold blood lust of the psychopath, all rationality, common sense and empathy is to be abandoned in the tooth and claw survival of the fittest. Hoarding, price gouging, and the theft of hand sanitisers are but some of the symptoms of this madness. Empty shelves spring up overnight. Yet some remain unflustered, seemingly calm and oblivious to the stampeding hordes. The irony is that this minority have already gone through this pain of self discovery, many over an extended period of years. The sleepless nights, the self-doubt. The agonising decisions, made for the best, trying desperately to cobble together a coherent strategy that balances morals, ethics, love and success in the glaring knowledge that our current society, as we know it, not only is a very fragile construct, but has been weakening by the decade. Those with ears to hear and eyes to see have realised for some time now that we have been on the brink, and prepared accordingly. A case in point. Before I got married, I had a very long and considered discussion with my wife over the thorny issue of having children. Naturally, I wanted to continue our blood line, but I was seriously concerned about the world we would be bringing a child into. Having seen how brutal life can be, and that a substantial minority of people are ambivalent to any sense of natural justice, decency, truth, wisdom or beauty, it was one of the most difficult decisions I have ever made. I wanted to bring my children into a blossoming heaven, not a burgeoning hell, but I could see the writing on the wall even then. What sort of world would I bring them into? So, as a father, you can understand the heartbreak I suffered when during one particularly heated discussion, I was brutally informed by my child that “They didn’t ask to be born”. Every major decision my wife and I have made, was to give them the best possible start, the many things we didn’t have as children. Thankfully, that phase has now passed, and I am an immensely proud father. That selfish, entitled attitude though, is so clearly prevalent in every aspect of the current Zeitgeist. Me too, is not just a political movement, it is a grasping, “Screw others” mentality that promotes the needs of the individual over the rest of society like a tiny, grasping, naked, god, akin to a dark star where even light itself cannot escape. As this pandemic spreads and takes hold, we will see the worst of human nature exhibiting itself. That is why my friend was so scared. Even if this pandemic burns itself out relatively quickly, the scars will undoubtedly remain.

So we are moving into the next phase, the political consolidation of control and centralisation. The only two countries I can see that have shown any sensible approach to this outbreak so far are Singapore and South Korea. Rather than allowing the disease to exhibit “J” shaped exponential growth, they have enforced strict isolation and quarantine measures, thereby giving their healthcare systems sufficient headroom to cope with the incoming deluge of cases. This “Slow burn” strategy is particularly important as ICU, staffing and oxygen provision are at a premium, and the last thing you want is stressing your frontline staff to the point that they become casualties, something that can easily happen due to the infectiousness of this disease, even with adequate PPE. Intubation is not just a risky procedure for the patient under such circumstances. As the saying goes, the medical staff need to be lucky all the time, the virus only once. So with the exception maybe of Italy, which has shut the door well after the horse has bolted, at least they have made a token effort, all be it too little, far too late. No such luck here. We have a media that has brought the frog encrusted pot to the boil, and the occupants are not going to be able to jump out any time soon.

Like all other Western nations, we are potentially racing towards a healthcare and infrastructure crisis unseen in generations. Give it a month or so, and we too, like Italy, are quite likely to be operating crisis triage in hospitals. No point in trying to save someone or waste resource when the prognosis is not good. The full horror of how much the NHS and local authorities are able to care for the vulnerable will quickly become apparent. The lie that the system will save you will be exposed for what it is, for the system does not, never had, and cannot ever, have unlimited resources. Once that truth reaches those that have just awoken, the collective cognitive dissonance will result in one thing. Man, as whenever he is faced with an existential threat, will reach into his limbic brain and make one of two choices – fight or flight. Those who followed the sage biblical wisdom of having oil in their lamps, will be the few with any wisdom or light in this scenario. The remainder will descend into an unspeakable terror and loneliness, for he who cares only for himself, sees only his own reflection looking back at him from the abyss. The shock to the national consciousness will be immense, but not unexpected.

The government, clearly, has not panicked yet. Worst case, measures will be put in place, and these include closures of schools, restrictions on freedom of movement and public gatherings, rationing, and definition of essential employment categories. Emergency legislation will be passed categorising essential workers, giving them priority access to services, possibly giving local authorities stronger emergency powers. There may be disruption and rationing to national infrastructure, including water, gas and electric supplies. Non-essential services will be curtailed, including access to the Internet and mobile phone systems in order to prioritise access for the emergency services and prevent the spread of “Fake news”. Daily cash withdrawal and foreign exchange limits may be applied to prevent bank runs. You might think these are the ramblings of a madman, but these measures have been applied sporadically in times of crisis throughout history. The clue here again, is the media narrative. We are on a war footing – so they say. All of this won’t happen at once, clusters will develop, probably around major cities and densely populated areas at first. When they start quarantining areas or shutting schools, this will be the beginning of the push. Keep an ear to the ground regarding your local authority, they will be responsible to a certain degree for emergency planning. What is certain is nothing is certain, expect the unexpected and you will not be surprised. Make friends with your local radio amateurs, they are licensed by OFCOM, and fiercely treasure their kit, freedom of speech and the ability to broadcast. They frequently know what is going on, especially if normal communications are limited.

All of this, if, when, whatabouttery – is conjecture. As I’ve said previously, if I knew what was going to happen, I would be a rich man. We need to reach the tipping point before any of this happens, and for Italy this has been in the surprisingly low region of 9,172 cases with 463 deaths [3]. Italian critical care resources have 7,550 beds which works out at 12.5 beds per 100,000 population. In the UK, we run at 6.6 beds per 100,000. Germany has managed to keep things under control so far, with 29.2 beds per 100,000 [4]. The reason for the emerging care crisis in Italy is unclear, it could be that they have block reserved beds in other regions for their local populace, it could be the age demographics or it may be down to the strain of COVID-19 present there. Going by the Ebola outbreak, specific hospitals were designated as “Specialised” treatment centers here in the UK, as they are familiar with highly infectious disease protocols. This designation may change, but like the Italians, we may find ourselves in a triage position quicker than we might otherwise wish. Portugal though, will inevitably be in a very difficult place, with 2.6 beds per 100,000 population, it has a little more than one third of UK critical care capacity, and less than 10% of what Germany has available. What is becoming clear, is that when that tipping point is eventually reached, the descent into chaos is rapid and without warning. Like all complex systems, when disaster strikes, the results and the outcome is frequently not what we expect due to the ever capricious black swan. It is becoming clearer by the day though, COVID-19 is not just any old illness. Unless there has been a complete global coup d’état of all social and mainstream media, the news coming out of Italy, closest to us when it comes to population demographics, even with strong quarantine measures and twice the ICU beds, is not optimistic. Anyone who suggests otherwise doesn’t understand exponential growth and the “J” curve. We are currently only at the bottom. Unless the UK government makes some very tough choices very soon, between the economy, the welfare of its citizens and the reality of this outbreak, we are facing a grave situation needlessly. Some think it is already too late, and my friend made a very valid point. I have been arguing the issues with the supply chain are going to be the initial “Tells”, the canary in coalmine, so to speak. He made a much more salient point. What happens when one of the checkout operators in a major supermarket chain is found to have the bug? How long does it take to close, disinfect and reopen a superstore? What, realistically, are the chances of tracing contacts? More worryingly, what will a mass of scared people do in response? Will there actually be a co-ordinated, rational, government reaction or just the inevitable panic followed by the finger pointing, knee jerking and blame game? Now that COVID-19 has been nicknamed “The gammon flu”, I don’t think a certain proportion of the populace has an abundance of love, generosity and empathy towards a certain, more vulnerable segment of society. On that bittersweet note, I’ll finish with the one piece of good news. Jon Snow is out of self isolation. Despite his left-wing credentials, I am genuinely pleased and wish him well. The fewer that succumb to this wretched virus, the better, regardless of political stripe.

(Apologies again for disjointed sections, I am updating ”On the hoof” as more news comes in and the situation changes).

References

[1] Channel 4 news, Thursday 12th March 2020
[2] Podcast and transcript from Italian medics
[3] JHU coronavirus map
[4] EU availability of critical care beds
[5] Accurate breakdown of COVID-19 casualties by age, gender etc.
 

© Rookwood 2020
 

The Goodnight Vienna Audio file