Does not the leadership of the UK , that is, as well as the UK Government (UKGOV), all those who lead corporations , institutions, businesses, unions and public services, now have to advance together with the single purpose of galvanising people to hard work and mutual help and roll back the collateral damage of Covid-19 (CV)?
The gradual easing of the lockdown, emphasising caution to prevent a second wave which overwhelms the NHS, presents an incredible challenge to all people in the UK; because at the same time, as a matter of urgency financial experts seem to largely agree, the country has to return to as near full working capacity as possible if a lasting economic meltdown is to be avoided. While maintaining a healthy respect for CV’s potency to ensure citizens do their best to take precautions, citizens have to also be convinced to understand the real risks and to live with CV as part of daily life. At the same time experts speak with a hundred different voices – whether scientists or economists or business or political activists – as to the past, the present and the future.
- Some say lockdown started too late
- Some say there should never have been a lockdown
- Some say the lockdown has gone on too long
- Some say it is too early to be easing the lockdown
The trade-off that has always existed, but which perhaps the politically correct UK hardly talks of, needs to be faced. The tragedy of over 40,000, maybe a lot more, CV deaths is mostly at the senior end of society, lives well lived, and every one representing a sad story. The collateral damage of avoiding deaths at all costs is horrific potentially. Infection with CV and some resulting deaths has to be risked when weighed against the huge cost of leaving beds empty just in case and other treatments postponed, financial ruin for many, and young lives and prospects permanently scarred.
There is lots of opinion , easy critics who know best, but nobody knows with any real certainty what is the best course week by week or what would have happened if different decisions had been taken at different times.
So where does the UK stand now?
WHAT CAN AND CANNOT BE DONE BY CITIZENS?
Everyone who works is now encouraged to travel to work if they cannot work from home, and provided the business concerned is permitted to be open (by 15 June the majority of restricted businesses will be those that are in the leisure industry). Employers are to do their best to keep employees safe. Urging people to avoid public transport where possible makes life harder for workers.
There are new rules as to what behaviour is illegal. A person is no longer forbidden from leaving home unless they have a reasonable excuse (eg to acquire food). Instead a person, unless they have a reasonable excuse, must not stay anywhere overnight except where they live (examples of a reasonable excuse include for work purposes). There is also advice, or guidance, for people to “stay alert”, which also encourages people to stay at home. The old prohibition on people meeting together has gone, replaced by a new anti-gathering law.
Instead, up to six people may meet together outside (or more if all from the same household). However, people from different households may not get together indoors at all for social reasons. Guidance requires that, in any gathering, indoors (where permitted) or out, social distancing of 2 metres apart should to the extent possible be observed. Evidently , even without examining exemptions and other urging guidance, of which there is a lot, the mix of law and guidance is now a fairly complex cocktail of requirements and permissions, with competing objectives. It is still important to record that “advice” and “guidance” from UKGOV is not the law. Because there is now complexity and a mixture of messages, people are urged to apply common sense. In applying that to any given set of circumstances, perhaps it is worth trying to recall the purpose of the combination of these “rules”: that is to contain CV and save lives by protecting the very vulnerable. So, In deciding any particular action, the question is whether the action jeopardises the purpose or, if it might, how can one best minimise the risk of CV spreading (eg by keeping distance and handwashing): however, if the emphasis now is to get the UK working and the economy to be revived, a 2 metre social distancing rule will seriously inhibit that revival.
UKGOV MANAGING THE CRISIS, AND MAINTAINING PUBLIC TRUST
The management of the CV pandemic by UKGOV has been and continues under a million microscopes all searching for error, inconsistency, incompetence, mind -changing, and pouncing on any perceived crack in the armour. The politicisation of CV is regrettable. But it is critical that public trust is ensured. There has been erosion and to some degree this can be attributed among other things to UKGOV changing policy or its decisions at different times: moving from abandoning testing and tracing in March to it becoming critical in June; no face coverings required for months and becoming compulsory on public transport in June; and, highly contentious, no quarantine for people entering the UK from abroad, until its proposed introduction in June when all entrants must quarantine for 14 days in their residence – but with numerous exceptions where practicality overrules the spreading risk (for example, road hauliers and fruit pickers).
SAGE science suggests quarantine is valuable when the infection rate of CV is on the way down to reduce the risk of spreading. But why it was not required before seems not to have been answered to the satisfaction of many. The quarantine requirement means that almost no tourists will visit the UK – this barely matters currently as all hotels, and other tourist places to stay, restaurants and bars and other attractions are closed and so hardly anyone is likely to come in any event! However, it will affect future bookings and the absence of tourists in the Summer peak could inflict huge, perhaps permanent, damage, on the UK leisure industry, resulting in mass unemployment in the millions in that sector alone, across large parts of the UK. This issue illustrates in technicolor the Catch-22 conundrum of impossible decision-making without severe risk which UKGOV and so all citizens face: long-term damage , economic, social and health, versus.more CV cases. Alternative solutions to quarantine must be adopted – body temperature testing, testing for infection, and air bridges, and there must be common internationally accepted standards at airports and for all air travel.
There seems to be little choice but to reduce the 2 metre rule to say 1 metre, as some other countries have. Obviously this would be less safe, and some scientists say the risk of infection would double, though it would still not be great: a risk which probably has to be taken. The plan must be as soon as possible to rid the UK of any distancing requirement.
In reaching decisions, UKGOV must continue with clear and well explained rationale, not platitudes about science – the public must by now understand the science around the balancing act provides no answers, but only some educated opinions within ranges of possible outcomes and based on mathematics and assumptions which can easily prove fanciful. Best efforts judgements, weighing risk honestly and carefully, but accepting that there is a trade off between saving certain lives from CV and saving lives and livelihoods for the vast majority of the population. The public perhaps must trust, but UKGOV must earn that trust every day: all leaders in every walk of life must help.
COLLATERAL DAMAGE – BY HOW MUCH DOES IT OUTWEIGH THE DEATHS FROM CV
Since April there has been considerable discussion of the damage beyond the deaths from CV ; that damage includes areas such as:
- Hospitals – NHS and Private – being closed for patients except CV patients
- Serious illnesses go unattended and deaths result or would result in the future: in April the Financial Times reported that in a normal month 30,000 cases of cancer are diagnosed, during CV it was 5000
- Child abuse; domestic violence; children going missing – huge rises
- Massive unemployment; whole sectors at risk – retail sector and leisure and aviation industry face potential decimation
- Education for millions of children seriously and perhaps irreversibly damaged and so their prospects too – to stop this must surely be a priority
- The young are most seriously prejudiced, and the most deprived will be damaged worst of all in numerous ways
- A very serious recession, longer lasting if there is no material rapid bounce back
- Damage to health, and deaths rising, due to economic disaster where UKGOV is financially exhausted through subsidising swathes of people and businesses
It is hard to put numbers on all of these and other issues: there are plenty of publications which demonstrate they are big numbers indeed. But in the long term collateral deaths alone may well outweigh the direct CV toll. And so there perhaps cannot be any justifiable second nationwide lockdown, even with a second wave of CV, and UKGOV should not use it as a threat – threatening the country with suicide seems unproductive. Scientists and leaders all declare that the UK, and the world as a whole, absent vaccine or effective mitigator drugs against CV, must find a way to live with CV, reducing to a minimum the collateral damage. The UK at least has plenty of hospital bed and ventilator and ICU capacity to deal with a big uptick in cases. The battle ground perhaps will have to be local or regional epidemics – the NHS, PHE and so UKGOV must deliver on test and trace: the whole of the UK should do all it can to make that a success, and political sniping at targets will not help progress. Second spikes are likely to occur but the response must surely not be a panic National lockdown. The lives and livelihoods that will be lost to collateral damage perhaps should have more weight than those which CV really threatens. Protecting directly the really vulnerable from CV, whether or not old, should be where the anti-CV effort is focussed.
THE UK TAKING OFF
Most of all perhaps a culture of carrying on the business of every day life, with extra vigour, needs rapid promotion and acceptance across the UK; getting the young educated, trained and into good work; opening schools to all children with practical, not impossible, CV measures; ensuring large parts of the NHS in all its guises are available for all necessary treatments, with CV not a risk for those who attend; the UK being as open to the world as it can be; while preparing for worse – becoming self sufficient in vital supplies, particularly medical and survival-critical products, or at least not being dependent on nations hostile in so many ways to the UK.
The balancing act of Catch-22 decisions continues, now at a critical stage, moving as perhaps it must, from absorbing pain in order to exhaust the virus, into aggressive reinvigoration of activity across the UK, casting off excess caution and draining regulations which inhibit progress and rapid change, moving quickly and decisively from decision to execution.
There can be no sacred cows, including Public Health England and the NHS.
See also https://sherbhert.com/more-covid-19-thinking-forward/
See also https://sherbhert.com/covid-19-a-balancing-act-for-government-and-all-citizens-part-1/
See also https://sherbhert.com/covid-19-a-balancing-act-for-government-and-all-citizens-part-2/
