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4 March 2020updated 04 Oct 2023 9:55am

Why the UK is unprepared for the worst coronavirus could inflict

In the free-market era, the health protection and promotion functions of the state have been allowed to atrophy.

By Paul Mason

China arrested the bloggers who reported the outbreak of the coronavirus. Iran blamed the US. Donald Trump claimed the disease was a “Democrat hoax”. Russian TV claimed that it had been engineered by Trump. Italy’s Matteo Salvini blamed African migrants.

Whatever biological science eventually concludes about coronavirus, the political science is conclusive: in country after country, the fundamental flaws of governance, ideology and civil society are being laid bare by the Covid-19 epidemic, and in places where it hasn’t even really started.

If the coronavirus does hit the UK hard – with tens of thousands of people infected – there is no doubt that the flaws in our own political culture will be exposed. These include casual xenophobia and a routine bureaucratic indifference, linked to privatisation, in which however bad things get, it is never anybody’s responsibility.

The worst-case scenario for the virus, say epidemiologists, is “very bad”. Those who drew up yesterday’s action plan were reluctant to put figures on what “very bad” means. But if we are now contingency planning for 20 per cent of the workforce to be absent at the peak of an outbreak, that’s six million people.

To understand how badly that might affect us, just consider the potential strain on the NHS. There are around 102,000 general and acute beds in the NHS in England. Of these, around 9,000 are routinely free overnightIn China, the location of the only full-blown outbreak so far, around 8 per cent of reported cases have become “serious or critical”. If the proportions were the same here, then only 113,000 people would need to be reported as infected to fill those 9,000 spare beds with coronavirus cases. That’s a long way short of six million and, long before we reach the higher figure, the NHS would be overwhelmed.

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What is the lesson from this? In the next few months everyone in the UK really, really has to listen to the public health messages coming out of government, even if it is conveyed by clowns like Boris Johnson and incompetents like Matt Hancock. And for that to work, the government needs to build trust.

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The government has outlined its strategy: we are in the “contain” phase, where tracing and testing infected people should work, and everyone has to wash their hands. If we move to the “delay” phase then, as the Whitehall document warns, “the pressures on services and wider society may start to become significant and clearly noticeable”. Schools will close, football matches and conferences will be cancelled, and if other countries are experiencing the same level of infection they might shut down international travel routes even if we do not. 

Once a full-blown outbreak begins, stockpiles of medicines will be consumed, police will concentrate only on “serious crime and public order”, contact tracing will end, and NHS staff (some by now depleted by infection themselves) will begin a Blitz-like operation simply to treat the most acute cases. Under this worst-case scenario we will still defeat the virus, but everyone in the UK will feel the effect of it – in cancelled operations, cancelled travel, cancelled public events, the presence of the military, and the enforced distancing of people from each other. As people try to self-medicate at home, the supply of over-the-counter medicines will come under strain.

Are you ready for this? I’m a late baby-boomer, so as a child I was bombarded with public health messages – brush your teeth, get vaccinated, sneeze into a handkerchief, look left as you cross the road: my generation are pre-indoctrinated to follow orders from the state. 

But I am not sure British society is ready for the worst-case scenario. In the free-market era we’ve allowed the health protection and promotion functions of the state to atrophy. There’s some superb preventive work going on, both in the NHS and local government, around everything from Hepatitis C, to sexual health and mental health. But much of it is done through side-projects and philanthropic funding.

Meanwhile, the marketisation of all human life in the past 30 years has eroded the mindset of citizenship and replaced it with that of the consumer. We “consume” public services like refuse collection and higher education and expect “value for money”. But in a serious epidemic there is no consumer choice; no value for money metrics; no customer satisfaction survey at the end.

Given the danger, has the UK government done enough, quickly enough, to stop the epidemic reaching Britain? With the first UK case reported on 31 January, Johnson’s decision to wait until early March to hold a COBRA meeting and produce an action plan looks sluggish.

The action plan is deliberately vague but it’s clear the government is preparing to make radical changes to policing, public order and NHS admissions if the disease takes off, and to take emergency powers to do so if needed. But Johnson’s administration appears unwilling to convey the potential seriousness of the situation.

There is an obvious reluctance to consider international travel restrictions, both because of the economic impact and because epidemiological studies suggest they are only effective if very tough. A World Health Organisation study of research on travel bans found that they can delay the peak of an outbreak by up to two weeks, but only if over 90 per cent of all flights are cancelled.

Yet the lesson of all previous epidemics is that the public clamour for travel bans usually wins. And the draconian internal movement ban implemented by China, at huge economic cost, has raised the popularity of the measure elsewhere.

The most rational fear – and the legitimate political line of attack for opposition parties – is that the UK’s fragmented and marketised system of governance doesn’t respond effectively enough. Marketisation creates a space between government and business in which it’s sometimes very difficult to apportion responsibility. 

Two years after the Grenfell disaster, it is still not clear who was to blame. Senior officers in the London Fire Brigade didn’t train for the disaster, while a web of outsourcing contracts obscured responsibility for ensuring the building met safety standards. 

And let’s remember, this is a government currently at war with the civil service, intent on recruiting “weirdos” to challenge the professionalism and rigour of trained and experienced administrators. If it comes down to a decision to cancel flights and close universities, I would rather have a Whitehall mandarin overseeing this than a 27-year old eugenicist who thinks black people have low IQs.

In essence, coronavirus requires us to trust a government that is not trustworthy, and a public-private technocracy with a history of shirking responsibility. For now, however, the biggest danger is that the disinformation industry will step into the space between fear and reliable information. Thanks to extensive right-wing populist networks on social media, and an overtly racist press, there is a ready audience for xenophobia and misinformation. Though this week’s attack on a Singaporean student in London was an isolated incident, I’ve heard more widespread anecdotal evidence of verbal abuse and irrational fear targeted at British ethnic minorities over the virus.

Meanwhile, the online conspiracy theorists have been quick to spread the rumour that the virus is a hoax, designed to cover up the real cause, which they believe is the 5G mobile phone technology pioneered by Chinese firm Huawei. To get a taste of what’s in store, look at Italy. There, Matteo Salvini, the leader of the hard-right Lega party, has openly linked the spread of the virus to the arrival of refugees by boat from Libya, and called for a total travel ban from China. In one region, far-right activists plastered the windows of Chinese businesses with posters saying “Coronavirus? Buy Italian. It’s a moral duty.”

Anybody who thinks Britain is immune to this kind of scaremongering wasn’t on the doorstep during the general election. So it’s not enough to limit public information messaging to “wash your hands”. Boris Johnson should be out there saying: refugees and migrants are not to blame, racism linked to the coronavirus is unacceptable. But given he has founded his entire political career on xenophobia, this might be a tough ask.