Monday, November 30, 2020

A Covid-19 Christmas


There are two schools of thought in dealing with a pandemic. There is the medical, which favours shutting everything down, never leaving the house, and boiling your extremities daily. And there is the economic, the laissez-faire capitalism approach where people die or do not, and the state has no part to play other than ensuring that the process of buying and selling continues uninterrupted.

The government have done some in-and-out running with regard to which school they’re following in their pandemic strategy. In April or May, at the end of first, full-duck lockdown, Taoiseach Varadkar believed nothing could be so terrible as to open up and then have to close again. When Doctor Holohan returned to NPHET and advised that the lockdown needed to be tightened in October, Tánaiste Varadkar pronounced that the advisers advise and governments govern, and that should be the end of it. Doctor Holohan’s advice was implemented two weeks later.

Now the government are four-square behind a different Christmas, but a good Christmas. A Christmas Ryan Tubridy can be proud of, and with no gloomy medicos acting as bad-news bears to spoil everybody’s fun.

Does the government ever wonder if Covid-19, the novel coronavirus, know it’s Christmastime at all? Is the government at all concerned whether or not Covid-19, the novel coronavirus, can tell if any particular environment is a wet pub or the perfume counter in Brown Thomas?

The government is betting that the people’s need for a “normal” Christmas, and the economy’s need for Christmas business, is greater than both the people’s intolerance of a third lockdown or the potential crisis caused by the HSE’s unknown ability to deal with a surge of post-Christmas cases.

Pat Leahy made the case for the economic benefit in a recent Irish Times column. The problem is that those economic arguments were no less true during the time the government locked down as they are now when it wants to lift lockdown. What is different? What is it about now that is was not the case a month ago, other than political opportunity? Could we, perhaps, save some money by not burning it on the altar of the Children’s Hospital instead?

On the people tolerating another lockdown, that seems to be a fifty-fifty proposition if an Ireland Thinks poll in yesterday’s Mail on Sunday is to be believed. If Ireland Thinks polling is anything like their website that may not be a worry. If the poll is on the level, then the government, and the political establishment in general, have badly misjudged the public mood.

How much the government suffer in consequence of this depends on how much the people suffer, which itself depends on how toasty things get for the HSE.

The HSE is not having a good pandemic. The HSE doesn’t do well in normal times – what hope have they in times of pandemic? This is under-reported in the press. There may be different reasons for this, but there can be no doubt that the government are handing out green jerseys at official and unofficial briefings morning, noon and night, and urging the media to “act responsibly” for the good of the nation.

But keeping schtum on the dysfunction of the Health Service does not serve the good of the nation. It serves the good of those who benefit from that dysfunction, to the detriment of the good of the nation. The media can only serve the good of the nation by keeping the nation informed of what the nation needs to know. And the nation needs to know that if there is a spike in cases to which the government is slow to respond, is likely to see a lot of business.

The argument against this is that the virus is not as deadly as it was. There are two possible reasons for this. The first is that the virus has mutated, about which your correspondent knows nothing, quite frankly. The second is that treatment has improved as the medical world has had a year to study the thing. This is demonstrably true.

Against this is the remarkable sloth and inertia of the Health Service in Ireland. Change comes dropping slow in the HSE. Its ability to triage cases in an epidemic situation has never been tested but reader, as it creaks so badly at the best of times, what hope has it of surviving the worst?

A state’s ability to ease lockdowns in times of epidemic is proportional to the state’s ability to trace outbreaks to their origin. In New Zealand, they’re able to trace down to the cluster. Thirteen cases at a wedding in Wellington. Twenty-five cases at the Ruby Princess Cruise Ship in Hawke’s Bay. 

The highlight of Ireland’s case-tracing came in August of this year, when we managed to trace an outbreak to somewhere in Offaly, Laois, or Kildare. This does little for confidence in an agile response to a post-Christmas outbreak.

The importance of speed of response, again, is critical because of the speed with which the virus is propagated. A quick example. Let’s say you decided to walk north up O’Connell Street, and give yourself six minutes to do it, which is about what it takes at an average walking speed of five kilometres an hour.

If you travel at that speed, after three minutes you’re a little past the spire and the next three will see you at Parnell Street. But if you’re not travelling at that speed – if you’re travelling at an R-number of 1.1, say – you reach the spire only after 5 minutes, 53 seconds. You then cover the remaining half of the street in seven seconds. In another minute, that rate of acceleration will have you in Belfast.

The R-number doesn’t map exactly to rates of cases, of course, but it is useful in showing how quickly a health system can be overwhelmed if infections aren’t spotted and dealt with it in time. 5’53” to the Spire. Seven seconds the rest of the way. One minute more to Belfast. Happy Christmas.