All together, but individually we will win

Just over a week ago, I started to brief my friends and family for this emergency. I am fortunate to have the tools, resources, access to data and education to make my own analyses and conclusions on the situation ahead and so, as I spoke with my Mother and two sisters, I faced a highly personal but micro-focussed analogue to the macro-situation facing governments as we get deeper into this crisis.

My Mother is 87. The evidence is quite clear that if she contracts this virus she will die and the only grace is that it will be very quick - lasting perhaps 1 or 2 days. I explained to her that she should shut and lock her door to the communal living space within her block of private apartments in an enclosed elderly community. I told her this was going to be like WWII from her childhood. She is a former nurse and I told her she would have fellow residents banging at her door, begging her to help them or their loved ones and she should prepare now to be strong and to refuse to help.

I instructed my mother that she should cease any but electronic contact with her grandchildren immediately and then briefed her on fresh air contact drills with my sisters for handover of supplies and the decontamination measures necessary. She stated that she was already compliant but some minutes later in that conversation she interrupted me to announce that Imogen was at the door and dropped the phone to admit her. Imogen of course is one of my nieces. Here indeed was the an illustration of one of the challenges that the government faces as it does its best to keep the nation informed yet not panicked and balance the competing needs and priorities of the nation as a whole. 

As I chided my mother, I felt like I was stripping away layers of her humanity and hacking at the Christian ethos that has been her guide throughout her life of caring and service to others. I questioned whether it would be better to leave mum alone and let her perish as the warm, soft and kind mother that I knew and loved rather than hardening and changing her in the name of existence and my own selfish desire not to lose her.

My sisters each have two teenage daughters with no pre-existing conditions who thus have very low Severity and Mortality ratios and hence should themselves be at minimal risk but of course pose an infection risk to their 50 year old parents and their aforementioned grandmother. As best I could, I gave instructions for their immediate social exclusion and suggested they prepare for possible civil unrest and to think carefully about the need to keep occupied and isolated until maybe July. I had to get very direct and it left the adults all in tears last Thursday. I hope it bought them a vital 3 or 4 days chance to remain uninfected. But they will make the final choices that determine their fate. One of us 3 won’t be here for Xmas I told them 

I have to confess that despite my analysis being at considerable odds with the then government figures I chose to reduce my assessment of personal risk to a point midway between my calculations and those of the government and this was largely due to confusion over the mortality figures. Now that these are becoming clearer, I realise I may have sealed my own fate. The government must also be facing a similar challenge. At the outset it was not obvious that at peak demand 500,000 or so ventilators with trained staff could be required and hence 45,000 would fulfil only 10% of demand with staff availability reducing this to perhaps 1%.

Yet unlike me, the government also has the defence of the nation to consider. The MoD will retain its principle focus during this crisis which is of course national defence. The ability for this crisis to cripple western defences will be closely observed by hostile nations including China, NKo, Russia and other rogue states as well as low level ad hoc or organised actors and so NATO must continue to function and any attempts to probe or even attack must receive a robust response. In the unlikely, but not inconceivable event that this crisis be the making of a hostile nation then they must be made to realise that their ploy has been unsuccessful, at least to the degree required for conventional follow-up and this would then be the subject of intense FCO activities 

Irrespective of the conspiracy theories or scenarios one might conjure, the UK MOD will have been in institutional isolation from the earliest opportunity and will now be reorganising to take account of the success of its isolation activities and will be co-ordinating multi-domain global war fighting options and detailed planning amongst allies.

As a secondary stream, military assistance to the Civil Authorities has been authorised and I suspect Queen’s Orders may now be in effect. I trust that the police and military are now working hard to effect the best structure for this crisis whilst minimising cross-infection and reduced police numbers on the streets are the visible result. DEFRA and DCMS are being allocated additional ministerial responsibilities over and above their usual tasks. 

The reason for all this preparation is that China managed to contain the spread to just 0.08% of its population yet we are expecting up to 80% of the UK to be infected. This is a headline figure of 1,000 times greater demand on the healthcare system than reached bursting point in China. Even if we spread this load it is evident that only a handful of patients will be able to access the necessary medical attention as has been witnessed in Italy and elsewhere.

So the government is facing an impossible choice. If we examine the figures it is quite clear that attempts to resuscitate those over 55 will largely be unsuccessful and to save as much life as possible would squander our precious resources. Similarly providing resource intensive critical care to anyone over 40 with complicating conditions would tie up staff in work that consigned others with greater chances of pulling through to rely on hope and prayers. But even if we remove everyone under 25, over 55 and over 40 with pre-existing conditions our healthcare system could quickly be compromised.

I am self-isolating. I will know by next week if I have somehow avoided the infection and will then wait until I can test to confirm whether I had a mild episode or am still COVID-19 na?ve and thus at risk. That will determine whether I can venture out or I must wait for the vaccine that may appear by the end of the year. If I become ill then I will most likely be unable to access medical help and without it I will perish.

Looking to the future, this crisis will change the world in fundamental ways. Air travel is an obvious example as public demand may mean that future quarantine arrangements require invasive and expensive medical protocols or involve such long quarantine periods as to make another form of travel preferable. Ironically, given the early days of COVID-19, sea travel might be considered to possess an in-built quarantine mechanism as well as having a fractional carbon footprint.

This crisis is likely to lead to an unexpected windfall for the government in Inheritance Tax and reduced pension provision and this windfall will also benefit the financial services providers who may suffer an immediate LIFE liquidity issue but will have huge future pension annuity provisions eliminated from their risk portfolios. This will also shake up the housing market as property passes down through a generation or even multiple generations due to the demographic bias of this contagion.

As this outbreak hit Europe, the utter impotence of the EU was thrown into stark relief as one-by one its nations took unilateral decisions to act for themselves and their citizens. Ths was not necessarily in a selfish manner but resulted from the total absence of leadership, accountability and empathy from the EU’s administrators. In the meantime the G7 has been an effective collaborative hub and of course the WHO has been instrumental and this episode amply justifies its budget requests for more resources I am sure.

I salute those in government for their brave leadership and the CMO, Chris and Sir Patrick the CSA for taking hard decisions on all our behalf. Matt Hancock in particular will be remembered, I am sure as the Churchill of the moment as he sets an example for the many but too few who will throw themselves and their medical skills at this onslaught for the minority, but nevertheless many, that will need their help.

Let’s plant 20 trees for every coffin we bury and make good out of this.

FearNaught and Good Luck.

Let’s plant 20 trees for every coffin we bury and make good

FearNaught and Good Luck.