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Does the Government have an 'acceptable level' of coronavirus deaths?

Don Anderson


It had for Troubles-related killings and it would be naive to think it doesn't for Covid-19, argues Don Anderson

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People queue at a walk-in coronavirus testing centre staffed by soldiers in Cheshire

People queue at a walk-in coronavirus testing centre staffed by soldiers in Cheshire

PA

Reginald Maudling

Reginald Maudling

Matt Hancock

Matt Hancock

PA

Florence Nightingale

Florence Nightingale

People queue at a walk-in coronavirus testing centre staffed by soldiers in Cheshire

Is there an acceptable level of sickness and death tacitly underlying Government policy in dealing with the Covid-19 pandemic? In Northern Ireland, the expression "an acceptable level" has actually been used officially within living memory.

In December 1971, Reginald Maudling, then Home Secretary, publicly stated that the situation in Northern Ireland at that time amounted to "an acceptable level of violence". As the mayhem continued, unionist politicians, in particular, asserted that this term was describing the security policy of British governments prepared to tolerate paramilitary outrage, so long as it remained within manageable limits.

Maudling's comment was made during, arguably, the worst period of the Troubles. By the end of 1972, when he left office, over 500 lay dead here. So far, Covid-19 has not equalled that. And let's hope it never does.

However, Maudling's remark perhaps let slip that lurking within Government policy huddles, whether Sage or Cobra, or the Cabinet itself, there was then - and may be now - a wispy administrative culture of an acceptable national level of anything, from austerity to viral massacre, as long as it was deemed within manageable limits.

If so, this concept did not begin with the Troubles in Northern Ireland. For governments, an acceptable level of deaths may be as old as governments themselves.

This should not surprise. Within the military, which is an arm of government, there exists the concept of acceptable loss, meaning death and injury.

Napoleon once said, "You cannot stop me, I spend 30,000 men a month." For him, that was acceptable in the pursuit of victory, remembering that he was in the end only narrowly beaten at Waterloo by Wellington, a Dubliner, who almost certainly had his own acceptable level of loss.

However, in the 19th century, it is largely unnoticed that the majority of deaths in campaigns were not from flying metal, but from disease.

That extraordinary statistic, quite remarkable to us, made imperceptible impact at the time in any capital of Europe.

One reason was that the ravages of disease were accepted as part of normal life then, military and civilian.

Belfast has its own temple to historic disease disaster. Friars Bush graveyard in Stranmillis, regarded as Belfast's oldest Christian graveyard, contains the mass graves of hundreds who died in the cholera epidemic of the 1830s. It is a mound known as Plaguey Hill.

Rudimentary surgery, incomplete knowledge of how disease spread and too few treatments engendered a fatalistic outlook.

How many are in the mound is guesswork, because statistics, as we see them night after night on TV relating to the present pandemic, had barely been invented in 1815.

Of course, there had always been statistics. The Doomsday Book of 1086 is a rudimentary statistical survey of much of England and parts of Wales to tell William the Conquerer how much money he had to play with and, for the next seven centuries or so, that's how governments used statistics.

That brings us to Florence Nightingale, the Lady with the Lamp. Florence gained the nickname Lady with the Lamp during her work at Scutari during the Crimean War.

The Times reported that, at night, she would walk among the beds, checking the wounded men holding a light in her hand. Her work in nursing is the stuff of legend. That lamp did not illuminate her work as a statistician.

Much of Nightingale's published work, which is considerable, was concerned with spreading medical knowledge, with the idea of making it understood by ordinary people.

When you watch the daily Government coronavirus briefings, newscasts and print reports, you will bombarded with infographics.

Raise a hat to Nightingale, uncelebrated pioneer in data visualisation using infographics, the technique of using graphical presentations of statistical data.

Infographics make complex information easy to digest. They can provide a quick overview of a topic, explain a complex process, summarise a long report, compare and contrast multiple options and display survey data (the Doomsday Book could really have used them). That's what those charts, graphs, histograms and, yes, cartoons are all about.

The success of lockdown depends on those infographics working. In their modern iteration, we have Scotsman William Playfair to thank and Nightingale may have known of his work.

Playfair worked with James Watt, the steam power manufacturer, by making technical drawings of his engines. He realised that his illustration skills could make dry data and statistics in any field come alive. For example, he invented the circular pie chart.

Nightingale was a pioneer in infographics, but not the only one. By the middle of the 19th century, when Nightingale was in Crimea, infographics were used against epidemics.

When cholera ravaged London in 1854, physician John Snow mapped out where it was happening. He noticed a large cluster around a particular water pump.

The authorities closed the pump, the epidemic subsided and Snow's map helped advance the critical notion that diseases could be caused by contact with an unknown contagion - bacteria. Note that all maps are infographics.

Florence Nightingale was intrigued by numbers and, therefore, data. Data told her that too many were dying both on and off the battlefield and prompted her to do something about it.

She must also, therefore, have been wittingly, or unwittingly, familiar with the concept of acceptable levels - and what she was learning through statistics and data was unacceptable.

The Health Secretary, Matt Hancock, has confirmed that mass testing and contract tracing is the strategy once more, a strategy the Government abandoned on March 12, when it decided, albeit for a few days only, to let the virus spread through society.

Statistics quickly told him that depending upon "herd immunity" could lead to an unacceptable level of deaths. Infographics would soon have made that very plain to the rest of us.

Herd immunity is a euphemism. It is really the outcome of herd culling and older people, like me, are the ones most likely to be culled.

Infographics helped tell me that. Thank you, William Playfair and Florence Nightingale.

A level of pandemic deaths is unavoidable. Above that unavoidable level should be unacceptable.

But what is the unavoidable level?

Don Anderson is a writer and broadcaster

Belfast Telegraph