” Patient 31″ stands between Boris and Churchill

“It is no use saying ‘we are doing our best.’ You have got to succeed in doing what is necessary.” – Winston Churchill

I suppose the key to any musing about Boris Johnson is: How much do you buy into the caricature?

If you’re already – all in – on this idea of him as a bumbling, slightly oafish, scatter-brained English toff – well you probably shouldn’t read on much further.

I’ve never bought into it much. I’ve always viewed it as a largely self created image, honed in his youth, that liberates him to do and say things that a standard politician could never get away with. For me, behind it lies a keen mind, that in recent years has sharpened a philosophy of the Russian revolutionary Sergey Nechayev – The ends justify the means. And on the subject of coronavirus it seems he is particularly of this mindset.

Sir Patrick Valance is the Chief Scientific adviser to the British government. Quiet, reserved, understated and extremely competent. The polar opposite to the portrait we paint of his boss then. When he and the Chief Medical Officer Chris Whitty flank Johnson to speak about the radical British approach to the COVID-19 pandemic, one can’t help but feel the scientists deep, deep intelligence on the subject matter to hand.

It’s a reminder, to this Irish person, that we are not just talking about years of experience brought to bear on the problem in the UK. No, it is something more. It is years of experience built on the foundation of centuries of scientific practice and success. We forget that sometimes about the Brits. Once upon a time they didn’t just rule us – they ruled the world. Science and innovation was a prominent reason why.

With this in mind, I was watching Valance handle questions recently. A retired, scientific James Bond in a lab coat was the image that most sprung to mind. Leading an MI6 of scientific minds. Real or imagined it was a reassuring image.

However to deliver the science Valance and Co require Boris to calm the masses. This is undoubtedly the hardest task of all. Harder even than applying the theoretical science, because despite my previous comments – it is still a risky strategy.

The UK as we all know now, have taken a radically different approach to the coronavirus pandemic than the rest of the world. The approach is a dual pronged strategy. Currently media and the public are glossing over one of them. This is surprising because the second is the most important and is by far the most interesting and revealing.

It seems to me, the UK’s second prong begins with an admission. To paraphrase, it goes along these lines.

” As many of you as is safely possible need to get this disease this year “

By now, as we’re all coronavirus junkies, the phrase ” Herd immunity” has been added to our every day vocabularies. This idea that once 60%-70% of the population fall foul of COVID-19 – the herd – start to develop an immunity to it naturally, through mother nature and the genius of our collective anatomies.

To my mind, there is a huge buried lead missed by not examining this second overarching strategy in detail. Simply put, it must mean the UK scientific community are not envisaging a cure will exist for this virus any time soon. And by soon I mean years. The UK approach makes huge sense if you view it through that prism. I mean it makes no sense in any other prism really.

Another buried lead from Dr Valance is that the UK scientific brains trust have been working on this strategy since early January, which indicates global intelligence services have been aware and in communication with the scientists about coronavirus for longer than was previously thought. This is comforting insofar as it suggests the British approach is not some flyby the seat of your pants, Hail Mary attempt at the last minute.

Getting as many people immune to COVID-19 in as orderly and safe a method as possible will be the defensive barrier against the next wave of attack this winter or early next year. Of course, the catch is – eventual immunity only comes via infection rather than cure. And initial infection may wipe out tens of thousands if not hundreds of thousands in the first wave. That’s quite an inbuilt admission and quite a catch.

Of all the global scientific communities that speak about death and death rates of the coronavirus, the Brits are the most candid about the coming reality. People are going to die. Probably lots. Probably lots are already infected.

The danger is that this comes across as callousness and a survival of the fittest mentality. Public worry turns to panic and even worse mutiny. That is where Boris Johnson needs to allay the fear and it is no small job. There is every chance the British public could abandon the UK COVID-19 ship in the next two or three weeks if Boris doesn’t get the message and delivery correct. If dead bodies start to rack up before they are supposed to he is in career-ending trouble. But make no mistake they are supposed to rack up – it’s all about timing and a slow but steady drip, drip, production line in delivering them. I know it sounds horrible but there is no current means of avoiding it. In Britain or around the world.

To be fair, the first prong of the UK approach is broadly similiar to Ireland and the rest of the globe in many elements. The UK like everyone else wants to stifle a quick, untargeted spread of the disease throughout the country so that their health services are not over-run in the initial stages by a steep peak of severe cases. What we are seeing to date is that when supply of ICU beds, equipment and trained staff runs out – exponentially worse death rates begin to occur.

In that scenario mild cases turn severe due to lack of medical care and facilities. The UK focus at the moment is on safeguarding the elderly, people with pre-existing conditions and a simple but powerful method of dealing with symptoms. Powerful, If it is followed to the letter of the law by the general public.

The guidelines state that if a person in the UK develops a cough or a temperature of any description from anywhere they are to stay at home for a week and self-isolate. At a glance this may seem like cutting corners.

A week! – What about the 14 days every other country are advising?

But on closer examination the UK approach, is again, actually grounded in some science. The peak period for virus transmission is in the 7 days once initial symptoms do actually manifest themselves. But critically this still means some people following UK guidelines will infect other people before they have noticed symptoms and have quarantined themselves. Bluntly put, the UK want them to do exactly that.

If the elderly and people with underlying conditions are out of general circulation, it means the healthy infect the healthy and a lot of low risk groupings like the very young and women, who are largely asymptomatic will be recovered before doctors even know that they’ve had it. As some of the healthy get symptoms they are removed from society as per the elderly. If they develop more serious symptoms it is at that stage they move into the NHS. Where as many as possible are saved.

Theoretically it reduces the pressure points on ICU beds until they are actually needed. Staff can focus on ensuring mildly symptomatic patients don’t end up critical and that critical patients don’t end up dead. As many as possible at any rate.

The bonus is that the health service in the short term is not overrun with the initial wave of panic and un-targeted cases that seems to arise in every country. The added bonus is they are simultaneously building the critical mass to reach ‘Herd immunity’ state – in effect it is the opposite of survival of the fittest in an important element – It is first – the actual targetting of the fittest.

The problem of course is that this strategy requires honesty upfront. The UK government is de-facto admitting that it is actively trying to infect the population which if not explained will lead to mass hysteria.

Boris Johnson has been pretty direct on the subject to give him his due and that is why he’s being lampooned more than his average daily allowance for the past 10 days. The risk ultimately though is that it’s impossible to fully stop the strong infecting the vulnerable 100% of the time. The vulnerable don’t all have an elderly sticker on their foreheads.

The UK scientific community and their data modelling results obviously conclude less of the vulnerable die using the UK approach than the full quarantine interventions of China/Italy. I guess, the argument strengthens further when in the medium term it leaves the country much stronger. A greater percentage of the British population will be immune and so a much smaller number are fighting the next wave of virus attack in the winter of 2020. Or so the story goes anyway.

It all sounds fine and reasonable if a little science fiction right? – Wrong. There is another risk.

The risk is from the supers spreaders of coronavirus. One or two people can wreak havoc. To that end let’s chat a bit about coronavirus “Patient 31” from South Korea. It is almost impossible to understate how much damage this one person most probably did in that country.

In a short period of time, unknowingly of course, but through some negligence and stubbornness on her part, she caused huge devastation. Her individual contact tracing amounted to close contact with 1,200 hundred people over a short period of time. The evidence is mounting that this set off two cluster bombs of infection in South Korea.

Even people with only a passing interest in the coronavirus story will have heard about ” The Church in South Korea ” the epicenter of the South Korean virus explosion. Evidence is mounting that Patient 31 was the match that set the blaze aflame.

Korean Clusters of Coronavirus

In the diagram above you can see the five main clusters of coronavirus in South Korea. The biggest one and one of the smaller ones are now believed to have been ignited by Patient 31. The NHS might survive one Patient 31 but two or more together could bring down the NHS in short order. The key to the British approach is calm, steady progression of the virus. The Patient 31’s of the world create immediate and potentially devastating spikes of infection.

There is another problem in this arena – we have no real scientific analysis as of yet as to why one person is a super spreader and another person is not. There are many cases in South Korea where a person with contact tracing in the hundreds did not set off a similiar chain of events.It is not all down to high contact volumes. It seems she was the perfect storm a high contact person and a super spreader

So given all that, it’s not an understatement to say Boris needs some luck on his side. He might rightly point out in his defense that Patient 31 will cause devastation in any scenario – and that the trade-off is worth the gamble at the moment. But it is vital he sees some early success in his strategy before encountering a ‘Patient 31 in Britain. Otherwise the ‘ herd mentality’ of panic will sweep him away.

Which brings us finally to a brief history of Boris if you will and some of the clues it may offer in the present.

Glancing back at the Brexit referendum from a purely gamblers perspective – Boris backed the outsider – and won. In pure horse-racing terms – he correctly forecast the outsider was a winner – 4 months before the race. Now, I don’t for a minute believe he’s this anti-European crusader in the mould of a Nigel Farage. He saw Brexit was an opportunity. An opportunity for him and for Great Britain. But for him first. His instinct was correct about both the opportunities and the chances of the outsider.

In 2012, he was the London Mayor front and centre of the London Olympics. On the political landscape he somehow made those games the Boris Olympics. Not David Cameron’s, Not the Queen’s but Boris Johnson’s. He was the political face and is still remembered for delivering a great Olympics.

But Why?

Danny Boyle is why. He delivered the best opening ceremony in living memory.

How much credit Boris Johnson deserves for that is a moot point which you can argue among yourselves. I suspect a fair amount though. Most conservatives wouldn’t have backed the working class values of bringing a Danny Boyle type on board and letting him run with his own vision. The choice was bold, brave and finally bountiful.

In the moments after the final curtain call of the ceremony there was a brief media silence. Sometimes when an occasion is so overwhelmingly unexpected and moving it can be difficult to trust your own judgement. A ‘ Did that just happen moment ‘ on what you just witnessed and so we look around for confirmation of the verdict.

History tells us most of the UK were moved beyond words. A collective and again unexpected bubbling of pride in being British. None more surprised than the British themselves. Not your usual Olympic fare then.

In that short pocket of media uncertainty as the masses weighed it up – a good number of conservative politicians reverted to type

” Ah your typical leftie claptrap ” they sniped as they also looked around for confirmation.

” Stupefyingly Brilliant “ was Johnson’s instant diagnosis.

Of course, undeniably, Johnson had skin in the game not just with the Boyle decision but the Olympics as a whole, but not for the last time he gauged the reaction of the majority of British people instantly. The truth about Boris Johnson is he understand his own public a lot better than almost any other British politician in recent memory. But allows the the caricature to hide the canniness most of the time.

It will not be lost on him that the NHS were the centerpiece of that 2012 ceremony. In 2020 he is asking them to compete in the Games. And win Gold. Usain Bolt style.

I suppose the point of the summary is that they are examples of his instincts. Generally speaking they are good. Not always but somewhat higher than 50% of the time. They’ll need to be in the months ahead – Coronavirus is his ultimate and all defining test.

It also offers his Winston Churchill moment and that too will hone his senses and no doubt his appetite – for in essence it is a war. A war against a seemingly invulnerable and all powerful opponent to boot. Aptly, the people in the trenches with him are doctors, nurses, medics, and emergency services instead of soldiers.

As the Irish famine resides deep in the DNA of the Irish so to do the World Wars in the makeup of the British. It is in their DNA to respond resolutely, stoically and with no little humor when the going gets tough. Boris Johnson understands that I think, he just needs to convince the public he is the man to lead them through the darkest days. To do it he needs to drop the mask of carefully crafted buffoonery for a time. His moment has come.

In the face of global turmoil, widespread panic and fear of the unknown – we can but look to the man’s history and distill it down to his instincts. Are they good or are they bad and hope that if they are good – they are enough.

While undoubtedly, in the modern age of instant communication and critique, Johnson must constantly address his nation on coronavirus 2020 like Winston Churchill – he must now also prove that he can walk the 1940 walk.

For more info on South Korean ” Patient 31 “ click here

Written By Gerry O’Neill – Facebook Click here

%d bloggers like this: