Politics and pandemics

Governments around the world have been relying on the certainty of experts to guide them in making decisions on pandemics. This is neither a problem that began with the current COVID-19 pandemic, nor with each of the present existing governments.

Purpose ahead of Profit

One of Britain’s most prominent scientists, Nobel Prize winner Sir Paul Nurse, no pun on him nursing the pandemic, has launched a scathing attack on the handling of the Coronavirus crisis asking, who is actually making all the key decisions. He said, “the country had been rather too much on the back foot, increasingly playing catch up, firefighting us through successive crises”.

He has cast doubts on whether there was a proper strategy to combat not only the killer virus, also about how to come out of it.

Who really is in charge of decisions, he asked? “is it ministers? Is it public Health England, The National Health Service? The Office of Life Scientists, Sage? I don’t know, but more importantly, do they know?” 

He added: “I think you are quite right to say that everybody’s involved – not just the politicians, the scientists and the doctors – we are all making mistakes.” 

Every government, every national Task Force around the world we note, is having a  Fall Guy to blame it on, for not developing the strategy and the operation and the implementation of that strategy, as echoed in the wise words of the scientist. 

We can have as many Task Forces to get the best advice, but in my opinion, it is the Prime Minister or the President of the country, or both who are ultimately responsible. 

How about business? 

Of course, business cannot make decisions on health of a nation, but they can prepare the nation, the government, and its people to navigate the human and particularly the business impact of the pandemic. Businesses are thus rapidly adjusting to the changing needs of the customers and suppliers while navigating the financial and operational challenges.

Out of necessity, business will have to be agile to stabilise revenues and take care of their customers, particularly to reshape their business purpose. Deferred decisions, delayed actions have immediate and long-term business continuity impact. 

Some ways business is coping with the shutdown 

There is not one way that business around the world is coping with the consequences of COVID-19.A variety of organisations are working with key workers and have adapted to respond to the urgent needs of people of not only different parts of the globe, but also different parts, say of United Kingdom, as well as different sectors of business. 

With billions of Sterling Pounds of retail stock currently in in ships in the high seas on its way to the UK, analysts predict there is going to be a sales bonanza sooner or later. Shoppers are in for a treat as there is going to be a tidal wave of bargains as retailers try to flog stock since shutdown 23 March 2020. We are likely to see the best deals in spring and summer clothes throughout July, August, and September 2020.Some shops have already started their sales on the internet and H & M, a UK clothes retailer is offering as much as 70% discount.

In the hospitality sector, travel firms are planning after June 8th to exploit a loophole in the 14 day quarantine period by flying holiday makers into U.K via Ireland (which is exempt from new isolation rules). Dublin has become the “air bridge” named as the “Dublin dodge”. 

Is Profit the purpose of business today? 

You and I may think, that business is all about profit, that business people are unethical and business is all guile and greed. 

Milton Friedman of the Chicago School of Economics in 1970 defined business as “maximising profit for shareholders”. 

According to Peter Drucker: “there is only one valid purpose for a business, that is to create a customer.” The customer is the foundation of a business and keeps it in existence. 

We now need to recast the very way we think about business after Coronavirus. 

Of course, profit is the reward for risk taken in business. Every business operates in order to earn a profit. But the purpose of business today has changed along with the other “new normal.” 

A sense of perspective, some of it unconventional,l is setting over global commerce. At the 50 World Economic Forum at Davos in February 2020, a month before the spread of Covid-19, the high minded discussion centred on Climate Change, Global Trade and Artificial Intelligence (A.I) rather than business “Purpose” just for profit. 

People and businesses too are thinking of a “social conscience” in business. How you behave, rather how business behave, not solely to provide dividends for shareholders, has been spotlighted. How you behave towards your employees, customers, suppliers will have a long lasting effect on reputation and the licence to operate. 

The bail out of business by Governments

The public agree with additional economic support in these difficult times for business, there is perhaps, a cost for all business support. The public seems to want strings attached for its support. 

What we are seeing is that the general public now favour increased regulation of essential sectors of the economy such as healthcare, food supply and energy sectors.

Unless business can assert their “purpose to provide solutions for people’s lives,” there may be a risk of a powerful shift in people’s attitudes towards the role of the State and literally against the solely profit motive of business. 

Business must respond in a way that meets the moment and the expectations of the people. 

Cash was king and Profit was queen. Today, “Purpose” is both King and Queen.

Victor Cherubim

What makes a lung transplant difficult?

The medical world had long discovered a transplant for the heart, a kidney transplant,a bypass mechanism for many organs in the human body. They never thought it necessary to find a way for replacement or a bypass for our lungs. The time had come that there were too many "oldies" in Care Homes being spoon fed on an Artificial Life, with carers playing music and dancing and imitating a life they had already lived during their virile days.

That this "carnival was over" as their death rate was intolerable, was pressed hard by the Labour Opposition Leader, Sir Keir Starmer, during Prime Ministers’ Questions.in Parliament yesterday.

Of course, most things are beyond our control. But the things we can do something about are screaming for attention. The initiative to do something should not come out of compulsion or prompting, but that is what we are told is under consideration in faraway Vietnam.

                                                         

Vietnam Health Ministry held a meeting on 14 May 2020 about a 43-year-old British man in Ho Chi Minh City Hospital for Tropical Diseases since he developed fever and cough on 17 March. They decided that the only way to save his life was with a lung transplant.

His life has been on life support and is being treated with antibiotics and dialysis. They said his right lung has collapsed.

His case has been in the public limelight as regular updates are published on state media and many in the country have volunteered to help and wishing him well.

We are now told that 10 people including a 70 year old military veteran has volunteered themselves as lung donors. Prof Nguyen Van Kinh, an infectious diseases specialist said, doctors were “considering the option of performing a lung transplant for the patient”.

However, another report from abroad stated that Vietnam National Coordinating Centre for Human Transplantation (VNHOT) said current regulations “don’t allow to transplant lungs donated by most living people”.

We are also told that Vietnam has spent more than 5 Billion Dong (US$ 200,000) trying to save him.

Lung transplants have been performed by a medical team in east China’s Jiangsu province for a patient infected with COVID-19. They have also been performed in Michigan, USA recently.

Risks of a lung transplant in COVID -19

The major risk of a lung transplant, according to specialists, is organ rejection. “This happens when your immune system attacks your donor lung as it were a disease. “Severe rejection could lead to failure of the donated lung. Other serious complications can arise from the drugs used to prevent rejection”.

Doctors in Canada normally prefer keeping a person on the “extracorporeal membrane oxygenation machine” or on dialysis.

Lung transplants are not carried out frequently in UK. This is mainly because of lack of donors

                                                       

Are we “Future Ready”?

Not only do science find a correlation between our “genetic tendency” and our immunology to ACE2 receptors in CORVID-19, but they have traced  a Vitamin D deficiency and complication known as a “Cytokine storm” which occurs when our immune system goes into overdrive, turning not only against the virus but also against our own immune system.

A study has found patients with coronavirus have a severe deficiency of Vitamin D and those who have a blood group “A” and “B” are twice as likely to experience potentially lethal complications in their immunology, to be most susceptible to COVID -19. Those with blood group “O” tests have shown that they have an antibody already built in.

Race for Vaccine

                                                         

Besides, the race for who develops a vaccine for Coronavirus, there is also the fear that COVID-19 is continually “transmuting”. It is changing its symptoms, and the fear is that

In the process of mutation, it affects not only the vulnerable elderly, but also the young.

“Kawasaki” disease which overwhelmingly affects young and infants causes inflammation of the blood vessels and in some cases the swelling of the heart. The cause is still not known but studies suggest it is a post infection inflammatory response that is triggered specifically by coronavirus.

This is more so the reason why scientists are racing to find a vaccine. The Pharmaceutical giants Pfizer has begun testing multiple versions of experimental Coronavirus vaccines in health young people in the US last week, the first step in establishing the safety and dosage characteristics for trials.

Moderna Therapeutics platform development based at Cambridge, Mass. USA has received fast track approval from the US Food and Drug Administration (FDA) for its COVID-19 vaccine candidate mRNA 1273. We are informed it will speed the clinical trials by September 2020.

Victor Cherubim

Business Continuity

With lockdown slowly easing small businesses are looking back to what needs fixing, or to be re-examined. In this time of uncertainty, they want to have their bases covered financially as well as professionally. They have a lot of thinking to do about their professional goals. They are amid trying to see if there is not some way to approach things differently.

They face a time of monetary shifts. How to make up the money they have lost. They need additional information wondering what happens to their various contracts that they have entered, especially if the lockdown has affected them in such a way, where the contract can no longer be carried out.

Most legal contracts generally include a “Force Majeure” Clause. The clause allows a contract to be suspended or extensions of time provided to carry out the obligation each party has in line with the terms of the contract. This clause comes into play if either of the parties to the contract cannot fulfil it because of events which could not have been predicted when the contract was originally entered into and if the same events are beyond the control of the signatories.

In this instance they need proper legal advice and guidance whether their contracts are covered under this Force Majeure clause. Should the contract lack such a clause the worry for a small business or individual of default on a contract, that they are likely to be sued for breach of contract.

However, they may be eligible for defence called “Frustration of the Contract”. This may bring a contract to a premature end. Thus, small businesses need a strategy to overcome their problems and it is important to get legal and business advice prior to applying for bankruptcy proceedings.

What can be done without contemplating on termination of business?

Business continuity is a key phrase whenever a business large or small contemplates updating, testing their disaster recovery plan, generally referred to as Business Continuity Plan (BCP).

A Business Continuity Plan will have at its core Risk Management procedure. But no one saw it coming when COVID-19 struck, or rather not “in terms of the scale and spread of its spread” and especially a risk of a global pandemic.

This COVID-19 Risk is, according to many observers, going to be a permanent feature, whether we like it or not, say many analysts.

A Business Continuity and Risk Management has taken on a whole new priority now, especially with almost all businesses globally in lockdown, on an unprecedented scale never seen before.

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Business Risk Landscape

                                                        

The world of work has changed. Measures have been initiated by governments around the world to safeguard continuity of work, by preparing emergency communication planning, identifying alternative sources of labour, assuring supply chain, preparing policies on payment for work from home and on furlough, considering possibilities of healthy working practices among others, during lockdown.

But small businesses have a much more difficult assignment, a much more difficult decision on return to business continuity after lockdown is eased. They must consider other possibilities. They include redundancies, re-finance, trading practices, changes to product, services, and basis of interaction with customers, as well as tough choices about staff levels to keep their business profitable.

This is no easy task. To do this they need expert advice not only on how to update contracts to changing working hours, make temporary staff layoff, plan a watertight redundancy process, if necessary. Redundancy is a complex process that requires legal input and takes time. Employees still have notice periods and can claim unlawful dismissal.

Scenario Mapping     

Besides, it is not only business continuity that needs a re-think. Scenario mapping is really an important tool in the days ahead. Why not consider your worst case scenario, however tedious and painful it may be and work back? What are the protective measures that would need to be taken to avoid it? If the worst case becomes your reality, what is is your plan of action?  

See also ways to tighten your belts, extra cost cutting, stager not only hours of work, but also large planned expenditure.

See the other opportunities opening, like a voluntary pay cut, say 20-30%, flexible and remote working.

But most of all “be kind, be thoughtful, be considerate and work with not against people.”

Victor Cherubim

Why we shouldn't go back to normal after Coronavirus

A return to normal after COVID-19 lockdown is unthinkable, but that is what we must never ever contemplate after the slowdown.

The Coronavirus was like a bolt from the blue.But it was long overdue.Every three centuries,nature shows a correction of man's inhumanity to nature. Population explosion, biological warfare, longevity of life,genetic engineering, among others.

It was getting time to make time to hear ourselves think,when we would be likely to pick up on the most valuable clues,hunches and insights.

After easing  of the lockdown people may not only think of their respiratory organs,the lungs, but as we are now told the virus attacks our bodies.

Angiotensin Converting Enzyme or ACE2 -is present not just in our lungs,but in our gastrointestinal track as well.The suggestion is that the gastrointestinal symptoms are caused by the virus invading the ACE2 -containing cells that are found throughout the bowel.This shows another possible route of infection and transmission. Thus maintaining a healthy microbiome or bacteria living in our gut,or the digestive system,to fight Covid-19 is now thought important. Much of the focus now has shifted to eating plant based food to feed the microbiome rather than fast food meat. 

the natural world has been given a breather. we have to prepare for a different type of normal.                                                       

Why do Sri Lankans hope to mimic the West?

Economic nationalism v Weak Science?

Sri Lanka is ranked 61 among 66 emerging economies by The Economist, some five places over Venezuela, as one of the nations most in peril,due to COVID-19 pandemic.

We are informed that this is due to Sri Lanka's high public debt, its mounting foreign debt repayments which are due this year and its low foreign reserves. It is thus ranked the worst hit economy in South Asia. 
                                                  

It is well known that The Economist has taken umbrage with Sri Lanka over a long period.It is also known that Sri Lanka would find it awfully hard to rebut these figures due to its weak
position especially at this crisis time,tackling both a pandemic and an economic situation. 

But as is known, Debt is not only a Sri Lankan problem,but a world problem. The world debt stands around US$ 250 Trillion. The world has never been so indebted.The problem has been brewing for decades, at least since 2008,which itself was a problem about debt. The situation has become worse,with the virus being a catalyst to bring it to world attention.

Any debt is deflationary, so to reduce it will cause a reduction in demand,already hit by three factors, the virus,demography and technological advancement.

Deflation makes debt more expensive and makes assets cheaper,the same assets that much of this debt is based upon. By quantitative easing or throwing even more money at the problem, nations hope to do their best to stop it, and in the end they may well win, but the cost would be inflation in double digits.

No one wants the world economic system or the economy of Sri Lanka to freeze up, but what exactly is the message sent by the Economist in its ranking of Sri Lanka and other similar nations? Is it their plan to drive us to "economic nationalism"? Do we have our Action Plan B to contain, both the debt and the virus? 

It is up to us to challenge, those who think that Sri Lanka is a pushover, perhaps,at a time of our choosing?

Why use Decontamination Chambers and disinfectant sprays on people? 

While tracing,testing and repulsing the spread of COVID-19 in Sri Lanka, have we tried to better the West?

Over the weeks we see on TV of mass decontamination chambers,the spraying of chemical disinfectants on people and places, inside trains, buses,private vehicles, as a precautionary hygiene measure.
                                        

Today, we are told by Sri Lanka College of Microbiologists that "spraying of people with chemical disinfectants ,such as chlorine compounds,oxonated water and soapy water and (UV) radiation is physically and psychologically harmful and does not limit either the spread of COVID-19, nor has it been tested, as clinically acceptable".

Whilst the West and UK in particular, has always been guided by a team of Scientists and have not resorted to spray of chemicals on people or places,Sri Lanka,appears to do better. 

If spray of chemicals is a so called,"weak science," in UK, why is it any different in Sri Lanka?

Why have we ventured to use chemicals as if it was like spraying fertiliser on fields, which was the recommended practice. and have after months been advised otherwise? 

The contention is "even if a person is infected with the COVID-19 virus,spraying the external part of the body does not kill the virus inside the body and may worsen the clinical condition of the individual",microbiologists now warn.  

Why was this advice not available to all all concerned earlier?

Why was the WHO "World Health Organisation" recommendation against the spraying of individuals or groups with chemical disinfectants or detergents" not acted upon?

Perhaps,in our anxiety to protect the public and to sanitise the mode of transport, have we tried to better the "science". 

Victor Cherubim

Care Homes and Coronavirus

Care Homes and Coronavirus

The total number of elderly and vulnerable patients in UK Nursing and Care Homes is estimated around 13.5 of the population of 65.64 million.

                                                        

Coronavirus does not discriminate when it comes to choosing its victims. But Care Homes in UK and across Europe are battling to stop the spread among the elderly.

Why?

1.    The news is particularly worrying because medical advice suggests that people over 70 years and with certain existing health conditions are particularly vulnerable to developing serious COVID-19 symptoms.

2.    Deaths in UK Care Homes linked to Coronavirus has shot up by 2,375 to 4,333 in just one week – the week to April 24,2020.

3.    Many have complained that the most vulnerable people in society may have been abandoned and left to die, where everyone’s mind was on the care in NHS hospitals, up and down the country to contain the spread.

4.    The Personal Protective Equipment (PPE) needed for those working in Care Homes had been singled out as of the lowest priority. The Labour Party Opposition has claimed this is the primary cause of deaths in these homes.

5.    The Guardian newspaper report has claimed that Care Home deaths are counted separately and never make it to the daily Department of Health & Social Care statistics. One Care Home has told the paper that a third of its residents

had died of this pandemic.

Deaths reported as Coronavirus statistics

Deaths which happen outside of hospitals such as in Care Homes and at homes,have not been included the daily statistics given by the DHS.

                                                 

Asked of the Chief Medical Officer UK, Chris Whitty, if deaths were recorded properly in such settings, he said: “Everybody who sadly dies in Care Homes, the Doctor will make an assessment based on their view about what is the cause of death, that’s what

the death certificate says in all cases.”

Besides, deaths in Care Homes or at home can take longer to trace because of important steps such as post-mortems, funerals and paperwork to pass through Coroners’ offices. Thus, there is no way of knowing for certain the numbers in Care Home deaths, as there is only a weekly figure published by ONS (Office of National Statistics).

New data collated by Care England, the country’s largest representative body for Care Homes, suggests the number of deaths from COVID-19 is far higher that the figure published by ONS.

It is not only in Nursing & Care Homes, but also the poorer parts of England have seen 55.1 deaths per 100,000 population, compared with 25.3 deaths per 100,000 in the wealthiest parts of UK.

The data also showed more people died of the virus in London than in any other areas per 100,000 population. 
                                          

What exactly is the true picture of deaths due to Coronavirus?

With Parliament in lockdown until recently, the Labour Opposition has not been able to call the Government to account. There has also been a media clamour and public concern for the correct total of deaths due to COVID-19.

This week the Opposition Leader, Sir Keir Starmer has called for daily figures from the Government to be published of people dying in Care Homes, so that the true scale of the problem is public knowledge.

Government response  

In a bid to give hope to worried Brits, Prime Minister, Boris Johnson has this morning (1 May 2020) said: “I can confirm that we are past the peak of this disease, we are on the downward slope.” He also promised to set out a comprehensive plan next week to kickstart the economy, get schools open, and find a way to make workplaces safer, by perhaps, “Brits to wear face masks in public”. But he also inferred the lockdown could last for months until the minimum number of new cases falls below 1000 a day.

What is the R” rate?

While details of an exit strategy are to be reviewed as planned by 7 May,2020, the Government has said it needs to be satisfied of five (5) key Tests before considering it safe to moderate the current lockdown measures. One of them is the “R rate.”

The “R rate” refers in simple language to the " effective reproduction number" and is a way of measuring how a disease spreads  through a population. Mathematicians call this phenomenon exponential growth,and it explains why coronavirus infected so many people all over the world so quickly.

As this pandemic, according to science, has an estimated reproduction number, meaning an infected person will likely pass the virus to at least three (3) other people. A reproduction number that is higher than 1 poses a significant risk, making it harder to contain the spread and for NHS to cope with it. However, if this number is lower than 1, it is the science that the virus will eventually die out in time.

But the opposite is true,if R is below one,then an epidemic will eventually fizzle out altogether. If R was 0.7 then 100 infected people would go on to infect 70 people,who would go on to infect 49 people,then 34 and so on. That's why anything over 1 is bad news.

The “R rate” today according to ONS is between 0.5 and 1.Keeping the R number low will be critically important if the UK is going to prevent a second wave of coronavirus infections.

How do we measure it?

There are lots of different ways of calculating R. Scientists have been looking at the genome of the virus to see how it changes as it infects new people. They can also look to death and  hospitalisation figures to get a sense of how many people have contracted the disease.The problem is that most of these methods involve looking into the past to some degree. To get a more up-to-date sense of the coronavirus R number, the UK is starting to test samples of the population to see how many of them have the disease. this should help the Government track the changes in R over time and see if the infection rate is rising or falling. Also critical is that the UK does not exceed its critical care bed capacity,and that the NHS has enough space capacity to resume normal treatments.

What are the five tests before lockdown is slowly released?

1.    Protect NHS ability to cope and provide sufficient critical care across UK.

2.    A sustained and consistent fall in the daily death rate.

3.    “R rate” -the infection rate is in decline.

4.    Confidence that Test capacity and PPE are in hand and to meet future demand.

5.    Confidence that any adjustments to the current measures would not risk a second peak.

All the above tests are a balancing act to provide and protect the public, the health of the people and the economic health of the nation, so that confidence is restored. But nothing is certain in love and war and now in Coronavirus.

Victor Cherubim