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Journal of the Plague Year: And What to Expect in 2021

Byline Times’ chief medical officer, Professor John Ashton, looks back on the first year of the COVID-19 pandemic and warns that –without radical change – next year will be even bleaker

Lorries parked up on the M20 in Kent near to Folkestone services whilst the Port of Dover remains closed on 22 December 2020. Photo: Andrew Matthews/PA Wire/PA Images

Journal of the Plague Year& What to Expect in 2021

Byline Times’ chief medical officer, Professor John Ashton, looks back on the first year of the COVID-19 pandemic and warns that – without radical change – next year will be even bleaker

The metaphor of the perfect storm may be overused, but the events of recent days make it an inadequate one.

Far from understanding and learning from the mistakes of the first nine months of the COVID-19 pandemic, Boris Johnson and his Government have been repeating them and adding more for good measure.

As we go into the Prime Minister’s ‘Merry Little Christmas’ the immediate prospects for the New Year are bleak. It seems increasingly likely that, in the UK at least, the Coronavirus crisis may now extend well past the spring.

The reality of escalating infection rates coincides with the latest evidence of over-promising and under-delivering with the roll-out of the COVID-19 vaccination programme. This is combined with deteriorating staff sickness and morale across the public and private sectors in general, and the NHS and schools in particular.

The main charges against Johnson have been well-rehearsed: his superficiality, short attention span, lack of attention to detail and unwillingness to take responsibility for matters when things go wrong.

There is a tragic symmetry to his distraction from the pandemic by Brexit. Four-and-a-half years after the EU Referendum, the catastrophic consequences of leaving the EU have been exposed by one of nature’s smallest and most powerful forces.

Centralised and Out Of Control

There was a chance of getting a handle on the Coronavirus after the first lockdown in the Spring, but it has now been given a new lease of life by the failure to decentralise the response and fully resource local public health teams.

Local teams have always been the custodians of the expertise to control local and regional outbreaks in concert with their communities. This has belatedly happened in Liverpool with the advent of mass, lateral flow testing and an empowered public health team – in stark contrast with the private sector companies without such expertise which have squandered billions of pounds of public money.

This is aggravated by the breakdown of trust between the governors and the governed. The tipping point came in May when the Prime Minister’s chief advisor Dominic Cummings broke lockdown rules by driving to Barnard Castle. Before he left his Government role, he was reportedly rewarded with a £40,000 pay rise. The consequences of such a breakdown of trust could be seen most vividly last weekend with the mass escape from London. Railway stations were reminiscent of the escape from the Martians in War of the Worlds.

The past few days will go down in the history of the pandemic as significant as Boris Johnson’s lost month of February. Or the week beginning 9 March which saw the Cheltenham Festival and the Atletico Madrid-Liverpool football match going ahead – both potentially ‘superspreader’ events.

When it comes to the limitations of a centralised response, the special place of London and the ‘home counties’ (aptly named as an indication of the lingering colonial mindset that still dominates Whitehall) deserves to be highlighted. The first wave of the virus in the Spring began among the February half-term returning skiers who lived predominantly within the M25 and along the M4 and M40 corridors, who then took it to their weekend cottages.

If London and the south-east of England had been locked down early this Spring, the same fate may have been spared the rest of the country. Instead, the virus moved steadily from the wealthy to the more disadvantaged areas where it became entrenched, extracting a dreadful price on those with health vulnerabilities. The reluctance to place the capital in tier three of the special measures this Autumn has now allowed the virus yet another wind, with a so-called third wave in prospect.

Fumbling and Bluster

Looking forward to 2021, we are facing the perfect storm: an alienated public, a revivified virus, a chaotic Brexit, and the seizing up of commerce and transport between England and Europe, food shortages and perhaps even rationing to come.

‘Normal’ UK winter deaths shame our reputation and are not to be found in other northern European countries. These have barely started and will create a backlog of the dead in mortuaries and gymnasia, waiting weeks for funerals.

Shortages of personal protective equipment are once again likely to become an issue, stranded in lorries unable to come in from the continent. Mental health issues will become ever more pressing. Though a lid has been held tightly down on prisoners – held in their cells for 23-and-a-half hours a day – this may finally blow.

Civil disturbance is a distinct possibility with shortages of foods and essential goods and anger over access to the vaccine programme. The distasteful rush to lay claim to the first administered vaccines (which were Belgian-produced in conjunction with American pharma) was equalled by the by now familiar boasting and blagging about the number of vaccines to be administered by Christmas.

Johnson’s claim of 10 million vaccinations by Christmas dwindled to perhaps two million. The fact that 350,000 first doses had been given in one week was acclaimed as a vindication. At this rate, with a population of 65 million, it will take more than two years to achieve a substantial level of immunity across the community. The private sector-led computer programme to record vaccinations doesn’t talk to the NHS’ computer, so vaccinations must be recorded manually. This hardly inspires confidence.

Where does this leave us? Not in a good place. The public has been failed by the Government and must now lead from behind. How that will happen is very hard to predict but if it doesn’t, and if the Conservative Party fails to find competent replacements for an inadequate Prime Minister very soon, 2020 may just turn out to have been a taster of some very dark days ahead.

John Ashton is the author of ‘Blinded By Corona

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