I never thought I’d echo a thought expressed by Donald Trump, of all people, but if we’re effectively under house arrest, maybe we should be worrying about the cure for coronavirus being worse than the disease?
Draconian restrictions of liberty are difficult to justify in almost any circumstances. The government is heavily hinting that a variety of lockdown scenarios will extend way beyond the three-week period initially announced by the Prime Minister. Estimates vary between three to six months, and maybe even further. As it stands, the current lockdown is likely to carry on into May and June. Some permutations of it may remain in place until September (and if there is a severe second wave of the virus, a lockdown would almost certainly be re-imposed in the autumn). Given this kind of timescale, I believe we should scrutinise the strategy very rigorously, evaluate the impact and consider alternative approaches.
Boris Johnson may tell us that “there really is such a thing as society”, but strict lockdowns where people are deprived of social contact could conceivably fragment society and jeopardise community cohesion. Indeed, the fabric of society could quickly become unstitched and fall apart before our eyes. There’s the potential for democracy to be hijacked and for the UK to be turned into a police state. A top police officer has already warned that his force will consider setting up roadblocks and searching shopping trolleys to stop lockdown flouters ‘putting lives at risk’. I wouldn’t go so far as to speculate that people might get a criminal record for buying their kids Easter eggs. That would be ridiculous. Nevertheless, we should be very wary of authorities imposing overzealous rules and enabling overzealous enforcement of them. Also, no one should underestimate the detrimental impact of social isolation on people’s mental health.
It also doesn’t help that government and health officials frighten us with misleading statistics. For example, according to a study by ISS (Italy’s national health authority), the vast majority (more than 99%) of the country’s coronavirus fatalities so far have been people who were already suffering from one or more severe medical conditions. It is not being made clear to us how many people are dying of coronavirus, as opposed to dying with coronavirus. There’s so much iffy data out there. When the health secretary claims that 761 million items of PPE have been distributed to front line health workers, I can’t help wondering if he’s counting a box of 100 pairs of disposal gloves as 1 or 100!
Our leaders neglected to close our borders and failed to urgently address the inadequacy of testing kits, PPE and ventilators. Meanwhile, our lives have morphed into a strange quasi-science-fictional scenario, where government policy is determined by statistical modelling (based on partial and selective data) and communicated by means of a “stay home, protect the NHS, save lives” mantra which implies that what should have been treated as a public health emergency is being treated as a public order issue.
So, what are the alternatives to lockdowns? Obviously, the development of a vaccine is, if you like, the holy grail. But the process of research, followed by clinical trials, followed by manufacturing and deployment, means that a viable, safe and effective vaccine will not be available until the early part of next year at the earliest.
That leaves the policy, favoured to some extent by countries like Sweden, of an effectively managed infection control programme, leading to a degree of natural ‘herd immunity’. When the outbreak first emerged in the UK, this was apparently the UK government’s preferred approach (although the Health Secretary has since denied this). Self-policed social distancing was considered an adequate response, but they got cold feet when health experts predicted a high peak of hospitalised patients requiring intensive care. The potential impact on the scandalously underfunded NHS became evident and anything short of a strict lockdown was deemed to be politically unpalatable, prompting a change of strategy. Everything was then focused on protecting the NHS. Well, obviously, none of us want to see the NHS overwhelmed, and we all recognise health workers as heroes, particularly at this time. I hope government ministers reflect seriously on the lack of PPE and testing kits and critical care beds when they join in the ‘Clap for Carers’ tributes.
We know so little about this virus. Is it seasonal? What if lockdown measures barely succeed in containing the outbreak? And what if relaxing the measures after a few months simply gives rise to a further escalation of the epidemic? And, in any case, what is the point of just kicking the can down the road? There can be no definitive resolution to the problem until the population acquires immunity.
Immunity can only be achieved through vaccination or by populations surviving the disease and acquiring antibodies. The trouble with draconian lockdowns is that even if the spread of the virus is slowed down, the majority of survivors fail to become immune and therefore remain at risk. Effectively shutting down the economy and imposing strict regulations limiting public movement may be acceptable over a timeframe of a few weeks, but most of us need social contact in order to function properly. I’m very worried for our collective mental health if our lives were to be impoverished in this way for the year or more it will take before a vaccine is ready… a period in which we will suffer individually as sentient human beings and society may get torn apart. How many lives will be lost to the side effects of the lockdown treatment (poverty-related factors, violent crime and suicide)?
Understandably, we’re all having emotional reactions to all the stuff that’s going on. At the top of this post, I referred to the lockdown as like being under house arrest. I’ve now calmed myself down by considering a different analogy – perhaps an extended period of salutary hibernation? It’s a complex issue and none of the solutions available to us right now is benign, but when we’re comparing evils, it’s incumbent on us to determine which is the lesser of them.
In the meantime, I don’t wish to give the wrong impression – much as I would love to go out and meet up with friends and family, I’m obeying the rules for as long as this remains the consensus of the scientific and medical communities. Now more than ever, we must all take personal responsibility for our actions and inactions, own up to mistakes, learn from them and put other people first whenever possible. After all, those principles underpin an ethical, empathetic and civilised society. And we must certainly expect those principles to be applied by those who govern us. This is a test of our humanity.
So, let’s come back to the question: is the cure for coronavirus possibly worse than the disease? It would almost certainly have been better to have adopted better isolation measures at the outset. And better distribution of protective equipment would possibly have avoided the tragedy of frontline NHS workers losing their lives. Unfortunately, we’re hamstrung by the government’s lack of early decisiveness and lack of preparedness. Their shift of strategies came too late and we’re competing with countries across the world for components and chemicals required to conduct mass testing. This means contact tracing and isolation of cases is not as effective as it might otherwise have been. On balance, right now, I guess we have to accept that the worst case scenario is the NHS becoming entirely overwhelmed, such that people would struggle to get treatment for anything life-threatening, whether it’s related to COVID-19 or not.
Yes, we should go with the current protocols… for now… but we should monitor the impact on people’s psychosocial well-being. We certainly shouldn’t put too much credence in the principle of Occam’s razor and assume that simple solutions are the best just because they’re easier and more convenient to execute. Obviously, public health is vitally important, but our freedoms, rights and liberties are very precious too. I know it may seem unconstructive, in these unprecedented times, to criticise our government. There will be many who feel we should simply trust that they’re doing their best for us. But I believe we should continue to question everything and have a debate… because it’s so important that the policy makers get it right.