What does the fuel crisis tell us about Brexit?

We have learned a lot about what Brexit means since the days of “Brexit means Brexit. A key consequence of Brexit has been to put pressure on supply chains and make the UK more vulnerable when it comes to dealing with shocks.  Covid has also caused huge supply chain issues across the globe.  The combination of these two huge shocks has resulted in much more acute disruption here in the UK, especially compared to our European neighbours.

I think the current petrol crisis is a good example to understand the approach of the government to managing the country under Brexit.

Why is there a fuel crisis?

The current fuel crisis is being driven by a lack of HGV drivers in the UK. 
This has structural roots across Europe before any of the recent crises, but Brexit and the pandemic have made it worse as follows:

Structural issue
HGV driver is simply an unattractive job.  Regulation is poor and poorly enforced so pay and working conditions are awful.  Few people are entering the profession and the aging driver population is retiring and not being replaced.

Pandemic issue
An interruption to testing of HVG drivers means even fewer new drivers and accelerates the decline in drivers across the EU.

Brexit issues
1. EU drivers working in the UK leave due to visa issues. 
2. Previously in times of a surge in demand, extra drivers come from the EU, but now they cannot due to visa issues.

Trigger: 
The trigger has been a sudden, general awareness that fuel supply is close to breaking point after BP announced that they could not supply all of their petrol stations.  This implies that, even operating at full capacity, we cannot supply the current demand.  This sparks a rational desire to stockpile, which cannot be quickly met by increasing supply as the system is already failing to meet demand.

It is the combination of these factors which creates a major crisis. 


How long will this fuel crisis last?

Some key numbers

High Demand for petrol

8,000 – Number of petrol stations in the UK

4,000 – Daily tanker deliveries to petrol stations

13,000 – Number of tankers of fuel needed to add ¼ of a tank of fuel to every car in the country to meet an estimate of stockpiling demand.

Any extra supply?

We were already on the margin of being unable to supply petrol stations before.  After all, that is what caused the “panic” buying – although why is it “panic” when it is rational?  This would mean that at the moment some people have more fuel than they normally have, and others have less than they normally have.  Anecdotally this feels quite accurate.  The way this system gets back in balance is very slow with a combination of long queues and higher prices reducing the amount of driving and making stockpiling more expensive so only the people that are highly motivated get the fuel.


Government action

I think the extra visas, coming next month, will have very little impact on the fuel crisis but may help to reduce the risks around Christmas supply disasters.

The government has also excitedly announced the recruitment of 150 army tanker drivers.  If they each do 3 deliveries each a day, it would take them a month to supply the extra fuel needed.  My guess is that it would be quicker than that, as perhaps my estimate of the average car having ¼ more fuel is too high, perhaps people driving less will help and perhaps if fuel starts to be delivered, the desire to stockpile will reduce. 

Brexit

The fuel crisis is important in itself but it also tells us a lot about the UK’s vulnerability to supply chain problems and our approach to dealing with them.

Supporters of Brexit point to the non-Brexit causes above but ignore that we would not be having this crisis without the Brexit factor.  After all, no-one in the single market has this problem, including N Ireland. 

It is also worth noting that these types of Brexit issues are not unanticipated or unintended.  In fact, this can be seen as one of the main points of Brexit- to stop EU labour working in the UK. 

Isolationist

The approach is clearly for the UK to sort it out itself and not use EU drivers as before.  This is clearly consistent with Brexit and can be seen as one of the main objectives.  A small number of visas for a limited period is a clear intent not to go back to the previous way of managing supply issues. 

Laissez Faire

A “left-wing Brexit” and the “laissez-faire” approach of the government seek to resolve the issue of more drivers in different ways.

A “left-wing Brexit” sees the removal of low-wage labour as an opportunity to increase the pay and conditions of HGV drivers.  Increased regulation leads to better working conditions such as bathrooms and rest breaks.  Unionisation of the drivers leads to higher wages.  State intervention leads to apprenticeships and training programs. 

A “laissez-faire” Brexit leaves it all to the market, the government has no role.  The industry is allowed to remain fragmented with faith in “market forces” to solve all problems.  They might argue that the market leads to the same outcome as the interventionist approach, as the reduced supply of EU workers leads to wages rising and conditions improving for UK drivers.  Unfortunately, all evidence is that this is a libertarian fairy tale and that without regulation, market failures are commonplace.  Or even without market failures, we might have outcomes we do not like.  For example, the current shortage of fuel has a very simple economic answer.  Higher prices.  Petrol stations should simply increase the price of fuel until demand reduces.  As any first-year economics undergrad is taught, rationing is not efficient.  The extra profits can also be used to pay for more drivers and so the outcome is one where there is more supply and higher prices. 

What happens next?

Since I cannot find an answer to the question of how much extra fuel is being delivered at the moment, I cannot give a sensible guess as to when this crisis ends.

What I am more confident of is that supply chain crises are an important part of the Brexit plan.  Gove would call them “speedbumps”.  We should expect to see more of them.

Vaccine Hesitancy

As the rollout of COVID vaccination programs progress, the issue of reaching as many people as possible becomes critically important. 

The anti-vax movement gets a lot of press in the news but that is not the group I want to talk about.  They seem to be broadly typical of conspiracy theorists, so there is nothing I have to say which would make any sense to them. 

The group that is far more interesting are the vaccine hesitant, who are not conspiracy theorists but often have rational foundations for not wanting to take the vaccine.  I should be clear that I am very pro-vaccine and got mine as soon as I could and encourage others to do so, but I would like to explain why and how my views might differ to a vaccine hesitant person.

My friends and family don’t trust it so nor do I

I would think this is the most common reason and the most easily understood.  They will often put more weight on the opinions and behaviors of those close to them, and so it should not be a surprise that vaccine enthusiasm/hesitancy exists in pockets with groups of friends and family likely to have similar views.
Reaching out to communities in ways that make sense to them is key and there is no simple answer.

I have a personal history to not trust new medicines

This is very real and very understandable.  People who have had bad experiences with other medical treatments are likely to be cautious and require more convincing to participate. 

I don’t trust the government

Nor do I.  I have a lot of sympathy with people who are confused by the messaging and have lost faith in this government.  Boris and his cronies lie all the time; they have used the crisis to create a kleptocracy where they and their friends are given lucrative contracts and serial failures like Dido Harding are promoted and given £37bn to waste.  I am particularly annoyed that in the chaos of Boris Johnson’s government, important public health messages are often hidden. 

But thankfully we do not have to take Boris’ word for the vaccine being good.  The globally available information is compellingly behind the vaccination program including every government, international agency and scientific body.  To think that there is collusion between all of these groups takes us into the realm of conspiracy theorist rather than hesitant.  A good rule of thumb to know whether a conspiracy theory is plausible is to think about how many people have to be in the conspiracy and for how long.  Tens of thousands of unconnected people keeping the massive secret for over a year is just not possible. 

I have Information overload

There is vast amount of information available on COVID and the vaccine.  Plenty is true but complicated, and a reasonable amount is misinformation.  Sorting through it is not simple, especially for a general population with no particular training in medicine, statistics or ethics with low trust in authority. 

In the face of this, people can find it very hard to make decisions and ‘doing nothing’ becomes the default and easiest outcome.

The technology is too new

mRNA technology has actually been around for a long time.  The first vaccines were developed 30 years ago and 10 years ago we had good working candidates.  But it took the pandemic for the funding and regulatory attention to move them into production. https://www.nature.com/articles/d41586-021-00019-w

I expect to hear much more about this technology in the coming years as we develop new ways to treat diseases such as cancer. 

The vaccine was rolled out too quickly to be safe

This was a concern of mine but some research last year showed that a lot of the slowness in previous vaccine approvals came from bureaucratic delays rather than safety requirements.  Much of the approvals process can be done simultaneously rather than sequentially which really sped things up.  Similarly the vast funding enabled us to develop later stages of the research before waiting to finish the early stages.

Also, each vaccine had to be separately approved by each country’s own regulator ie you have a very large number of independent entities with chance to raise issues with the vaccines or the process.


It is best to wait to be sure it is safe

This makes sense as an argument. 
The reason I do not agree in this case is that normally you would be waiting until lots of people have done it in case there is a problem which the testing stage missed.  This normally takes time but given the speed of the rollout this time there have now been 5.6 BILLION doses delivered.  This is an unfathomably large number, so far above the number you need to get approval which is in the thousands. 

I am worried about the side effects

This would be a sensible reason for hesitation and is a normal human response.  I do not share it as, related to the point above, we know so much from those 5.6 BILLION doses.  With that many doses, it would be a shock if there were no individual tragedies, but the scale of the rollout means that our confidence is very high that the risks are vanishingly small.  Unlike for COVID where the risks are well documented and much higher. For example, the risk of blood clots from the vaccine do exist but are vastly less than the risk of blood clots from COVID.

A complicating factor is misinformation about side-effects (e.g. leads to fertility issues or contaminates breast milk) – these are simply untrue.

Another common fear is that there might be a long-term problem (e.g. you will get cancer in 20 years’ time).  I do not have much to counter this except to wonder why no other vaccine has ever had that problem.  I am also very well aware of the long-term effects of COVID which are very real and could be very severe so I would much rather be protected from that. 


I value my freedom and do not want to be forced to take it

This argument feels backwards as freedom for most people increases if we all have the vaccine as the vulnerable can safely leave their homes.  I wonder if they feel this way about other forms of government coercion and want to protest their right to drive through red lights at 100 mph outside schools while drunk.  Sometimes society limits our “freedom” to damage other people. 

The vaccine does not really work

The argument here is that you can still catch COVID after being vaccinated.  This is true but misses that you are drastically reducing the risks of more serious problems and virtually eliminating the risk of death. 

Similar arguments are made about masks and other prevention measures, but I think this is a conceptual error on safety.  Reducing risk is still a good idea even if it cannot be reduced to zero.  I happily wear a seat belt and drive a car with an airbag even though it is still possible to die in a car accident.

The best metaphor I have seen about combining risk reducing strategies is to think of each of them as a slice of Swiss cheese.

Any single slice has large holes in it.  But put them all back-to-back and you cannot see through it.

Some of the slices such as masks may have larger holes and some like vaccination have smaller holes.  They are not alternatives but work best in combination.

You can still pass on COVID if you are vaccinated and so my decision only affects my health which is my business

This has some appeal as an argument.  Even if you are double jabbed then you can still catch COVID and you can still infect other people.  So what is the point?

This is misleading because vaccinated people:

  1. are less likely to catch COVID ie less likely to have it
  2. likely to have a much lower viral load ie are less infectious
  3. are likely to recover much more quickly ie are infectious for less time

The combination of these three means that you do not have the exponential growth in the population and the virus dies out. 

Conclusion

With a little reflection, it is pretty obvious that if no one were vaccinated right now, deaths in the UK would again be in the thousands per day not dozens.  If everyone took the decision to delay, we would collectively be in a terrible situation.

In fact, a notable positive from the rollout has been how large the take up has been.  Polls suggested that a large number would not take the vaccine but the take up has been far in excess of that. 

This suggests to me that the anti-vax believers have likely not changed their mind but the numbers of vaccine hesitant has been steadily reducing.  The arguments I have made above are far from new, and people are gradually moving towards accepting the vaccine. 

Trump – Biden what to watch for tonight

Here are the possible outcomes tonight

  1. Biden big win (70%)
  2. Biden moderate to narrow win (20%)
  3. Trump narrow win (10%)

Below is the election forecast from Nate Silver’s 538 website. He helpfully produces a snake of all of the States in order of the current polling – deep red for Trump and deep blue for Biden.

The tipping point state is Pennsylvania and polls show Biden ahead not only there but in many more states than he needs to simply win. This is why the most likely outcome is a big win for Biden.

Some simplifying observations:

  • For Biden to win he needs to win the Rust Belt i.e. Pennsylvania, Michigan, Wisconsin
  • For Trump to win he needs some of the Rust Belt but also ALL of the Sun Belt i.e. Texas, Georgia, N Carolina, Florida, Arizona
  • If Biden picks up some of the Sun Belt then he is heading for a big win.

By coincidence these States also split neatly in these categories by how they are processing votes. See below for a nice summary from the FT.

We will know the results tonight from the Sun Belt but the Rust Belt may be less clear, especially if it is close.

Drawing it together:

  • If Biden wins some of the Sun Belt – then we know he has won big and the delay in the Rust Belt does not matter
  • If Trump wins all the Sun Belt – then the election looks closer than the polls suggested. It’s likely the Rust Belt will also be closer meaning that we will genuinely have to wait until all the Mail-in ballots are counted. Even if Biden is still the winner this will be enough for Trump to contest the election and we may have prolonged chaos and conflict.

What to watch for

Florida will release results around 8pm ET / 1am UK time. If Biden is a clear winner then I think it is all over. If Trump wins then it could be a long night/week/month.

Regeneron – Has Trump found a cure for Covid?

I have followed Trump’s Covid case very closely and it has been very confusing as the timeline of symptoms and treatment has not matched up to what we know about the progression of this virus. I am left thinking that the main difference between the particular case of Trump and others was his use of Regeneron. He claims it is a cure, I’m thinking it may have made him worse.

Timeline

  • Tuesday Sep 29th – We see Trump debate for 90 minutes. I see no signs of any symptoms.
  • Thursday Oct 1st – He tests positive. The only symptoms are reports of fatigue on the Wednesday and Thursday, but clearly not severe as he attended a fundraiser without major incident.
  • Friday am Oct 2nd – Trump personally requests and takes “Regeneron”, supplied by his golf buddy from the company Trump has held shares in. This is an experimental drug not approved by the FDA, but he gets emergency clearance to take it and Dr Conley agrees to administer it. His doctor then reports that his only symptom is mild fatigue.
  • Friday evening Oct 2nd – Trump has a rapid drop in his oxygen levels and takes a helicopter to hospital. Scans show signs of lung damage (i.e. pneumonia) and he is seen by a team of world class pulmonary experts. He is treated with remdesivir and notably the strong steroid dexamethasone.
  • Over next week – only very sketchy and misleading medical reports. From his videos we can see indications of pneumonia with a cough and shortage of breath. However he does appear to be improving and so the reason for the lack of transparency is not obvious.
  • Oct 13th Trump appears much improved, reportedly testing negative for Covid.

Is this a normal timeline?

It really isn’t. The onset of mild symptoms and rapid recovery would imply that he had a mild case of Covid, which is the most common outcome, even for people of his age and weight.

The hospital admission, lung damage and use of dexamethasone prescribed by highly regarded experts in their field can only mean that he was genuinely very ill and in real physical stress. For this to have been caused by Covid, it would imply a much more serious case – but in a Covid case these more serious symptoms typically occur 7 days after the onset of symptoms because they are caused by the overstimulation of the immune system going into overdrive. Further, if it had been caused by Covid, then it would not make sense that he could be released from hospital after only 3 days.

The evidence of serious illness is certainly clear, but the timeline is not consistent with it being caused by Covid.

How to reconcile this inconsistency?

Trump’s explanation that Regeneron cured him fits his view of himself as a genius who can treat himself better than anyone. He asked for this specific drug just as he asked for Hydroxychloroquine earlier this year, which Dr Conley also agreed to administer to him. But the timeline is exactly the wrong way round. He took the Regeneron before the emergence of the lung damage and drop in oxygen levels so it is hard to see it as the cure.

A common theory is that Trump had Covid for a week before he admitted to having it, and so the emergence of the overactive immune response is still the correct timeline. This does not reconcile with his rapid recovery unless we combine the theory that he had been sick for week with the theory that the Regeneron helped shorten his illness. This does not explain why he had no visible symptoms all week, whilst having a severe case of Covid which was about to get much worse.

I am left wondering if it was the Regeneron that caused the problems. In this hypothesis, Trump has a mild case of Covid but takes a massive dose (8g) of monoclonal antibodies which strongly stimulate his immune response. This overstimulation might have lead to pneumonia which is then treated by dexamethasone, after which he is recovering well. Trump does not want to admit that he caused the problems which would explain why he did not allow his doctors to give details on his condition.

Perhaps his Covid case was always mild and so it would have gone away without much intervention.

Breaking news

Eli Lilly has a very similar drug to Regeneron. Their trial has been paused due to safety concerns.

https://edition.cnn.com/2020/10/13/health/eli-lilly-pauses-trial-monoclonal-antibody-coronavirus/index.html

Would I take Regeneron?

I do not want to make a judgement from such sketchy information on a new drug. I would prefer to wait until clinical trials are completed and then we can see if it works or not.