SAFETY FIRST
“No-one is safe until everyone is safe” is the current buzz phrase used to encourage the even distribution of vaccines against Covid-19(CV) between the developed wealthier world and more deprived nations. In fact, of course the principal reason for fairness is the moral imperative, not just the practical need.
The sentence “No-one is safe until everyone is safe” is also incorrect: it is clear from the scientists that vaccines are not 100% effective. Only one disease, smallpox, has ever been eradicated by vaccination, and leaders of healthcare systems are not espousing eradication, emphasising time and again that the world will have to live with CV as another of life’s everyday risks, but nobody will be guaranteed to be safe from it. However, the risks can be mitigated by behaviours and the consequences of infection can also be mitigated by remedies. The UK, once vaccinated, will still have to accept a level of deaths due to CV each year, with accompanying suffering just as with flu and other unfriendly bugs.
But the sentence illustrates well how embedded the obsession with safety is in Western societies, arguably to the point in some circumstances where it unbalances decision making and slows progress. There is a feeling or even a philosophy which seems widespread that all risk be removed, and absolute safety be guaranteed, even if other adverse consequences may flow. Perhaps excessive health and safety has long been the mantra of EU and to a lesser extent the UK authorities, and they have developed policies where they see themselves as the guardians of health and safety on the basis the public cannot have sufficient knowledge of risk to manage it for themselves. Total safety is impossible and every day the individual consciously or intuitively weighs risk versus benefits, whether in the simple act of driving, walking a street or letting children run around, let alone more complex decisions. That impossibility makes a philosophy of zero risk foolish. It will also restrain innovation, change, ventures to the unknown, experimentation and progress. A sense of proportion is required when comparing benefit or need against dangers. The precautionary principle which is at the heart of EU policymaking has reared its head excessively in the pandemic and disproportionate application of it has been destroying confidence, which is a vital component of recovery.
THE PRECAUTIONARY PRINCIPLE
This guiding principle of the EU seems to apply primarily to any new course of action which may carry a risk to the environment or health: if science is unable to show that the risk is not a concern, caution must prevail, and the course of action be rejected until science provides appropriate comfort to underpin a decision. It exemplifies the safety-first philosophy and passion for regulation which pervade EU decision making.
The application of the principle, too cautiously, to vaccination is arguably the reason for the failure so far of the EU programme. Perhaps also it has been invoked to justify why the behaviour and decision making has been appropriate, while the evidence proves that lives are being lost and will continue to be through bureaucratic ineptitude and mistakes. Their caution led to criticism of the quick approval of vaccines by the MRA in the UK while the EU EMA promoted its prudence but took several weeks longer to reach the same conclusions. The undermining over several weeks by senior health officials and heads of state, such as Emmanuel Macron and Angela Merkel, of the Oxford/AstraZeneca vaccine (OAZ), while it was totally supported as safe by the EMA, WHO and the UK’s MRA, has seriously destroyed public confidence in that vaccine on the continent: so much so that stocks lie unused. All the more amazing when the EU has ordered tens of millions of doses of the jab and the protection of their populace depends on it to some degree. Now a few (tens of) cases of serious blood clots in people who have had the jab has resulted in suspension of its use in much of Europe by national authorities while the EMA and WHO continue to assert that its benefits far outweigh the risks by far. Even if a causal link were to be found between the OAZ vaccine and cases of thrombosis, the cases are so few that benefits still far outweigh risk (risk of thrombosis being some 1:600,000), experts say. Driving cars does not get suspended because it is known thousands of deaths each year around Europe will result. Indeed, as regards CV, it is evidenced by analysis of UK data that many thousands of lives have been saved already by OAZ, far outweighing the few deaths from thrombosis, which deaths may have occurred vaccine or no vaccine.
CONFIDENCE WILL HASTEN FREEDOM
The pandemic has shone a light on the importance of balanced risk management, such as in lockdown versus non-lockdown. But not just at the Government level but also for each individual, assessing the application of guidance to their circumstance, weighing their susceptibility to serious CV against the risks to mental health and even health generally in deciding for example whether to seek treatment for non- Covid illness. Excessive fear has no place in that process, though it feels as if fear often unduly influences some Government decision making, when “damned if you do and damned if you don’t” is the situation. Those fears, for example of blame later for a mistake, are a damaging product of a blame led culture particularly in politics and the media.
Perhaps success in combating the CV depends on confidence, more than any other prevailing feeling or attitude. Where there is public confidence in government decision making and health advice, such as in the UK vaccine regulator, the MRA, implementation of their decisions and advice yield so much more success. While fear of death and illness has been engendered to underpin lockdown observance, it is confidence that CV can be defeated that will hasten recovery. That confidence of individuals in the UK is being demonstrated in how they have adapted their business models and innovated to still carry on while locked down, reducing economic damage. The behaviour of leaders in Europe, which creates the impression at least of a disastrous vaccine strategy and implementation, risks breaking confidence, as shown by German press describing their country, once renowned for and proud of its organisation competence, as a laughingstock for incompetence: it is to be hoped they can quickly reverse that trend and succeed, which would be in the world’s interests.
In the UK, particularly in the first half of the pandemic, UKGOV certainly lost a lot of the confidence of media, if not the people generally, as they tackled a virus which was barely understood by anyone in the West. Thankfully, the last few months have restored confidence through vaccine success and stronger and clearer communication of decisions and intentions. Of course, if vaccinations falter or cease to work, that confidence can be thrown into reverse. Delivering on promises is a powerful driver of confidence and that is what the vaccine programme in the UK is doing. The Times of 2 April reports business confidence at its highest for 7 years. Also on that day, the Daily Telegraph reported that lockdown had caused only a small, if any, reduction in the UK economy, thus proving totally incorrect the OECD forecasts of a 4% reduction and the UK recovery being the slowest recovery among its peer economies. Economic forecasters are reversing their earlier gloomy predictions for the future to a rapid bounce back story for the UK. There is a sense of optimism as Spring coincides with the first and second jabs. Hope is an essential ingredient of confidence, and that is bolstered by the statistics of reducing pain and suffering due to CV. It is regrettable the opposite is true in Continental Europe and a strategy to hasten their recovery needs pronouncement by their leaders. Of course, things can change as the one lesson that is clear is events during the pandemic are unpredictable.
There is little value or future in pessimism. Good leadership promotes optimism. Good risk management plus optimism engenders confidence. Accepting risks exist but embracing ambition and persistence to make progress are essential for confidence. Maintaining confidence in Government, scientists and oneself are core to the ongoing upward trajectory of the UK.
