Dawn

Dawn

Friday, January 29, 2021

Thoughts from Pontevedra, Galicia, Spain: 29.1.21

 Night’s candles are burnt out, and jocund day stands tiptoe on the misty mountain tops.

Spanish life is not always likeable but it is compellingly loveable. 

- Christopher Howse: 'A Pilgrim in Spain'


Covid

Another tour-de-force from MD of Private Eye below. There’s a UK bias, of course, but also a brief analysis of German success against English up-to-now failure. 


Living La Vida Loca in Galicia/Spain .   


As if we didn't know . . .


So, the good news is that: Ikea will launch Home Solar, its solar panel service for Spain and Portugal in the spring. Buyers will not have to do any self-installation as Contigo Energía will be in charge of the installation and management of these systems for rooftops. Without giving out any more details for the moment, the Swedish company claims that it will be an affordable offer that facilitates access to self-consumption "for the majority", in addition to being a "simple" option for home-owners… Let's hope this time round the Spanish government doesn't very heavily penalise folk for going this route, to the benefit of their mates in the utility companies


Marìa's New Year Same Old: Day 28. 


The UK


Caitlin Moran: This week has been the worst so far, hasn’t it? Time seems to have turned into a single grey, interminable blob, stretching out as far as the eye can see. Boris Johnson will try to jolly things up by madly saying things like, “We could start looking at easing lockdown in mid-February!” but even the most ardent fans of Johnson’s fecklessly positive bullshit have long stopped believing anything he says. The government's answer, she says, is “Festival UK 2022”, which, in a way, is bringing people together: together in hating the Brexit festival. As author Danny Wallace pointed out this week, its official title abbreviates to “FUK 2022”.  At this point the most British thing the government could do is to issue a press statement saying, “It’s all gone wrong, we’re so sorry” and quietly forget about the whole thing. After all, the one thing the British are still pre-eminent at is apologising.


Ireland


If you want to understand the long and (very) complicated relationship of this country with Britain, this BBC series is for you.


The EU


Yesterday I cited this headline: Covid is a 1914 moment for the post-Cold War globalised order. Vaccine nationalism and border closures mark a paradigm shift with vast implications for freedom. The full article is below.


The UK and the EU 


No one who's been reading Richard North's blog for years will be surprised at the major problems now faced by British exporters into the EU - for which the only(?) solution is to invest in an operation on the Continent to deal with at least some of the non-tariff barriers. As the British government is responsible for this mess, does the solution lie in it setting up central government facilities on both sides of the Channel for meeting this challenge, providing a free service for all exporters? Not that this would be very efficient, of course.


The Way of the World


'Ho' was, I think, American slang for 'prostitute', from 'whore'. God knows what else it means now. But, anyway, you have to laugh . .  Facebook apologises for flagging Plymouth Hoe as an offensive term, after it mistakenly labelled posts referring to the Devon hillside as misogynistic. 


Finally . . .  


British cuisine: A Spanish writer spills the beans on the UK's saucy secrets. For the record, I've never tried Marmite or bread sauce.


THE ARTICLES


1. MD one Covid in the UK


Good news 

We are leading the pack on vaccine roll-out, with 14.9m of our highest-risk citizens promised a first jab by 15 February, and a further 17m by spring. It's a tough ask, and government promises have depreciated markedly in value over the past year, but NHS GPs and pharmacies have a good track record delivering vaccines, and the addition of hospital centres and regional mega-hubs could make this achievable, provided supply can keep up with demand. 

But don't have a post-vaccine party. 

Protection takes at least 3 weeks to kick in. We don't yet know if vaccines prevent transmission or infection, or just reduce severe infections and death. We don't yet know if the 400,000 people who have had 2 doses will have significantly better protection than the 4m who have had one. With the over-80s at least partially protected, Covid deaths should fall from next month, but the median age of an ICU patient is 58, so hospitals will remain busy. 

To control Covid globally, all countries need fair access to vaccines. Many rich countries, including the UK, have over-ordered vaccines and must redistribute any surplus via the global COVAX initiative. With more than 2m deaths and counting worldwide, vaccination should happen according to risk, not wealth. 


Bad news 

TheUK is leading Europe in both Covid deaths and excess deaths. Over the year, Scotland and Northern Ireland have performed better than England and Wales. 

Excess deaths are the best measure of how a country has dealt with the pandemic overall. It encompasses not just how well we managed to control infection and treat Covid, but also how well we have promoted public health and kept other services open to treat cancer, heart disease, stroke, mental illness, etc. Unsurprisingly, countries with the lowest excess deaths have also suffered the least economic, educational and psychological harm. 

Alas, last year's deaths were up 15%, or 75,925 above the five-year average in England and Wales. This was the largest increase in deaths in a single year since 1940; our life expectancy, which had levelled off alarmingly in the years running-up to the pandemic, will now fall. The virus has exploited all our systemic weaknesses. We were poorly prepared for the pandemic, with poor public health and poor public service capacity. And our government played "chicken" 3 times with the virus on the rise and lost. 

The new variant was spreading well before Christmas, and it is impossible to know how much extra spread occurred with the "escape the mutant" rush from London and the South-east on 19 December. Many people had already planned to cut back at Christmas, but Boris Johnson "battling the experts to save Christmas" (as the Express put it) before his screeching U-turn just sowed panic and confusion. Covid is like a dirty bomb that detonates in those who are most susceptible 21 days or more after infection. Whole families have gone down with the new-variant and daily deaths are now higher than they ever have been.

It has been clear since March that winter would be the time of highest risk for a respiratory virus resurgence, variant or not. An NHS overloaded with Covid now has a waiting list of 4.5m, and more than 1,000 patients in London need urgent cancer surgery but have no data for it. The private sector must help. Also, we're trying to vaccinate during an outbreak, which gives the virus more chances to spread and become resistant. So, not ideal. 


Vaccinating during a surge 

It's much safer to vaccinate in advance of an outbreak, as we do with flu, than during one. The virus currently has more opportunities to mutate and may spread in clinics, which vary in how well spaced and ventilated they are. Cathedral clinics with drafts and very high ceilings would be ideal. Health and care settings are the highest-risk places to contract Covid, and many NHS staff are over 5O and overweight. Vaccinators need vaccinating too. 


Vaccine homework 

According to a YouGov poll, 80% of Britons are willing to have a Covid-19 vaccine, although BAME citizens may need more reassurance. There are excellent information leaflets at www.gov.uk on vaccine types, ingredients (no pork or beef), indications, side effects and protection. 

If you want to delve deeper, the Green Book is the vaccination bible for NHS workers and contains much of what we currently know about the virus and the vaccines. It is also freely available on the www.gov.uk website (chapter 14a). You may get more than one invitation for a vaccine (from GP, pharmacy and regional mega-hub), so only accept one. If anyone asks for money or personal details, it's a hoax. 


MD's jab 

I had my first Pfizer BioNTech jab last week at my hospital. Thank you. I had mild side effects, which are a good sign the immune system has responded to the vaccine, but it takes a few weeks for a decent measure of protection to evolve. A few of my younger NHS colleagues have had worse headaches, arm pain, enlarged lymph glands and higher temperatures post vaccination, especially those who have already had Covid. However, nearly all pass in 48 hours. 


Post-vaccine deaths 

Unsurprisingly, MD is already being sent social media posts claiming the Covid vaccine has killed someone. In general, vaccines are among the safest health interventions known, with around one in a million people suffering life-threatening side effects. Most recover with prompt anaphylaxis treatment, but if you vaccinate billions globally, some will die as a

result of vaccination. 

However, many more will die from Covid, including Covid they caught around the time of vaccination that will be blamed on the vaccine. Others will die after vaccination from something completely unrelated (eg dementia). The older you are, the more likely you are to die at any time, and we are vaccinating the oldest in our population. So expect post-vaccine deaths, nearly all of which aren't vaccine-related. There is no "zero risk", and all serious after-events should be reported via the Yellow Card Scheme. 


Tribal warfare 

In a liberal democracy, people are free to believe any old bollocks. The completely deluded believe Covid doesn't exist, all the tests are false vaccines are unnecessary and our hospitals are empty. At the other end, there are those who strongly believe in the pandemic, believe it is a consequence of the way we live on this planet and that a global cull of destructive humans for virus food is welcome evolutionary payback. 

Between these extremes, both pro- and anti-lockdown factions believe in vaccines. If you're anti-lockdown, you just want all the highest risk people vaccinated to reopen society completely; if you're (usually reluctantly) pro-lockdown, you think at least 70% of the population need to be vaccinated and even then we may be wearing masks next Christmas. 

MD is far more cautious than I was a year ago. And countries which kept coronavirus at the lowest possible level have had far fewer deaths, school closures and job losses than those who tried to keep it at "a manageable level". With exponential growth, manageable very soon becomes unmanageable, as we keep discovering. And so now has Germany.


England v Germany

Comparing the UK to New Zealand or other smaller population nations isn't fair, although we can clearly learn from them. China managed to brutally suppress the virus by brutally suppressing its people, but that isn't the British way. 

Germany is democratically, culturally and climatically similar to us. It has a larger population than the UK (83.02m v 66.65m), and we have the advantage of island status to better control our borders from viral invasion. We should have outperformed Germany over the year, but it put us to shame in round one. It's still beaten us in rounds two and three, but they have been closer. So are we getting better or has Germany got worse? 


Round one 

Preparation is key in any pandemic. If we'd matched the percentage of GDP Germany has put into healthcare just since 2000, we'd have put an extra £260bn into the NHS up to 2018. Think how much extra capacity that would have bought us. Germany has the most hospital beds and ITU beds per 1,000 people in the European Union. Unlike the UK, it had testing and tracing infrastructure in place at the outset, was first to come up with a PCR (polymerase chain reaction) test, and the country's 400 local health authorities quickly tracked, traced, isolated and supported the contacts before numbers got out of control. 

Crucially, it took the pandemic seriously from the outset. Angela Merkel (scientist) declared it the country's greatest threat since the Second World War, while Boris Johnson (optimist) was shaking hands in hospital and encouraging people to carry on as normal. 

Unsurprisingly, it is the UK that has posted the highest excess deaths since the war. Wave one German deaths peaked at 2. 78 per million people, compared with 13.88 in the UK, 13.59 in Italy, 16.87 in France and 18.57 in Spain. Germany had barely any excess deaths. 


Rounds two and three 

Germany was first again to come up with a vaccine (BioNTech), but the UK wasn't far behind this time (Oxford) and we were quicker to approve vaccines and roll them out. 

There has also been a convergence of behaviour as we became "habituation nations". If your individual risk from infection is low, there is a limit to how long you will make huge personal sacrifices to help those less fortunate and save your health service. In both Germany and the UK, the workers most at risk from Covid can least afford to isolate. Many are under constant pressure to go to work and put food on the table. Covid is low on their daily risk list. 

Germany's citizens experienced so few deaths in wave one they relaxed over the summer, and an autumn surge emerged that even their track and trace couldn't contain. It went into "lockdown light" on 2 November, with schools and nurseries remaining open. But it hasn't worked and Germany now has 1,000 Covid deaths a day. Why? 

Christmas markets were largely cancelled, but there was still a lot of festive mingling and "mulled wine to go". Some restaurants bent the rules. Merkel warned that Christmas was high-risk, but under pressure from the chief ministers of Germany's federal states, rules were relaxed. It now has 4 times as many infections as in the peak of spring, and 4,000 Covid patients in intensive care. 

As in the UK, the more infectious variant is partly responsible. Unlike the UK, there won't be the huge number of excess deaths in Germany because it has far more healthcare capacity. 


Home or hospital?

If you got what you think is Covid and are trying to tough it out at home, when should you call for help? NHS England has an excellent leaflet - Important information to keep you safe while isolating at home. Ambulance services and hospitals are overloaded in many areas and they're encouraging people to phone 111 first. The leaflet tells you when to go to A&E or call 999. GPs can provide free home-use pulse oximeters for those most at risk. It's an emergency if your blood oxygen levels are 92% or less (retake your reading immediately before calling). If it's 93-94%, call 111. 

Symptoms can worsen very quickly with Covid, and indeed any health emergency. In reality, it's bloody hard to judge how sick you are when you're also frightened, which I suspect is one reason so many have died at home this year. Like the government, the tendency is to hope for the best and delay taking action - never a good plan in an emergency. 


Animal Farm 

Vaccines may be our way out of this pandemic but they won't change the social and environmental conditions that allowed the virus to jump species. We have to change fundamentally the way we treat animals. Until we do that, we'll continue to be at risk from zoonotic viruses. 


2. Covid is a 1914 moment for the post-Cold War globalised order: Vaccine nationalism and border closures mark a paradigm shift with vast implications for freedom: Allister Heath, the Telegraph.


When the assassin’s bullet felled Archduke Franz Ferdinand on that fateful day of June 1914, it didn’t only set off a chain of events that led to unimaginable slaughter. It also abruptly terminated the first modern era of capitalist globalisation, reversing four decades of integration that had transformed living standards.


John Maynard Keynes’s The Economic Consequences of the Peace, published in 1919, contains the classic account of that lost Edwardian civilisation; the parallels with our own times are stunning, proof again of the maddening circularity of human endeavour.


“The inhabitant of London could order by telephone, sipping his morning tea in bed, the various products of the whole earth, in such quantity as he might see fit, and reasonably expect their early delivery upon his doorstep,” Keynes recalls.


They could invest their savings in businesses worldwide and “secure forthwith … cheap and comfortable means of transit to any country or climate without passport or other formality”. Most tellingly, the educated metropolitan classes “regarded this state of affairs as normal, certain, and permanent, except in the direction of further improvement, and any deviation from it as aberrant, scandalous, and avoidable”.


Yet just like our own pre-Covid universe, when we thought we had conquered disease, it was too good to be true. The Great War wiped it all away, and it took around 100 years for the global economy to surpass the level of integration it had reached in 1914.


It is now Covid’s turn to wreck the assumptions that underpinned another period of globalisation: a wonderful, freewheeling, ultra-mobile 30-year affair that started with the downfall of communism in 1989 has come to a screeching end. A paradigm has shifted: a shrinking, integrating world is expanding and fragmenting again.


Many of the freedoms we had taken for granted have been revealed as temporary privileges, revocable at any time, by states that are flexing muscles we thought had atrophied. A liberal era is over; a new phase of managed globalisation is upon us. It will affect all of us hugely, in two major ways.


The travel bans and quarantine hotels are this new philosophy’s first, most shocking manifestation. For the first time since the mid-Forties, governments are preventing citizens from leaving their countries via hard borders. In Britain, it is now against the rules to go on holiday, and guarded hotel quarantines are being imposed on citizens returning from high-risk countries. This policy will surely be extended drastically as more mutant virus strains pop up across the world.


The old certainties – that it would always be possible to visit family abroad, or grab some sun, or find a job in Dubai if things went really wrong – have been dashed. Psychologically, this closing of exit strategies will be oppressive for many. In just nine months, border shutdowns have gone from inconceivable impositions in the modern, easyJet world to one of the state’s key public health tools.


Whether one believes this new approach to be vital to save lives, or a calamity, is irrelevant: it is the new normal. Travel bans and quarantine hotels won’t be a one-off. There will be more outbreaks of infectious diseases in the near future, and also false alarms, and they will all be accompanied by crippling restrictions.


So what does this mean? The costs of changing country have shot up, and international lives, from second-home ownership to Eurostar commuting, less worthwhile. Zoom-style technologies help, and have richly rewarded a small number of tech firms, but ultimately are an ersatz: the trauma for the millions of families with relatives abroad will be immense. Many will be forced to reorganise their lives.


Entire industries are now uninvestable. Corporate vested interests have been exposed as toothless: in a pandemic, or any other emergency, states will act without cost-benefit analyses, disregarding the financial and economic impact. Human rights rules are equally meaningless, including the “right” to education, private property or simply to walk freely. Given that there will now be regular lockdowns, we may need new constitutional norms to govern such events.


Every firm will have to plan for the likelihood of future lockdowns. Travel bans will become like recessions: a known risk to be managed. Many business models will no longer make sense. There will be huge demand to travel and eat out when this period ends, but hotels, airports and airlines have become speculative investments, the value of which could fall to zero at any time. There will be calls for state guarantees, with foul consequences, including a vicious circle of higher tax and greater economic decline.


For London and the South East, dependent on short-term overseas labour, business travel and leisure tourism, the blow will be especially devastating. Of the 1.3 million immigrants who have already left the UK, 700,000 were Londoners, slashing the capital’s population by 8 per cent. Will London reinvent itself, or will it be levelled down? What of the rest of Global Britain?


All of this takes us to the second major shift: the return of competitive protectionism and the collapse of supply chains. Free trade is fragile, and illiberal forces are acting to destroy a system that has rescued billions from abject poverty. We first saw during the race for PPE that countries were willing to ban exports and seizing output from factories located in their territory. We are now witnessing a war for vaccines, engineered by a desperate, incompetent and grotesque EU. Contracts and the rule of law are being fatally undermined.


Tragically for free-traders, this will force countries to reshore capacity in a range of areas. Yet where does this end? Countries will need their own vaccine and PPE plants, but what else? What about factories to build microchips (dangerously concentrated in Taiwan)? What about China’s control of cobalt and lithium? How do we prevent a nihilistic race for Thirties-style autarky, triggering another Great Depression?


Covid is a human tragedy, the West’s most lethal pandemic since the Spanish flu. But it is also upending our political economy. The old world is gone, and no amount of wishful thinking or vaccination will bring it back.

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