Thread by @HZiauddeen

🧵 COVID-19: The playbook of politics

Mainly UK-centric but elements will apply to other countries as well
As the pandemic has continued to progress as expected, one wonders what exactly is being managed by our pandemic management strategies.
(1/30)

The UK strategy is certainly not managing case numbers (currently ~40,000/day), deaths (~150/day), or health service capacity (overwhelmed +++). As for #LongCovid...
(2/30)

https://twitter.com/martinmckee/status/1462081324869693443?s=20

If not these key outcomes, what else could the UK strategy be managing?
Our expectations?

'People of Britain! For too long have you expected your govt to protect you from dying of preventable infections. No more! It is time to take responsibility for yourselves!'
(3/30)

That was a joke. Our govt does not care about our expectations.

It seems like our current strategy is working hard to minimise interventions of any kind (apart from vaccinating & that too mainly adults) and maximising infection.
(4/30)

The goal seems to be strive valiantly (yet again but this time we'll do it!) for herd immunity, particularly through infecting children, who will then serve as boosters for adults because it's high time their generation started earning its keep.
(5/30)

However this is all part of a much larger covert operation that through massively increasing cases and deaths, will lull SARS-CoV-2 into a false sense of victory, make it decide to dial down operations and become endemic & finally become 'just like the flu'.
(6/30)

20+ months in, it feels futile trying to point out just how flawed, dangerous and absurd these strategies are but I hugely respect my colleagues who are still fighting the fight as we need to keep hearing the truth otherwise only the lies and spin will be onstage.
(7/30)

There MAY have been a point early on in the pandemic when we had a lack-of-information problem i.e. we don't know enough to act.
('may' because we knew how to deal with a novel airborne pathogen from basic public health and many countries took these steps)
(8/30)

But that was early on in the pandemic and I'd argue that for at least a year (being very, very generous) we have not had a lack-of-information problem i.e. we have known enough to act and known what would happen if we did not act.
(9/30)

We have gathered a hell of a lot of information now (a lot of it in lives lost and damaged) but it has produced almost no change in direction.
I've written before about my thoughts on what the approach of those who really hold power is.
(10/30)

https://twitter.com/HZiauddeen/status/1439730298930012161?s=20

What troubles me most is that all this data has made little difference to the scientists & clinicians who have pushed for & justified these strategies & continue to do so and have been complicit in the creation of a disaster of this scale.
(11/30)

https://twitter.com/HZiauddeen/status/1414236543137591299?s=20

It is very clear that these people have comprehensively won the fight and those of us who have been fighting for continuing mask mandates, mitigations in schools, vaccinating children, basically trying to control the pandemic in any way, have lost.
(12/30)

The strategies we (and other countries) have followed have essentially been GBD style herd immunity. You cannot look back on what's happened and is still happening (and is likely to continue happening for several months), and think 'yeah, we got it right.'
(13/30)

But instead of a reconsideration of direction, which could be done without having to admit that you got things wrong by saying that new data have changed the picture, what we're seeing is a shocking doubling down, 'we need to keep going'.
(14/30)

This indicates that it's really not a lack-of-information problem because if this much information has not produced a change, then either no amount will or it would take a catastrophic amount to produce change (because data are lives lost and damaged).
(15/30)

We've reached a point where prominent paediatricians (who've said children don't get ill with COVID, schools aren't important in transmission,etc) are arguing that only X number of healthy children have died of COVID and the other kids who died had underlying conditions.
(16/30)

This is the position of our policy makers, including senior leaders in the UK paediatrics community. The Telegraph ran a headline saying only 6 healthy children had died of COVID. There are arguments about kids having died 'with' vs 'from' COVID.
(17/30)

I am not making the emotionally powerful 'the children are dying!' argument (I think that pretty much makes itself). The point I am making is that values have shifted so dramatically that paediatricians in authority are adopting these positions.
(18/30)

https://twitter.com/HZiauddeen/status/1437024094915072009?s=20

For pretty much all other conditions, we take child deaths and child morbidity incredibly seriously, the threshold for action is very low indeed (as it should be). Yet we're around 100 deaths and 69,000 cases of #LongCovid and this is what's happening.
(19/30)

While there are likely multiple different reasons why different players are pursuing and supporting this strategy (financial, power, ego, fervent belief, defending their past positions), the way this is being played appears to be from the playbook of politics.
(20/30)

Press your position relentlessly, create the narratives to support this, use the tools of propaganda, attack your critics and detractors, use facts as convenient, do not admit mistakes, if you are attacked you double down,...
(21/30)

...things just happen (you didn't do anything to make them happen), control the frame of reference, create the sense of what is important (freedoms!), argue the particular in isolation (only X children have died, don't consider that you could have protected them),...
(22/30)

... talk about your chosen values (freedom, kids need to be in school) rather than the concrete realities (kids aren't safe in schools, we could make them but we won't),...
(23/30)

...talk about vague hypothetical futures rather than real past and present (we don't know about long-term side effects of childhood vaccination), choose the bits of reality you will consider (#LongCOVID remains to be understood/is not really a thing),...
(24/30)

...create divisions and enemies and killjoys within the population, narratives and positions that people can pick and fight against the other, use misinformation and disinformation widely, gather/ally with disparate groups and factions that will compound disorder,...
(25/30)

…create your legitimacy (this is why we are doing what we are doing, this is why we did what we did, we did what we believed was right).

The last point is key because while this started out as a natural disaster the scale of it, is to a great extent man made.
(26/30)

Given the way the world is going, I am not sure if even those most clearly responsible will ever see a reckoning. But even there is any form of this, one consideration will be, were they following a reasonable course of action?
(27/30)

One of the points that will determine this is, was it a course of action that others were following? Because this gives it a certain legitimacy.
(28/30)

So when the authors of the GBD and the architects of the disastrous Swedish response are advising other govts, and the architects of the current UK policy argue for their approach to be adopted more widely across the globe, consider the above.
(29/30)

I do not have any solutions to offer but I think it is important to bear the above perspectives in mind, to at least recognise these things when they happen and how and why they are part of the playbook.
And remember, more information is not what’s needed.
(30/30)