Covid: no easy answers

By Pete North - September 24, 2020

I’ve been reluctant to come down hard on any side on the matter of Covid, particularly since like the post-Brexit debate, it is not a binary issue. It is not a matter of being pro or anti lockdown. We are all anti-lockdown. We just need to know that if we are going to trash our economy that we’re doing it for the right reasons in the right way.

Initially we were told it was to flatten the curve to reduce peak loads on the NHS. That was when the government still following an influenza plan. Having been unable and unwilling to admit its error, it never came clean that we moved to a policy of eradication – which can be done through lockdowns in conjunction with test and trace.

So why do it for a virus that kills so few people? That’s the question that’s been troubling me. I am sure the lockdown has saved lives and slowed the spread which accounts for the low death rate but it’s still not the killer most of us thought it was. But, of course, it’s not just about deaths. I know of people who have had it, got very seriously sick with it, and have not returned to their pre-covid levels of health – and perhaps never will.

There is then the rather cold assessment that it tends only to kill people over seventy and mostly those in their nineties. But those years matter. It’s about living to see your twenty year old grand children becoming adults, and perhaps even seeing your children become grandparents. It’s about keeping memories alive. Our living link to the past. What’s that worth in pounds and pence?

There are some horrifying dilemmas here, with care homes having to tell relatives they can’t see their elderly relatives for another six months. But if they admit just one carrier they could kill everyone they care for. Nobody wants to make that decision, and any decision has equally heartbreaking outcomes.

I’ve seen all the macho libertarian blowhard arguments on Twitter, and they’re all so full of themselves, as certain about this as they were WTO rules that they’ve never read. Thus I have come to mistrust certitude.

They were all so certain that Sweden had cracked it but now we learn that Covid is still smouldering in the background and just as likely to blow up as winter closes in and people spend more time indoors. They were certain that it was just the flu, but flu has limited airborne spread. The “wash your hands” schtick was developed for flu. A Covid sufferer infects between two to three others – a reproduction rate up to twice as high as seasonal flu – hence the masks only after the objective changed from the influenza plan.

In March I wrote “If you think we’re overreacting you’re wrong. Corona in many respects is worse than Ebola. Ebola is so deadly (90% mortality) it kills before it can spread. Because C19 is milder it can spread further (especially in high mobility densely populated society) so it will kill more. This virus can move undetected throughout the population because symptoms are mild, to become a huge reservoir of infection, and then pass to the vulnerable which it kills. We’ve likely missed the window for containment. The best we can do now is put out the brushfires of infection but unless people stay put (which they won’t) this will run and run. The fallback strategy now is to throw everything we’ve got at treatment, but nobody serious thinks the NHS will cope”.

I wasn’t far off. That it hasn’t killed more is because hospitals very rapidly worked out what treatments and remedies worked. We do not have a vaccine but we can treat it. We also got lucky that it wasn’t nearly as deadly as it very well could have been.

As to herd immunity, I don’t think that’s a gamble we could have taken on the basis of the data we had – and still don’t have. We’ll know more if Sweden does indeed have a second wave. There are plenty of viruses we didn’t develop a herd immunity to – and there is every reason to believe there is more than one strain in circulation. Reinfection is a distinct possibility and may be contingent again on viral load.

The most urgent question remains one of excess deaths where if we devote the entire health service to Covid then many more could die from unrelated illnesses. This has been a particular worry among cancer patients. It is something of an outrage that we have been unable to coordinate even routine treatments. There are signs this is improving, but for many it’s too little, too late.

The latest containment measures appear to be precautionary in nature, on the presumption that the second curve could rise as fast as the first, if not faster due to seasonal change. This I think is a reasonable assumption and if it does start to go that way then a second national lockdown, and even a third could be required – depending on how successful the latest attempt at track and trace is – and to what extent public cooperation starts to break down.

That, I fear will be the problem. Parliament is not comfortable with granting the government any further powers without parliamentary consent and Tory MPs particularly will be under pressure from anti-lockdown hardliners and we will see more protests and public disorder – depending on the weather.

I certainly understand the frustration. I’ve taken a long time out of my career, perhaps irrecoverably, to write about Brexit, and was hoping that in the new year I could make a living again. Covid seems to have binned that idea. I need this like a hole in the head. But all the same, I’m prepared to be patient. I won’t break from this particular point of view until I see some unequivocal evidence that says otherwise.

My only “breaking point” is if it looks like the government isn’t getting to grips with its test, trace and isolate programme. If it isn’t working by December, there’s a strong chance ti never will by which time we probably have to rethink our entire approach. There are some saying we should do that now, looking to protect the vulnerable, but again I don’t see how that can be done without wider cooperation. Again, Sweden will be the yardstick. If Sweden has failed in the way I suspect it has, then the Covid refuseniks don’t have a leg to stand on.

The one outstanding question, is one of affordability and sustainability of bankrolling the entire country. Hard choices are coming sooner rather than later. With the Brexit transition coming to an end in January, by february we will have a more complete picture of where trade flows are going. That will inform our financial planning for the following year. I’m afraid it won’t be pretty. Council tax will be going up, pension locks will vanish, and in all likelihood so too will universal entitlement. We may face even harder questions about the sustainability of the NHS as we know it. That’s the one thing the Covid cranks are right about. The easter bunny is not paying for this. There is a bill coming and it is we who are paying it.