Owl hopes the Devon and Cornwall MPs who supported the #pleasecomebacklater campaign in such a timely manner will also back this campaign, based on the expert advice of Dr Bharat Pankhania of Exeter University’s medical school. 

Dr Bharat Pankhania says contact tracing, isolation and testing should be introduced ‘as a matter of urgency’ in the south west, north west, north east, Scotland and Northern Ireland.

Owl urges readers to contact their MPs as well. 

Devon councillors urge MPs to press for a regional approach to tackling Covid-19

Philippa Davies  www.sidmouthherald.co.uk 

Three Devon county councillors, including Otter Valley representative Claire Wright, are supporting the call by an infectious disease and public health expert.

Dr Bharat Pankhania of Exeter University’s medical school believes that effective control of the disease in the least affected parts of the country would be an important step towards a national solution.

He said contact tracing, isolation and testing should be introduced ‘as a matter of urgency’ in the south west, north west, north east, Scotland and Northern Ireland.

The councillors, Hilary Ackland (Exeter), Martin Shaw (Seaton and Colyton) and Claire Wright, have released a joint statement, which said: “The south west is experiencing the epidemic in a different way from other regions.

“We have the lowest levels of hospitalisation and death from Covid-19 in the country.

“South west councils, MPs and the police have had some success in preventing second-home owners and tourists further spreading the virus.

“We therefore support the call by Dr Bharat Pankhania, Exeter University’s infectious disease and public health expert, to take advantage of the lockdown to introduce a regional approach to the epidemic in the south west, with intensive testing, tracing and quarantining to eliminate the virus.

“We call on Directors of Public Health in the region to devote all available resources to this approach, and on Devon MPs to press the Government to give the necessary support for this.

“While we do not believe the lockdown can be lifted imminently, effective control of the epidemic in the south west would be an important step forward towards a national solution, and would enable local leaders to make the case for a regional approach to lifting the lockdown in due course.”

Cllr Shaw added: “As of two days ago, 21 people had died of Covid in the Royal Devon & Exeter Hospital Trust, compared to almost 200 in many trusts in other regions.

“This shows that the epidemic is still very uneven – a patchwork of variable local epidemics, as Dr Pankhania has argued in the British Medical Journal.

“We should press for an effective south west strategy.”

Across Devon as a whole there have been 84 deaths from the coronavirus in the four main hospitals. The official figures provided by NHS England do not include deaths in care homes or the wider community.

Twelve lessons to learn (quite a long read) – is that too many for our Politicians? 

Fascinating time to be Owl: slow decisions, poor decisions, good decisions, weak leaders, strong and decisive leaders all exposed like lab rats in the laboratory by Covid-19 within weeks.

No place to hide.

As governments fumbled their coronavirus response, these four got it right. Here’s how.

Angela Dewan, Henrik Pettersson and Natalie Croker,  London (CNN) edition.cnn.com 

Like a line of dominoes, country after country has been shut down by the novel coronavirus. Despite signs the threat was making its way across the globe, there was a clear pattern of response in many parts of the world — denial, fumbling and, eventually, lockdown.

In our globalized world, it’s puzzling that so few lessons were learned in the early weeks of each country’s outbreak, when the chances of containing and stopping the virus were highest. Now the focus is on flattening the curve, or slowing the virus’ spread, to keep death tolls from climbing further.

As much of the world mulls gradually lifting lockdowns, there are still lessons to be learned from these four places that got it right. Here are 12 of those lessons.

Sitting just 180 kilometers (110 miles) off the coast of mainland China, Taiwan’s outbreak could have been disastrous. At the end of January, the island was estimated to have had the second-highest number of cases in the world, according to Johns Hopkins University (JHU). 

But Taiwan, with a population of around 24 million people, has recorded just over 390 cases and six deaths, and yesterday, it reported no new cases at all. It’s managed to do that without implementing severe restrictions, like lockdowns, or school and nursery closures.

In terms of its death toll, at least, Taiwan doesn’t even have much of a curve to flatten, more of a line with a couple of rigid steps.

Compare that to the United States — now the world’s hardest-hit nation, at least in raw numbers — which has reported at least 26,000 deaths. Even when you take population size into account, a level of success like Taiwan’s could have meant just 83 deaths in the US.

Although Taiwan has high-quality universal health care, its success lies in its preparedness, speed, central command and rigorous contact tracing.

Lesson #1: Be prepared

Taiwan’s preparedness came largely from some hard-learned lessons from the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003, which killed 181 people on the island.

As a result, the island established a specialized Central Epidemic Command Center, which could be activated to coordinate a response in the event of an outbreak. In a sign of how Taiwan wanted to get ahead of the coronavirus, the center was activated on January 20, a day before the island even confirmed its first infection.

Because its authority was already established, the center was able to implement stringent measures without being slowed down by lengthy political processes. It put more than 120 action items into place within three weeks, according to a list published by the Journal of the American Medical Association (JAMA). That list alone could serve as a manual on exactly what to do during an outbreak.

Lesson #2: Be quick

Taiwan’s action came well before its first Covid-19 infection was confirmed on January 21. Three weeks before, within days of China’s first reported case to the World Health Organization (WHO), Taiwanese officials began boarding and inspecting passengers for fever and pneumonia symptoms on flights from Wuhan, the original epicenter of the virus in China. The island issued a travel alert for Wuhan on January 20, and two days later, still with just a single case, officials began updating the public in daily briefings.

A week after its first case, Taiwan began electronic monitoring of quarantined individuals via government-issued cell phones, and announced travel and entry restrictions, mostly targeting China’s Hubei province, of which Wuhan is the capital. Just about every day after until the end of February, the government implemented new measures to keep the virus at bay.

Taiwan had only 329 cases when it imposed strict social distancing measures on April 1. In comparison, there were already 335 deaths and more than 3,000 cases on March 20, when Prime Minister Boris Johnson announced that pubs and restaurants were to close, and that most children would be pulled from schools and nurseries. And as the UK is not testing widely, the true number of infections is believed to be much higher than official figures show.

Lesson #3: Test, trace and quarantine

Authorities carried out widespread testing and tracing the contacts of infected people, putting them all under quarantine. It proactively tested anyone who got off cruise ships and even retested people diagnosed with influenza or pneumonia, to make sure they hadn’t been misdiagnosed and were infected with coronavirus.

Lesson #4: Use data and tech

“A coordinated government response with full collaboration of its citizenry [was] combined with the use of big data and technology,” associate professor of pediatrics at Stanford Medicine, Jason Wang, told CNN. Wang has also studied public health policy and co-authored the JAMA report on Taiwan’s response.

Taiwan merged national health insurance data with customs and immigration databases to create real-time alerts to help identify vulnerable populations.

“Having a good health data system helps with monitoring the spread of the disease and allows for its early detection. When someone sees a physician for respiratory symptoms, the national health insurance database will have a record of it. It is easier to track clusters of outbreaks,” Wang said.

Taiwan used mandatory online reporting and check-ins for 14 days after travel restrictions. It also employed “digital fencing” for close to 55,000 people in home quarantine, where alarms would sound if a quarantined person wandered too far from home. The technical surveillance methods used in Taiwan and by other governments have raised privacy concerns from civil society groups.

Iceland

Getting a coronavirus test in many countries can be near impossible, unless you’re already very ill. Not so in Iceland, where anyone who wants a test gets one. Widespread testing has been crucial to the country’s low number of infections and deaths, authorities there say. Only around 1,700 people have been infected in Iceland, and only eight have died.

Lesson #5: Be aggressive

Iceland’s response to the coronavirus hasn’t been particularly innovative. It’s just been meticulous and quick. Like Taiwan, its speed has meant it hasn’t had to be too restrictive — people can still meet in groups of up to 20, if they stay two meters away from each other. While universities are closed, schools and nurseries are still open, allowing more parents to work.

“From the beginning, since we diagnosed our first case, we worked according to our plan. Our plan was to be aggressive in detecting and diagnosing individuals, putting them into isolation, and to be very aggressive in our contact tracing. We used the police force and the healthcare system to sit down and contact trace every newly diagnosed case,” Iceland’s chief epidemiologist Thorolfur Gudnason told CNN.

“We are finding that above 60% of new cases are in people already quarantined. So that showed that contact tracing and quarantining contacts was a good move for us,” Gudnason said.

Lesson #6: Get the private sector involved

In a public-private partnership between the National University Hospital of Iceland and biotech company deCODE Genetics, Iceland designed tests early and expects to have tested 10% of its population by the end of this week. It aims to test just about everyone and has already become a valuable laboratory for the world to learn more about the novel virus.

Recent revelations that 50% of the people who tested positive in a lab in Iceland showed no symptoms at all, for example, has prompted other countries to take firmer action through social distancing, as they begin to realize preventing the virus’ spread will be more challenging than initially thought.

Kári Stefánsson, CEO and director of deCODE Geneticsm, told CNN that as of Monday, it had found 528 mutations of the coronavirus in mass testing in the community. These mutations could give insight to how lethal the virus becomes and offers important data to the world to better understand how it operates.

Lesson #7: Act preventatively

Icelandic Health Minister Svandís Svavarsdóttir has emphasized speed as a powerful tool, saying the approach is to stay “ahead of the curve.” The country appears to have done just that. After just six imported cases were confirmed on March 3, Iceland immediately issued quarantine measures for all travelers returning from Italy, and increased travel restrictions in the following weeks.

The National Police Commissioner declared a state of emergency on March 6, when the first two community-transmitted infections were confirmed. This sent a signal to government bodies to improve their preparedness, but it kept public gatherings as they were, only warning vulnerable people to stay away from crowded places.

The country closed universities and junior colleges on March 13 and banned gatherings of more than 100 people on March 16, when it had just 61 confirmed cases and not a single death.

Three days later, all Icelandic residents that entered the country were required to go into 14 days of quarantine, regardless of where they were traveling from.

It wasn’t until after all this action that, on March 24, Iceland’s first death was reported. That same day, authorities banned gatherings of above 20 people and shut down public amenities, such as bars, swimming pools, museums and gyms.

Lesson #8: Use tech, but respect privacy

Like in Taiwan, Icelandic officials also made an app available for people to download to help chart the virus’ spread. It creates a log of where the user has been. Users don’t have to share that data with authorities — but many do as it helps contact-tracing teams work out who may have been put at risk.

In comparison, the UK’s response has been slow. A government-supported app is only now in the works and is weeks away from launching. As it lags behind in testing, it is only just now looking into public-private partnerships.

South Korea

It’s telling that South Korea reported its first coronavirus case at around the same time as the US and UK. South Korea is confirming around 30 new cases a day, while in the UK it’s around 5,000, and the US it’s more than 20,000.

The way each country tests varies, but their death rates among the population contrast just as dramatically. Fewer than one in every 100,000 people in South Korea’s population have died from the virus, while in the UK it’s around 18. It’s almost eight in every 100,000 in the US, JHU data shows.

Lesson #9: You can drive-through test

South Korea’s success has been largely down to its testing, according to Dr. Eom Joong Sik from the Gil Medical Center near Seoul. Eom is treating coronavirus patients in hospital and sits on a committee that advises the government in its response.

“Early diagnosis, early quarantine and early treatment are key,” he told CNN.

“Since the first patient was confirmed, by installing more than 500 screening clinics all over the country, we sorted suspected cases and conducted tests, and we have worked hard to develop and maintain a system to conduct many tests with a small workforce over a short period of time,” he said.

The country has also been innovative in how it tests. Eom’s advisory team had hundreds of drive-through booths, just like at a McDonald’s, set up across the country to offer tests that were largely free, quick and done by staff at a safe distance. The US has since replicated that model in some states.

On March 16, the WHO called on governments of the world to “test, test, test.” South Korea had already been doing that for weeks, and has to date tested more than 500,000 people, among the highest number in the world per capita.

Many countries are struggling to carry out thousands of tests each day. It’s so difficult to get tested in the UK, for example, that people have been turning to mail-order kits, in an industry that hasn’t yet been regulated by the government.

South Korea was also quick to move, implementing quarantining and screening measures for people arriving from Wuhan on January 3, more than two weeks before the country’s first infection was even confirmed. Authorities rolled out a series of travel restrictions over the weeks after.

South Korea has also been rigorous in its contact tracing, though it was able to do that easily when it realized a large number of cases could be traced to one religious group in the city of Daegu, making contact tracing easier and giving authorities a specific area to carry out intensive testing.

“By carrying out tests on all members of the congregation and diagnosing even infected people without symptoms, the government carried out quarantine and treatment side by side,” Eom said.

Once Daegu was established as the epicenter, authorities were ready with the ability and political will to test broadly, to trace contacts of people infected, and to quarantine them to try and contain the virus before it became a case of mitigating widescale death, as is now the case in much of Europe and the US.

Lesson #10: Learn from the past

South Korea was able to move quickly because, like Taiwan and many other Asian nations, it had been burned before. South Korea was mostly unaffected by the SARS outbreak, only reporting three cases and no deaths at all. But it was caught off guard by the Middle East Respiratory Syndrome in 2015, when it recorded 186 cases and 38 deaths, making it the worst-impacted country outside the Middle East.

So the political will needed to enforce measures during the coronavirus outbreak wasn’t a problem and there was good coordination between the central government and the provinces.

It also helped that South Korea is one of the most technologically innovative countries in the world. Much of life there is already conducted online, so developing and enforcing the use of an app to monitor people in quarantine wasn’t too difficult, though activists there too have warned of invasion of privacy.

Germany

Germany’s case is a little different. The country hasn’t really been able to keep infection numbers at bay much better than some of the hardest-hit nations. It currently has more than 132,000 confirmed infections, the fifth-highest in the world, JHU reports.

But Germany has been able to keep the death rate in its population relatively low. More than 3,400 people have died from the virus in Germany, around four people in every 100,000 across the country. That’s well below Italy’s 35 and the UK’s 18.

Lesson #11: Test more as restrictions ease

Germany’s success has also been its mass testing, but its well-resourced universal healthcare system has played a major role too, according to Martin Stürmer, a virologist who heads IMD Labor in Frankfurt, one of the labs conducting tests. Germany has also drawn in the private sector to make sure enough tests are carried out.

“From the beginning, Germany didn’t stick to one or two or three central labs doing all the tests. Many private companies were involved, so we’ve been able to do 100,000 tests a day,” Stürmer told CNN.

“There are some countries that have done it even better than Germany, in controlling infections, but what’s quite important is broad testing, where we were able to see what was happening in our population. Only with mass testing can you identify people who might be infected.”

Like Taiwan, South Korea and Iceland, Germany devised a test for the coronavirus and prepared a large number of kits early, well before the country even reported its first death.

As German Chancellor Angela Merkel announced Wednesday that the country would begin gradually scaling back its lockdown, the country is planning on carrying out even more tests, in case the increased contact leads to a second wave of infections. Like many countries, it will also test for antibodies to try and determine who among the community may be immune to the virus.

Germany’s death toll has remained relatively low in part because the coronavirus trickled into the country mostly in young people. Many had been visiting Italy or Austria on ski trips.

Authorities were able to test people returning to Germany from these ski resorts and trace their contacts for testing too. Most of those people were young, and still today, the biggest age group by infections is 35-59, followed by 15-34. The virus is proving to be deadlier among the elderly around the world.

But as communal infections in the country grow, Stürmer fears that more elderly people could die in coming weeks and that the country’s death rate will go up.

Germany recorded 315 deaths from complications related to Covid-19 in the past 24 hours, the country’s center for disease control, the Robert Koch Institute, wrote on its website on Thursday. This is the first time more than 300 deaths have been reported in a 24-hour span.

Lesson #12: Build capacity at hospitals

Germany ranks 18th in the world in terms of access to quality healthcare, according to an index published by The Lancet, sitting above the UK at 23rd and the US at 29th. But these indices only tell us so much. Italy, for example, ranks ninth and the country also carried out rigorous testing, yet it has recorded the second-highest number of deaths per capita in the world, after Spain.

In this situation, the difference appears to be the German healthcare system’s huge capacity. Germany is projected to need about 12,000 beds at the peak of this outbreak in the middle of the month, according to projections from the Institute for Health Metrics and Evaluation. It has over 147,000, more than 10 times its need.

In contrast, the US has around 94,000 beds, some 15,000 beds short of its need. Germany has more spare beds in intensive care units that Italy has altogether.

In fact, Germany’s health system has such a large capacity, its hospitals are now treating people for coronavirus from Italy, Spain and France.

Authorities have been able to get people with even moderate symptoms to hospital well before their conditions deteriorate, leading some experts to consider whether treating people early, getting them on ventilators before their condition worsens, for example, improves their chances for survival.

“Germany is not in a situation where the healthcare system is overloaded, like you see in Italy, where they need to decide whether to treat a patient or not. We don’t have that,” Stürmer said.

Different story on a care home in the South Hams to that in East Devon

www.totnes-today.co.uk

A Dartmouth care home has reopened to take patients discharged from hospital to help relieve pressure on the county’s NHS hospitals.

The Fleet care home, formerly known as the Riverview, was due to reopen later in the year to provide nursing care in the local community, but the decision to open it immediately, and with potentially more bed capacity, was escalated by Devon County Council as part of its response to the coronavirus pandemic.

Only patients in need of specialist care are being kept in hospitals. Other patients are being discharged safely to ensure hospitals have more capacity to deal with those who are acutely ill, including patients suffering from Covid-19.

Devon County Council is making sure there are enough places for people to move to when they leave hospital. Most return home, but some require more support until they are a bit better.

Residential and nursing homes, which may otherwise be an option for them, are also under a lot of pressure to meet demand, and the authority is working with organisations that have accommodation with a view to these places being used temporarily by people when they can leave hospital.

The Fleet Care Home was due to open this year with 14 nursing care beds, but it will now open imminently with the potential to increase capacity by an extra 24 beds temporarily for people being discharged from hospital or moving in from home due to ill-health.

The council is also in discussion with a hotel owner in Bideford about opening up similar accommodation for discharged patients.

Alongside the potential Bideford facility, and the Hilton Hotel at Exeter Airport, which is already taking people discharged from hospital, the three facilities would provide an extra 200 beds, staffed by trained and experienced health and care professionals.

Councillor Andrew Leadbetter, the cabinet member responsible for adult social care, said: “These will be for people who do not need to be in acute hospitals, but who require extra care before returning home or until residential or nursing places can be found for them.

“They can also be used by people with care needs who have been living at home, but who can no longer do so – if their carer becomes unwell, for example. We are doing absolutely everything we can to ensure that people in Devon continue to receive the care and support they need.”

Lee Baxter, associate director at Torbay and South Devon NHS Foundation Trust said:

“We are working in partnership with all providers to ensure we can deliver the best possible care during the pandemic.

“As a key part of this we are working closely with Devon County Council to ensure we have facilities and accommodation available to keep NHS beds available for those who may need them at this time.

“We are very pleased to be working with Fleet as part of this approach.”

Anthony Mangnall, MP for the Totnes constituency, which includes Dartmouth, has welcomed the decision to bring forward the reopening of The Fleet, following several months of discussions and meetings. He said:“I am delighted to hear that The Fleet will be reopening this week.

“Dartmouth’s healthcare services have been of huge importance to me and I raised this issue with the Health Secretary, Matt Hancock, when he visited in late 2019.

“Ensuring that Dartmouth is not cut off when it comes to its healthcare provisions has been a top priority and I am pleased with today’s announcement.

“I have been working with Devon County Council and the Clinical Commissioning Group to ensure that residents not only have reassurance when it comes to their healthcare services but that access across rural and urban areas is as comprehensive as possible.

“I will continue to work with local and national groups to maintain these provisions as we tackle COVID-19.”

Dartmouth’s county councillor Jonathan Hawkins, added: “I am very pleased that this building is being bought back into use and that it is going to be a nursing home that

Dartmouth and the surrounding parishes have been calling for a nursing home for many years so this is very welcome.”

Melody Walters, regional manager for Care Concern Group, which own the Fleet said.

“The team has worked tremendously hard to bring the opening of the home forward, they all feel very proud to be helping the local community during these trying times, and are looking forward to providing the new residents with a caring and luxurious environment.”

The Fleet Care Home in Dartmouth will have 14 beds and has the capacity to provide 24 more if needed.

Devon County Council says this will ease the pressure on district hospitals who should only be dealing with people who are acutely ill in the coronavirus outbreak.

Dartmouth Area Healthcare Action Group asked why the former community hospital, closed in March 2017, was not brought back into use instead of paying for private care.

Solveig Samson from Devon County Council said Fleet was a better than the “clinical” atmosphere of a hospital.

“A community hospital is for short-term nursing care but a nursing home is for long-term care,” she said.

“It’s better for them to have their nursing are needs met in something much closer to a normal home rather than in a hospital.

“I can see where there could be confusion but its a differet type of care need.”

Owl wonders if Councillor Christine Channon and Chris Davis, who advised her, in late January that the Shandford Care home in Budleigh was not “viable”, had known Covid-19 was coming, would they have tried harder to keep it open? Do they have any regrets, now the full consequences of their fateful decision are becoming exposed?

Owl has previously reported that a different group of local experts, with very relevant professional experience, believed there were strong grounds to challenge the case for non-viability.

The local community, given time, had also expressed the will and energy to re-create a local Community Interest Company to take over and run Shandford but has been denied access to essential information.

Daniel Clark Local Democracy Reporting Service BBC

A second facility has opened in Devon to take patients discharged from hospital to help relieve pressure on the county’s hospitals. 

The Hilton Hotel at Exeter Airport is already taking people discharged from hospital and now the Fleet care home in Dartmouth, formerly known as the Riverview, is also to be used to help relieve the pressure. 

It will open imminently with the potential to increase capacity by an extra 24 beds temporarily for people being discharged from hospital or moving in from home due to ill-health. 

Devon County Council is also in discussion with a hotel owner in Bideford – named last week as the Durrant House Hotel – about opening up similar accommodation for discharged patients. 

Alongside the potential Bideford facility and the Hilton, which is already taking people, the three facilities would provide an extra 200 beds, staffed by trained and experienced health and care professionals. 

Cllr Andrew Leadbetter, Devon County Council’s Cabinet Member responsible for adult social care, said: “These will be for people who do not need to be in acute hospitals, but who require extra care before returning home or until residential or nursing places can be found for them. 

“They can also be used by people with care needs who have been living at home, but who can no longer do so – if their carer becomes unwell, for example. We are doing absolutely everything we can to ensure that people in Devon continue to receive the care and support they need.” 

The work is part of Devon County Council’s coronavirus (Covid-19) response.

Statement by County Councillors Hilary Ackland (Exeter), Martin Shaw (Seaton and Colyton) and Claire Wright (Otter Valley):

“The South West is experiencing the epidemic in a different way from other regions. We have the lowest levels of hospitalisation and death from Covid-19 in the country. South West councils, MPs and the police have had some success in preventing second-home owners and tourists further spreading the virus.  

We therefore support the call by Dr Bharat Pankhania, Exeter University’s infectious disease and public health expert, to take advantage of the lockdown to introduce a regional approach to the epidemic in the South West, with intensive testing, tracing and quarantining to eliminate the virus.  

We call on Directors of Public Health in the region to devote all available resources to this approach, and on Devon MPs to press the Government to give the necessary support for this.

While we do not believe the lockdown can be lifted imminently, effective control of the epidemic in the South West would be an important step forward towards a national solution and would enable local leaders to make the case for a regional approach to lifting the lockdown in due course.”

For further information contact:

Martin Shaw

Independent East Devon Alliance County Councillor for Seaton & Colyton  07972 760254

https://seatonmatters.org/

“It’s now clear that so many people have died, and so many more are desperately ill, simply because our politicians refused to listen to and act on advice. Scientists like us said lock down earlier; we said test, trace, isolate. But they decided they knew better.”

Helen Ward is professor of public health at Imperial College London www.theguardian.com

In mid-February a colleague mentioned that for the first time in his life he was more concerned than his mother, who had been relatively blase about the risks of Covid-19. It felt odd for him to be telling her to take care. We are both professors in a department of infectious disease epidemiology, and we were worried.

Two months on, that anxiety has not gone, although it’s also been joined by a sense of sadness. It’s now clear that so many people have died, and so many more are desperately ill, simply because our politicians refused to listen to and act on advice. Scientists like us said lock down earlier; we said test, trace, isolate. But they decided they knew better.

Am I being unfair? The government assures us that its decisions and timing are based on science, as if it is a neutral, value-free process resulting in a specific set of instructions. In reality, the science around coronavirus is in its infancy and developing daily, with researchers across the world trying to understand how the virus spreads, how the body responds – and how to treat it and control it. The speed at which our knowledge has increased is impressive, from the sequencing of the virus in January through to having candidate vaccines in early February.

Mathematical models are being refined to predict the extent and speed of spread and estimate the impact of control methods. My own group is studying the response of communities, showing how the epidemic is amplifying existing social inequalities. People with the lowest household income are far less likely, but no less willing, to be able to work from home or to self-isolate.

But while scientists carry out observations and experiments, testing, iterating and discovering new knowledge, it is the role of policymakers to act on the best available evidence. In the context of a rapidly growing threat, that means listening to experts with experience of responding to previous epidemics.

When I say that politicians “refused to listen”, I am referring to the advice and recommendations coming from the World Health Organization, from China and from Italy. The WHO advice, based on decades of experience and widely accepted by public health leaders and scientists around the world was clear – use every possible tool to suppress transmission. That meant testing and isolating cases, tracing and quarantining contacts, and ramping up hygiene efforts.

The UK did well in the early phase, but then, on 12 March, the government alarmed many public health experts by abruptly abandoning containment and announcing that community case-finding and contact-tracing would stop. The aim was no longer to stop people getting it, but to slow it down while protecting the vulnerable.

The evidence underpinning the government’s decision appears in a report from 9 March summarising the potential impact of behavioural and social interventions. The report did not consider the impact of case-finding and contact-tracing, but it did suggest that the biggest impact on cases and deaths would come from social distancing and the protection of vulnerable groups.

And yet social distancing was not recommended then. That day, 12 March, after hearing with disbelief the government announcement that didn’t include widespread social distancing, I recommended to my team at Imperial that they should work from home for the foreseeable future. Indeed, I have not been to my office since.

Neither the advice nor the science were followed that week. My colleagues, led by Neil Ferguson, published a report on 16 March estimating that without strong suppression, 250,000 people could die in the UK. The government responded that day with a recommendation for social distancing, avoiding pubs and working from home if possible. But there was still no enforcement, and it was left up to individuals and employers to decide what to do. Many people were willing but unable to comply as we showed in a report on 20 March. It was only on 23 March that a more stringent lockdown and economic support was announced.

Between 12 and 23 March, tens, if not hundreds of thousands, of people will have been infected. Boris Johnson himself may well have been infected that week, and his stay in the intensive care unit may have been avoided if the government had shifted to remote working on 12 March. The current best estimate is that around 1% of those infected will die.

So where to now? Once again, public health experience, including modelling, leads to some very clear recommendations. First, find cases in the community as well as hospitals and care homes; isolate them, and trace their contacts using a combination of local public health teams and digital tools.

Second, know your epidemic. Track the epidemic nationally and locally using NHS, public health and digital surveillance to see where cases are continuing to spread. This will be essential so that we can start to lift the lockdown while shielding the population from hotspots of transmission. Build community resilience by providing local support for vulnerable people affected by the virus and the negative impact of the control measures.

Third, ensure transmission is suppressed in hospitals, care homes and workplaces through the right protective equipment, testing, distancing and hygiene. Investigate the differential effects on black and minority ethnic groups, and provide appropriate protection.

Fourth, ensure that the most vulnerable, socially and medically, are fully protected through simple access to a basic income, rights for migrants, and safety for those affected by domestic violence.

Many, including the Labour leader, Keir Starmer, say that now is not the time for blame. I am not looking to blame – but for scrutiny so that lessons can be learned to guide our response. We need to avoid further mistakes, and ensure that the government is hearing, and acting on, the best advice.

EDDC Leader Ben Ingham also says: “We must do everything we can to control the Covid-19 virus and save lives.”

Before posting the full text of his welcome to the Nightingale, Owl thought it might be helpful to illustrate how the speed with which Covid-19 rips through our population sorts Leaders from Followers.

Just for the purposes of illustration, Owl will nominate the day when Cornwall Council and its Local Enterprise Partnership (LEP) asked visitors to stay away from the County as K-day (K for Kernow). At the time the estimated transmission rate for Covid-19 was given as doubling every three to four days. Owl will take the slower, four days, for illustration. In the events catalogued below the dates given may not correspond with decision dates because of delays in publication.

K-day (20 March)  Cornwall calls for visitors to stay away

K+2 Group of Devon and Cornwall MP’s back the #pleasestayaway campaign, Devon and Cornwall Police declare a ‘major incident‘.( infections now 1.4 times those on K-day i.e. an increase of 40% )

K+3 Government imposes lock down, Devon County Council says enforcement will be removed from many parking places including coastal and tourist destinations. (Infections now 70% up on K-day)

K+6 EDDC Winter car parking rates extended until May across East Devon reported “in order to better support town centre businesses” (Infections are now 2.8 times those of K-day)

K+12  Devon County Council “This afternoon (Wednesday, April 1) issued an all-party message for visitors to ‘stay away from the South West’ ahead of the Easter weekend.” (Infections are 8 times those of K-day)

K+16 EDDC Leader Ben Ingham goes on spotlight to back the please stay at home campaign (Infections are now 16 times those of K-day)

New Nightingale Hospital serving East Devon welcomed by council leader

Joseph Bulmer  sidmouth.nub.news

The creation of a new Nightingale hospital serving East Devon and Exeter has been welcomed by the district’s council leader.

A new NHS Nightingale Hospital will be opened in Westpoint Exeter to provide 200 extra beds for patients with coronavirus symptoms if needed.

The NHS Nightingale Hospital Exeter, announced by NHS Chief Executive, Sir Simon Stevens, brings the total to seven confirmed NHS Nightingale Hospitals in a matter of weeks.

East Devon District Council Leader Ben Ingram has welcomed the hospital’s creation, he said: “It is essential we do everything we can to protect people at this time.

“The new Exeter Nightingale Hospital at Westpoint will play a vital role in creating space and improving safety in our Devon hospitals.

“We must do everything we can to control the Covid-19 virus and save lives.”

The five hospitals in Devon and Cornwall will provide the majority of care for critically ill patients with coronavirus, and have plans in place to increase their critical care capacity up to 500 beds across both counties.

The new NHS Nightingale Hospital, which is expected to be ready for the first patients, if needed, by early May, will provide a regional resource of 200 beds for Devon, Cornwall and neighbouring counties to meet the care needs for patients who are seriously unwell due to their coronavirus symptoms.

Elizabeth O’Mahony, Regional Director, NHS England and NHS Improvement – South West, said coronavirus was “the single biggest challenge facing our country for generations.”

She added: “We can learn from the work we are doing in Bristol and the other Nightingale Hospitals across the country. We want the NHS in the South West to be as well prepared as possible.

“The Nightingale Exeter will support our existing hospital network to care for critically ill patients from the south of the region. We are taking steps now to ensure that the hospital is available if required but we hope that it is not needed.

“We ask everyone in the South West to continue to follow the national recommendations to reduce transmission of the virus, please stay at home, observe social distancing, protect your local NHS and each of you will help save lives.”

The set-up of this new facility will be overseen by Philippa Slinger, an experienced NHS Chief Executive, and currently lead Chief Executive for the Devon Sustainability and Transformation Partnership, she said: “I would like to thank local people for their extraordinary support to the NHS by staying at home.

“Where people have needed to go out for essential reasons, they have by and large practised good social distancing. These actions need to continue as they are helping us to manage the pandemic.

“However, our new NHS Nightingale Hospital will ensure we have the right critical care capacity in place to help us manage the expected upsurge in cases.

“Getting our new facility open is a huge task and will be a real collaborative partnership between all NHS providers, commissioners, partner agencies, the armed forces and contractors.”

The new Nightingale Hospital will be hosted by the Royal Devon and Exeter NHS Foundation Trust.

Police dished out 169 fines and gave 960 verbal warnings to people flouting coronavirus lockdown rules in Devon and Cornwall over the Easter weekend.

East Devon Reporter eastdevonnews.co.uk 

A quarter of the penalties were issued to offenders who did not live in either county, the force revealed today (Wednesday, April 15).

Officers spoke with more than 5,500 people while carrying out targeted, ‘high-visibility’ patrols which included visits to 4,000 beauty spots and businesses across the region.

Devon and Cornwall Police says its preferred approach is one of ‘engagement, explaining and encouragement’ – with enforcement ‘a last resort’.

Assistant Chief Constable Glen Mayhew said: “We shared the concern of our communities that a small number of people continued to breach the restrictions and were putting lives at risk.

“Our approach was to speak with people and I am really pleased that these figures show a proportionate response.

“With around three per cent of these checks resulting in enforcement, we believe that this shows that our officers used enforcement proportionately and as a last resort.

“We all wanted to enjoy the weather this weekend, but thankfully our beauty spots continue to remain noticeably quieter, which shows that the vast majority of the public are taking government guidance seriously, and are playing their part in helping to reduce the spread of Covid-19, protect the NHS safe and save lives. 

“We have seen a slight increase in traffic on the roads, but our roadside checks are establishing that the majority of these who are on our roads are undertaking essential travel. 

“I understand the appeal for people to go out, but we need to keep to the restrictions.

“The signs are that they are having an impact, so we all need to do our part to reduce the strain on our NHS as this will ultimately save lives.

“Policing with the support of our communities is our priority and we will continue to use discretion and only use enforcement as appropriate.

“I also want to praise the hard work of partners and volunteers who over the bank holiday weekend supported our activities.

“This included patrols on the beaches and moors to explain to people the importance of the restrictions.

“I would also like to recognise the vast number of other key workers who have also worked incredibly hard, ensuring our core services have continued to deliver.

“Naturally, the coronavirus is at the forefront of our mind, but I want to reassure our communities that we continue to undertake everyday policing; we are still answering over 650 999 calls a day, still responding to incidents and still tackling crime and protecting the vulnerable across Devon, Cornwall and the Isles of Scilly.

“My message to the public is that we are here for you.

“Finally, I would like to thank the public for your continued support and understanding during this challenging time. The messages we have received across social media and comments from the public during our interactions show how difficult we all finding it but how well we are all adapting.

Police and Crime Commissioner Alison Hernandez added: “Police, staff and volunteers in our force have very sensibly taken the approach that they will educate and inform the public of their obligations, but we always knew there would be a cohort for whom enforcement was the only option. 

“We also knew that, despite the warnings, and a #ComeBackLater campaign supported by us and our many partners, our part of the country would prove irresistible to many who put their own wants before the needs of some of society’s most vulnerable members and we’d see some attempting to travel to the South West over the Easter weekend.

“The vast majority of the public are making extraordinary sacrifices at the moment in order to prevent the spread of Covid-19 and I think they want those who put others at risk dealt with using these new powers.

“Our Chief Constable, frontline officers and staff have my full support, and I believe, the support of the vast majority of our elected leaders, parliamentarians and the public.”

A Sidmouth woman is asking for help to supply the area’s doctors and nurses with fresh scrubs to help keep them and their patients safe during the coronavirus outbreak.

Joseph Bulmer  sidmouth.nub.news

Emma Wickham, a concrete tester from Sidmouth, has stitched together a crack of seamstresses and is raising money to create medical scrubs for the area’s healthcare workers, who are struggling to get hold of these essential garments.

In three days Emma has raised more than £1,100, with a target of £1,500, to buy good quality fabrics, waistband tapes, threads and patterns.

Speaking to Nub News Emma said: “I have sewing skills and it seemed a shame not to use them while nurses and doctors are struggling to get hold of medical scrubs.

“We hear that nurses are having real problems with sourcing scrubs, with some hospitals resorting to using paper sets which are impractical and prone to breaking.”

Emma is a regional coordinator of For The Love Of Scrubs, a project set up by London nurse and seamstress Ashleigh Lindsell.

“Ashleigh started making scrubs for herself and put a shout out to her community asking for help,” explains Emma.

“The response was so overwhelming that she and her husband George decided to find people all over the country to act as regional coordinators.”

Emma grabbed the opportunity to help with both hands and already has orders from Honiton Surgery and Exeter and East Devon’s Children’s Palliative Care Team.

The team, so far, consists of 12 seamstresses but the number of volunteers is expanding daily. Three new seamstresses have joined the team in the last 24 hours.

Emma and her volunteers are keen to stress that all the materials are washed thoroughly before work begins and they are working with a specification from RD&E Hospital, ‘to stay true to the regulations’.

A nurse who ordered scrubs from the project sent Emma this message: “You really are a life saver to us!

“We are a community children’s nursing team which covers four special needs schools, community children’s nursing service which is for children with complex health needs providing care within the children’s home and children’s palliative care which is for children with life threatening or life limiting illnesses.

“Day to day we see lots of babies on oxygen, children with feeding tubes and carry out children’s bloods at home as well as just generally providing emotional support to our amazing families and currently our big focus is nursing poorly kids at home to keep them out of hospital.

“Scrubs not only allow us to change between visits protecting the kids we care for but they protect our own families by allowing us to just chuck them in the machine when we get home.”

The donations will be used to buy rolls of poly-cotton scrub material (approximately £160 per roll), rolls of cotton herringbone tape for waistbands, rolls of sewing machine thread and pattern printing.

“It’s really important that we get help with donations and more seamstresses come forward,” said Emma.

“Doctors and nurses are desperate for more scrubs, they really need more than one set to be safe and keep their patients safe.

“We’re buying good quality fabric and have some excellent seamstresses, one of our team is a former textiles teacher from Sidmouth College. We’ve also got a former London tailor on board.”

Walter Einenkel Daily Kos Staff www.dailykos.com

Sir David King, the U.K.’s chief scientific adviser from 2000-2007, told LBC Radio on Wednesday that a quicker response to the growing 2019 novel coronavirus pandemic would have saved lives. While telling the station that he was saddened by situation England found itself in, he was also very clear when he explained that if leadership had acted sooner, untold numbers of people would still be alive.

Stating that “it seems that we were unprepared and we didn’t take action,” King went on to detail how the recent efforts by politicians like Prime Minister Johnson to cut back on management programs has led them into this very predictable predicament. “For me, this is very upsetting because we had set this preparation process in place, as I say, back in 2006.”

Since the beginning of this crisis, King has been critical of the prime minister’s response and policies. At the beginning of April, King publicly slammed Johnson and the Conservative Party, saying cuts to the country’s National Health System (NHS) would only exacerbate the terrible situation that bad leadership has already gotten the Brits into. He also told Sky News at the time: “We know that what we should have done, early on, is take all sorts of precautionary measures to see that the virus did not get to the level it is now in this country, once we had seen what was happening in China.”

King’s criticisms mirror the very same ones leveled against Republican leadership. In Trump and his Republican Party’s case, huge tax giveaways to the rich have helped to justify attempts (and successes) at dismantling our already overstressed social programs and safety infrastructures. Like Trump’s administration, Johnson has lied and dragged his feet when it comes to the important containment tool of testing, having promised “100,000 tests a day by the end of April” and not even coming close.

As King explained, an early response—a proactive response—was available to any country of almost any means. “You go to Greece and the management of the epidemic, starting very, very early on, has been really astoundingly good. Go to Africa, go to Rwanda, you’ll find the same thing.”