THE British government says that it wants to slow the spread of Covid-19 to reduce peak demand on healthcare – an approach known as ‘flattening the curve’. Yet some of its policies and practices achieve the opposite.
Telling people to develop ‘herd immunity’ is encouraging some Britons to talk about getting infected as quickly as possible before healthcare is overwhelmed. Such a pursuit is akin to selfish panic-buying. It is certainly the opposite of flattening the curve.
And while the government still poses as being ‘scientific not political’, it is U-turning. Having said last week that mass gatherings won’t be banned, it now says they will be banned some time this week. The British government is following the Scottish government, just one day after Boris Johnson said he would not follow Scotland’s lead.
Private organisers started postponing sporting events before the government did. Academic institutions are also taking their own initiatives. Britons had already started ‘social distancing’ – following American advice, not British. In the latest survey on Saturday, a majority of Britons do not approve of government handling of Covid-19. Approval of the prime minister is even lower. ConservativeHome has accused him of a lack of leadership.
What lingers in popular approval is the government’s scientific posture. Saturday’s survey shows that most respondents trust the Chief Medical Adviser. Social media is full of vociferous defence of the government, although I suspect that the government’s truth unit, which was set up to counter misinformation about Covid-19 in social media, is propagandising.
Often, this defence is framed nationalistically against the supposed panic responses of Donald Trump and the EU. In fact, British policy doesn’t look remarkably different from the EU’s ‘dire’ response. Borders remain open; responses are left to the individual; money is being thrown at institutions that are already unaccountably inefficient (e.g. the NHS and the EU’s border agency Frontex), and tests and treatments cannot meet demand.
While the US has declared a national emergency, Britain’s official line is ‘keep calm and carry on’. While the US has banned travel from the continental EU, Britain has not, even though the infected were incentivised to travel through Britain to get to America! As I predicted on Friday, the US added Britain to its travel ban on Saturday. National separation has worked for Taiwan, South Korea and Japan, and is the belated norm. Yet the British government claims an exception, based on a ‘science’ all its own.
The British government is badly placed to ask for our trust on Covid-19. It never acquired the testing capacity to track this virus, and it has committed to testing only those hospitalised with severe symptoms. The World Health Organisation has slammed the policy as contributing to ignorance and indecisiveness.
The government should not be selling policy as science. At best, science describes what is, while policy prescribes what should be done. And policy involves trade-offs. For instance, a policy of not testing the self-isolated saves resources, but leaves people uncertain and anxious in their homes, and leaves the government without data. Not closing borders preserves trade, but accelerates infection. The pursuit of ‘herd immunity’ sacrifices people now in the hope of pre-empting peak pandemic later. One former British public health official estimates that the policy is condemning 500,000 Britons, mostly elderly and sickly, to die.
Posing as scientific is misplaced anyway: the government is managing risk, but betrays misunderstandings of risk. It justifies ‘herd immunity’ in terms of reducing vulnerability, but actually the target’s side of the risk is a combination of both vulnerability and exposure. Bear with me: this is not complicated. The government has already dumbed this down too much, so let me smarten it up.
The government thinks the way to reduce our vulnerability to the virus is to build immunity – by getting the virus. This is perverse!
In fact, we don’t need immunity to defeat the virus: a virus dies out once its infection rate falls below either the exposure rate or the vulnerability rate. One way to lower the vulnerability rate is to vaccinate everybody, but a vaccine is not available yet. The other way is to let everybody get the virus and thence immunity (for those who survive!) Pursuing infection and thence immunity is riskier than advocates realise. With Covid-19, some people have mild symptoms like a common cold, but others have severe symptoms such as pneumonia, and we don’t yet understand why some people get away with it. I see a lot of public comments dismissing the lethality rate in China by blaming the higher rate of smoking, but the West has separate risk factors, such as obesity.
Even if symptoms are mild, a carrier puts others at risk for up to two weeks either side of the symptomatic period. What matters more than the vulnerability rate is the exposure rate, and this is the part that the government is neglecting, even while most countries are restricting travel, assembly, work and play.
Relying on voluntary self-isolation alone is naïve: people cheat. They might self-isolate, except they don’t want to waste tickets to the theatre this Saturday, or they’ll just nip to the shops quickly, or they’ll make the family gathering that has been planned for such a long time. Saturday’s survey contains evidence for personal unreliability: only half of Britons claim they are washing their hands more than normal, even though that is explicitly what the government asked them to do. And respondents always exaggerate compliance.
Furthermore, washing one’s hands should NOT be the primary advisory against Covid-19. As a secondary advisory, it is useful: we don’t need to spread germs by shaking hands or touching tables, then failing to wash our hands before eating or touching our face. So please keep washing your hands.
However, the advice to wash hands is misleading people away from what should be the primary advisory: avoid breathing in close proximity to the infected. Breathing in aerosolised mucus is the primary vector by which Covid-19 spreads. Washing your hands will not protect you from this particular vector. The only protection is to avoid exposure: do not socialise. Wearing a mask will protect you from someone spitting in your mouth, but won’t stop chaotically-flying aerosolised particles from finding a way behind the mask.
Political scientists call nationalistic herding in wartime ‘rally around the flag’. It’s good for national cohesion in crisis, but also gives the government a break from criticism, and an opportunity to entrench bad policy. Bad health policy means that more people die than need to; and that’s a British problem predating Covid-19.