Thread by @fascinatorfun

Germany’s virus response shines unforgiving light on Britain - ⁦@FT⁩

“If you follow a herd immunity strategy, why would you not build treatment and testing capacity? That’s what puzzles me” said Devi Sridhar, prof of global health.

ft.com/content/c41559…

That is the question that keeps bugging me because surely intensive & large scale testing is triply important were it seen as a strategy rather than a consequence, for you sure as hell need to know who has got it, who is immune and who to shield?

Without that there is no strategy.

I concluded that the whole response has been driven by a desire to try and hide the consequence of the hugely politically embarrassing truth. That 15 years of curpts have hollowed out our “diagnostic industry” and our tracing capacity.

*cuts*.

Hospital and public health labs have been “amalgamated and “rationalised” thus reducing capacity massively of our “diagnostic industry” ...and it takes time to expand it.

But even that doesn’t explain the shameful delay in ordering ventilators.

So the reference to “diagnostic industry” is to somehow point the finger if responsibility at industry rather than at political choices.

Ditto ventilators

Germany had 10k order in a week before Johnson asked non-ventilator makers to invent the sodding things.

At the same time joking about it “Operation Last Gasp”. It displayed the frame of mind of a frivolous amateur, a Panto Queen, not a leader.

We don’t know to what extent yet that buying time and slowing ingress will save lives overall.

And Germany tested their options carefully

Our Government’s approach was muddled. And when met with emerging evidence that the Chinese data leading to WHO assertion on asymptomatic transmission was unreliable, but Johnson’s lack of urgency in taking time out in Chevening set the tone.

If it peaked mid May to June “Glastonbury should be alright” suggested one minister anxiously.

GLASTONBURY SHOULD BE ALRIGHT?!
Glastonbury

Good God.

I do understand why countries may have thought it was like SARS (symptomatic transmission) & that will have resulted in modelling errors but not by then.
Already by mid Feb S K data suggested asymptomatic or barely symptomatic transmission. Ditto German.

So where was the urgency

The iceberg problem.

Diminishing the “don’t know” arena thus tuning up effective response.

The value of testing.

But we didn’t have enough capacity due to wilful cuts.

And small uni labs are not set up for mass diagnostics and information systems securely to connect the right patient, the right organisations, the right GPs and the right results.

Germany had more large scale diagnostic labs. Therefore testing ingredients & batch processing

It looks as if there was a big scale up in testing in Germany in mid March

We couldn’t match it, meanwhile the admissions and death data from Italy suggested a far faster spread of the virus than anticipated.

Far greater ICU capacity issues than previously estimated from China

Meanwhile U.K. non pharmaceutical interventions were slow with (at the very best) confused messages coming from the Government to stay in whilst going out and enjoying yourself.

A PM saying he was shaking hands with everyone & would continue.

Big events remaining uncanceled.

Followed by a message to avoid public events and bars - without shutting them.

So of course people kept going. Sure. Some did the sensible thing -so some partial effect maybe. But many saw going as a last fling and a demonstration of the British bulldog sensible spirit

The trouble is none of us have a clear exit strategy save, maybe, S Korea. And any safe exit strategy requires large scale highly reliable testing & tracing & immunity testing programmes

With no anti vitals and no vaccine we all have to face this

Tens of millions -no immunity

During April Germany is embarking on a rolling programme of both testing FOR COVID & for immunity 100k at a time.

But remember. We still do not know what the true RO is without suppression measures. Or with.

So Germany’s results may not apply fully to us
Different measures

Different affect on RO.

We don’t really know how wide spread immunity is or will be by -say- June or a September either here or in Germany or in S Korea depending on measures taken.

We are in a large world of don’t know.

And we need to reduce that fast.

*Effect* dammit