My fear with this Cummings debacle is that the erosion of trust and depletion of consent to be governed is coinciding with sending people back to work and school. All before #TestTraceIsolate is functioning.

“You only get to say Go out, trust me once,” https://www.theatlantic.com/health/archive/2020/05/patchwork-pandemic-states-reopening-inequalities/611866/

Selectively isolating cases and those who have been exposed to them through #TestTraceIsolate is now a proven successful strategy in many countries. Surely it is the way we could afford to relax general distancing sustainably. Yet we're not doing it and it's hard to watch.

It is an emergency to get out of lockdown (bluntest and most expensive containment measure), which is why it was bad to be late (delay implementing adds many weeks to duration), but we are still not testing, contact tracing and isolating so we still need it. Painful as that is.

Due to not contact tracing, we have very little idea about where and in what circumstances transmission is ongoing in our communities and have bought no room to relax distancing.

We also don't know which areas are seeing local outbreaks or for why. This week we read about a local hospital in one part of the UK closing their doors in crisis. Talk about a lagging indicator!

I think that there is a serious risk that the fragile trust and consent that is left after this Cummings saga will be completely eroded by having to reverse the misjudged relaxation of lockdown. And personally I don't think I have the emotional reserve for a step backward.

We do need to get out of lockdown. To do it we need competent #TestTraceIsolate and agile and effective local outbreak control systems integrated into the rest of the health service. So it is an emergency to get this established. There's no magical alternative absent a vaccine.

We need that to get children back to school, and to get people back to work, and certainly to get students back to universitities, and definitely to get restaurants, bars and pubs open again.

But we're 10 weeks into lockdown, we've given private patient data to shady big data firms with no oversight, sequenced an impressive number of viruses, and have an enviable number of mathematical epidemic models per capita and yet...

we're not doing any contact tracing and with ~100,000 infectious people we're smashing on to relax the lockdown. Honestly?!

If we don't get this right we will nix any chance we have left of an economic recovery because once faith in the government is gone, and epidemic is not controlled, and progress is dashed, people will act as they see fit and gov dictats will cease to be effective.

As for Cummings, on the forensics of his story it is clear he has told at least some lies and some big ones which make his entire story to me likely to be a brazen attempt to fit a story to the incriminating facts.

By his own admission he left a hotspot and used an ambulance and hospital in another part of the country. I'm inclined to give latitude to people for the decisions they make when they're scared and ill. If he was truthful and apologetic I would forgive this.

Other people who have suffered directly due to lockdown may not forgive so easily. But his story doesn't make sense. He isn't being truthful. There are at least several blatant falsehoods. The story is brazen and ridiculous in parts. On the forensics of it alone it fails.

And yet, he shows no remorse and amongst his lies he is on the offensive against the MSM (who have gone easy on him if my listening to members of the public calling into LBC is anything to go by). Brazen again as his and his wife's own media accounts of events were inaccurate.

He seems to have falsified a blog posting to make himself look prescient about specific risk of coronaviruses (relevant since gov response has been too flu-centric) and he was the PM's eyes and ears on SAGE, so his integrity and truthfulness are surely newsworthy.

We are in a mess, neglecting the essentials of epidemic management, and focusing on specific branches of science that appear to be in DC's personal narrow sphere of interests. It's not clear what the route out of it is at this point if he has to be conducting the orchestra.

My hope is that devolved powers in the UK strike out on boldly different path from now and, by example, this helps shift the emphasis for the whole of UK.

#TestTraceIsolate and empower local primary care, public health teams and front line service managers to make bold calls.

Unpopular opinion: we should stop focusing on genomics, app development, and mathematical modelling* until the broken fundamentals of a basic public health response to an epidemic are fixed.

*All helpful, but not necessary for a competent response see Vietnam/Latvia.

Firing Cummings would be an encouraging step in the right direction but I'm beyond caring about him.