Air transport is a key factor in the rapid global spread of the SARS-CoV-2 virus.
In the absence of air transport the spread of Covid-19 to the United Kingdom would have occurred later and Covid-19 might perhaps not (yet) have reached the United Kingdom at all.
It was the existence of air transport from China, whether by direct flight or indirect, that necessitated the closure of the UK Border on 31st January, to which I referred in an earlier post on this blog:
The United Kingdom's border should have been closed on 31st January 2020
I mention the key role of air transport in spreading Covid-19 infection because the closure of the UK Border on 31st January 2020 would inevitably have caused major disruption to air traffic to and from the United Kingdom.
On the principle that "the polluter pays" there is a form of natural justice that the adverse effects of the proposed closure of the UK Border would have fallen primarily on airlines.
The airlines were a key factor in introducing Covid-19 into the United Kingdom.
It would have been fair that the industry which was in course of damaging the public health in the United Kingdom should be first to pay the cost.
20 June 2020
The United Kingdom's border should have been closed on 31st January 2020
For some time, the header of this blog has asserted that Boris Johnson has caused thousands of avoidable deaths due to Covid-19.
In this post I set out in broad outline the actions which Boris Johnson ought to have taken on 31st January 2020 in order to avoid almost all Covid-19 infections in the United Kingdom and, in my view, to avoid all Covid-19 deaths in the United Kingdom.
For centuries, quarantine has formed a basic tool to prevent the introduction of a dangerous infection to a susceptible population.
When quarantine was first practised there were no effective treatments for bubonic plague and other dangerous infections carried by traders or on traded goods.
Similarly, in January 2020 there were no specific effective treatments for a serious coronavirus infection such as Covid-19.
So what should a competent Prime Minister have done in order to protect the United Kingdom's population?
Boris Johnson should have protected the lives of UK residents by closing the UK border on 31st January 2020.
That border closure should have applied to air, land and sea.
Ideally, in order to minimise disruption on the island of Ireland the UK border closure should have been agreed with the Government of Ireland.
A coordinated border closure which applied to the United Kingdom and the Republic of Ireland would have kept the British Isles essentially free of Covid-19 infection and, in my view, avoided all Covid-19 deaths in the United Kingdom and in Ireland.
In light of the United Kingdom's dependence on imported food and other imported essentials it would have been necessary for the UK Government to allow a very limited exemption for those transporting supplies essential to the United Kingdom, for example drivers of food lorries and pilots of planes carrying genuinely essential supplies.
In parallel with those tightly limited exemptions, active steps should have been taken to minimise any potential transmission from, for example, lorry drivers to those unloading food lorries at supermarket depots.
Staff at supermarket food depots who might have come into close contact with lorry drivers importing food etc should have been advised to minimise contact with all drivers of lorries coming from abroad, to wear face masks and to minimise fomite-mediated spread by regular, thorough hand washing.
The possibility of creating an emergency trans-shipment depot in Kent should have been actively explored. That would have minimised the areas of the UK to which drivers importing food etc would have travelled to.
As of today, if the UK border had been closed on 31st January 2020 in excess of 40,000 avoidable Covid-19 deaths would have been avoided.
In my view Boris Johnson was grossly negligent in not taking steps to protect lives in the United Kingdom by closing the UK Border on 31st January 2020.
If I am correct that Boris Johnson was grossly negligent there are legal consequences which potentially follow, a matter which I will address in a future post.
In this post I set out in broad outline the actions which Boris Johnson ought to have taken on 31st January 2020 in order to avoid almost all Covid-19 infections in the United Kingdom and, in my view, to avoid all Covid-19 deaths in the United Kingdom.
For centuries, quarantine has formed a basic tool to prevent the introduction of a dangerous infection to a susceptible population.
When quarantine was first practised there were no effective treatments for bubonic plague and other dangerous infections carried by traders or on traded goods.
Similarly, in January 2020 there were no specific effective treatments for a serious coronavirus infection such as Covid-19.
So what should a competent Prime Minister have done in order to protect the United Kingdom's population?
Boris Johnson should have protected the lives of UK residents by closing the UK border on 31st January 2020.
That border closure should have applied to air, land and sea.
Ideally, in order to minimise disruption on the island of Ireland the UK border closure should have been agreed with the Government of Ireland.
A coordinated border closure which applied to the United Kingdom and the Republic of Ireland would have kept the British Isles essentially free of Covid-19 infection and, in my view, avoided all Covid-19 deaths in the United Kingdom and in Ireland.
In light of the United Kingdom's dependence on imported food and other imported essentials it would have been necessary for the UK Government to allow a very limited exemption for those transporting supplies essential to the United Kingdom, for example drivers of food lorries and pilots of planes carrying genuinely essential supplies.
In parallel with those tightly limited exemptions, active steps should have been taken to minimise any potential transmission from, for example, lorry drivers to those unloading food lorries at supermarket depots.
Staff at supermarket food depots who might have come into close contact with lorry drivers importing food etc should have been advised to minimise contact with all drivers of lorries coming from abroad, to wear face masks and to minimise fomite-mediated spread by regular, thorough hand washing.
The possibility of creating an emergency trans-shipment depot in Kent should have been actively explored. That would have minimised the areas of the UK to which drivers importing food etc would have travelled to.
As of today, if the UK border had been closed on 31st January 2020 in excess of 40,000 avoidable Covid-19 deaths would have been avoided.
In my view Boris Johnson was grossly negligent in not taking steps to protect lives in the United Kingdom by closing the UK Border on 31st January 2020.
If I am correct that Boris Johnson was grossly negligent there are legal consequences which potentially follow, a matter which I will address in a future post.
11 June 2020
The United Kingdom's Pandemic Influenza Strategy - links to documents
One of the potentially important pieces of background documentation which it is relevant to examine with respect to the failures by Boris Johnson and Chris Whitty to effectively protect the Public Health in the United Kingdom is the UK's Pandemic Influenza Strategy.
This blog post provides links to a number of documents dating from 2011 and subsequently on the United Kingdom's preparedness (sic) for an Influenza Pandemic.
This blog post provides links to a number of documents dating from 2011 and subsequently on the United Kingdom's preparedness (sic) for an Influenza Pandemic.
- 22nd March 2011 - The Scientific Summary of Pandemic Influenza and its Mitigation: Scientific Summary of Pandemic Influenza & its Mitigation
- 10th November 2011 - UK Influenza Pandemic Preparedness Strategy 2011: UK Influenza Pandemic Preparedness Strategy 2011
- 13th August 2014 - Pandemic Influenza Strategic Framework: Pandemic Influenza Strategic Framework
- 13th August 2014 - Pandemic Influenza Response Plan 2014: Pandemic Influenza Response Plan 2014
- 2017 Exercise Cygnus Report - The version currently publicly available links from an article in the Guardian on 7th May 2020: Revealed: the secret report that gave ministers warning of care home coronavirus crisis The document as published by the Guardian is slightly redacted. Its content is not limited to issues which relate to care homes.
28 April 2020
Boris Johnson's Let it in! Let it spread! Let it kill! Strategy
In an earlier post, Combatting Covid-19: The Keep it out! Kill it off! Strategy, I briefly set out what I believe would have been an effective strategy to combat the Covid-19 strategy.
That Keep it out! Kill it off! Strategy contrasts with the dangerous, indeed deadly, strategy adopted by Boris Johnson and his Government which, with variants during defined time periods, can be summarised as
With at most minimal intervention regarding flights direct from Wuhan the SARS-CoV-2 virus has been allowed to enter the United Kingdom without significant barriers having been put in place.
Apart from an initial period (termed the "contain phase" in the UK Government's paper of 3rd March 2020) no serious attempt has been made to stop the spread of the SARS-CoV-2 virus in the United Kingdom.
It was madness to try to identify cases in the UK while allowing the SARS-CoV-2 virus freely to enter the United Kingdom.
It is like mopping up the floor surrounding an overflowing bath and leaving the taps running.
The inevitable effect of Boris Johnson allowing the SARS-CoV-2 virus to enter the United Kingdom with minimal or no hindrance, and making ineffectual attempts to stop the virus spreading, it became inevitable that Covid-19 would kill in the United Kingdom in large numbers.
That Keep it out! Kill it off! Strategy contrasts with the dangerous, indeed deadly, strategy adopted by Boris Johnson and his Government which, with variants during defined time periods, can be summarised as
- Let it in!
- Let it spread!
- Let it kill!
With at most minimal intervention regarding flights direct from Wuhan the SARS-CoV-2 virus has been allowed to enter the United Kingdom without significant barriers having been put in place.
Apart from an initial period (termed the "contain phase" in the UK Government's paper of 3rd March 2020) no serious attempt has been made to stop the spread of the SARS-CoV-2 virus in the United Kingdom.
It was madness to try to identify cases in the UK while allowing the SARS-CoV-2 virus freely to enter the United Kingdom.
It is like mopping up the floor surrounding an overflowing bath and leaving the taps running.
The inevitable effect of Boris Johnson allowing the SARS-CoV-2 virus to enter the United Kingdom with minimal or no hindrance, and making ineffectual attempts to stop the virus spreading, it became inevitable that Covid-19 would kill in the United Kingdom in large numbers.
Boris Johnson has caused thousands of avoidable Covid-19 deaths in the United Kingdom
The incompetence of Boris Johnson and those who surround him has caused thousands of avoidable deaths in the United Kingdom due to Covid-19.
Boris Johnson and his Government have failed to observe one of the most fundamental Public Health protections when faced with an infectious disease for which there is no treatment.
Boris Johnson failed to keep people infected with the SARS-CoV-2 virus away from the uninfected.
That failure manifested in two contexts:
On 31st January 2020 I believe that there was sufficient evidence of the seriousness of the Covid-19 pandemic to justify the UK Government closing the borders.
That closure of the UK borders would, in my estimation, have been immediately achievable by virtue of powers that the UK Government has by virtue of the Civil Contingencies Act 2004.
A closure of the UK borders on 31st January 2020 would have been for an initial period of 7 days, by virtue of the effect of Section 27(1) of the Civil Contingencies Act 2004, which requires that Regulations made under the Civil Contingencies Act 2004 must be laid before Parliament as soon as reasonably practicable and lapse after 7 days in the event that the Regulations are not approved by a resolution passed by each House of Parliament.
Boris Johnson's failure to close the UK borders continued for weeks, despite the growing evidence of the seriousness of the Covid-19 pandemic.
Boris Johnson and his Government have failed to observe one of the most fundamental Public Health protections when faced with an infectious disease for which there is no treatment.
Boris Johnson failed to keep people infected with the SARS-CoV-2 virus away from the uninfected.
That failure manifested in two contexts:
- If the United Kingdom had closed its borders on 31st January 2020 the numbers in the UK infected with Covid-19 would have been tiny. Deaths to date from Covid-19 in the UK would have been tiny and possibly zero.
- After the failure by Boris Johnson and those surrounding him to close the UK borders on 31st January 2020, the National Health Services in England, Scotland, Wales and Northern Ireland failed to take effective steps to keep Covid-19 infections in most hospitals as close to zero as possible.
On 31st January 2020 I believe that there was sufficient evidence of the seriousness of the Covid-19 pandemic to justify the UK Government closing the borders.
That closure of the UK borders would, in my estimation, have been immediately achievable by virtue of powers that the UK Government has by virtue of the Civil Contingencies Act 2004.
A closure of the UK borders on 31st January 2020 would have been for an initial period of 7 days, by virtue of the effect of Section 27(1) of the Civil Contingencies Act 2004, which requires that Regulations made under the Civil Contingencies Act 2004 must be laid before Parliament as soon as reasonably practicable and lapse after 7 days in the event that the Regulations are not approved by a resolution passed by each House of Parliament.
Boris Johnson's failure to close the UK borders continued for weeks, despite the growing evidence of the seriousness of the Covid-19 pandemic.
09 April 2020
Boris Johnson's Covid-19 strategy is dangerously incoherent
The United Kingdom is currently in an established pattern where hundreds of people are dying each day of Covid-19.
The overwhelming majority of those deaths have been avoidable.
Had Boris Johnson implemented a "Keep it out! Kill it off! Strategy" I believe Covid-19 daily deaths in the United Kingdom would likely have been in single figures or otherwise far lower than the current appalling number of daily deaths.
The appalling carnage which follows from Boris Johnson's failure to apply a "Keep it out! Kill it off! Strategy" at the right time cannot be undone. (I'll turn to the need for a "Take Back Control Strategy" in a future post.)
In this post I attempt to explain why Boris Johnson's policy on Covid-19 is dangerously incoherent and can be expected to cause yet more avoidable deaths.
Put simply, there are two mutually inconsistent elements to the Johnson policy:
The "Stay at home" policy greatly limits the physical contact among many UK residents. Properly applied that would reduce the spread of the SARS-CoV-2 virus.
At the same time (and for readily understandable reasons) hundreds of thousands (perhaps millions) of UK residents are still mixing on a daily basis, for example by going to work, shopping for food, going on the London Underground or other public transport.
Such (essential) activities aid the spread of the SARS-CoV-2 virus.
So, we have two contradictory policies being applied at the same time, one aiming to stop the spread of Covid-19 and the other assisting the spread of Covid-19.
The chance of two such contradictory policies achieving timely control of the spread of the SARS-CoV-2 virus is zero!
The Government must urgently introduce measures progressively to reduce the risk of the essential activities currently allowed in the UK assisting further spread of the SARS-CoV-2 virus.
One such measure is the use of face masks.
A Government recommendation for the routine use of face masks in settings where physical distancing is impractical is essential.
We know that the SARS-Cov-2 virus is spread by droplets and other tiny particles expelled from the respiratory tract of an individual with Covid-19.
Face masks worn by infected individuals reduce or eliminate the introduction of infective particles into the environment.
Face masks worn by uninfected individuals reduce or eliminate the inhalation of infective particles.
The effectiveness of face masks depends on a number of factors, for example, the type of mask, how well it fits and how it is removed.
I would like to see supermarkets routinely issuing face masks to customers before they enter the supermarket. (Of course, individuals would need to understand how to remove a face mask safely and be provided with a means to dispose of used masks.)
There is no single measure which can reduce spread of SARS-CoV-2 virus to zero during essential activities.
There is no way to reduce physical mixing to zero among those engaged in essential activities.
The Government must urgently examine how to reduce spread of the SARS-CoV-2 virus among those who continue physical mixing.
The overwhelming majority of those deaths have been avoidable.
Had Boris Johnson implemented a "Keep it out! Kill it off! Strategy" I believe Covid-19 daily deaths in the United Kingdom would likely have been in single figures or otherwise far lower than the current appalling number of daily deaths.
The appalling carnage which follows from Boris Johnson's failure to apply a "Keep it out! Kill it off! Strategy" at the right time cannot be undone. (I'll turn to the need for a "Take Back Control Strategy" in a future post.)
In this post I attempt to explain why Boris Johnson's policy on Covid-19 is dangerously incoherent and can be expected to cause yet more avoidable deaths.
Put simply, there are two mutually inconsistent elements to the Johnson policy:
- Reduce or stop physical mixing (the "Stay at home" policy)
- Allow physical mixing to continue
The "Stay at home" policy greatly limits the physical contact among many UK residents. Properly applied that would reduce the spread of the SARS-CoV-2 virus.
At the same time (and for readily understandable reasons) hundreds of thousands (perhaps millions) of UK residents are still mixing on a daily basis, for example by going to work, shopping for food, going on the London Underground or other public transport.
Such (essential) activities aid the spread of the SARS-CoV-2 virus.
So, we have two contradictory policies being applied at the same time, one aiming to stop the spread of Covid-19 and the other assisting the spread of Covid-19.
The chance of two such contradictory policies achieving timely control of the spread of the SARS-CoV-2 virus is zero!
The Government must urgently introduce measures progressively to reduce the risk of the essential activities currently allowed in the UK assisting further spread of the SARS-CoV-2 virus.
One such measure is the use of face masks.
A Government recommendation for the routine use of face masks in settings where physical distancing is impractical is essential.
We know that the SARS-Cov-2 virus is spread by droplets and other tiny particles expelled from the respiratory tract of an individual with Covid-19.
Face masks worn by infected individuals reduce or eliminate the introduction of infective particles into the environment.
Face masks worn by uninfected individuals reduce or eliminate the inhalation of infective particles.
The effectiveness of face masks depends on a number of factors, for example, the type of mask, how well it fits and how it is removed.
I would like to see supermarkets routinely issuing face masks to customers before they enter the supermarket. (Of course, individuals would need to understand how to remove a face mask safely and be provided with a means to dispose of used masks.)
There is no single measure which can reduce spread of SARS-CoV-2 virus to zero during essential activities.
There is no way to reduce physical mixing to zero among those engaged in essential activities.
The Government must urgently examine how to reduce spread of the SARS-CoV-2 virus among those who continue physical mixing.
08 April 2020
Combatting Covid-19: The Keep it out! Kill it off! Strategy
The fundamental failure of Boris Johnson, his Ministers and his advisers has been the failure to implement the Keep it out! Kill it off! Strategy at a time when it was possible.
In the absence of an effective vaccine against the SARS-CoV-2 virus the Keep it out! Kill it off! Strategy was the only approach available to the UK Government which would effectively protect UK citizens and residents.
In failing to implement the Keep it out! Kill it off! Strategy at the right time, Boris Johnson, his Ministers and his advisers have, in my view, caused thousands of avoidable deaths in the United Kingdom from Covid-19.
The Keep it out! Kill it off! Strategy has two basic components:
In future posts I will elaborate on how each of the above two points may be modified to accomodate practical issues such as ensuring the continuing importation of food.
If Boris Johnson had implemented the Keep it out! Kill it off! strategy at the right time, UK residents would have been spared the current (partial) lockdown, thousands of deaths would have been avoided and the cost to the Treasury would have been much less than the costs to the Treasury of Boris Johnson's half-baked (and dangerous) "policy".
It seems likely to me that Governments around the world will seriously consider having the Keep it out! Kill it off! Strategy as part of their contingency plans for future possible pandemics.
In the absence of an effective vaccine against the SARS-CoV-2 virus the Keep it out! Kill it off! Strategy was the only approach available to the UK Government which would effectively protect UK citizens and residents.
In failing to implement the Keep it out! Kill it off! Strategy at the right time, Boris Johnson, his Ministers and his advisers have, in my view, caused thousands of avoidable deaths in the United Kingdom from Covid-19.
The Keep it out! Kill it off! Strategy has two basic components:
- Close the United Kingdom border to incoming traffic
- Find every case that has already entered the country and quarantine infected and infective individuals
In future posts I will elaborate on how each of the above two points may be modified to accomodate practical issues such as ensuring the continuing importation of food.
If Boris Johnson had implemented the Keep it out! Kill it off! strategy at the right time, UK residents would have been spared the current (partial) lockdown, thousands of deaths would have been avoided and the cost to the Treasury would have been much less than the costs to the Treasury of Boris Johnson's half-baked (and dangerous) "policy".
It seems likely to me that Governments around the world will seriously consider having the Keep it out! Kill it off! Strategy as part of their contingency plans for future possible pandemics.
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