Issue 248: 2020 09 24: Managing Covid

24 September 2020

Managing Covid

An impossible task.

By John Watson

As you would expect from a distinguished sportsman, Marcus Rashford’s reaction to Johnson’s decision to extend free school meals through the summer break was gentlemanly and courteous.  “Johnson didn’t have to change his mind” he said to the Financial Times, adding that it takes a lot for someone to U-turn, even to do the right thing.

Well yes, I suppose so, but there have been a lot of government U-turns in relation to the Covid pandemic and the public are clearly getting fed up with them.  To the man or woman in the street it is discombobulating.  They understand that the pandemic is worldwide and that the country needs to take measures.  The lockdown involves sacrifice and people understand that too.  Having worked out how it will affect them they mostly grit their teeth and try to see it through.  So far so good, or, at least possibly, so survivable.  What is not good at all, however, is to discover that the measures have not done the job, that more restrictions are waiting round the corner and, worst of all, that much of the sacrifice so far has been wasted.  No wonder people are losing confidence in Mr Johnson’s handling of the crisis and no wonder that many of them think that others – from Sir Keir Starmer to Michael Gove – would be making a better job of it.  But would they?  It is really very hard to say.

We were always told that there might be second wave but as the first wave figures became manageable we hoped that more localised and fewer restrictions would be sufficient for the future and the politicians made decisions accordingly, hoping to rescue as much of the economy as possible.  As further waves crash across the world it is now all too obvious that we were wrong.  But would it have been realistic to keep a full lockdown in place?  I suspect that the speed at which it was relaxed reflected the fact that against the background of falling figures it was losing public support, and that takes us to the heart of a vicious circle.  It goes like this:

  • whenever the pandemic slackens the public begin to look forward to the relaxation of the very restrictions which reduced it;
  • that makes it steadily more difficult to keep them in force/maintain them;
  • the consequent relaxation allows the pandemic to build back up.

At first sight you might think that this was a self adjusting mechanism and that a resurgence of the pandemic would increase the acceptability/efficiency of restrictions but alas it is not quite as simple as that.  Look at the current situation where there are large increases in infection but so far, as in the UK although not in Spain or France, a relatively small resurgence of death.  No doubt the upturn in infection will go some way to reconciling the public to tightening measures but to some extent that will be counteracted by the slower rise in death rates which makes the disease appear less serious, a false comfort if it simply reflects the fact that hospital admissions and deaths lag infection by a period of 2 to 3 weeks.

But, as always, the key word in the last sentence is “if”.  Is the apparent discrepancy between infections and deaths really just down to time lag, or is it because the treatment of the disease has radically improved, or is the virus being replaced by less virulent strains which help it to spread by leaving the host alive?  I have heard all three versions from knowledgeable medical people over the last week, together with the comment that viruses often weaken as they spread.  Goodness knows what the truth of it all is.

So put yourself in the place of the government.  What courses are open to you and what are the pros and cons?

The first is a full lockdown of the type we have had before.  It would clearly do huge damage to livelihoods, particularly as the Chancellor may not be able to rerun the furlough scheme.  Also it may not work.  No doubt it would depress the figures for a time but would we be able to follow it with a successful “whack a mole” approach?  Or would the figures creep back up for a third wave, and then a fourth, and then a fifth…  with improvements in medical intervention being undermined by diminishing public support for restrictions.  If in the end it delivered nothing permanent there would be huge public resentment that a full lockdown had been tried at all.  Not a good option that one.

What then of the other extreme, allowing the virus to run while taking steps to shelter those who are most at risk?  If herd immunity was being built at a reasonable rate while deaths were kept at an acceptable level, this would be the obvious course; but immunity seems to build very slowly and then may not last long (it is “may” rather than “if” this time, but the point is essentially the same).  Also there is a limit to the number of infections we can actually deal with and no one wants to see the NHS’s capacity being overwhelmed.  Not a good option either.

Then there are the options in between: a brief lockdown; more limited restrictions; hope that the combination of some herd immunity and some measures pushes the R number below one.  Here it could all go wrong.  The economy could still be damaged and the virus could get back out of control.  That could be the worst possible result.

It cannot be pleasant to have to contemplate these options and the temptation must always be to follow the middle course, not least on the basis that it represents some sort of mean of public opinion.  Still, whether it is the right course or not must be hard to judge and it must be with trepidation that the authorities decide on their next step.  No wonder they appear uncertain.  It must be hard to look decisive when you’re aware that in a week’s time the measures you are introducing will look too weak/too strong/or just misconceived.  The tactic of calling a meeting of Cobra may help to share the blame with others outside government but it will not of itself help to make the decisions.


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