Friday, April 17, 2020

COVID 19 - work in progress

Like many of us in public health, I've been rather busy with COVID-19. I thought it might be useful to bring together what I've been involved in in one place:

Papers in scientific journals:

15.          Patel P, Hiam L, Sowemimo A, Devakumar D, McKee MEthnicity and COVID-19BMJ 2020; 369: m2282 
17.          Oh J, Kavanagh MM, Gottschalk K, Subramanian SV, Shibuya K, Hirschhorn LR, Alonso C, Torres I, Awoonor-Williams K, Minh HV, Bawah AA, Tran H, Kachur SP, Sáenz R, Barrios OA, Kwon S, Nam EW, Choi JW, Lee J-K, McKee M, Gostin LO. Announcement of launching the JGHS Commission on COVID-19 Response. J Global Health Science 2020; 2: e20
18.          Roberts CM, Levi M, McKee M, Schilling R, Lim WS, Grocott M. COVID-19: a complex multi-system disease Br J Anaesthesia 2020: DOI:
19.          Han E, Chiou ST, McKee M, Legido-Quigley H. The resilience of Taiwan's health system to address the COVID-19 pandemic. EClinicalMedicine. 2020 Jun 27:100437. 
20.          Toffolutti V, McKee M, Stuckler D. Is theCOVID-19 pandemic turning into a European food crisis? Eur J Publ Health 2020; doi:10.1093/eurpub/ckaa101

21.           McKee M, Gugushvili A, Koltai J, Stuckler D. Are Populist Leaders Creating the Conditions for the Spread of COVID? Int J Health Pol Management 2020: doi: 10.34172/ijhpm.2020.124

22.          Rajan S, Cylus J, McKee M. What do countries need to do to implement effective ‘find, test, trace, isolate, support’ systems? J Roy Soc Med 2020; 113: 245-50

23.           McKee M. England’s PPE procurement failures must never happen again. BMJ 2020: 370: m2858

24           Shanks S, Van Schalkwyk MCI, McKee M. Covid-19 exposes the UK’s broken foodsystem. BMJ 2020; 370: m3085

25.      Gugushvili A, Koltai J, Stuckler D, McKee M. Votes, populism, and pandemics. Int J Publ Health 2020:

26.           McKee M. Learning from success: how hasHungary responded to the COVID pandemic? GeroScience 2020:

27.      Vanoni M, McKee M, Bonell C, Semenza J, Stuckler D. Using volunteered geographic information to assess mobility in the COVID-19 pandemic context: cross-city time series analysis of 41 cities in 22 countries from March 2nd to 26th 2020. Globalization Health 2020 Sep 23;16(1):85.

28.     Han E, Tan MMJ, Turk E, Sridhar D, Leung GM, Shibuya K, Asgari N, Oh J, García-Basteiro AL, Hanefeld J, Cook AR, Hsu LY, Teo YY, Heymann D, Clark H, McKee M, Legido-Quigley H. Lessons learnt from easingCOVID-19 restrictions: an analysis of countries in Asia Pacific and Europe. Lancet 2020: S0140-6736(20)32007-9

29           Agius RM, Robertson JFR, Kendrick D, Sewell HF, Stewart M, McKee M. Covid-19 in the workplace. BMJ 2020; 370: m3577

In press

Kontis V, Bennett JE, Rashid T, Parks RM, Pearson-Stuttard J, Guillot M, Asaria P, Zhou B, Battaglini M, Corsetti G, McKee M, Di Cesare M, Mathers CD, Ezzati M. Magnitude, demographics and dynamics of the impact of the first phase of the Covid-19 pandemic on all-cause mortality in 21 industrialised countries. Nature Med

Crozier A, Rajan S, McKee M. Fixing England’s COVID-19 response: learning from international experience. J Roy Soc Med

Ramon Martinez, Shah Ebrahim, Lucas Sempe and Martin McKee. Potential impact of COVID-19 on human mortality tool. This allows you to apply the age specific mortality seen in Italy or China to age distributions worldwide
Link to description
Our monitor is bringing together structured reports on how countries across Europe are responding to the COVID-19 pandemic. You can select themes and countries to generate your own pdf. We are also adding thematic analyses, for example on testing practices across countries.

I am a member of the Independent SAGE, convened by Sir David King. Our first report was published on 12th May 2020 
Our second report, on reopening of schools, is here
Our third report on FTTIS is here
Media (selected)
Washington Post 23rd March
BBC Radio Ulster: 24th March , 2nd April
Daily Telegraph 6th March
BBC Radio 4 The World Tonight 13th April
Sky News 15th April
Toronto Globe and Mail 3rd April;  20th April
Sydney Morning Herald 4th May
Därför kan en ekonomisk kris skada folkhälsan mer än det nya coronaviruset. [Therefore, an economic crisis can harm public health more than the new corona virus] Dagens Nyhater 20th April
Tragiczny błąd Zachodu w walce z koronawirusem Rzeczpospolita [In Polish: A tragic mistake by the West in the fight against coronavirus] 4th May
Discussions/ podcasts
BBC World Service The Real Story. Discussion with Zeke Emanuel, Ben Cowling, Emma Frans and me. 17th April
The public health response to COVID19. BMJ podcast 
BBC Radio 4 The Briefing Room. 23rd April 
BMJ podcasts

Letters to newspapers

Letter to Financial Times critiquing Oxford study

Letter to Financial Times calling for a public inquiry:

Friday, August 17, 2018

E-cigarettes - more evidence of English exceptionalism

The House of Commons Science and Technology Committee has just published a report on e-cigarettes. Those involved in tobacco control outside England are amazed at its conclusions although not entirely surprised as the England has long been an international outlier on this issue, far out of step with the rest of the world. For example, two major reports, from the US National Academies ofScience and, only a few days ago, from Australia, highlight how much is not known. The American Heart Association agrees that " the potential health effects unknown, especially in long-term users" and has made a series of recommendations that are almost the opposite of those in the Commons report. And it's not just in the Anglophone world. leaders of the European Respiratory Society recently responded to a paper on e-cigarettes in England saying "(A) There is little evidence that e-cigarettes are an aid to smoking cessation and much evidence that tobacco manufacturers are advertising e-cigarettes as a bridge to starting nicotine and as a vehicle for long term continuation”; and “(B) no-one, expert or otherwise, can credibly assert that e-cigarettes are safer than tobacco in the long term, given that they contain a whole new tranche of unregulated and unstudied compounds being inhaled into the lung."
It is especially astonishing that the 95% safer figure is used, given that it has no credibility internationally. There are serious questions about the funding of the meeting it came from and it is simply impossible to know how safe a product is when it has only been used widely for a relatively short time. It took decades to discover the health effects of smoking. 
The World Health Organisation has said explicitly that a precise figure cannot be given, referring to "Unsubstantiated or overstated claims of safety and cessation". Also, as reported earlier this week in a study from Birmingham, new evidence is appearing weekly raising concerns about safety.
It is equally astonishing to see the claim that they are a proven smoking aid given the recent publication of a large controlled trial in the New England Journal of Medicine concluding that "Among smokers who received usual care (information and motivational text messages), the addition of free cessation aids or e-cigarettes did not provide a benefit. ". Moreover, there is now lots of evidence from observational studies that they reduce quitting.
The suggestion to increase nicotine is especially worrying given that organisations such as ASH have argued that the UK is safe from the rapid increase in use of Juuls by schoolchildren seen in the USA because of the lower levels permitted here. The report simply dismisses concerns such as that by the former chair of the American Academy of Pediatrics Tobacco Consortium, who has said “Juul is already a massive public-health disaster". But then, the report ignores the considerable evidence that these products are a gateway to smoking.
Fortunately, other countries are not following England's direction, despite massive pressure from a very well funded Big Tobacco operation. Instead, they are waiting for the results on our giant experiment on our people.

Friday, November 17, 2017

The EHIC post Brexit: The devil is in the detail

The House of Lords Home Affairs Committee has a sub-committee on the EU. It is an extremely impressive group, chaired by a former head of the diplomatic service, and with a former chief executive of the NHS among its numbers. I was asked to give evidence on the prospects for retaining the European Health Insurance Card post Brexit. What other arrangements does the EU have with third countries? Are there arrangements from before we joined the EU that we could revive?
This involved a lot of homework - for example, dredging through the National Archives to find ancient treaties. That was a fascinating exercise. Several were with countries that no longer exist, such as Czechoslovakia (although in that case it seems that David Davis is unaware that it split in two in 1993), Yugoslavia, and the USSR. The wording revealed how far we have come. Many of the treaties talked of how, if a national of one country was residing in another, he would be entitled to something, as would his wife.  Clearly, the possibility of a woman ever working abroad was unimaginable to them.
I've written a blog about what I discovered on the BMJ website. But to cut a long story short, it is clear that, once again, UK ministers are living in cloud cuckoo land. Their remarks reveal a profound ignorance of even the most basic aspects of how the EU works. I cannot see any prospect of retaining the EHIC given the UK government's red lines.
No wonder our European neighbours are now planning for the worst. Until now, they persisted in the belief that the UK government could not be so stupid. But now they realise that it is. And it is both tragic and embarrassing.

Wednesday, November 01, 2017

A running commentary

The Brexit negotiations continue - I deliberately do not use the word progress. It is now abundantly clear that the UK is totally unprepared. The Cabinet is hopelessly divided. Weekly, politicians make statements revealing their deep ignorance of how the EU works. The general view is that if they wait long enough, someone else will find a solution.

The Prime Minister has said that she won't provide a running commentary. She seems strangely shy about sharing the news about what she seems to think will be an amazing success, refusing to publish her government's assessments of the impact of Brexit. This may not matter - even the ministers in the department that is meant to be negotiating Brexit haven't read them - and can't even confirm they actually exist. Still, if she isn't willing to, I thought I could help with some observations from time to time. So as well as the blogs mentioned in previous posts here, I've added a few more. I hope you find them interesting.

BMJ blogs:

UK in a changing Europe:

Tuesday, April 04, 2017

The sound of ideology smashing into the wall of reality is echoing around Whitehall

The UK government has issued its latest Brexit White Paper. Well, some of it is white. Five of the 44 pages are completely blank. Another 5 only have blue rectangles. One wonders how much time was spent in deciding what shade of blue was used. It must have been light relief from the much more difficult task of thinking of words to include. Yet it does say something. It seems to recognise that Brexit will be much more difficult than the Leavers thought, and many will be very disappointed. But it also shows that the UK government still has very little clue if how to proceed.
My take on it can be seen in my latest BMJ blog, which you can read here.

Thursday, March 30, 2017

So Theresa May has triggered Article 50. It didn't go down well. First, she called for talks on the UK's exit from the EU to proceed in parallel with those on a free trade deal. Clearly she hadn't been listening to what everyone else had been saying for months. It isn't going to happen, as Angela Merkel (and many others) quickly pointed out. Then she issued a veiled threat - be nice to us or we will stop co-operating on security. At a time when all European countries face a severe threat, this is not good timing. And her obvious disregard for the interests of Scotland, Wales, Northern Ireland and Gibraltar greatly increases the likelihood that, in 10 years time, it will be England alone outside the EU.
Maybe we could be more reassured if we felt that the UK government had some plan for how to proceed. Sadly, as I noted in a recent blog for the BMJ, it is now all too apparent that it doesn't. Indeed, listening to the news today simply confirmed my suspicion. Those who support Brexit simply don't understand the EU and our relationship with it, something that has taken 40 years to develop and, by all accounts, will take 40 years to disentangle ourselves from.
Can the notification of Article 50 be revoked. Certainly our European partners think so. And for this we should be very grateful because, sometime in the next few years, the UK will hit the wall we call reality. And we may be very grateful for an escape from this insanity.

Saturday, February 04, 2017

Brexit White Paper - or should it be Blank Paper

I've written a new blog on the Brexit White Paper on the BMJ website. You can read it here. As you will see, I was quite amazed that any government would have the audacity to produce such an appalling document and pass it off as a something as serious as a government White Paper. It adds almost nothing to Theresa May's Lancaster House speech, contains factual errors, and includes no serious analysis of the challenges ahead. It has all the realism of a 5 year old writing to Santa Claus.
Others have noted how, by reading the metadata on the HTML version, one can see that it was only finished at 4 am in the morning it was published. One feels that it may only have been started the evening before.
Those wanting to read more (and after reading the White Paper, anyone with even a passing interest in Brexit is likely to want much more) should also look at Steve Peer's excellent analysis here. There is also a great thread by on twitter by Schona Jolly, another perceptive observer of these things.

Tuesday, September 13, 2016

Brexit 2 months on

It gets worse. Once, when a UK cabinet minister spoke on his brief at the despatch box in the House of Commons it was assumed that it was government policy. No more. Of course, the blame doesn't lie entirely with the Secretary of State for Exiting the EU. The problem is that there is no government policy. Or indeed, no prospect of developing one.
It must now be clear to everyone that:
a) the UK government lacks the capacity to actually leave the EU (unless it wants to just walk away in the desperate hope that something will turn up, which it won't)
b) the arguments advanced by the Leave campaign were blatant lies
c) there is no easy way out - Theresa May can't even call an election and lose it, leaving someone else to clean up the mess as the lamentable state of the Labour Party means that she would win
I've written a few new blogs that try to set out some of the issues. They are pretty depressing. But they may inject a degree of reality to a debate characterised by political demonstrations of optimism that make one wonder if the speakers inhabit the same world as the rest of us.

Brexit - the confusion continues. BMJ 8th September 2016

"Brexit means Brexit" Health Policy & Planning, 7th September 2016

Sunday, July 03, 2016

The EU referendum and beyond

So now we have a result. And it is not good. A brave politician has been murdered. We have had months of blatant lies by those supporting the Leave campaign. We have had a massive upsurge in racist attacks. We now know that some politicians were willing to bring our country to the brink of disaster in pursuit of their own personal agendas. The two main political parties are rudderless. Research collaborations are already being damaged. Citizens from other EU countries are terrified.

We show no evidence of learning the lessons of history, whether they are from the 1930s in Europe or from the last time a UK government launched a major initiative without a plan, as we will hear in the Chilcot Report in a few days.

Those who supported Leave are revealing massive optimism bias. They make Voltaire's Dr Pangloss look like a pessimist. They think we can negotiate trade deals rapidly, despite our lack of negotiators. They show no sign of appreciating the crisis we face. Yet there is no excuse - they just need to look at the Swiss situation. But of course, they think they will be different. This is verging on teh delusional.

None have a clue what to do. The unwillingness of those who have at least some insight to trigger Article 50, which would start the clock ticking, is revealing. See David Allen Green (aka Jack of Kent) for the best analysis.

The only reassuring thing is that some day, they will realise the complexity of what they seek and that it is likely to paralyse the parliamentary process for years. But the damage done by then will be enormous.    

I've written a few blogs on the fallout from the EU referendum are on the BMJ site:

24th June 2016: We have no idea what will come next, but it won’t be good

27th June 2016:  Brexit and health—the confusion grows

30th June 2016: Fair and balanced? Science in a post fact society

Thursday, May 02, 2013

Why are people losing faith in conventional politics?

People in many countries are losing faith in politics as usual. Some are returning to the politics of an earlier age, voting for neo-fascist parties such as Golden Dawn in Greece and Jobbik in Hungary. Elsewhere, those calling for transparency and direct democracy, whereby those elected should represent the people rather than powerful vested interests, are achieving success. The most newsworthy example was in Italy, where a party led by a professional comedian emerged as the largest single party in the 2013 general election although elsewhere, the Pirate Party, which originated in Sweden, is seeing electoral success in a growing number of countries, with Iceland only the most recent. In the England, the UK Independence Party is now in third place in opinion polls, despite revelations from e-mails exchanged by its senior officers that it is so desperate to have semi-coherent policies on a range of topics that it is considering buying them from sympathetic think-tanks. 
History, especially that of Europe in the first half of the twentieth century, reminds us that a failure by politicians to manage an economic crisis can lead to a rejection of conventional political parties so, to some extent, what is happening now should not be a surprise. But history also reminds us that the importance of these developments should not be underestimated. No matter how justified it may seem to describe parties such as UKIP as being composed of “loonies and fruitcakes”, this rather misses the reason why a disillusioned electorate has lost faith in conventional politics.
Two recent health-related events typify this view. The wave of revulsion that followed the shooting of 20 children and six staff in Sandy Hook Elementary School, in Connecticut, seemed to many people to be a game changer. The National Rifle Association attracted ridicule when it suggested that the best way to prevent more deaths in school shootings was to arm teachers. Opinion polls shows overwhelming support for tighter gun control measures, with 92% supporting the closure of loopholes that enable those buying firearms at gun shows to avoid background checks. Yet, when even such a modest measure such as this reached the Senate, it was defeated. 43 of the 46 senators voting against it had received campaign donations from the National Rifle Association. They found every excuse possible, no matter how incredible, to justify their failure to act against products responsible for the murders of over 8,000 Americans every year.  Having striven relentlessly to prevent any research that might challenge their position being undertaken, they ignored or dismissed what did exist, such as that showing a clear link between the laxity of state-level gun control laws and shootings. Bizarrely, a few days later, many of the same senators, who had rejected what they saw as intrusive surveillance by the federal government, rushed to condemn the FBI for failing to identify the Boston bombers before they acted.
About the same time, the upper chamber of the UK parliament was debating another health-related matter, the regulations requiring NHS services to be opened to competition. Ministers had offered copious reassurances that the Act, from which the regulations flowed, meant something other than what it plainly said. When the regulations confirmed its true meaning they claimed it was a mistake and, after scattering a few words such as integration almost at random, claimed to have fixed it. Legal opinion, not refuted by the government’s response that sidestepped the key issues, confirmed that the revised version was effectively unchanged. A major campaign was launched to ensure that peers were aware of this and the concerns of by health professionals and their representatives, some of whom seemed finally to have woken up to the threat being posed. Yet as in the US Senate, the government dismissed the evidence. A subsequent detailed legal analysis suggests that the speech by the minister introducing the regulations was incorrect in almost every respect. Despite overwhelming opposition by those who had studies the provisions, the government was successful, leaving those responsible for managing the NHS struggling to reconcile the regulations with ministers’ stated intentions. Quite why so many peers supported this obviously flawed legislation remains unclear but, as with the US Senate, a growing number of people are asking questions about the financial links between the private healthcare industry and some of the most eloquent supporters of the Act and the subsequent regulations.
 Politicians are meant to represent the views of the people, not powerful vested interests. Unfortunately, at times, they seem to echo the suggestion by Bertolt Brecht when he observed that, as the East German communist party had lost the confidence of the people, “would it not be simpler if the government simply dissolved the people and elected another?” Maybe they should reflect on this if they don’t want to join the Communist Party of the DDR in the dustbin of history. 

Wednesday, December 26, 2012

Hinchingbrooke - a (very minor) correction

Mr Birrell has, correctly, pointed out that I was mistaken in saying that the Public Accounts Committee had condemned the franchising arrangements at Hinchingbrooke Hospital. In fact, the Committee has yet to issue a final report. I should instead have said that members of the Committee had condemned it. I was thinking, in particular, of the closing comments of one of their members in their report of evidence taken: “I have to say, this should never ever happen again, because it is a financial disaster for value for money and for taxpayers.
I should also have mentioned the report into the franchising by the National Audit Office, which was the basis of the Committee’s hearing. Although measured in its wording, concludes that “The Authority should work with the Department to undertake a formal lessons learned process before agreeing any further franchise agreements.” This is on the basis of a long catalogue of problems, including a lack of clarity about transfer of risk and what measures of success were being used. One of the Committee members, used to reading these reports, describes it as “probably the worst report of financial incompetence in the NHS that we have seen. The chair noted that “I haven’t read a Report as bad as this on the health service. This is probably the worst.”
The views of the members suggest a fairly consistent tone of incredulity, such as “this report is chock-a-block full of people saying, "Never before anywhere in the NHS has this level of savings been achieved." McKinsey, who are probably the consultants who are around the NHS more than anybody, say that they think it is unachievable. We accept that it is early days. We know from Mr Parsa that they have not got to where they planned to be when they put the bid in to you. We know from the document here that they added 25% savings in at the last minute to give you a viable bid that you could accept. You seriously sit here and think that that will be achieved? You are seriously doing that?
Of course, as the evidence presented to the Committee and the NAO report indicate, there are many serious concerns about the franchising process, and not just the fact that Circle has a get out clause if it racks up excessive losses. But then, maybe this is unsurprising, given the description of the calculation of risk in public-private partnerships as "pseudo-scientific mumbo-jumbo".
I do hope that this has put the record straight. The Committee has not yet reached a considered conclusion on the Hinchingbrooke franchise but, I would suggest, it is already pretty clear what it is likely to be.

NHS privatisation - we are right to be afraid

Just before Christmas David Cameron’s former speechwriter, Ian Birrell, wrote in praise of private sector involvement in the delivery of healthcare (NHS privatisation fears? Grow up). It is no secret that many members of the current government see the NHS, along with the BBC and the Royal Mail, as ripe for privatisation (or what you and I might describe as untapped opportunities for profiteering by their friends and supporters in large corporations). Yet Birrell’s enthusiasm for privatising the NHS overlooks two fundamental characteristics of private companies. They hate uncertainty (as their advocates tell us again and again) and they will invest their capital wherever they can be sure of making the greatest profits.

For health care to be attractive to them it is necessary to distort the delivery of care so much as to make it almost unrecognisable. As Margaret McCartney has set out in detail in her excellent book, The Patient Paradox, it must exclude anyone whose condition cannot be put into a tidy box and costed. Hence, the concern he voices for elderly and disabled patients seems at odds with the profit imperative to get rid of them, ideally to the social care sector where their care will be means tested. As we have shown in a recent paper, this is only part of a multipronged attachment on older people (or as certain politicians would say, sotto voce, those who have outlived their usefulness). Consequently, while no-one wants to see older people stuck inappropriately in hospital, we must consider the motives of those now suggesting that they should never be in a hospital at all. Recall that, in many cases, it is only possible to know that someone is entering the final few months of life in retrospect. The exclusion of old people from the health system will free space needed to screen the worried well until some harmless anomaly can be found and treated at a guaranteed profit.

Private providers will only contract with the NHS if the market is rigged in their favour, for example by capping their losses as happened in the deal with Hinchingbrooke Hospital, since condemned by the Public Accounts Committee. He invokes Germany as an example of a country where the private sector is heavily involved in health care delivery but seems unaware of the very different model of Rhineland capitalism in force there, with trade unions represented on supervisory boards of firms. The benefits of this approach over the Anglo-Saxon model we use have been set out at length by Will Hutton. The situation in our two countries is entirely different.

Birrell’s claim that “competition works in health, just as it works elsewhere” displays an ignorance of a literature stretching back fifty years. The theory was set out in 1963 by the Economics Nobel Laureate Ken Arrow and the empirical evidence gathered since then. He must surely know that the research he cites has generated results that are medically implausible and have been heavily criticised.

People with complex disorders, cannot be commodified. The abject failure of the market-based health system in the USA to improve health outcomes, despite spending vast sums of money, should give him pause for thought. On a whole range of measures, the NHS in the UK outperforms those in other industrialised countries. When someone is proposing something so completely at odds with the evidence, it is only reasonable to ask why and who will benefit?

Friday, August 17, 2012

My perspective on London 2012

This blog originally appeared on the LSHTM site

Something quite remarkable has happened to me in the past 10 days. Normally I find televised sport barely more exciting than watching paint dry and I share Dr Samuel Johnson’s view that patriotism is the last refuge of a scoundrel.
Yet, somehow, I’ve found myself avidly watching sports events that, if I knew they existed (omnium, keirin?) I certainly didn’t understand the rules. Now I’m even beginning to understand what the judges are looking for in gymnastics, beyond not falling off the apparatus. So what has happened?
It began even before Danny Boyle’s fantastic opening ceremony. What an amazing surprise! But there was the clue. It was a surprise even though many thousands of people, the performers, the technicians, those present at the rehearsals, knew what was going to happen.
But they kept it to themselves so that they wouldn’t spoil the surprise for the rest of us. Not because they were threatened with arrest under the many powers that the British government now has to prevent freedom of speech. Rather, because Danny Boyle asked them to.
And what a surprise! A feat of sheer technical mastery, with the most amazing special effects presented with superb timing. A combination of seriousness (the tribute to the dead in the London bombings the day after London was awarded the Olympics, even if not shown in the version on NBC in the USA) and comedy (combining the queen – not Helen Mirren but the real one – and Mr Bean). But above all, a celebration of Britain, showing where it has come from but also where it is going.
There was something for everyone, with Chelsea pensioners alongside rap artists. Well, not quite everyone.
There was Aidan Burley, the Conservative MP who complained on Twitter of “multicultural crap” and a columnist in the Daily Mail who ridiculed the idea that one could find an ethnic minority father living with a white British family in a stable family union. He obviously didn’t know who Jessica Ennis was, but presumably he does now as the story has been removed from the paper’s website.
But the storm of protest that these comments provoked showed that, at a time when politicians are doing their best to divide us, vilifying migrants (perhaps we need a few more like Mo Farah), older people (like Hiroshi Hoketsu, the 71 year old Japanese equestrian  team member who is at his last Olympics as his horse will be too old at Rio), and anyone who is different, the vast majority of the British people realises just how much we benefit from diversity and we will not tolerate those who seek to divide us.
And of course we have the actual events. For years it has seemed that there has been no association whatsoever between ability and fame in Britain. News stands are lined with “celebrity” magazines telling us the latest exploits of some sad individual plucked off the streets to be exploited by the producers of reality TV, the modern equivalent of the Victorian habit of going to Bedlam to laugh at the lunatics.
Now they are covered with images of people who really do have talent and, most importantly, have worked to develop it. The commitment that these athletes have made is remarkable. Interviewed after winning Gold in the 10,000 metres, Mo Farah said that running 120 miles a week was hard, and long distance running was lonely. What an understatement!
Yet, as Malcolm Gladwell wrote in his book Outliers, real success at anything seems to require about 10,000 hours of work. What a difference from today’s celebrities with their 15 minutes of fame.
Of course, none of this could have happened without the volunteers. People of all ages, smiling and cheerful even in pouring rain, doing everything possible to welcome the world to this great cosmopolitan city. What a contrast to those who sought to exploit the games for profit.
The reputation of G4S, which so spectacularly failed to provide the security it promised is now in ruins. Coca-Cola and McDonald’s sponsorship of the games has simply attracted attention to the contrast between the health promoting focus of the games and the health damaging effects of their products.
The involvement of ATOS in the Paralympics, given its treatment of disabled people being assessed for work has appalled those who watched recent television investigations into their practices, is beyond parody.
But here I am rather more pessimistic. Will anything change? The idea that G4S should receive any money for its lamentable performance is bizarre and, if they do, it begs the question of what was going through the mind of whoever wrote the contract. How can they possibly be allowed to bid for another government contract for many years?
And now we must look forward to the legacy. These games have surely inspired countless young people to take up sport. Few will become the elite athletes winning medals at future Olympics (although some will). But that is not the point.
In a country with rapidly increasing rates of childhood obesity, what we need is simply to move us all up a notch on the activity scale. But this means investment. We are forever being told by ministers seeking to cut spending that “it is not simply a matter of money”.
Maybe not entirely. But Britain’s success (recall the one Gold medal at Atlanta) is very substantially about money. Yet there are now real fears that as soon as the Olympics are over the budget for sport will be slashed.
This would be a tragedy and the British people must not allow it to happen. What is more important – high quality sports facilities in every school or a nuclear deterrent almost entirely under American control and which no-one can suggest a realistic scenario in which it would ever be used?
This takes me to my final point. What the Olympics have shown is that government works, whether in its investment in athletes or its stepping in, with the armed forces, when a private corporation fails (yet again).
If a government funded sports strategy can work so well, why do we seem so determined to avoid a government funded industrial strategy? The reason that politicians were given brains was so that they could learn from experience. Now is the time to break the habit of a lifetime and do so.