Welcome to Zero COVID: eliminating the noise before defeat

1.

Here is a little game for you. Can you spot the deliberate untruth in this story about a city of the future:

“A woman who has been a long-term resident of a large city recently travelled abroad to visit family. She had a COVID antigen test both before her return and on her arrival. Both were negative. Some weeks later, she complains of a loss of taste and smell which started around the time of her trip. Her doctor orders Coronavirus antibody tests and they came back positive for IgG, the “long term” antibody, suggesting she has had an infection at some point. But, the test also comes back weakly positive for IgM, the “acute phase” antibody — suggesting that infection may have been within the last 10 days.

The government lab informs the local track-and-trace team, who arrive unbidden at the clinic to look at CCTV footage and give advice on deep cleaning; they agree which staff should self-isolate; other possible contacts are identified and contacted. The scene is tense (no one wants this to be an active case) but clinic staff are congratulated on helping to spot a potential carrier.

Meanwhile, across the city, another track-and-trace team arrive at the woman’s home. They take a swab — an antigen test — to find out if she has active disease. Thankfully, within 24 hours this comes back negative. However, to be certain, she and her family are isolated at home for a further 48 hours. She has two further tests on each of the following days. Both of these are also negative. She and her family are permitted to leave her apartment and return to work and school; they can again enjoy what the city has to offer.

The city remains COVID free.

Now, before I confess about the lie in this story, let’s just imagine what this city would be like. The bars, pubs and restaurants would be open and the cinemas, parks, schools would all be functioning normally. Because there aren’t that many cases, anyone with suspected symptoms would be rapidly tested. There would be plenty of track-and-trace staff available to manage all such cases quickly and effectively.

Every single case of Coronavirus would be rapidly found, isolated, and contained – even if it was flagged up by a fairly non-specific antibody test.

Sounds nice, I’m sure you would agree. Life would be less fearful, less anxious and a whole heap more productive. The economy would be back to normal.

You may sincerely hope that one day we might all find ourselves living in such a world.

So … confession time. Did you spot the lie? I’ll give you a hint. It’s in the introductory sentence. This is not a future city. This is happening today.

This is Shanghai.

2.

Western governments have clearly failed to keep the Coronavirus pandemic under control. The health and economic outcomes are awful; and their terrible extent was largely avoidable. China, by contrast, has largely eliminated the virus and the economy is returning to normal.

Is this because their political system - their governance - is superior? I don't think so. Most of us in the West, believe it is preferable to live in a democracy where political decision-making is subject to the full scrutiny of an open press with judicial oversight, even if that oversight isn't perfect (trip to Barnard Castle, anyone?). We don't have to change our political system to emulate this.

Is it because their demography, biology or culture is somehow superior? It is true that there are elements of Chinese culture which help to secure better compliance with rules and which support a more co-operative and less individualistic approach to social problems. But not to the extent necessary to make a huge difference. Chinese people are as self-centredly human as the rest of us.

It's actually very simple.

China has a better strategy.

3.

Why do I say this?

Well, here is the exposition of the UK’s Coronavirus strategy, as outlined on the Today programme by the Health Secretary, Matt Hancock, on 17th September (starts @ 2:20:47)

“The strategy is to keep the virus down as much as is possible whilst  protecting education and the economy, while doing everything we possibly can for the cavalry on the horizon of the vaccine and mass testing and the treatments …” 

To help you think what this chewy soundbite represents, let me offer a famous quote from Sun Tzu’s “Art of War”:

Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat

Matt Hancock’s statement beautifully illustrates the second sentence. Everything he mentions is, at best, tactics.

Waiting for a possibly non-existent cavalry is simply NOT a strategy.

Mr Hancock is offering us the noise before defeat.

4.

So, for Matt, and Boris, and Donald, and Emmanuel … and all the other politicians trapped in the same tactical thinking: here is an alternative strategy to consider.

“Zero COVID: eliminate the virus”.

This has been the strategy of the Chinese government for the last nine months.

It has clearly worked. We should emulate the strategy.

5. 

You may well argue that I’m just being clever after the fact. So to ensure that I’m not just an armchair strategist, let me offer you some armchair tactics too.

Here are five tactical approaches that I think would support a zero-COVID strategy and prevent Sun Tzu's “slowest path to victory”.

A)  Close the borders: Anyone crossing in-or-out of the country, needs a COVID test on the point of entry and to be quarantined at government expense in a local hotel until they have three negative tests. Yes. Governments need to commandeer a bunch of hotels. The hotel industry will love you. Foreign truck drivers – you need to do this too. Sorry.

B)  Introduce a guaranteed minimum income. No, I don’t know how much. Let’s say ￡1,000 - ￡2,000 per month for every adult and/or child. Fiddle with the income-tax brackets to get this back from the wealthy at the end of the tax-year. This is a demand side crisis. No one is spending enough. Everyone is terrified of not having enough money. They can save it up for after the lockdown. Universal income is quick, it’s easy and it benefits the truly needy immediately and without quibble. Cheques in the post for everyone. 

C)  Do another lockdown — properly: No excuses. No going out. No ifs, no buts. No “eye tests” in the car (Note to Dom: no one will never forgive you). Make it clear that unless you’re dying, delivering food or providing essential care, you stay home for the next month. No schools. No pubs (jeez … pubs??? What were they thinking?). If you have to buy food, one person leaves the house, once a week. The government can pay for ramping-up food delivery too.

D)  100% mask wearing in public and wherever households necessarily mix. Masks are not perfect, but until the cavalry arrives, they're all we have. For those that object to this, I paraphrase an NHS-support poster: Mask-up, shut-up, grow up. It's a mask. Not the barrel of a gun. Oh, and the government can give away free masks to everyone. Cheap, by comparison.

E)  Introduce compulsory testing to find and isolate every single case or suspected case. Add-in some serious fines for non-compliance. And ensure that everyone is encouraged to report people who break the rules . Forget Crimestoppers, we need Virus-stoppers. (In a different “The Art of War”, Sun Bin said: “The one who does not know how to use spies will be defeated”).

Oops … I almost forgot! Let’s not forget Matt ... we need six, not five tactics:

F)  Call for the Cavalry. Do everything we can to support vaccines and treatments. Everyone needs hope at a time like this.

6.

Let me just repeat that strategy again:

“Zero COVID: eliminate the virus”.

I hope that’s clear.