Fall by Andrew Preston
Robert Maxwell is not a person that is well known these days but readers of a certain age will remember his relentless presence in the media until his death in 1991. This is a fascinating and compelling insight into the man. You would be hard-pressed to describe him as likeable. He is now best remembered as the owner of the Daily Mirror who was a criminal, stealing the pension fund as he tried to prop up his failing empire, and condemning many people to financial hardship and despair. As a media mogul he makes Rupert Murdoch look like a pillar of moral rectitude.
Maxwell was born into grinding poverty, fought in the Second World War, was a Labour MP, a spy, a billionaire entrepreneur, a raging egomaniac, and destined to die in mysterious circumstances on the brink of the collapse of his business. His youngest daughter, his unabashed favourite, is Ghislaine Maxwell. You may have heard of her.
I hadn’t known Maxwell had been an MP and been awarded a Military Cross. I certainly didn’t know he was alleged to have been involved in the extra-judicial execution of a German civilian. Preston also describes an episode where Maxwell, who was by then an officer, machine-gunned German soldiers after they surrendered, describing how the British soldiers grumbled it wasn’t fair.
Maxwell had a major role in the post-war development of scientific publishing. According to this biography he recognised the potential to monetise what was essentially free — knowledge. Many would argue that is still going on with large corporations profiting from the work of academics while restricting access to that same research with paywalls. Maxwell became the UK and US distributor for Springer-Verlag and his fortune was built on the company Pergamon Press (which had started life as Butterworth-Springer). In 1991 Elsevier bought Pergamon and it continues as in imprint.
Elsevier is incredibly profitable with annual operating profits approaching £1 billion in recent years. And much of those profits, though not all, are built on publicly-funded research. This Guardian Long Read covers in some detail the background to Maxwell’s publishing business, his recognition of the opportunities, and the ongoing challenges faced by scientific publishing. Meanwhile, Elsevier continues to print
8 May 2021
April 2021 reading List
A good month and a dozen cracked off. As ever, these are in the order they were finished. If I had to pick one to recommend then it would be Failures of State and there are some notes on that.
Okwonga’s book, One of Them, is a slim volume, very readable, and damning. There is perhaps a risk with it that it’s simply a reinforcing book — if you have a problem with Eton and the private school system then there will be much here to bolster your beliefs. Otherwise, I’m not sure it will change minds.
Wright’s book is not quite as radical as the title might suggest but How to Be an Democratic Socialist isn’t nearly so catchy. It is a brilliant overview of all the ways one might oppose the current system without necessarily calling for a full-blooded revolution.
1 May 2021
Monthly Reading List
- Failures of State by Jonathan Calvert and George Arbuthnot
- Woke: A Guide to Social Justice by Titania McGrath
- Free Speech And Why It Matters by Andrew Doyle
- The Art of Disruption by Magid Magid
- Pryor Convictions by Richard Pryor
- A River in Darkness by Masaji Ishikawa
- The Inimitable Jeeves by PG Wodehouse
- How to Be an Anticapitalist in the Twenty-First Century by Erik Olin Wright
- Nicotine by Gregor Hens
- Crack House by Harry Keeble with Kris Hollington
- Anti-Social by Nick Pettigrew
- One of Them: An Eton College Memoir by Musa Okwonga
Failures of State by Jonathan Calvert and George Arbuthnott
I finished this book a couple of weeks ago but it is one that has stayed with me. You know how it is — your mind keeps drifting back to a book, it won’t quite let you go. This is one of those. It is all the more remarkable when you consider it is recounting events that we’ve lived through, or at least most of us have, in recent months. A lot has happened.
I’m not quite sure where to start with my outrage. There are so many avenues down which it can be channelled. Perhaps my greatest disgust is reserved for the repetitious nature of the mistakes. Pandemics are not common and we can allow a certain latitude. Yet the abject refusal to recognise the inevitable and to vacillate while people died is unforgivable. One of the bleakest passages is the description of the “clandestine Sunday evening rendezvous with the prime minister” with four academics in September as Johnson considered a circuit breaker. Following the science? Read it and weep. Three academics put the case for a more liberal approach. They don’t come out looking good. The fourth academic advising Johnson and Sunak, Professor John Edmunds, if he re-iterated the advice in a co-authored Sage report, would have been recommending an immediate two-week circuit break. (He declined to report to the authors what he said in the meeting.)
The political bunfighting continues but the COVID situation is widely held to be brightening. As long as you are myopically squinting at the UK and that you don’t care too much about the rest of the world. At the time of writing the WHO is pointing out that the pandemic is a long way from over, indeed it is “accelerating”. The situation in India is horrendous. But it surely can’t be any secret that the problem of unchecked infection will come back to stalk us in the form of variants?
I’ve picked out some of the quotes I highlighted with some comments.
The initial response
Those months in early 2020 were excruciating as we waited to go into lockdown. It was perfectly obvious it had to happen and the delay seemed inexplicable. Meantime, the infection was spreading and that, of course, means that the death toll will have been ticking up. It was initially quiet and easy to be lulled into a complacency but it was baked in. Calvert and Arbutnott are scathing about the early response and Johnson’s efforts.
He did not attend any of the first five meetings of Cobra, the key national crisis committee that commanded the UK’s response to the pandemic. The first Cobra meeting Johnson attended was on 2 March and by then the virus had already firmly gained its foothold in the country. As many commentators would point out after our first article: this was an extraordinary dereliction of his duty as a prime minister, which would have enormous consequences.
A study by Southampton University has shown that 190,000 people flew into the UK from Wuhan and other high-risk Chinese cities between January and March and were allowed to travel across Britain at will. The researchers estimated that up to 1,900 of these passengers would have been infected with the coronavirus — guaranteeing the UK would become a centre of the subsequent pandemic.
In fact, according to the analysis, there were only three occasions in the last 10 years when a prime minister, who had been in Westminster, had skipped a Cobra meeting.
The lack of action was described by Doris-Ann Williams, chief executive of the British In Vitro Diagnostics Association, which represents 110 companies that make up most of the UK’s testing sector. Amazingly, she said her organisation did not receive a meaningful approach from the government asking for help until 1 April — the night before Hancock bowed to pressure and announced a belated and ambitious target of 100,000 tests a day by the end of that month.
As part of 26 key recommendations from Cygnus, the NHS was told it needed to make urgent and drastic improvements, which would have to be paid for with money the government was advised to specifically ring-fence for that purpose. That did not happen.
There was also a critical lack of laboratory testing capacity. According to Martin Hibberd, a professor of emerging infectious disease at LSHTM, a key reason for that had been money. The NHS had moved away from using its own laboratories in the years before the pandemic and had increasingly farmed out its work to privately owned facilities in an effort to cut costs.
The herd immunity fallacy
We lost valuable time at the start of the 2020 as the herd immunity fallacy played out. While few would dispute that the CMO and CSO are people of integrity the sense is that they have grown into their roles. One wonders how hesitant and how diffident they were at the start; and for all the denials there seems to have been a strong flirtation with herd immunity in many who were looking at the early signs.
One well-known senior Conservative confided: ‘I had conversations with Chris Whitty [the chief medical officer] at the end of January, and they were absolutely focused on herd immunity. The reason is that with flu, herd immunity is the right response if you haven’t got a vaccine.’
Whitty denies that he has ever been an advocate of herd immunity other than as part of a vaccination programme. But herd immunity was a view that appears to have infected the government.
The concept of herd immunity is toxic politically because it effectively means that the weakest in society — the ill and the elderly — are left to perish.
Herd immunity was a dangerous experiment with no proven upside, but Johnson’s government was willing, nonetheless, to try it.
Since herd immunity was self-defeating, the government’s strategy of delaying the introduction of measures to suppress the virus was a calamitous miscalculation.
The Domoscene conversion
Dominic Cummings had initially favoured the government’s delay-and-mitigate approach, but he changed his mind. ‘Dominic himself had a conversion,’ a senior Tory said. The ‘Domoscene conversion’, as it became known, was said to have happened at an earlier meeting with scientists.
It is difficult to imagine a man who could be much more reviled in public life than Dominic Cummings after his Barnard Castle. There can be few who were genuinely persuaded by his performance in the Rose Garden on Downing Street. This caught my eye at the time as it is a reminder that our Dom is very much his own man. There is little likelihood that he can ever be rehabilitated in the public’s eye but some on the left may find themselves cheering him on and he is catnip for the commentariat. And, given his apparent willingness to hang Johnson out to dry, any testimony he offers to a future inquiry will be box office. We’re going to be hearing a lot of Cummings for a good while to come.
The NHS was overwhelmed
Most people think we got away with it and we coped. The NHS weathered the storm. Yet, when the system gets overwhelmed it wouldn’t typically collapse in a televisual way.
Downing Street was anxious that critical care units should not be visibly overrun as they had been in Italy, Spain and China, where patients in the city of Wuhan were photographed dying in corridors. So a veil of secrecy was now placed over Britain’s hospitals. The publication of critical care capacity figures was suspended, which meant nobody outside the corridors of power would be able to tell whether hospitals were being overrun, and a general ban was imposed on information being passed to the media without sign-off from central command. The NHS management had shifted to a war footing.
There may well have been efforts to downplay the scale of the problem but one graph is revealing. It’s difficult to shift away from this — logical reasons for this drop, other than a form of rationing, are very thin indeed.
This is a compelling image. That drop down to 6% involves a staggering amount of loss, grief, and pain. It also screams of the missed opportunities. If anyone, like the government, ever tells you that ICUs weren’t overwhelmed then remember this dismal curve. Thousands of decisions were made that meant people weren’t sent to ICU who otherwise would have been.
The evidence was buried away in data collected from 65,000 people who were admitted to UK hospitals with the virus up to the end of May and that had been analysed by the Covid-19 Clinical Information Network (Co-Cin), which reports to the Sage advisory committee. This data produced by the Co-Cin team is the government’s best record of how patients with the virus were treated in hospitals during the outbreak. Overall, it showed that just one in six Covid-19 patients who lost their lives in hospital during the first wave had been given intensive care treatment. This suggests that of the 47,000 people who died of the virus inside and outside hospitals, an estimated 5,000 — just one in nine — received the highest critical care, despite the government claiming that intensive care capacity was never breached.
In the middle weeks of March, 13 per cent of that age group admitted to hospital with the virus were given an intensive care bed. By the start of May, that figure had more than halved and was down at 6 per cent.
In October we had revealed evidence that access to intensive care had been rationed in hospitals across England, which had led to patients being denied life-saving ventilation. This had sparked an intemperate reaction from Professor Stephen Powis, the NHS national medical director, who claimed our story was ‘untrue’ and was ‘deeply offensive’ to health service workers. Powis was adamant that ‘even at the height of the pandemic there was no shortage of ventilators and intensive care.’ The consortium’s findings suggest he was very badly informed.
The Inquiry will come
The government is in no rush for an inquiry. It is, obviously, an entirely political decision. There may be a skimpy argument that we are still fighting through and now is not the time. There is certainly some credibility in recognising that the pandemic has a way to go. You don’t have to be over-cynical to feel that the government is unlikely to come out well from an inquiry and they are delaying the moment. It will be much easier to bear the political cost if lives have returned to normal and people are focusing on getting back to the quotidian concerns of family, work, and leisure.
History is unlikely to be kind to Johnson and his government’s stewardship of Britain’s response to the pandemic.
28 April 2021
Weatherby and Abrahamson believe that Johnson’s conduct could also amount to ‘the criminal offence of gross negligence manslaughter’, although they believe it is unlikely that the Crown Prosecution Service would take up such a case. That may change, they note, if further evidence emerges at a future public inquiry.
Wake Up by Piers Morgan
Now it is no great shakes to declare that 2020 has been full of surprises, few of them in truth that pleasant. If there was one person I didn’t think would feature in my writing around medicine and politics and books it was Piers Morgan. Like many, though by no means all, I’ve been a long subscriber to what could be called the Hislop School of Thought. The Private Eye editor and HIGNFY panellist has a particular enmity for Piers Morgan and, frankly, it didn’t seem that unreasonable. That said, I’ve always been wary about ‘hating’ celebrities, or politicians for that matter, as we never know these people, not truly.
Piers Morgan has come over as a raging egotist, a Trump apologist, and shameless self-promoting narcissist. Yet, looking back there have been clues. There’s the Youtube video of him in the cricket nets gamely being peppered by Brett Lee’s fast bowling. He took it, cracked rib and all, with impressive courage. Chapeau. I also read Emily Maitlis’ book Airhead earlier in the year and Piers Morgan appears in there, a friend of Maitlis, and the portrayal hints at the decency of the man. I seem to recall, though don’t quote me, that she also mentions Morgan’s assertion that he regards himself as a feminist. He was also the editor of the Daily Mirror. Now, like any tabloid, particularly in that era, it was hardly a bastion of moral rectitude. But, there was the matter of the vociferous opposition to the Iraq War from Morgan and colleagues, a good moment for him and the Mirror.
Anyhoo, back to the politics and medicine. Perhaps then it shouldn’t come as quite such as surprise that he has been the surprise hero of the COVID-19 pandemic. He has, with considerable gusto, thrown himself into holding the British Government to account. To be fair, given the vacillation, the u-turns, and the sheer agonising ineptitude this should be more in line with shooting fish in a barrel. Yet, it has been largely beyond the media. Not so Piers.
He describes himself as a liberal and the book is an extended rant against “illiberal wokery”. Now, I don’t agree with him about several arguments within the book and it is all too easy to hear Morgan ranting in sections. He does have a very valid and real point about cancellation culture. It’s difficult to reconcile free speech with the no-platforming approach. For some of the most despicable hate speech mongerers there will be legal grounds for this but one feels it should be held in reserve and deployed in only the most egregious of cases.
And, he is on the side of the angels, well Obama, here as well. Personally I’m less certain this is about wokery, as he characterises it, and more about polarisation. Morgan’s ‘wokery’ is just one manifestation of the divisive nature of social discourse. In some ways Morgan is resisting the polarisation, not letting himself get dragged to either extreme. It is an impressive example of self-confidence, possibly mildly pathological, and those torrid forces tugging at his ego have resulted in him coming across as vaguely unhinged as he has raved about men wearing papooses or vegan sausage rolls.
I took a bit of a deep breath before reading this book, thinking it might be one to puncture my filter bubble. In the end, not so much. I was worried it would provoke some visceral reaction, deepening my own bias. It has, in many ways, given me a tremendous amount of pleasure. It’s all too easy to read books that simply confirm one’s bias. It turns out I almost certainly have more in common with Morgan than we are apart. Arguably, Morgan is now an unusual beast, someone who has not gravitated to an extreme pole, holding liberal views from decades past, but not letting himself be pulled further. The political tectonic plates are shifting but I suspect Morgan has barely budged an inch even as the ground under him has been rent. He has, in 2020, found his mojo again and, to borrow a slightly grim phrase, he is having a ‘good’ pandemic. Which is good for him. And as it turns out it’s pretty good for us too.
Morgan ranting about it is just intolerant and it’s even vaguely bullying; a quality that is often not too far away with our Piers.
Let me finish on a sidenote and say a few words about vegan sausage rolls to hark back to Morgan’s days of petty irrelevance. I don’t actually know what Morgan’s beef is with them but I suspect the problem is the lack of the ‘beef’, well pork. Often it is when plant-based food tries to imitate meat products that it often goes wrong. The thing is, many of us have grown up with sausage rolls, they are a comfort food. Yes, I could eat something completely different but that roll of pastry with a salty tasty smear running down the middle is good. For me, it is just as good, in fact even better, than the meat version. I get the same fatty salty flaky warmth and comfort without the dead animals. Win-win.
Morgan ranting about it is just intolerant and it’s even vaguely bullying; a quality that is often not too far away with our Piers. He does, to his credit, acknowledge this in a few places in the book. I’m not sure his day-to-day behaviour has improved with this self-awareness and insight. I still see him regularly calling out some muppet on Twitter by citing his own follower count. Morgan might be putting in an unexpected bid for national treasure status but the planet-sized ego is still capable of eclipsing and undermining his own arguments. The book is well worth the read though.
19 November 2020