A pandemic is like a war, not only because people die or because it dominates everything. Pandemics can shatter illusions of competence. Failure in managing a pandemic reveals gaps between bombast and reality. So it has been with Covid-19.
The United Kingdom has had a notably bad pandemic. I fear that the decision to open up is going to prove to be more of the same.
The UK has the world’s second highest official death rate per million, behind Belgium, surpassing Italy and Spain, despite being hit later. While its testing capacity has improved, the number of tests per confirmed case lags far behind those in New Zealand, Australia, Taiwan, South Korea, Germany and Italy.
One explanation for the high death rate is the delayed response: the higher the infection rate when lockdowns were imposed, the higher the mortality rate. Yet there is more to the story than that delay.
An article by Professor Martin McKee of the London School of Hygiene and Tropical Medicine and others notes more failures: a lack of coordination with devolved governments and local authorities; failed procurement of essential goods and services; failures of coordination between government, the National Health Service (NHS), Public Health England and local public health departments; as well as the chaotic coordination with the rest of Europe.
The government needs to recognise and learn from these failures. Yet, in the introduction to last month’s road map for recovery, Prime Minister Boris Johnson dared refer to what he said in his previous plan, published in March: “I said we’d take the right decisions at the right time, based on the science. And I said that the overwhelming priority of that plan was to keep our country safe.”
The government has not in fact kept the country safe, by any reasonable standard. So will exit from lockdown be better managed than entry?
Governments have responded to the pandemic with three distinct strategies: suppression, containment and herd immunity or, more simply, “let it rip”.
Under suppression, as in East Asia and Australasia, the aim is to eliminate the virus from society. This should allow everybody to lead a normal life, which is economically and socially desirable. But it has required early, effective action.
The aim of containment is merely to limit the virus to manageable levels. If the pandemic has already taken strong hold, lockdowns will be briefer than under the goal of suppression. Social and economic activity will then restart sooner. The disadvantage is that economic and social activity will be more limited than under suppression, as the virus will remain widespread. For the same reason, second or third waves of infection are also likely to be economically damaging, even absent lockdowns.
Containment looks to be the strategy of much of Europe. Finally, “letting it rip” is the policy of Presidents Jair Bolsonaro of Brazil and Donald Trump in the US: nobody seems as indifferent to the fate of the people as populists.
Mr Johnson seems to have chosen containment. This was consistent with the tests the government laid down for reopening: The NHS could cope; the country had a sustained fall in death rates; the rate of infection was at manageable levels; the testing capacity was adequate and effective; and there was no risk of a second peak of infections.
Whether these tests have been met is a matter of judgment. What we know, however, is that “R” – the reproduction rate – is still not far below one, and the official number of new confirmed cases has been running at 1,920 per day against about 390 in Italy, 440 in Germany and 570 in Spain.
Given the still high number of UK cases, the effectiveness of test and trace is very much in question. Infections are quite likely to take off once again. If so, a return to economic and social normality will not occur, whether or not there are further lockdowns, because many people will remain very cautious.
What would the government do then? It will, I expect, go to “let it rip”, hoping that the NHS would cope and that it could protect the most vulnerable. If it does let the disease rip, while European countries make their tougher strategies work, then the economy would probably do worse and the death rate would continue to be higher. British exceptionalism could look very ugly.
Mr Keir Starmer, leader of the opposition Labour Party, has told Mr Johnson to “get a grip”. He is right. The escape of the Premier’s special adviser Dominic Cummings from lockdown has seized the headlines. But the real story is that the UK has made blunder after blunder, with fatal results. With its rushed exit from lockdown, it is taking another gamble. If that, too, goes wrong, has it any idea what it would do?