I know of no episode in history where a government has willingly aided and abetted the spread of a dangerous infectious disease among its own population. History is being made. The government of the United Kingdom seems to actually want people to catch Covid-19 in the summer, rather than in the autumn and winter. Ministers reason that the understaffed and underfunded NHS will be in major trouble over the winter. To “go now” with the removal of all legal restrictions, thus producing an even higher level of infections, appears to be regarded as the right thing to do as it will reduce the inevitable problems later this year.
This extraordinary policy has been revealed to the population in small dollops via Downing Street press conferences where the Prime Minister is flanked by civil servants. There is no obvious strategy and there is no published plan. In the view of much of the rest of the world, and most of the medical organisations in the UK, there is no possibility that this will be anything other than yet another failure that will cost lives and livelihoods.
Throughout the pandemic, the government has constantly sought the silver bullet of a technological intervention that will curb the virus and enable a rapid return to full economic activity. Ministers and their advisers have, from the start, frequently suggested that “science” will come to the rescue and deliver us from the pandemic. With their close connections to the healthcare industry, they have chosen to take an approach that relies on the medical-industrial complex to provide total solutions. Ministers have explicitly stated that the new public health body, the UK Health Security Agency, will be a core part of UK PLC. The minimal success of mobile phone apps, antibody testing, lateral flow tests and the expensive Test and Trace system (£37bn) have been largely forgotten in the enthusiasm for the vaccine.
The UK is rightly proud of its vaccine roll-out – 68 per cent of adults have received two doses and this has dramatically reduced hospital admissions and deaths. But both are now rising again and rising fast (each by 39.4 per cent in the last seven days). The UK government has steadily removed social restrictions in recent months while making no effort to implement effective measures that might keep the virus under control. It has lifted the legal restrictions that made wearing masks in shops and on public transport mandatory and has failed to provide adequate financial support for those self-isolating. Even before the full reopening today, Britain had one of the highest number of new daily cases of Covid-19 in the world (48,161) and for weeks has had more cases than the rest of Western Europe put together.
The government is ignoring the absolute certainty that such high levels of new infections will produce another wave of “long Covid” cases and all the misery and suffering that results. This policy of standing back and letting the virus reproduce freely also risks the generation of new variants. Most worryingly, it gives a competitive advantage to those variants that can dodge the partial immunity created by the existing vaccines. If that happens, there is a real risk that we could once more suffer substantial levels of deaths.
From the experience of dealing with many other infectious diseases, we know that vaccines are only truly effective as part of an overall programme of public health intervention. Although for individuals, vaccination will reduce the risk of both hospital admission and deaths substantially, little attention is paid to the reality that even people who are doubly vaccinated can become infected, infect others and suffer a debilitating illness, or worse. In addition, the significant variation in uptake of vaccination risks leaving precisely the communities that have suffered most during the pandemic in a position where outbreaks and flare-ups will disrupt lives in the coming months and perhaps years.
The lack of willingness of the government and its advisers to recognise that airborne transmission of the virus needs to be curbed is remarkable. While other countries have acted to improve indoor ventilation, the UK has ignored the opportunity to intervene to prevent transmission of the virus. The use of C02 monitoring in indoor spaces, upgrading ventilation systems to include virus filtration, and relatively simple measures such as ensuring that windows and doors can open, and can be left open, are all actions that the government has neglected to promote. Trade unions and our legal system could play a significant role. The law requires that employees are provided with an adequate supply of fresh air in enclosed areas of workplaces, but this legal requirement appears to be being ignored by some.
The failure to acknowledge that Covid-19 is mainly spread through airborne transmission, rather than through droplets or surfaces, has also meant that simple cloth face coverings are still widely used. There has been a mandated shift to the much more effective and expertly manufactured FFP2 or FFP3 facemasks in several European countries. These basic and effective preventive measures don’t require lockdowns or significant social restrictions. They do, however, need to be promoted and implemented by a government that genuinely wants to prevent its citizens from becoming infected and ill.
It’s not too late to start building a proper public health response to get us through the rest of the pandemic but it is not going to be easy. England, in particular, has steadily disrupted and marginalised its once robust public health systems and workforces. Resources have been cut substantially, and the workforce depleted. Above all, the UK needs a strategic plan based on real public health science (not the fairy-tale version) that is adequately resourced and implemented by people that know what they are doing.
This article appears in the 21 Jul 2021 issue of the New Statesman, The Chinese century