Things in Australia are now moving almost as rapidly towards a less insane policy as in the UK. It is already too late to avoid catastrophe in the UK but Australia has more time in which to at least reduce the scale by a larger factor than the UK can hope to achieve.
Basically scientists have been unleashing a flood of papers that make it pretty clear governments will be held criminally liable for negligence, with proof beyond reasonable doubt. They are more polite about it, but they are “expert witnesses” spelling out the case for prosecution.
The UK Center for Mathematical Modeling of Infectious Diseases has published some prototype “Explorable Explanations” with widgets eg so that anybody can get a “feel” for the UK running out of hospital critical care beds by the end of this month (with the numbers needed doubling every 1-2 days).
These are still server based Dashboards probably prepared from Jupyter R notebooks using “Shiny”. But they seem to have the server bandwidth to sustain the traffic so far. It won’t be long before easier to understand “Explorables” are available for routine inclusion in any blog post using only browser resources without server support. The difference in impact is roughy comparable to the printing press vs copying out manuscripts by hand. But the prototypes had to come first.
The “Group of Eight” Universities have come out with a group of experts from all relevant fields insisting that the government must “go hard and go now”. Oddly the only google link for that is here:
At the end there is a link to the UK Government’s Scientific Advisory Group for Emergencies – SAGE:
That page is now being updated “on a regular basis with the latest available evidence provided to SAGE.” Note the word “to”, not from. The flood of research is now spilling out of academia onto official government web sites.
There is even a fine grained Agent Based Model for Australia now available via a link from this summary:
I am still studying it, but it does argue that 80% compliance with “social distancing” measure would be needed to get the outbreak under control in 4 months. It does not spell out that 80% compliance is rather implausible without Quarantine accommodation.
Nor does it emphasize that “under control” merely means ending the first outbreak so that it isn’t just doubling every couple of days and there is time to cope. Controls will need to continue on and off until either an effective vaccine has been deployed or most of the population has been infected at a rate the hospitals plus any anti-viral drugs developed can cope with.
I still haven’t seen anybody else advocating a crash program for Quarantine accommodation to isolate infected and vulnerable people from the households they are in. But there is now lots of thinking about how to organize school children during a long shut down.
As explained in my last post in this series that Quarantine accommodation can be arranged much actual new buildings. But it still takes time and needs lots of help from tradies. So it is particularly stupid that the construction industry as being treated as though it was an “essential service” when it obviously isn’t constructing anything essential – like Quarantine accommodation. Most of the construction workers still getting infected on the job will recover in time to help with fitting up Quarantine accommodation for the next few waves if not for the first one. But it suggests there is still no intention to rapidly move into using the establishments and workforce now shutdown to actually do anything to reduce infection rates apart from staying at home.
Still, the complacency is ending. That had to happen for action to begin.
We are not in that situation nor anything like it. But there is an impending catastrophe which has been thoroughly documented by the “Imperial College Covid-19 response team” in a series of technical reports:
The current absurd floundering will not result in famine. But it could result in more avoidable deaths from Covid-19 than the total deaths from the “Spanish Flu” which killed more people than the “Geat War” that immediately preceded it – the “War to End All Wars”.
This is very likely in countries ruled by Kleptocracies like many in Africa. But already the failure to prepare is killing large numbers in Italy, with Spain and France close behind and London less than three weeks behind Italy on the same trajectory. Lots of people will also die unnecessarily in countries that are modern industrial democracies with blithering idiots in charge of pretending the owners care about the people.
The potential catastrophe we face is much smaller than the consequences of famine. A Case Fatality Rate of 6% or so instead of less than 1% that could have been achieved if quarantine arrangements were prepared to spread out the peak case load. Say half a million avoidable deaths in the UK, 2 or 3 million in the USA, less than a hundred thousand or so in Australia. Nowhere near as bad as famine…
Most of the deaths will be the result of hospital Intensive Care Units so overwhelmed they cannot provide life saving treatment for the most severe case numbers beyond available capacity.
Figure 3 of this recent authoritative announcement has a clearly labelled graph on “flattening the curve”:
Instead of just the usual horizontal line showing “Health System Capacity” lower than an early high peak and just above a slower spread out peak it adds a label for the very large shaded region above that line for the high peak and the smaller region still above that line, for spreading out.
The label is “Unmet Need”.
That is clear enough. A sharper version, more easily understood and acted on would be:
“Avoidable DEATHS not prevented”.
But even the milder version is omitted from more recent authoritative announcements.
Australia is on roughly the same trajectory as London, Italy and the United States. “Community Transmission” is already well under way in NSW and Queensland and has just got started in Victoria. It makes sense for the other States and Territories to close their borders to buy some more time just as it made sense internationally.
But it won’t be enough.
Update: If this sounds alarmist check out today’s Australian on what others far more qualified to express an opinion are saying:
Infectious disease modellers say the current round of restrictions would quarter the number of likely infections at the peak of the epidemic, but even with those social distancing measures in place, unless further measures were taken, Australia could still hit a peak of 125,000 infections a day — a level that would overwhelm the nation’s intensive care units.
Cases of COVID-19 are currently doubling every four days in Australia and heading towards a trajectory of a three-day doubling. If the epidemic were allowed to continue in this manner, University of Melbourne epidemiologist Tony Blakely said infections could climb to as many as 500,000 a day within weeks.
Under that scenario, the reproductive number of the virus is 2.5 — meaning every person infected with the virus would pass it to 2½ others. Social distancing measures are likely to reduce the reproductive number, known as R0.
Professor Blakely has modelled the impact of social distancing measures and predicts the moves to close pubs, clubs, restaurants and sporting facilities could reduce the R0 to 1.2 by the end of May. That would see the epidemic peak at about 125,000 infections a day in late May, with 60 per cent of the population infected.
Based on modelling completed by epidemiologists from Imperial College London, and adapting their model to Australia, Professor Blakely predicts that by the epidemic’s end, 165,000 people, or 0.84 per cent of cases, would require intensive care, assuming 60 per cent of people of all ages were infected.
Below on “How to Combat It” is mainly about short term measures. Days and weeks of “Impending Catastrophe”.
Fortunately longer term measures are already under way as explained at the end
Scientists and “nerds” are already pushing aside the barriers to effective cooperation from “Intellectual Property” far more rapidly than the rest of society is moving to push aside other forms of private property in the means of production.
The Enlightenment “Republic of Letters” is emerging again in a modern form with rapid mobilization forcing changes in public health policy as documented in earlier articles of this series:
It also makes sense to immediately commandeer hotels as well as private hospitals for conversion into Emergency Hospitals and use entirely separate hospital buildings for covid-19 rather than attempting infection control within the same hospital buildings as wards for other patients. No doubt that will all be done along with many other things to raise capacity.
For those interested in the measures for rapidly expanding healthcare capacity a thorough current account of covid-19 for Emergency Medecine Critical Care professionals is here:
Only the first section is likely to be of wider interest to other health workers. I think that first section is adequately summarized for a wider general audience in the public information campaigns now based on accurate advice from Centers for Disease Control etc. Note that the discussion of precautions against possible airborne transmission in above link is only relevant for those actually treating infectious patients.
No doubt surgeons no longer doing elective surgery will be taught how to do intubation procedures to provide ventilation for the vastly increased numbers of severe cases with viral pneumonia including many with further complications such as bacterial pneumonia, even though most of the teaching will be on the job assisting. Inferior split ventilators will be used and supplies will be ramped up.
Naturally the main focus of the media has been on shopping. The newspapers are printed on the back of ads for shopping and the broadcast news is squeezed between ads for shopping both online and on air.
My view is that the shopping shambles is not of major signifcance and will be sorted out without major impact. Even if 80% of the workforce have mild to moderate illness lasting 2 to 3 weeks over the same relatively short period and there is disruption generally, essential services can be maintained. Most workers are employed to not do anything useful, let alone essential. Workers from large sectors shutting down now can be fairly rapidly mobilised as (unskilled and bewildered) assistants in essential areas while training on the job.
That is what I expect to happen when the blithering idiots in charge notice that funding businesses to continue trading while insolvent does not actually achieve much in the long term for a shutdown that reduces their turnover to near zero. Even the sheer idiocy of disrupting all credit arrangements by not enforcing payment terms so that deliveries will only be for cash will not be catastrophic in itself although the financial system may be fragile enough to come up with a related catastrophe.
Some fumbling and blunders are inevitable. The supply chains for groceries and pharmaceuticals will recover from panic buying without those stuff ups in emergency management causing many unnecessary deaths. The shortage of face masks and alcoholic sanitizers was avoidable but not necessarily catastrophic.
So what is the “Impending Catastrophe” if the Medium term is looking good, healthcare capacity can be rapidly expanded and supply chain hiccups are not especially catastrophic? Simply this.
There is no reasonable prospect of increasing the capacity of Intensive Care Units rapidly enough for a pandemic that will accelerate to double the case load every 2-3 days. A week after hospitals reach full capacity they will be dealing with a case load more than four times capacity. A fortnight later, more than 16 times. This is happening now in Italy. London is about 3 weeks behind Italy and Australia and the USA not much further behind, all on much the same trajectory that leads to catastrophe.
What cannot be fixed quickly enough for the first peak is the supply of mechanical ventilators etc for Intensive Care Units. Vastly accelerated scale up still cannot possibly keep pace as countries are now entering the period of doubled demand every 2-3 days:
Clin Infect Dis. 2015 May 1; 60(Suppl 1): S52–S57. Published online 2015 Apr 10. doi: 10.1093/cid/civ089 Estimates of the Demand for Mechanical Ventilation in the United States During an Influenza Pandemic Martin I. Meltzer,1 Anita Patel,2 Adebola Ajao,3 Scott V. Nystrom,4 and Lisa M. Koonin5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4603361/
The impending catastrophe is lack of preparations for serious quarantine.
Given a shortage of Intensive Care Units and no vaccine, such measures are the ONLY way to prevent or reduce catastrophe.
The measures for people outside the health system to focus on are for “flattening the curve”. Spreading out the infection directly reduces the death rate by directly reducing the number of people with severe cases who cannot be treated when they all arrive at hospital Intensive Care Units at once and equipment is available for only a fraction of those who need it.
That is not something achieved by telling people to stay at home doing nothing. It requires actually building and organizing things.
We need to actively build and organize QUARANTINE facilities. This is not just passive “social distancing”.
The whole point of the “containment” phase of tracking new arrivals for a short period of “self-isolation” and closely tracking the contacts of anybody infected was only to buy time before “Community Transmission” began. Containment merely keeps the numbers of new infections “contained” at a smaller rate to delay the “local transmission” that will inevitably eventually grow at a much larger exponential rate until “herd immunity” is achieved with effective vaccination (expected 12-18 months away). Some cases were bound to get through and eventually result in enough people infected from unknown local contacts that the origin of most new infections is “the community” rather than some tracked or untracked individual cases seeded from outside. Then the pace accelerates from doubling each week to doubling each 2-3 days as in Italy and others that are near the first peak.
The World Health Organization, WHO, has recommended “test, test, test” because the surprise at the Italian hospital system being overwhelmed showed the pandemic was being fought blindfolded. Containment through border control and isolation cannot work when you do not know who to isolate from whom. It was known since late January that most people infected had only mild symtoms or none (with estimates of 86% of cases not reported in the statistics that media have been relentlessly staring at).
Even with an adequate supply of test kits there has to be somewhere to put people who test positive for the couple of weeks or so until most of them recover. Instead they are being told to stay at home and infect the rest of their household who are now (belatedly) being told to also stay at home. That will reduce the acceleration more than if they were told to just keep going out. But three very urgent measures were obviously necessary then.
Their necessity should have been announced loud and clear while rolling out implementation as fast as possible after announcement. So far not even the necessity has been announced. Here is my view of the three most urgent measures that are critically urgent now:
How to Combat It
1. Quarantine Hospitals for the mildly and moderately ill
Also separate facilities for unconfirmed suspected likely cases (eg travellers from areas with more community transmission to those with less).
I don’t know what the correct term is for what I have called “Quarantine Hospital”. People who don’t live by themselves should obviously not be told to just stay at home and infect their household while they wait to see if they are actually infected or while recovering. Nor should they occupy full hospital beds needed for people more severely ill.
The rest of their household can be told to just stay home for a couple of weeks to see if they are already infected or not, but anyone infected should be immediately separated from people who are not known to have been infected. That is blindingly obvious whether they need additonal medical treatment or not and whether any treatment they need is available or not. Any country not doing this is not seriously trying to flatten the curve.
“Quarantine Hospital” sounds better than “Quarantine barracks” but just somewhere to stay and be fed with some nursing staff is all it takes to seriously spread out a peak. It will require an enormous effort but it can be done using space that must be shut down anyway, emergency furnishings and staff from businesses that must be shut down anyway.
Commandeering hotels etc is for full emergency hospitals, not for the larger numbers of beds needed in Quarantine Field Hospitals. Lots of office space unused with people working from home and entertainment venues shut down must be converted to emergency accommodation. The kitchen facilities are available from the cafes and restaurants being shut down. The beds and bedding are available from households in proportion to the numbers moved out of households that will need those beds, and the staff are available from the huge numbers of small businesses trading while insolvent as well as from those already laid off. So far as I can see that has not even been planned, let alone started.
2. Quarantine Accommodation for the vulnerable
Older people and people with various severe health probems are especially vulnerable to being part of the less than 1% who might die before a vaccine is available or part of the additional 5% or so that are killed by government incompetence as a result of intensive care not being available for them when the hospitals are overwhelmed. No doubt local communities will get organized to help those who need help while staying isolated in their own homes but there are others staying in households with less vulnerable people equally susceptible to infection.
“Tough” restrictions on visits to aged care institutions are obviously ludicrous. These can only be intended as justification for very soon saying people had an opportunity to make their last visits immediately before an essential full shutdown until proper procedures for safe visits fully separated by glass barriers etc can be organized.
But vulnerable people currently living in households with others must also be offered accommodation separated from the rest of the susceptible population until the peak has passed and sufficient intensive care facilities are available. That will be hard for many. Many may refuse and many may die. But doing nothing to make viable separate accommodation available is criminal. That seems to be the current “plan”.
Neighborhood support groups are starting to be formed spontaneously through social media:
It is important to keep them entirely separate (although overlapping with) closed small “affinity” groups of households with children discussed in item 3 below.
3. Quarantine Separation of children
Obviously schools will have to be shut at some point except for children of households working in healthcare and other essential activities. Meanwhile schools are vitally important community organizing centers for households with children.
The shutdown won’t just be for a couple of weeks. It will end up lasting for many months.
while still open, and even after closing, schools should be organizing children into small groups, much smaller than class sizes, that will be allowed to interact with each other within school and after the shutdown and prohibited from doing so between groups.
This obviously needs to be coordinated with parents because all the households with children in whatever group any child continues to interact with will tend to get infected together. It will be especially difficult for households with children in different age groups and different schools but every household with children must be assigned to a particular group of households it is permitted (not required) to socially interact with. The kids are not going to just stay at home with their parents for six months, let alone eighteen months! Humans evolved in Hominid bands of a couple of dozen, not as isolated nuclear families.
Hopefully if we move really fast the necessary interaction can be online in Virtual Reality but we don’t know how well that will work, for how long or how quickly. It still ought to be based on non-overlapping groups that should be organized now by schools.
These separate child based groups are likely to continue to mix with and infect each other and must accept that their own group of households will or may end up having the larger risk of earlier infection corresponding to an enlarged single household. They must be confined to small numbers of households who trust each other to maintain isolation from the rest of the world to the same extent as the individual households.
Households with older and more vulnerable people are a major complication as self-isolation within a household is unlikely to be effective for long.
Six months is a rather optimistic estimate of how long this crisis will last. It could “conceivably” be as short as 6 months if all goes perfectly but that is not the period to plan for now. Avoiding overwhelmed hospitals requires dragging things out longer, until an effective vaccine gives “herd” immunity or effective anti-viral drugs reduce the death rate. Even if it could theoretically be even shorter than six months most serious estimates are for 12-18 months of on and off waves.
But even Italy where the hospital overload is currently greatest has only had 0.1% of the population as “cases”.
South Korea has a very long way to go before herd immunity and there is nothing in the lower numbers of new cases after the first peak or the success in dealing with that first peak to suggest that there won’t be many further peaks:
Likewise for Singapore, another success being hailed as though it were not just success with the first peak.
I don’t know whether anybody has solid evidence of whether and how it may be possible to stop transmission between househods via their children during an extended shutdown. As far as I can make out there is just empty hoping that for some unexplained reason it won’t happen. This mainly takes the form of highlighting the distraction that children have much less severe symptoms (which actually enhances their role as disease vectors).
Compared to Australia and the USA the UK is a model of serious but still unsuccessful efforts to explain public health policy to the public via journalists in a joint effort by the PM, the Chief Science Officer and the Chief Medical Oficer.
It is worth spending the time on these two long videos less than 5 days apart to understand how rapidly the situation is changing and how uncomprehending the journalists covering the “issue” are.
Coronavirus: Boris Johnson holds press conference after Cobra meeting 308,797 views – Streamed live on Mar 12, 2020 – starts at 23’30” of 1:10’57”
Coronavirus: Boris Johnson sets out “drastic action” BBC 292,849 views – Streamed live (Mar 16, 2020)
The pandemic model that now forms the basis for planning in the UK expects multiple waves of infection each time “social distancing” is relaxed after successfully suppressing the peak rates to reduce case loads to hospital capacities. This is in Report 9 from the Imperial College team:
A shorter Australian attempt at explaining the model to a journalist is this video from the ABC’s Dr Norman Swan on 17 March. (I watched it after having written the rest of this article). In many ways it is better than the UK and Australian official explanations but he still ends up distracted by issues of case tracking from the “Containment” phase rather than the current accelerating exponential growth on entering the “Community Transmission” phase. He simply does not get the fact that spreading out the peak necessarily reduces total deaths from unavailable intensive health care units and instead claims that a spread out peak could still have the same total deaths.
“Explorable Explanations” with widgets for people to actually manipulate the paramaters of the models themselves are really essential instead of literally hand-waving – with or without a background graph:
If any of these people trying to explain had access to such Explorables they would be using them on TV. Instead they are waving their hands.
The primary mechanism for transmission during a long shutdown might well be the overlap between different groups of children from different groups of households interacting to transmit the virus between their otherwise separated groups of households. It will certainly occur with younger children still at school.
Similar transmission will occur from the essential workforce in different workplaces also transmitting between different households, but stringent “social distancing” controls at work can reduce that far more effectively than among younger school children. Likewise smaller households without children will get infected more slowly than extended groups of households whose children infect each other.
School closure timing and arrangements is the hardest issue to grapple with and the least data is available as to transmission rates through these channels. Currently there have been no adequate systematic random samples of the population generally as test kits are only available for more urgent needs such as border control during the containment period and testing health workers.
In particular there is no blood testing yet to measure the immune system responses of people who have already had the virus without symptoms. Such testing is hoped for soon and could be a game changer for enabling decisions on the optimal timing for imposing and lifting isolation restrictions before and after hospitals are overloaded. It could also shed a lot more light on the transmission between children and between adults and children. At present decisions on how to time for less overloading of peak capacity in successive waves are being taken blindfolded.
The separation of groups of children and their households necessarily involves the widest participation in community decision making and implementation and the most discussion to come up with ideas right now. Explorable explanations with widgets are needed urgently for this.
All UK schools closed last week, very shortly after official announcements that the best “science” showed that overall effects of closing schools could be negative because of:
Large effect on essential workforce diverted back into parenting and child-minding, especially from already overloaded health system. (Private schools closed earlier but essential workforce is generally lower paid with a high proportion depending on schools for childcare while working in health system).
Likelihood that traditional reliance on grandparents to assist will result in more rapid infection of the most vulnerable.
Unlikelihood that school students will remain socially distanced from each other while away from school, short, medium and long term.
Previous announcements were correct. So is the new decision.
What follows from the correctness of the two opposite decisions of our dearly beloved leaders both 5 days earlier and 5 days later is that urgent mitigation measures can and should be taken for all 3 issues. Others can contribute more to discussion of those measures so I won’t attempt it in this article.
All I can say on it is that school closures will happen soon whether desirable or not.
Here is some confusing advice from USA of the same sort that will dominate discussion here:
In addition to the advice only now being widely disseminated by authoritative public health information campaigns, households with both children and older and more vulnerable people should carefully consider stronger advice from people who have been campaigning for full social isolation to be implemented sooner.
They cannot be considered “authoritative” but I will be carefully studying the technical background necessary to be able to understand both.
Epidemiology for the Uninitiated
Lots of people, like me, will need to acquire some basic epidemiological concepts to understand what the models are about. Studying this is very good practice for understanding the economics of the capitalist business cycle. (The Explorable Explanations will be more accessible for most people both for pandemics and for the business cycle).
If the serious critics are right there won’t be another peak in China and Italy after full social isolation measures are enforced. If the mainstream epidemiological view is correct (as opposed to the government waffle about 6 months) there will be successive waves over 18 months or so until a vaccine is effective, possibly ameliorated by anti-viral drugs. This is because “social distancing” restrictions end up becoming intolerable and therefore ineffective and get relaxed because they cannot be maintained for long when new cases decline to near zero after dealing with each peak in the overloading of ICUs and consequent deaths from unavailable medical treatment. Transmission can be expected to resume gradually and then again suddenly as long as there are large reservoirs of people still susceptible. There will still be large reservoirs susceptible to infection after the first peak overloading the hospitals is shutdown by emergency isolation measures just as there was for the first peak.
The business press is already editorializing about not “over reacting” and the importance of quickly getting people back to work for them. Their views will eventually prevail while the owners are still in charge. Here’s a couple of the Wall Street Journal’s editorials urging that more people be killed quickly to save money:
They can rely on help from lots of people who think correct ideas fall from the sky or are inherent in their minds as “just common sense” and are simply not interested in studying the knowledge acquired from social practice and from it alone. The three kinds of social practice include class struggle, the struggle for production and scientific experiment. This is not a good time to be glued to the business channels and ignoring the political class struggle and the struggle for production being waged by workers in the relevant sciences.
Simply assuming the first peak will be the last is as helpful as the Wall Street Journal’s editorials.
The kind of mathematical modeling that is done to help inform public health policy for dealing with this pandemic is closely related to the sort that is needed for understanding the capitalist cycle and the transition from capitalism. So studying the pandemic is not a diversion from other priorities.
The modern form of the “Republic of Letters” is very much based on the communist mode of production and distribution already widespread in the Open Culture (eg Wikipedia) and Open Science offspring of the Free and Open Source Software movement. Such intellectual activity was not enough to produce the Enlightenment, let alone the bourgeois democratic revolution against Feudalism. Nevertheless it was a very important precursor.
Wikipedia has an impressive portal showing the current extent of collaborative effort:
The main scientific publishers have accepted demands to make all covid-19 research immediately open access (they were being bypassed anyway by pre-prints on community archive sites and by Sci-Hub).
Activists have organized collections of relevant non-current background material. Major Big Tech companies have co-opted the US government to neatly classify what is “Open Access” and what needs to be extracted from behind paywalls and disseminated by activists:
Unfortunately Library Genesis does not have the only book in that list with the word “Intubation” in the title, nor any others in english that look relevant:
The Airway Cam Guide to Intubation and Practical Emergency Airway Management 1st Edition, Richard M. Levitan
Presumably anything relevant wih a doi can be obtained via Sci-Hub or this can rapidly and easily be arranged by the relevant professionals if necessary. Activists are working now to make the relevant materials freely available for people who will find themselves on the front lines along with other health workers quite soon.
Anyway, people are moving way faster than governments.
A new world is being born from the ashes of the old.
“We are under no illusions that the problem is over at all,” he says.
“If I made an analogy, it is not that the tide has turned, it is that we put the dykes up. We are watching very carefully to see where water may leak in, and if you take your eyes off it for a moment, suddenly I have an outbreak, like what happened in South Korea, and I will be in a perilous situation. It can happen to us at any time.
“Australia is grappling with the same problem. The countries around us in Southeast Asia are also facing the problem. It (the outbreak) is going to catch fire in many countries and is going to take a long time to burn out.”
“I would not say we have successfully prevented it,” Lee says carefully. “I think I would say so far we have reasonably successfully hindered the transmission.”
The key, Lee explains, is checking out all the people any infected person may have unwittingly infected before diagnosis.
“We work very hard to contact-trace,” he says. “Who are the people you have met within the last two weeks, where have you been, what have you done, who may have been exposed to you?
“We make every effort to trace those people down as well and put the immediate contacts either on notice or in quarantine, depending on whether they have symptoms. It is very labour-intensive. We have 300-plus cases now, but we have contact-traced several thousand people already, at least.
“It is labour-intensive but it is helpful in preventing a single case from becoming many hundreds of cases, if you catch it in time.”
“Looking at the behaviour of the disease and the way it is jumping from country to country, you can push it down within a country, but it has not disappeared worldwide,” he says.
“I think this is going to be with us for quite some time.”
“Their population is not immune to it yet, in very large numbers. Because even if a million Chinese have got the virus so far, that still leaves almost 1.4 billion people who have not yet, and are still, in immunological terms, naive and at risk.
“So, what you can hope for is that you control the spread of the disease, you hold the position, and hope and pray that the scientists come up with either a treatment or a vaccine within a year or two — and in time for us to exit this without the doomsday scenario, namely that the disease goes through the whole population, and then eventually we have herd immunity. Either it is going to leave you with huge casualties, or it is going to take forever to lock down.
“I think it is an enormous economic cost, and a human cost too.”
Note: Like South Korea the proportion of the population that remains susceptible to infection in the next wave is even higher than in China where one province, Hubei did have an initially uncontrolled outbreak so are substantial proportion of that province now does have at least short term immunity so there is a fair chance the next wave there will be smaller.
The proportion still fully susceptible in Singapore and South Korea is as close to 100% as makes no difference. So whether the next outbreak is smaller or larger depends largeely on how effectively long term “social distancing” can be maintained until a vaccine. The initial success was “containment” using tracking and quarantine. When actual “Community Transmission” develops rigorous quarantine becomes far more important as then tracking merely confirms that most of the new cases were infected from “the community” rather than from a specific known contact who can be promptly isolated.
Unlike any other statements I have seen from national governments Singapore is clearly stating what the media and pretty well everyone who thinks they don’t need to know more, does not yet understand.
But it still needs “Explorable Explanations” of the model for even a small minority to not be surprised when subsequent waves happen.
[Tried to add this update as a comment but will have to figure that out later]
Do above first for quick preview without spoilers. Numerous surveys done with this quiz. Consistently show that most people including most “experts” do worse on choosing between 3 plausible answers to basic factual questions about the world than random one out of three guesses of “Chimpanzees”.
Gramsci describes as a cultural revolution the period ushered in by the Renaissance and the Reformation. I’d not previously thought of these events, or movements, as cultural revolutions before, but he was right. They sounded the death knell of medievalism and it is worth remembering that the war was protracted, often bloody and characterised by what we have come to realise as historical transformations with their obligatory twists and turns. (This latter point should serve to reassure.)
It was from this cultural revolution that the modern individual arose.
There was a Cultural Revolution (CR) in Europe and it was accompanied by political struggle, war and revolution. It ushered in the modern era. Because of poor historical and theoretical understandings we are content to think that a CR is something that is launched – as it was by Mao in China. Communists in power will indeed launch GPCRs – its surely part of the job description, part of the deal in waging revolution. It is a conscious attempt to push things forward. Prior to this CRs were not prescribed or consciously directed and were more like a dogs breakfast (could do with a better description). They moved forward in fits and starts, often suffering defeats and being impossible to distinguish from the political and social turmoil that spewed it up. A slow moving but unstoppable tsunami, creeping forward here, being held back there, leaving untouched some remnants and swallowing up others. One way of reading Christopher Hill’s histories is through a cultural lens.
From the times of the English Revolution the big bourgeoisie in Britain only recognised a political personality, an individual, if they had property. This itself was clearly reflected in the franchise which, at the time of the revolution, was given to only about 3% of the population, a situation that changed only very slowly due to a franchise version of ‘bracket creep’ rather than reform. Gramsci makes this point regarding recognition in relation to the Catholic Church (no doubt he was right) but my thinking took me to the English Revolution and the rise of the capitalist class in Europe generally. The point is that a person is not worthy in their own sake, but only insofar as one is accompanied by wealth and the power implicit in wealth. The masses (and many pejorative terms exist to describe them) are the counterpoint to the valued, wealthy man of property and they arouse disdain and a strange mixture of indifference and fear. So long as they have no power and are accepting of this, it is the former; when they cease to accept their proscribed role and seek redress, it is the latter.
The primitivist appeal to the state of nature made during the revolution’s century saw man as a rational but isolated, atomized individual, set free from society. The appeal to the individual conscience, the religion of the heart, was ultimately an appeal to changing social norms. (Hill, Change and Continuity in 17th C England p 116). This too is the appeal of Locke’s tabula rasa.
Reactions to the French Revolution and their implications for individuality.
1. “… Semblance, I assert, must actually not divorce itself from Reality. If semblance do – why then, there must be men found to rebel against Semblance, for it has become a lie.” Carlyle, “The French Revolution.”
Marshall Berman’s page on this raises the matter stated by Marx that the dominant ideas of any epoch are those of the ruling class ->
xxxi Burke saw in 1790, before the revolution’s direction was clear, that the Enlightenment – the multitude of “ sophisters, economists and calculators”, had seized the initiative and “extinguished forever” “the glory of Europe”.
“All the pleasing illusions which made power gentle and obedience liberal, which harmonised the different shades of life, and which, by a bland assimilation, incorporated into politics all the sentiments that beautify and soften private society, are to be dissolved by the new conquering empire of light and reason. All decent drapery of life is to be torn off …”
Beautifully written tripe and an admission that the ”whole social system of Europe was essentially a system of lies.” The artifices of ruling class life and the ideological justifications of it were laid bare. Once again the emperor had no clothes – but this time they had been torn off. Semblance had not only become a lie, it had been seen to become so.
This masquerade, as Berman calls it, may well have been subtle for its beneficiaries (here straight jacketing the self expression of those within it) but it was hardly subtle for the peasants or the emerging proletarians. In Britain it was brutal (the Industrial Revolution) although Burke’s prose applies equally to the draperies employed by the capitalist ruling class in Britain as it did for the decadent feudal ones of Europe.
THE EMERGING INDIVIDUAL
a) in England – the role of Puritanism
Hill makes the point that the transition from tribal to village society involved a shift from kinship (blood bond) to neighbourhood – ie, tribalism to feudalism; and that the transition from parish to sect was a shift from local community to voluntary organisation.
Voluntary organisation cannot occur to any significant degree without the existence of self motivated individuals. Today this is everywhere around us. If we exclude work from our reckoning (it is a necessity and as such limits the ground in which voluntary organisation can operate) we see a plethora of activities, clubs, associations and the like which people engage in freely. It covers all classes, ages and tastes and could not occur without freely choosing individuals, all taking responsibility for fulfilling certain of their needs.
The communist movement has struggled with this aspect, that is, the ‘free’ aspect of the individual. A difficulty I see is that the free individual, as he/she emerged from the medieval quagmire, has been associated with the development of capitalism. In other words the free individual has more than likely been one of the ‘industrious sort’ so central and instrumental in the development of capitalism, in England especially (Tawney’s depiction makes this connection a defining characteristic). Bourgeois individualism has ‘form’ and communist movements have rightly identified these social elements (and the economic relations which generate them) as self serving and willing (and needing, more to the point) to exploit others.
This aspect of the individual’s development, while true, is also one sided. And it’s with the other side that we have had trouble understanding, coming to terms with and more importantly, relating to. Berman, in ‘The Politics of Authenticity’ and ‘All That is Solid…’ has, I think, attempted to correct this by focusing on the other side, that which deals with the emergence of the individual due to the development of modernity.
From a different discipline so too has the English Marxist historian Christopher Hill. One of Hill’s great contributions has been his determination to track and expose the development of both sides or aspects of the individual’s development in England from the 16th to the 18th centuries. That is, the individuals connection to bourgeois economic and social development, the aspect that has ‘form’, and the individuals development caused by modernity (although I cannot recall him using that term).
The Levellers wanted to extend voting rights to all adult men with a proprietary stake in the realm. While limited re today’s understanding, this demand was radical and aimed against their class enemy. The bourgeoisie, for its part, successfully sought to deny the common people this right. What is significant about this struggle is that it indicates that two streams of individuality/individualism had emerged – one was that of the bourgeoisie proper and the other that of the common people, the latter being led at this historical stage by the Levellers. (Paine’s ‘Rights of Man’ represent the logical development of the Levellers position.) This latter represents the historical tradition that we need to identify with. Its development took, what we could call, petty bourgeois and proletarian directions; Paine on the one side, Marx on the other. Figures like Goethe and Shelley sit somewhere in between, but much closer to Marx, I think.
Capitalism and modernity are not the same. Each has developed together and each has, within itself, contained the possibility of the other. This is best seen and summed up in the “all that is solid melts into air’” aspect, the dynamism, that is common to both.
By the early 19th C it was becoming possible to clearly distinguish between the two and to see that the development of one frustrated, distorted and held up the development of the other. Marx’s writings were very much concerned with this distinction; indeed he and Engels were key figures in making it. In effect they were saying: I like this part, the dynamism, the restlessness, the urge to develop, which in turn enables the individual to develop; but not this part, the tying of labour in perpetuity to market relations and the exploitation and alienation that goes with this. Marx and Engels spent most of their lives demonstrating that capitalist economic and social development will materially create the conditions where it can be superseded. Where, iow, (in other words) modernity can be fully transformed and shed itself of its capitalist aspect.
b) The 18th C Enlightenment
‘To be authentic, authentically “oneself”, is to see critically through the forces that twist and constrict our being and to strive to overcome them” In this sense we see Burke as not authentic, just true to his class (see comments on Burke’s take on the French Rev).
We are affected ourselves by the twistings and constrictions as we do this. We may move toward authenticity through willingly taking on (or perhaps even maintaining) other twistings as we identify and seek to overcome or overthrow the main source of that which twists and constricts us. (This needs some thinking through).
The notion of virtue draws a sharp line between the self and society: the self is virtuous only when it surrenders its freedom and submits to the laws of the society that imposes them. Yep; and clearly an important reason for women in particular to not be virtuous. When Berman wrote that sentence – the second is mine – he could not have imagined how prescient it would turn out to be for Muslim women in the late 20th and early 21st centuries.
In the Persian Letters Montesquieu tries to show that no social system can provide human happiness unless it posits – and its Government guarantees, a basic human right: the right of every person to be oneself.
a) this seems self evident as one needs a ‘self’ to get this.
b) the link between this idea and the American Rev, and its emphasis, well developed by the Revolution and crystal clear by the 19th C, on individualism.
c) The floods of migration from Europe to the Americas and a little later to Australia and other areas of the new world indicate a strong drive for economic betterment for family and for self. This often took the form of a sacrifice for one’s children, for the next generation, and it bore fruit. This drive has been overwhelmingly positive and progressive.
d) The self, oneself, is not a static entity. The self evolves, develops according to the constraints and possibilities of the level of social development in a given society. This applies between social systems and within them. This is especially so with capitalism
e) If communists don’t ‘get’ this, respond to it, work with it (not against it) we will be relegated to the margins of history, a curio blip, like a number of historically redundant beliefs and trends.
“The basic question, now, is how much freedom do the members of any state or society have to be the individuals they are – how far, in other words, is human authenticity allowed to unfold?”
Comment: This is historically and socially mediated, constructed even. As ‘they are’, the degree of unfoldingness, is developmental. This also applies within a historical epoch, to movements.
It applies to us on two levels:
1. The general, the historical.
2. The demands, impacts on oneself of the movement, group, whatever.
A repressive society – and this covers all pre capitalist societies and non democratic capitalist societies – creates a radical gap between people’s social identities (the roles they are forced into) and their real selves/identities. Personal identities must therefore be achieved. People cannot be themselves within the system but must strive to become themselves in spite of the system. This can take private, even mystical forms (see above) where the contradiction is maintained and where, therefore, authenticity cannot be achieved; or against the system. Here people cannot be themselves within the system and strive to become themselves against the system. Thus, Berman argues, revolt is the only mode of authenticity a repressive society allows (a variant of where there is oppression there will be resistance to that oppression, where our true nature is oppressed, revolt is inevitable).
The theory of revolution grows out of, and develops alongside, the idea of authenticity. This is consistent with our revolutionary history going back to the English Revolution. The question is: how well have proletarian parties, especially the successful ones – Bolsheviks, CCP being foremost – fulfilled this – or sought to fulfil – within the boundaries of what was historically and socially achievable? Within the west I think we’ve been mainly bench warmers and not players. Revolutions in the undeveloped economies led by communist parties present a more complex picture. With 80/90% of the population in China, for example, being peasant and where feudal practises, ideas and habits predominated, the communists had to work with the raw materials at hand and an emphasis on a collectivism that downplayed individuality was probably inevitable and necessary. (This did not mean that individuality did not develop – it did, in leaps and bounds – but that this aspect was not overtly promoted.) What I find disappointing is the lack (or maybe it’s an apparent lack?) of theoretical material from either the CCP or the Bolsheviks that laid the realities on the table in such a way that indicated that they knew the growth of the individual was an important goal, and a Marxist one to boot, but that circumstances did not allow them to focus on this. This distinction, the rationale, does not strike me as complex or beyond the ability of most people to ‘get’. That there does not appear to have been much written about this indicates that it was not seen as a problem. This reinforces my hunch that there is a deep ambivalence about the individual/individuality in revolutionary movements generally that has been dealt with through avoidance and a one-sided focus on notions of collectivism.
A comment on the romantic yearnings for an idealised, Arcadian past. What is yearned for is an equality of a simple, static, face to face agrarian economy based on scarcity and frugality.
And this is what makes it a reactionary yearning – it looks to the past, an idealised and non-existent one at that – and posits it as the future. Its most modern form can be seen amongst extremist greens and Islamic fundamentalists like the Taliban. It certainly had a presence in the English Revolution and re-emerged as a current of the Romantic movement which coincided with and responded to the Industrial Revolution.
We, however, envision, as Berman states, equality (and authenticity) within an urban, dynamic economy based on growth and abundance. And Amen to that!
Montaigne: (16th C) Nothing within the range of human experience was alien to him – anticipating Marx in the 19th who was no doubt paying tribute when he said it.
was self alienation. This was new. Rousseau: “they transform themselves into totally different men” (Confessions); in other words, the source of this alienation was men themselves. Philosophers had hitherto enjoined people to “know thyself”. Rousseau deepened this – not just to know, but to be oneself. His Confessions were aimed to bring his authentic self into being. The injunction to know oneself assumes a core self, an inner reality that, while masked, shrouded, hidden beneath layers of socially prescribed falsities (hypocrisies, two facedness) existed and was ready for development. The idea of a true self/false self dualism fits into this. Rousseau’s idea was much more radical. He posited that the inner self itself was a problem – that the self was only potentiality, something yet to be attained.
While stripping away the layers of the false self was a valid ‘work in progress’, the more important task was the actual creation of the self – a ‘work in progress’ from go to woe.
“It is no longer necessary for the self to go back into the past to search for its source. Its source is here and now, in the present moment”. This is a radical idea and one picked up within the psychotherapy field in the last century. Its truth, its value needs to be counter-posed to the observation made by Marx: “we suffer not only from the development of capitalist production, but also from the incompleteness of that development. Alongside modern evils, a whole series of inherited evils oppress us, arising from the passive survival of antiquated modes of production, with their inevitable train of social and political anachronisms. We suffer not only from the living but from the dead.” Capital 1 13. Together these views form a dialectical whole.
“…Rousseau showed how all the modes of personal identity – both traditional and modern – were actually modes of depersonalization, stumbling blocks which kept the individual self from coming into its own.” Marx would not have a problem with this.
“Servitude is so unnatural to man” writes Rousseau in Julie, “that it could not exist without some discontent”. He is grappling with a truth (let’s leave aside the unnatural bit as this is both true and untrue) that Mao was able to articulate in full force 200 years later – it is right to rebel against reactionaries.
Rousseau comments on his experience of servitude when, as a young man he was employed by the Countess de Vercellis. “She judged me less by what I was than by what she had made me; and since she saw in me nothing but a lackey, she prevented me appearing to her in any other light.” “But” continues Berman, “he himself had collaborated in the falsification, by acting as if her image were true.”
This objectification, and creation of a demeaned other in the process, continues today in all areas of life. What is different is that the individual has assumed centre stage and demands expression in ways unimaginable 250 years ago. How the individual exists or is portrayed in media etc – their central role in soaps, for example, are indicators of this development. While the ‘making’ aspect still applies it is now done much more consciously (because there is no other solution). This needs more teasing out………
That the Countess could have this effect underscored to Rousseau that he needed recognition – that he could be himself only to the degree that his self identity was confirmed by others. That which they did not recognise he could not assert. To Rousseau this suggested that others could mould people into whatever shape one wanted, and in a traditional hierarchy this power was held by the hereditary ruling classes – those at the bottom were forced to define themselves according to the terms dictated from above.
While this seems obvious, Rousseau’s conclusions came from a very personal experience via an examination of self. His conclusions indicate that he already had a well established self capable of self reflection and autonomous action. His ability to be self analytical and to resist sprang from that well.
It also indicates that resistance to ruling class pressure that distorts identity a la Rousseau’s experience begins in the individual (there must be formed individuals of which modern societies generate by the truck load) and then taken to a mass arena.
Another take on this: OK, so one can be moulded by the ruling class; this is old news. The interesting bit is the resistance. This was based upon the existence of an autonomous self, who drew the lessons and grew in strength. Today we are a much harder bunch to mould. The autonomous individual is churned out by the truck load. But this means that ‘we’ or, rather, ‘they’ will resist being moulded by us too. If we pigeon-hole whole bunches of people along simplistic class lines without recognising and respecting their individuality, we will be making a rod for our own individual and collective back.
Another aspect here springs from our social nature. We define ourselves in relation to the other. Developmentally the self is created through the interplay of the infant/child and external ‘objects’/subjects. Without recognition there is no self and therefore no individual. The question is not whether recognition is needed, but from whom/what and with what aim.
Traditional societies pigeon hole people; their identities are ascribed and fixed within very narrow limits
Modern societies enable identities to be achieved and transcended. Limits, roles are transcended regularly and to such a degree we barely notice. Your average Joe at work transcends himself out of work – is he a junior sports coach, team manager, assistant this or that, the secretary of a club, an amateur whatever, a blogger etc. How about a revolutionary? Now, that’s a novel idea!
Modern society has made it possible for the first time in our history for people to be themselves, to define and create their lives as they see fit, to create lives authentically their own. And modern capitalist society both enables and prevents this.
Cultural authoritarianism of the 18th C – Berman mentions the political Newtonian physics, used to promote ideas of clockwork perfection in science, everything in its place etc and neo-Classicism in the arts – was aimed at accustoming people to submit to fixed, eternal rules, externally imposed, closed to scrutiny… It’s an interesting idea – a defacto, partial, ideological united front between a decaying French feudalism and an ascendant British capitalism. The point of unity was the need for social stability. The British ruling class was largely successful in this quest because they had had a revolution; their French counterparts were not because they hadn’t. It’s also a consequence of the ER being forcibly stopped where it was. As social/economic developments continued to gather pace, the ruling class was attracted to and also had a need, to dust off ideas of stability and of permanently fixed social roles that they had challenged so successfully when the feudalists held sway.
This following quote has relevance for today:
By teaching to order and evaluate their experience according to received conventions, culture was depriving them of their strongest weapon against political oppression and social exploitation: their sense of self.
This was made regarding Rousseau’s evaluation of pre revolutionary France, albeit a Paris in the early throws of modernity. But the comment regarding culture stands alone. Culture that draws its authority from a closed and oppressive past cannot prepare or aid its members to negotiate the permanently turbulent waters that modernity throws up. For such cultures, the future has already happened and all it does is prepare people for another round of the same.
Rousseau saw modernity as possessing a paradoxical character: “as both the nadir of man’s self alienation and, simultaneously, the medium for his full self-liberation.” Yep, got it in one – well, almost. Seeing it as a paradox denies its dialectical nature although it is unfair to be critical of Rousseau here as he precedes Hegel. He deserves our gratitude for seeing both aspects of this ‘paradox’ which, as an 18th C thinker puts him one up on most the left thinkers of the following two, for, with notable exceptions, only one aspect or the other has been focused upon and only very rarely has their dialectical nature been understood. The left has been particularly guilty of this as it is they who have claimed the mantle of Marx’s critique. This includes the revolutionary left as well as the reformist.
Some interesting ideas here:
To overcome self alienation Rousseau understood that this (modern) social system (although I don’t think he understood it as capitalist), in the course of its own development, had created a mode of consciousness that was capable of transcending it. (He gets a cigar for this very profound insight). Re this, Rousseau drew upon his view that modern men inherently strove to transform their thoughts into practise (another cigar) and that, therefore, their alienation could be overcome via their consciousness being transformed into self consciousness (half a cigar because of the link to individuality and autonomy). In this way they may be able to solve their personal and social problems through reforms from within (no cigar). He hoped “to draw from the evil itself the remedy that can cure it.” (A dialectical view, but not a sophisticated one – a few puffs on somebody else’s cigar for this one).
It seems to me that Rousseau is swinging between idealist and materialist frameworks, anticipating, in some ways, Hegel. His dialectical thinking comes close, but there is no cigar because he is unable (by nearly a century) to link his observations and analysis of modernity to the economic relations driving it. Without this the slide into idealist solutions becomes seductive.