COVID-19 – THE CHANGING CONVERSATION, CONSENSUS AND COMMUNICATION

COVID-19 – THE CHANGING CONVERSATION, CONSENSUS AND COMMUNICATION

• The cost of lockdown and changes in sight
• The science cannot decide the right track
• What will the public accept?
• Unity and clear communication are critical

CHANGING CONVERSATION

The Covid-19 (CV) conversation in the UK is fast moving its focus to rekindling active life after lockdown and how CV can be lived with, and what new normals may be tolerated or even enjoyed. That conversation gains momentum daily and will require the UK Government (UKGOV) to start making changes, having regard to its five criteria. Those criteria have been at least tacitly accepted as reasonable; but the last one “no risk of a second wave which overwhelms the NHS “is unlikely to be achievable in a short time frame, as “no risk” will never exist. The wriggle room lies in the judgement as to whether a second wave will overwhelm the NHS.

A risk must be taken, and the task is to keep the risk to a minimum – partly by maintaining the NHS with spare capacity and equipment – while providing enough economic boost and freedom that there is hope among the public of a positive lifestyle and so bringing along public consensus. As ever a balancing act – which is the story of CV. 

To date UKGOV communication using the simple message of “stay at home – protect the NHS and save lives” has instilled enough fear and belief in the message’s importance, bolstered by death tables and stories of grief, that the public has been in general willingly compliant. If anything, given who CV mostly adversely affects, too much fear has been engendered and that could be a restraint on people getting back to full productivity.

The new conversation pitches the dangers of CV against the huge cost of UK having halted in its tracks, backed by a UKGOV money tree which will ultimately be a long-lasting yoke around the growth neck of the UK. UKGOV and its advisers recognised from the beginning that there is only a limited amount of time for which a lockdown will hold. There is a mood developing that as ideas like “excess deaths”, bankruptcies, non-CV patients missing vital hospital treatments, mental as well as financial damage, domestic violence and children suffering  gain more prominence, the fear of CV will be outweighed by fear of no hope for the future. On the other hand, it is becoming generally accepted that, until there is a vaccine and the populace has been inoculated, or drugs to alleviate CV are found to work, UK life will have to be adapted considerably to deal with it.

SCIENCE WILL INFORM NOT DECIDE THE RIGHT TRACK

 Science will provide the pharmaceutical solution, if any. However, UKGOV has been consistent in communicating that it “follows the science” or “is guided by the science” in its decision making. Again, that has lent credibility. Perhaps there is a change developing as Boris Johnson in his return speech on 27 April used the phrase “informed by the science”: that is a more appropriate term as it implies no hiding behind, or decisions being driven by, the science. The decision to modify the lockdown, to allow more activity within limits, will be a judgement call which is informed by, but not made by, the scientists. And it will not just be one science that will be in the mix, but many sciences: medical, statistical, epidemiological, psychological, behavioural, economic and financial, and the science of practicality and common sense. It is to be hoped that political gaming will be excluded.

The word “science” has given decision-making an air of mystical authority, as scientists stand and deliver their answers alongside ministers, demonstrating a unified approach. For most people science is for the clever amongst us, a world apart, which normal people cannot debate with. It could however be a big mistake to think that science is always about absolute truths – either right or wrong answers, particularly in this situation. Chris Whitty and the like have been clear that science is not all knowing – it is a state of knowledge at a point in time based on information then available and past experience; but it is also a moving dynamic target, a journey of exploration. The science around CV and how to deal with it is in the second category. What was accepted as science 100 years ago is very different from that accepted today. The science around CV 5 months ago is very different from that today as knowledge builds daily, and there is a lot more to learn. New knowledge may make past decisions regrettable, though fully justifiable by the science at the time.

Any judgement call to try to kickstart life and take the right track will be based on imperfect knowledge and everyone needs to accept that. It is common, though ridiculous, for journalists to ask politicians for guarantees about the future; guarantees as to the future are impossible and never more so than with CV. 

UNITY

Unity of purpose and goodwill in the UK has to date been critical through the behaviour of citizens and the framework for that behaviour provided by UKGOV. Decisions to move forward will need to be designed to promote and reaffirm that unity and not create division. Boris Johnson has promised transparency, a sharing of thinking, involvement of all stakeholders, including other political parties, and of the data and advice behind the thinking. That promise must be kept.

The British public must receive reliable and complete information, presented in an understandable form, so that they make the right decisions to meet their individual circumstances, needs and characters, and having regard to the collective interest. Each person needs to be able to assess risks against their own life criteria. In their judgements too will be a responsibility to others: with freedom comes responsibility.

In that vein, it is right, for example, that society seeks to protect the vulnerable (of whatever age), but equally those vulnerable people who are capable of making a choice must be free to make that choice responsibly. There is a debate acquiring currency over whether people by virtue of their age, while others may be freed up, should be kept isolated indefinitely for their own good – or imprisoned they may say? It may be, for example, that obese people of any age are more at risk with CV than say fit 75-year olds, but obesity is unlikely to be criteria for defining a regulated category. In deciding modifications to lockdown, perhaps ageism needs to be avoided. 

COMMUNICATION

Communication of any decision to retain or loosen constraints will be critical. New catch phrases may be adopted. Media responsibility will be key (see https://sherbhert.com/covid-19-silent-soothsayers-secret-accusers-junk-journalism/ ). A lot of responsible journalism enhances the debates and informs the public. Other presentations seek sensationalism and point scoring over the public interest of mitigating the effects of CV, direct or indirect. A good test will be the journalistic reaction to the results at the end of April of the daily level of CV testing as against the ambitious, and generally considered too tough, target of 100,000 set by Matt Hancock.

If the Target is missed, say by several thousand, will there be headlines of another failure or “too little too late again”. Will there be calls for resignation? Or will there be relief that so much testing is being done and the trajectory is good. If the target is met – at least with capacity if not actual tests – will there be cries of congratulation, or accusations of manipulation. Will focus be on the target or the interests of the public? An interesting watch to be had, whether of broadcasters or newspapers or social media. The BBC have daily been emphasising how far from the target of actual testing the NHS seems to be. A guess is the reaction will, for some, be guided by political prejudice and pet hates, not the state of the battle against CV for the British public.

That UKGOV should have an “adult conversation” with the British public has been a common refrain. Conversations are two way. If the media partly represent the public, their adult behaviour will be welcomed. In any event, UKGOV’s communication of any new measures and their rationale will need to have credibility, honesty and determination, with a hopeful objective and message that people across the UK from all sectors and backgrounds can associate with and recognise as sensible.