We’ve been cooped up for weeks, and finally there’s a faint glimmer of hope that a plan to end lockdown is starting to take shape. Only it may all be for naught. The UK is sleepwalking into the risk of a serious rebound in the infection rate, which will mean the reimposition of lockdown and we’ll all be back where we started. At least those of us who haven’t died will be back to where we started.
In an important article in The Guardian (click HERE), Devi Sridhar – who is a professor of global public health at the University of Edinburgh and an acknowledged expert in the field – warns that the UK is heading towards another Covid-19 disaster. Over two years ago Professor Sridhar warned of the risk of a coronavirus type outbreak. Experts in her field were aware of the risk and were talking about it publicly, but still the British Government allowed its pandemic preparations to run down. The UK entered the crisis woefully unprepared for it. It’s exiting the lockdown in exactly the same way.
According to Professsor Sridhar there are basically only three possible responses to a viral epidemic for which there is no vaccine. Firstly you can do nothing, and allow the virus to spread amongst the population. When one infected person infects two or three others, the virus spreads exponentially. Within a surprisingly short time a majority of the population contracts the virus. Most people will experience only minor symptoms and will develop a natural immunity. Their bodies fight off the virus and in the process create antibodies which remain in the body, primed to spring into action should they encounter the virus again.
When most people in a population have immunity, then the virus cannot spread effectively. This is essentially the herd immunity strategy that the British Government was considering at the start of this crisis. It is only an ethical strategy when the illness that the virus causes has a very low fatality rate. It’s also only an ethnical strategy when you are certain that infection and recovery creates a lasting immunity. There is simply not enough information about this virus in order to be sure of that. Not enough time as passed between the earliest infections and now in order to be sure that any immunity is going to last. Additionally there is now a growing body of evidence to suggest that people who suffer a severe reaction to infection are at high risk of being left with lasting health problems as a result.
However even a fatality rate of 1%, which sounds low, is going to cause mass casualties. Assuming that 60% of the population becomes infected, which is the figure that epidemiologists generally bandy about when they’re talking about effective herd immunity, that would mean 32500 deaths in Scotland alone, and about 400,000 deaths in the UK as a whole. By the time the British Government realised that it was facing death on such a scale, and an NHS and public services which would be unable to cope, the virus has already spread widely in the population.
That left the second strategy. This is to impose lockdown and ensure that people stay indoors and minimise contact with others in order to reduce the opportunies that the virus has to spread. This is successful in reducing transmission rates and spreading the load so that the health and caring services are able to manage. Yet it comes at a heavy price. It wreaks havoc on the economy and creates huge stress amongst people who are cooped up at home all day. Rates of domestic violence rise, mental health issues increase. Other illnesses and health conditions go untreated as people feel that they should not trouble an already stretch health service. There is an enormous cost in jobs which are lost as businesses are unable to survive the lockdown. People are unable to pay their rent or their mortgage, they worry about ensuring that there’s food on the table. Yet without other remedies, a society is condemned to repeated cycles of lockdown and release. Unless other measures are in place, when a society begins to loosen lockdown, the rate of transmission of the virus will start to rise again.
The third strategy is the only proven way of controlling a viral epidemic in the longer term until an effective vaccine can be developed. It entails the introduction of a rigorous scheme of mass testing, tracing those who have come into contact with infected people, and instituting quarantine and isolation measures on those who have the virus or who are in contact with infected people. This last requires a significant infrastructure to be in place, an infrastructure which doesn’t currently exist in the UK. The UK is still struggling to meet even the relatively low testing targets that the British Government has set. There is no reliable mechanism in place to trace those who have come into contact with infected people.
This is a strategy which ideally needs to be implented early in the outbreak, before the virus has had a chance to establish itself in the wider community. The UK has dithered and delayed, squandered the head start it got, and has missed the boat. By allowing the virus to become widely established, the British Government has made considerably more diffcult to get it under control.
Worse, there is clearly no consensus within the British Government about what strategy it needs to take. Westminster’s response has been characterised by confusion, mixed messaging, and contradictory statements. If those in charge of the UK’s response to the virus are unsure what to do, it’s hardly surprising that the public is as well.
In order to come out of lockdown successfully, Professor Sridhar identifies a number of measures that need to be in place. Firstly there has to be “mass testing, surveillance and real-time data to identify clusters of the virus and quarantine those who are infected.” PPE must be supplied to everyone who needs it. There must be effective checks on the health status of those entering the country and mandatory quarantine for all arrivals. Yet in the UK we are nowhere near ready to provide mass testing. The Government’s app is still in the early stages of testing, and there remains huge suspicion amongst the populace about what the British Government – which does not have a good track record with privacy and personal data – would do with the information it collects on all of us. After all, you can’t keep all your decision making secret as this Government has done, allow the UK to have the highest death toll in Europe, and then expect us to trust you.
The UK is loosening up some of its lockdown restrictions in a confused and confusing manner. This runs the risk of us seeing a new peak in infections which will force us back into lockdown again. We will be back where we started – at least those of us who are still alive and healthy – only with an even higher death toll, more grieving families, and more lives ruined. And all of this could have been avoided if the British Government had kept its eye on the ball. We’re all paying the price for Conservative negligence, for their ideologically motivated destruction of public services, and for their prioritising private greed over the public good.
And finally, because we could all do with some cheering up during these difficult times…
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