Health Care

That Stalinist NHS

Boris Johnson has been forced to shift strategy on the government’s testing regime for coronavirus after criticism of the slow pace of checks being carried out on frontline NHS staff.

Private laboratories are now being drafted in to do the tests where before these were being performed through a centralised process.

Cue someone complaining about capitalists profiting from the NHS in 3…2…1…


Aren’t Public Health England going to be pissed at this?

The world’s second-biggest cigarette maker claims to have made a “significant breakthrough” in the race to find a vaccine for the coronavirus and would be ready to start mass production within three months.

British American Tobacco (BAT), the FTSE 100 company behind Lucky Strike and Dunhill, said it could be producing up to 3m million doses of a vaccine a week by June – far faster than rivals, which are expecting to take at least a year.

BAT intends to start trialling its vaccine in humans as soon as possible. It is running pre-clinical tests and holding urgent talks with US drug authorities to fast-track permissions.

The treatment is being developed by the company’s health division Kentucky BioProcessing (KBP), which has previously come up with a drug to combat Ebola. It claims to have found an antibody that appears to fight Covid-19, and is manufacturing this using genetically modified tobacco plants….

The very thought of it, that Big Tobacco might be of some use!

Confusing information

It comes as the latest NHS data from UK hospitals showed a more than doubling of deaths in just four days, with 381 new deaths reported on Tuesday, bringing the toll to 1,789. They included 28 patients with no underlying health conditions, one of whom was a 19-year old man.

What’s the relevant number to be considering here?

Depends upon the definition of underlying really. But there’s at least an argument that the relevant one for public policy services is the 28, not the 381/

Not going to happen

Britain must remain in full lockdown until June if it is to avoid the worst effects of the coronavirus, the government’s leading epidemiology adviser warned last night.

As the virus claimed its 1,000th life in the UK — a doubling of the death toll in just three days — Professor Neil Ferguson said in an interview that the entire population could need to stay at home for nearly three months.

That might even be true about deaths from coronavirus. It would still be a damn fool thing to do.

It’s the same with every expert in a field – even assuming that he’s right and Oxford isn’t. He’s solving his specific problem and not accounting for the harms done elsewhere of his solution. Closing down the economy for a few weeks may or may not be the correct thing to do. Closing it down for many months isn’t.

Our aim, recall, is to maximise aggregate human utility over time. Not having an economy to come back to doesn’t do that – for all that the economy not existing at all is mere extremist rhetoric. There really is some point at which the economic loss – because economic losses cause deaths over time – is a greater cost than the benefit of not having to bury or burn 20,000 or 50,000 or 250,000 corpses.

Estimations of those values will differ, of course they will, but the underlying concept is true all the same.

Not as appalling as it seems

The mortality rate for patients put in intensive care after being infected with Covid-19 is running at close to 50%, a report has revealed.

You only put extremely ill people into ICU, a goodly portion of the extremely ill people you put into ICU die. This is not a surprise.

What would be interesting to know is what is the normal survival rate?

And do note, this is the number of those out of ICU in one way or another. Those still in aren’t as yet in that mortality rate.

It also appears to be – appears – those with Covid 19, not those there because of it.

Finally, of course, it says nothing at all about those infected who don’t need ICU.

Harsh but true

Government ministers across Africa have called for the suspension of debt interest payments as the Covid-19 crisis deepens.

The numbers of cases being reported in Africa are still behind Europe and the US but rises are being confirmed in South Africa, Kenya, Egypt, Algeria and Burkina Faso, among others, and there is fear of what economic consequences the pandemic might wreak.

Well, of course they’re calling for debt relief. When don’t they?

However, this is going to be instructive. Those African countries aren’t going to shut down. Simply because some of them at least are living at the edge already. An economic shutdown doesn’t mean a fall in GDP, or the loss of some output. It means significant numbers of people falling below the survival line.

Which will give us the counter-example. What does Covid-19 do if there isn’t that economic shutdown? Against which we’ll be able to measure the costs of what we’ve done.

Which will be interesting. Even if the experiment isn’t one we’d perform – because it would be horrific to deliberately do nothing for a population – it’s one that will happen.

The crucial point

This means Germany currently has the lowest mortality rate of the 10 countries most severely hit by the pandemic: 0.3% compared with 9% in Italy and 4.6% in the UK.

One argument being that Germany is testing more people, finding many more mild cases. Thus while the death numbers stay the same, the rate falls precipitately.

And if that German death rate is true then the actions governments are taking are a dreadful, dreadful, waste.

It’s possible to go further too. Those deaths are curtailing 40 years of healthy life? Or three weeks? Even if the former then we’re still doing too much. If the latter then grossly misjudging the whole thing. That Theory and Madness of Crowds is a real thing y’know.

Nope, we dunno as yet. It’s gonna be fascinating when we do.

Follow this logic

Nonetheless, a national health program with unified financing and governance – basically the opposite of what we have in America today – is a powerful tool in a health crisis.

The debate over Medicare for All in the age of Covid-19 is complicated by the fact that it is our public health agencies – and not the medical care system – that serve as our first line of defense against novel epidemics. In that regard, we’ve shot ourselves in the foot with a 12-gauge shotgun: year after year of underfunding of our federal, state and local public health agencies has left us ill-prepared for the Covid-19 challenge (as evidenced by the testing fiasco).

If it’s government financing health care then we’ll not spend enough on it. Because the bit of American health care that is government financed doesn’t have enough spent on it. Therefore all health care should be government financed.

Journalistic research

At the pharmacy.

Paracetamol in stock, one pack only per person.

Chloroquine, on prescription in this country, they haven’t got any anyway.

Plenty of tonic water in the supermarket next door.

Hand sanitizer, now everywhere, no shortage at all.

I think this is unlikely

Worldwide infections have grown to more than more than 86,000, according to the Johns Hopkins university tracker, while cases inside China stood at 80,860 as of Monday. Deaths outside China have risen to more than 3,241, while deaths in mainland China stand at 3,208 as of Monday.

That implies a death rate of over 50% among those outside China.

Slightly dangerous statement

I wouldn’t say that I am on the side of the nurses here:

Two nurses denied midwife jobs as midwives for refusing to carry out abortions have lost their legal bid to take Sweden to a top European court for violating their religious beliefs.

Ellinor Grimmark and Linda Steen had told the European court of human rights (ECHR) that being denied employment due to their beliefs against abortion was an illegal breach of their rights to freedom of religion and conscience.

Applying to do a job where you’re not prepared to do part of the jobs doesn’t sound like much of a case to me. The UK system, so far as I know at least, does guarantee that right to to take part. That’s also fair enough – the requirements of the job are known upfront, take it or not.

However, this looks like a very dangerous opinion:

“It is not a human right for nursing staff to refuse to provide care,” said Hans Linde of the Swedish non-profit sex education organisation RFSU.

Yes it is. It’s entirely a human right to withdraw your labor. Especially over moral concerns. We even agree tat soldiers can – should – rightfully mutiny over illegitimate orders.

That people who don’t want to perform abortions not take jobs where they might have to seems a reasonable enough bit of the system. But demanding that people must provide labour services on demand? Didn’t we do away with that a couple of centuries back?


What to do about coronavirus.

Sorry, not a scooby. Wash your hands, try not to touch your face sorta stuff. Other than that? Economic plans and actions? Shaft the landlords? Build windmills? Coronavirus QE?

Dunno. For which apologies of course but I do try to only push a course of action when I know something about the subject under discussion.

My intuition, and it’s nothing more than that, is this is just some shit that we’ve got to suffer through. It’ll be largely over, in Europe, by mid-April.


Italy’s government has ordered all shops, bars and restaurants across the country to close after the country’s death toll from the coronavirus outbreak rose by 31% in the space of 24 hours to a total of 827.

Not sure how much use this will be

All travel from Europe to America will be suspended for 30 days but the United Kingdom will be exempt, Donald Trump has announced in a major step to limit the spread of the new coronavirus.

The US president used a live address to the nation to announce the restrictions, saying they will take effect at midnight on Friday and US citizens once screened will not be affected.

I can see that there will be substantial – substantial – costs. But the disease is already free and wild in the US. I suspect the costs are going to be very much higher than any benefits. Still, politics, must be seen to be doing something, eh?

Coronavirus holiday cancellations

The local rag tells me:

60% of tourists cancel holiday bookings to Algarve
Portugal Resident-Mar 9, 2020
It’s not just that cancellations are flooding it, it is that there are ‘no sales for the summer’, he explained. People are so concerned about the risk of …

This article having been taken down. As the NYT tells us the truth:

The Portuguese Hotels Association (AHP) said its establishments were “already experiencing major cancellations” of bookings, without specifying further.

Algarve’s AHETA hotel association said 60% of the 411 hotels in the region, famous for its beaches and golf courses popular with tourists especially from Britain, have already seen cancellations

Ah, a slight difference.

And here’s what I want to know. I’ve got to buy some flights for the summer. When will the price bottom out?

It’s not the disease itself often enough

Rather, what we try to do about it:

Four dead as Chinese hotel for quarantined coronavirus victims collapses
The building’s first floor had been under renovation at the time of the collapse

Yes, obviously, weird example but still a truth. What we do about pandemics and such things is often what causes the damage, not the thing itself. Meaning we’d better be careful about what we do, eh?

And here we have a twat writing in The Guardian

Big surprise, eh?

The world is in the early stages of what may be the most deadly pandemic of the past 100 years. In China, thousands of people have already died; large outbreaks have begun in South Korea, Iran and Italy; and the rest of the world is bracing for impact. We do not yet know whether the final toll will be measured in thousands or hundreds of thousands.

Hundreds of thousands? That’s the sort of number we’ll only note by very detailed studies of the demographics. That’s less than the annual ‘flu toll.

Asian ‘flu in 1958 (with a smaller world population) killed 4 million mebbe. Spanish ‘flu in 1918 – a much smaller global population – anywhere between 20 and 100 million dependent upon whose guess you want to believe.

There are perhaps 60 million deaths globally each year. Hundreds of thousands doesn’t really move that needle.