Do nothing, do no harm or do the least harm.
Read Time:7 Minutes
There are many ways to respond to an emergency, or crisis. when it comes to COVID, the UK government responded terribly. Mark Shaw offers an innovative approach to stop such responses being repeated.
I contacted an old University lecturer (now a Professor), in the early phase of Covid and asked him why so many of the principles that had underpinned my education at Leeds Dental Institute seemed to have been abandoned. We debated a few issues – he agreed that everything needed to be questioned but added that “the constructive challenge is to come up with an answer”.
With regards to my concerns about what had happened to the Hippocratic Oath, he said, “I have come to disagree with the basic tenet of ‘first do no harm’. As (dental) surgeons everything we do causes harm at some level. I have come to work on the premise: ‘first do the maximum good whilst doing as much as possible to minimise the necessary harm’ – the intent is just as important as the act.”
I have considered this for some time and I am now inclined to agree with this premise.
However, the difference in wording of the same premise would not have been an excuse to justify Government Covid policy. Our exchange also leaves me with that constructive challenge of ‘how to come up with an answer’.
First, having seen the evidence for the huge overall harm resulting from Covid policy, I need to be sure exactly what set in motion the strategy. I strongly believe it was due to panic, groupthink, very poor risk evaluation and gross overreaction. On that basis, a proposed counter strategy would aim to protect the public from the potential disastrous consequences of future emergency action.
Immediate action can certainly be justified in a new emergency, but the level of scrutiny required in the risk assessment process must be raised accordingly. An example might be the use of CPR for a collapsed patient. The procedure is taught widely, including to employees of many small and large institutions and has the proven ability to save lives. The main reason for using this example of how to deal with an emergency situation is to highlight that – aside from it being a well tried and tested method – of the 7 steps described here.
The first and most fundamentally important is this:
No.1 – Check the scene and the person and make sure the setting is safe.
Without such caution lies potential catastrophe. It may be a Government is too scared of either:
- Not responding quickly enough to an emergency, or
- Being left behind by others already intervening so as to lay themselves open to the accusation of complacency.
That, in turn, prompts it into cutting corners and failing to make careful risk assessments – but that is no excuse. The most dangerous Government must surely be one that carries out policy in both a misguided and resolute manner. A poorly handled emergency can lead to one emergency after another, as we are seeing now. The Government hid their less-than-thorough job and gave the impression of competency in two ways:
- Other Governments had already rushed into action and,
- The use (or abuse!) of modelling.
Taking action that gives the public the impression of short term effectiveness and psychological comfort is nothing less than deception. Also, once politicians realise they have made a big mistake they seem to be inclined to do everything in their power to hide it and avoid accountability. This appears to be happening now, with so much data on the dire consequences of Covid management being viciously suppressed by the mainstream media and the Government itself.
Whether or not one believes the modelling used by Professor Neil Ferguson was a deliberate governmental scheming ploy to force through lockdown measures, vaccine mandates etc, the two-step strategy
I will advance in this article would build upon what we already knew early on in the pandemic; that Covid hastened the death of the elderly and vulnerable in a similar way to some of the worst outbreaks of flu and that the Covid infection fatality rate is now similar to seasonal flu.
The proposed system would ensure that the risk Covid or any new disease posed to society was subsequently accurately assessed in order to do the maximum good whilst doing as much as possible to minimise the necessary harm.
Before I begin, a key precondition necessary for the arrangement to work is the exclusion of any modelling involving members of Government advisory bodies with links to organisations that stand to gain directly from the proposed emergency action.
The first step would involve a ‘jury style’ appraisal of any provisional Government-accepted model intended for emergency use. The ‘jurors’ would need to be competent people, independent of Government; an idea would be to randomly select University (undergraduate and postgraduate) students from statistics courses or statistics combined with related areas including finance, actuarial science, computing or maths. Participation would be compulsory if called upon and the candidates would be equipped with all the necessary tools to reach a verdict on the mathematical/statistical fitness of the modelling within a reasonable time.
The participants would receive a payment in a similar way to jurors but, unlike jurors, would work alone in a confined, secure venue and would receive no direction or guidance. For modelling, a positive result might be a model assessed as being based on sound assumptions and parsimony. Negative results from a model could be defined as being non-parsimonious or unable to be evaluated within the allotted time.
If the positive-to-negative result ratio fell below 60%, there would be a publicly available notice and the suggested modelling would be forbidden by law from forming a basis for Government policy. If the ratio exceeded 60%, the modelling would then be subject to further scrutiny in the second and final step by a 50/50 Dove/Hawk committee meeting to examine the modelling and carry out a risk/benefit analysis to:
- Decide whether it was safe to proceed with the proposed emergency action and
- Determine the duration of the action prior to a subsequent meeting for reassessment of the situation and a review of any further modelling.
The ‘hawks’ would be experts in the relevant field with a track record of behaving proactively and expeditiously in response to emergencies, whilst the ‘doves’ would also be experts in that field but who have a history of acting more cautiously and sceptically. Examples in relation to Covid could be SAGE and JVCI members (hawks) on the one hand and Great Barrington Declaration and HART members (doves) on the other. A vote would be taken and emergency action only permitted when at least, again say, 60% of this committee agreed.
As well as for health, similar systems could be utilised to screen emergency modelling for radical climate and economic policy or a combination of them. Whilst we can observe what other countries do, if this style of governance is implemented it must be adhered to and, if necessary, the UK must have the confidence to go it alone in much the same way as Sweden or the state of Florida did. The initial system set-up would need to be fully in place well before an emergency arose to be ready at short notice.
The advantages of such a system are the following:
- No government would be able to say they were following ‘the science’ without these safeguards;
- Government would be held back from acting in groupthink with other countries;
- There would be more resistance to corruptive forces because Government and their advisory bodies would have less power, control or importance in decision making.
- The balance of power in our democracy would be more fairly distributed away from a richer, more powerful and usually older generation.
- The risk of a policy creating more harm than good would be reduced.
There is good evidence to demonstrate how erroneous the Covid modelling was. Any modelling that involves numerous assumptions is unlikely to be a veritable scientific method An excellent, in-depth analysis and critique of Imperial College’s method by David Kirkwood can be found here. Professor Neil Ferguson’s modelling track record was poor before Covid and is even worse now. Why did governments rely so much on just one model and thus maximise the huge potential for distorting the truth?
Governance should set the boundaries within which people operate. It identifies those responsible for making decisions and defines the process used to make legitimate decisions. It has become an essential part of safeguarding public interests in businesses and organisations around the world yet, somehow, governments have failed to carry it out diligently just when it was most needed.
The result was policy losing sight of overall priorities and decisions being made without understanding the context. Governments bulldozed their way into a crisis of their own making.
The highest standards of governance need to be implemented in Government emergency policy and the critically important evaluation that a disease, a postulated radical climate change or an economic shock might pose to society can never be rushed or influenced by hegemony.
The qualities of patience and procrastination in decision making are humorously summed up in Mark Twain’s saying:
“Never put off till tomorrow what you can do the day after tomorrow just as well”.
Source: Left Lockdown Sceptics
No comments:
Post a Comment