The Covid-19 Files (1): Tracking Cases in the UK (Email to MP)

You’re reading the very first public post to this blog, although I’ve (hopefully) migrated everything from the previous iteration of Uncharted Territory.

This is a slightly edited version (removing the chit-chat) of an email I sent to my MP as long ago as 4th February:

“My reason for writing … is … to express my concern at the government’s inadequate response to the coronavirus epidemic, and surprise that Parliament has not had some kind of emergency debate on the subject, considering issues beyond the scope of Matt Hancock’s statements, such as plans to respond to a full-blown UK epidemic.

I think I’m suffering from post-Brexit anxiety syndrome, but nevertheless it seems to me that transmission of the new coronavirus within the UK has to be stopped at all costs. Despite Matt Hancock and Public Health England (PHE) blowing the UK’s own trumpet at every opportunity, the steps taken so far seem ad hoc, and inadequate. In particular, we seem to be ignoring the inconvenient fact that modern airplanes are flying disease incubators and public transport is not much better.

As some commentators have pointed out, the evacuation flights from Wuhan were reckless. Just because other countries were flying people out without being sure they weren’t already infected shouldn’t have meant that we did the same thing. It’s being reported today that Belgium has identified a case amongst evacuees. All others on the same flight (including, I now read, 11 Britons), are at serious risk of also going down with the disease. Why didn’t we plan the flights after the evacuees had self-isolated in Wuhan for 14 days and were therefore effectively proven free of infection?

But, assuming quarantine measures in the UK are effective, the evacuation flights from Wuhan only put the evacuees themselves at risk. Far more worrying is the apparently half-hearted attempt to identify those at risk of having acquired the infection from the two patients currently being treated in Newcastle.

In 2009 I was living in Cambridge when the swine flu virus was not known to be in the town. On the evening of Sunday 7th June (the date is apparent from my email history), which was very early in the UK epidemic, I developed a fever, which I assume was swine flu (the NHS didn’t make it clear who I should inform, so I didn’t have any tests). Feeling better after one horrendous night shivering under a pile of duvets and, I recollect, even coats, I simply self-quarantined for several days. Whether it was swine flu or not, the point is I acquired the infection seemingly at random, probably on the tube in London (when travelling to look at properties for rent in Ealing, as it happens).

With that experience in mind, I wouldn’t be at all surprised if new coronavirus cases start appearing in the UK, seemingly at random, over the next couple of weeks.

The two known UK cases of coronavirus were found in York. Presumably those infected didn’t teleport there from Wuhan, so at least one of them must have flown recently from China and travelled on to York. Details of the flight they were on and any other travel are not in the public domain. Did they use the crowded East Coast main line? Did they fly into Heathrow and take the tube? It should be a simple matter to trace their movements and warn the public, so that anyone who might have come into contact with them (by using the same train etc) can either come forward for testing or at least isolate themselves and seek medical help sooner than they might have done otherwise, should they become ill. GPs (e.g. on the Piccadilly Line route) would also be forewarned. PHE is not publicising any details about the two patients, presumably for reasons of privacy and to avoid over-reaction by the public. I simply don’t see how it is possible for PHE to fully trace the patients’ contacts if they don’t ask passengers who shared public transport with them to come forward. I’d like to see it at least debated whether it is the right decision to keep their travel history secret.

It seems to me we are either keeping our fingers crossed that the coronavirus outbreak in the UK is limited to the two patients currently quarantined in Newcastle and has been contained, or are reconciled to the inevitable. But a full-blown coronavirus epidemic would be a very serious problem. The Chinese haven’t taken the drastic steps they have just to show off.

The fatality rate of coronavirus is quoted as about 2% (or 20,000 deaths per million cases), that is about 50 times more than swine flu (0.04%, according to Wikipedia), which killed hundreds of people in the UK, in an epidemic with of the order of a million cases. Since 2% seems to be simply the number of fatalities so far divided by the number of confirmed cases, the actual percentage of deaths could go up (since the vast majority of the confirmed cases have not yet fully recovered) or down (if there are a lot of mild, undiagnosed cases). It might also be worth pointing out that the UK has a higher proportion than does China of older people who are more vulnerable to the disease.

The numbers quoted for onward transmission of coronavirus per case also seem to be higher than that for swine flu, though it seems the latter spread faster because of a shorter incubation period.

So what are the plans if coronavirus takes hold in the UK? Are we going to go into lockdown as is being done in China? Or are we going to let the epidemic run its course, at the cost of many thousands of early deaths and the complete paralysis of the NHS? What preparations are being made by the government? Maybe there’s a plan beyond “wash your hands and don’t cough on people” (duh!), but, if so, perhaps it would be a good idea if it were not just in Dominic Cummings’ brain, which will surely be full sometime soon.

I’d really like to see the Commons properly debate the government’s response to the threat of a coronavirus epidemic in the UK. If it achieved nothing else, such a discussion might at least show that the House is not just there to rubber-stamp whatever Cummings tells Johnson to do.”

Letter to MP, sent by email 19:05, 4/2/20

Excuse the formatting. I’m still getting used to the new interface that’s come with setting up my own domain. And copy-paste from my email has added some spurious double spaces and removed others! They’re mandatory between sentences, of course, though annoyingly seem to be being stripped out when I publish, and elsewhere are a source of even more extreme irritation! I’ll try to correct…

The reply, which I suspect was boilerplate Labour “party line”, highlighted concerns about sick pay and NHS and social care funding. Legitimate issues, but not challenging the government’s overall approach.

So, 5 weeks on and where are we on the issues I raised on 4th Feb?

China has apparently closed down their epidemic, so why don’t we simply do what they did? In particular, they (and some other countries in Asia) have used “big data” and social networking technology to track cases. We haven’t even been publicising which trains were used by those subsequently found to be infected. .

And if things were sloppy with arrivals from China in February, they’re a shambles with those coming from Italy.

A lot of what I read (such as planning for 20% absentee rates) implies the government is going to let the Covid-19 epidemic run its course in the UK, merely trying to “flatten the peak”, in the hope that the NHS will somehow be able to cope, and protect the most vulnerable.

Heaven help us!