Pandemic Predictions
Jul. 23rd, 2020 09:53 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
jackThe good outcome
When lockdown started I was scared the infection rate was just going to go up and up. I thought the government was likely to just reflexively sleepwalk into a strategy of "go through the motions of lockdown, downplay the problem, bury the numbers, pretend everything is fine" and switch seamlessly to "oh well, completely unforseeable, will of the gods, too late now, no point crying over spilt milk, lockdown failed, lets try to get the deaths over with as quickly as possible".
If everyone gets sick at once would our clockwork supply chains falter? Would we have actual food shortages? This seemed like a real risk. Although a "real risk" can mean anywhere from "not likely, but likely enough to need a plan" to "likely" depending on the type of risk, which I didn't consciously think through. I was torn between a justified status quo balance and a recognition that we had almost no precedent for how we'd deal with a pandemic like this.
But that didn't happen, the infection rate actually DID go down again despite government shilly-shallying. Delaying turned a short lockdown into a long lockdown, and we might yet get another one, but it didn't yet turn it into the worst case scenario, so that was a lot better than it might be.
What else turned out well?
The bad outcome
I remember asking, what good might come of the lockdown. Would we normalise convenient supermarket delivery? Would supermarkets have to collaborate into a national delivery service that had fewer separate vans and private cars driving around? Would the government have to admit it NEEDED a basic income to keep the country running? Would working from home be normalised?
Would the idea of "oh, we can just pressure mothers to do childcare AND a job" as a foundation for society finally die?
Would we eliminate habitual flying?
Even if none of that, would the government take basic steps like providing funding for quarantining anyone going into a nursing home, and giving decent sick leave to people working there (or ideally, paying people to live on site!)
I had all these plans for how society might change. Every time somneone in governbment got sick or something important shut down I thought "maybe NOW government will take it seriously".
But just like the worry slowly ebbed away with familiarity, so did the hope.
I think I really should have foreseen that none of that happened. The government poured resources into keeping things going as much like normal as possible. New services happened slowly if at all (because obviously, the government aren't any good at anything). Everything happened via the government telling businesses what they had to do, with little help or responsibility from the government.
They didn't set out to infect everyone, but they aggressively concentrated on problems of businesses and on ignoring the problems of nursing homes :(
As many people as possible were forced back into work to keep middle class lifestyles ticking over as much like normal as possible :(
Gender roles if anything became more polarised :(
Flying fell to about half and has climbed back up again ever since. I've no idea what all those flights are but they are happening :(
What else turned out badly?
The Ugly outcome
This is a dress rehearsal for whether we take action on climate breakdown. I always thought, surely when it gets THIS bad even the government can't gloss it over. They'll have to admit that they need to take SOME measures fairly promptly.
Ha ha. No. If they'd locked down as soon as it became clear Italy hadn't contained it, we might have got away with locking down a couple of cities. Or putting quarantines on people entering the country. No, they delayed until we had to have months of lockdown, and are erring on the side of opening up too soon and recreating the same problem.
If they can't make the logical leap from "opening businesses without a functioning test and trace system was bad in March, maybe it's also bad in July", they're doing exactly the same thing about climate change, waiting until public pressure forces them to act, when every delay makes the problem many times worse :(
People: Oh no, we're racing toward the cliff edge of no return!
Government: Don't worry, we've blacked out the windscreen. Maybe the cliff isn't really there, how would we know?
When lockdown started I was scared the infection rate was just going to go up and up. I thought the government was likely to just reflexively sleepwalk into a strategy of "go through the motions of lockdown, downplay the problem, bury the numbers, pretend everything is fine" and switch seamlessly to "oh well, completely unforseeable, will of the gods, too late now, no point crying over spilt milk, lockdown failed, lets try to get the deaths over with as quickly as possible".
If everyone gets sick at once would our clockwork supply chains falter? Would we have actual food shortages? This seemed like a real risk. Although a "real risk" can mean anywhere from "not likely, but likely enough to need a plan" to "likely" depending on the type of risk, which I didn't consciously think through. I was torn between a justified status quo balance and a recognition that we had almost no precedent for how we'd deal with a pandemic like this.
But that didn't happen, the infection rate actually DID go down again despite government shilly-shallying. Delaying turned a short lockdown into a long lockdown, and we might yet get another one, but it didn't yet turn it into the worst case scenario, so that was a lot better than it might be.
What else turned out well?
The bad outcome
I remember asking, what good might come of the lockdown. Would we normalise convenient supermarket delivery? Would supermarkets have to collaborate into a national delivery service that had fewer separate vans and private cars driving around? Would the government have to admit it NEEDED a basic income to keep the country running? Would working from home be normalised?
Would the idea of "oh, we can just pressure mothers to do childcare AND a job" as a foundation for society finally die?
Would we eliminate habitual flying?
Even if none of that, would the government take basic steps like providing funding for quarantining anyone going into a nursing home, and giving decent sick leave to people working there (or ideally, paying people to live on site!)
I had all these plans for how society might change. Every time somneone in governbment got sick or something important shut down I thought "maybe NOW government will take it seriously".
But just like the worry slowly ebbed away with familiarity, so did the hope.
I think I really should have foreseen that none of that happened. The government poured resources into keeping things going as much like normal as possible. New services happened slowly if at all (because obviously, the government aren't any good at anything). Everything happened via the government telling businesses what they had to do, with little help or responsibility from the government.
They didn't set out to infect everyone, but they aggressively concentrated on problems of businesses and on ignoring the problems of nursing homes :(
As many people as possible were forced back into work to keep middle class lifestyles ticking over as much like normal as possible :(
Gender roles if anything became more polarised :(
Flying fell to about half and has climbed back up again ever since. I've no idea what all those flights are but they are happening :(
What else turned out badly?
The Ugly outcome
This is a dress rehearsal for whether we take action on climate breakdown. I always thought, surely when it gets THIS bad even the government can't gloss it over. They'll have to admit that they need to take SOME measures fairly promptly.
Ha ha. No. If they'd locked down as soon as it became clear Italy hadn't contained it, we might have got away with locking down a couple of cities. Or putting quarantines on people entering the country. No, they delayed until we had to have months of lockdown, and are erring on the side of opening up too soon and recreating the same problem.
If they can't make the logical leap from "opening businesses without a functioning test and trace system was bad in March, maybe it's also bad in July", they're doing exactly the same thing about climate change, waiting until public pressure forces them to act, when every delay makes the problem many times worse :(
People: Oh no, we're racing toward the cliff edge of no return!
Government: Don't worry, we've blacked out the windscreen. Maybe the cliff isn't really there, how would we know?
no subject
Date: 2020-07-24 07:36 am (UTC)ignoring the problems of nursing homes
I would say that as well as ignoring the existing problems with care homes (vulnerable population plus high turnover of staff and visitors) they exacerbated those problems, by discharging people from hospital to them without testing.
no subject
Date: 2020-07-27 02:43 pm (UTC)In defence of the doctors who did that discharging, though, they were acting for good reasons — they thought that every bed was going to be needed to deal with a tsunami of cases, that never materialised, but that wasn't knowable at the time — and they had incomplete information — while it was known that there were asymptomatic cases, it wasn't known at the time that the disease had already spread so far and so fast through the hospitals.
As far as they — or anyone else at the time — knew, they were discharging healthy patients to somewhere where they would be safer, before coronavirus arrived in their hospitals. Had they known coronavirus was already there they presumably would have acted differently.
So when judging them it is important not to go too hard on them for not using their retrospectoscopes.
no subject
Date: 2020-07-27 05:01 pm (UTC)I don't know how avoidable it was in terms of the knowledge available at the time. However:
Faster movement on testing could have mitigated it even without even knowing that asymptomatic hospital spread was a major threat: with adequate testing capacity it would have been fairly natural to test people on their way into care homes (for any reason) since we know that respiratory diseases spread in them already, from experience with flu.
no subject
Date: 2020-07-27 08:10 pm (UTC)Um I don't think that's agreement, I think that's the exact opposite of what I wrote, which is that it was precisely a lot of individual, but perfectly understandable given the state of knowledge at the time, failures.
Faster movement on testing could have mitigated it even without even knowing that asymptomatic hospital spread was a major threat
True. I don't know how much of the failure to increase testing capacity was simply unavoidable (the lack of reagents due to the fact that we don't have a chemical production industry like, say, Germany's) and how much was culpable (Public Health England's control-freakery and refusal to allow private and university labs to help with tests).
no subject
Date: 2020-07-28 07:59 am (UTC)The system-level failure was the policy promulgated mid March to rapidly discharge patients without any testing (https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/880288/COVID-19_hospital_discharge_service_requirements.pdf).
That wasn't something individual doctors came up with independently as a result of insufficient information, it was a centralized policy decision which was only changed a month later (https://www.gov.uk/government/publications/coronavirus-covid-19-adult-social-care-action-plan/covid-19-our-action-plan-for-adult-social-care para 1.30).
The people 'on the ground' were just following the centrally defined policy in good faith. If they'd been making up their own policies we'd probably have seen a wider range of decisions.
no subject
Date: 2020-07-28 08:30 am (UTC)It just did the wrong thing.
Like if you go off for a drive, and the car is the system. A 'system-level failure' would be the car breaking down, or maybe even you misreading the map. If the car works perfectly and you navigate correctly but you just go to the wrong place (perhaps because you didn't realise that your friend had moved since you last visited and went to their old house) then there was no system-level failure but you still didn't end up where you should have.
no subject
Date: 2020-07-28 08:35 am (UTC)But again, a policy that was perfectly reasonable — and as far as anyone knew was entirely correct — given what was known at the time.
no subject
Date: 2020-07-24 08:46 pm (UTC)So far, the decision seems to have been that people are expendable but money is precious.
no subject
Date: 2020-07-27 02:38 pm (UTC)I wonder what you think they should have done about the problems of nursing homes? Unlike hospitals, which are run by the NHS and which have to do whatever the Minister demands of them, most nursing homes are private businesses and the government has no direct control over them. Given that, what could they have done?
It's also worth pointing out that two-thirds of nursing homes had no coronvavirus deaths at all. So these 'problems' weren't inevitable: the nursing homes that were hit clearly did something wrong, that the others didn't. What was it?
no subject
Date: 2020-08-02 02:25 pm (UTC)That second doesn't follow from the first at all. Hospitals were sending asymptomatic, untested patients to them before we really knew that was a thing.
no subject
Date: 2020-08-02 02:24 pm (UTC)Yeah. God the level of incompetence... we've had plenty of nasty PMs, but few who were so bad at their jobs. Obviously the pandemic would've strained anyone's abilities but Johnson's been shambolic as Mayor of London and Foreign Secretary too; it didn't need to be THIS bad.
The collapse that's coming re: climate change terrifies me, because I entirely agree on that front.
no subject
Date: 2020-08-04 03:27 pm (UTC)We had one thirteen months ago!
no subject
Date: 2020-08-04 05:23 pm (UTC)