Cliffe

Yesterday at Cliffe.

The first time I've been outside (apart from bins, clapping, garden) for four and a bit months.

Quite pleasant.

Give it another 19 weeks and I might do it again.

Garden : Mid July

The garden on a breezy, sunny day in mid-July.  Bees are buzzing, butterflies are flitting, plants are blooming, tomatoes are promising and the pond has been cleared back of thirsty arum lilies.

Nice not to be thinking about the plague!

The Westminster Plan for the Coronavirus

One thing missing from the Westminster Government’s response to the pandemic is a clearly-explained overall goal.  How do we get out of this?

They’ve told us it isn’t herd immunity, because of the resulting number of deaths, and it isn't clear that it can even be achieved with this coronavirus; there is emerging evidence that immunity only lasts a matter of months.

The Independent Sage group have proposed an achievable goal of ‘zero Covid’ in the community, defined as minimal weekly cases occurring per million people in the population, as the best option for health and for the economy.  New Zealand and China have achieved this; Scotland and Northern Ireland are close.  But England is a long way off this target, and case numbers in England are slowly increasing again.  So this can’t be the goal, or the Government wouldn’t have relaxed the lockdown so much.

If it isn’t herd immunity or zero Covid, what’s the plan?  Perhaps to manage down the numbers of cases and protect the vulnerable, opening up some parts of society, while an effective treatment or vaccine is developed.   A risky gamble at best, in both health and economic terms.  It’s unclear if or when the developments will deliver, while many of us won’t go back outside while we don’t think it’s safe.  And it risks a second wave.

Finally, maybe, there is no plan.  That the UK approach is essentially reactive, dependent upon the news agenda, favoured lobbyists, and what they think will play the best each day.   A process of ongoing fudge and bluster.  Sadly, from the evidence so far, this seems to be closest to the truth.

Dessert

A couple of days ago.

In the oven too long.

Toast and Butter Pudding.

Lansley, NHS organisation and data, and Covid-19

It is wholly unsurprising that local authorities do not have sufficient detailed data to understand local coronavirus prevalence, and to manage hotspots and other breakouts. 

This is at least partly an effect of Andrew Lansley’s benighted reorganisation of the English NHS in 2012, which removed significant access to detailed care data from local commissioners, and moved public health departments to local authorities, where they had even less access to key data - and were also hit by the cuts to local authorities’ budgets over the last ten years.

The Lansley act centralised a lot of key NHS and care data with a single central body, now known as NHSX.  This was in line with a narrative of centralised control of the service and a disempowerment of local bodies. 

This policy has acted as a contributory factor in the Government’s ill-fated attempt to build a ‘track and trace’ app based on a centralised data store.   It is now clear that alongside central direction and guidance, control of the pandemic requires agile local epidemiology and professional management, backed by up-to-date, detailed data, to lead local test, track and trace activities and manage change.  Much of this existed, in depth, before 2012, but has been significantly eroded since.  Despite this,  almost all the successful case tracking currently being done is down to these pre-existing local, experienced public health teams, not Hancock’s vaunted new, parallel structures.

However, what we are now witnessing, finally, is a partial U-turn of the policies of the last eight years.  Data is beginning to move.  Sadly, the paucity of timely local data in the right place will take time to fix properly, as providing it still runs counter to the centralising mindset, and the system will need to create new capacity to get it to where it properly belongs.

...And a Hard-Boiled Egg