LIVING WITH COVID
Europe has been shedding Covid-19 (CV) restrictions for some time, even though concerns are increasing about the Delta variant: its prevalence is not totally appreciated as Europe’s testing levels are a fraction of the UK’s. However, the Financial Times of 12 July includes expert quotes that lockdown restrictions should not be required again in Europe, as the level of hospitalisation and deaths is manageable.
The only route out of Covid serfdom in the UK is the amazing vaccines. They have been proved to work against all known variants to an acceptable level: that one day a problematic variant may emerge, in theory, cannot justify excessive caution as there is little point allowing theoretical issues to drive draconian and damaging restrictions. It has always also been made very clear by UKGOV and scientists that no vaccine is 100% effective – the vaccinated can still catch CV, and in some cases with bad symptoms, but hospital treatment is low risk and death very low risk for most people. It remains the case that the very old and those with underlying health conditions, especially the obese, are at greater risk than others: true of a lot of diseases. It is astonishing that people are heard being shocked that they may have had double vaccination but still became infected, such as even an intelligent man like Andrew Marr bemoaned on his own programme a few weeks ago.
For months the necessity to learn to live with CV has been propounded as the only way to go on living in a social world as normal people must do, mixing, travelling, and gathering. Chris Witty and others keep saying that living with Covid means accepting a level of deaths at its hands, but a number cannot and should not be put on it. A new attitude needs to embed itself which mourns deaths but does not let them destroy living. This means not taking extreme and highly damaging measures such as lockdown.
It has been noted before in Sherbhert that some 150,000 deaths a year in the UK are attributable to cardiovascular issues, and 80% are considered to be avoidable medically, because so much of such disease is caused by bad lifestyle, such as poor diet and failing to exercise even a little. The victims are not confined mainly to 82 years old or more. That means that UK society has been willing to accept for many years disease-caused deaths in large numbers without imposing drastic measures to curtail freedoms (e.g., by banning highly processed food and drink, designed to leave the consumer wanting more). The lockdown measures imposed during the pandemic were unique in their denial of free choices to ordinary people: and now that CV is reasonably well, if not totally, understood, that denial can no longer possibly be justified. It surely is unacceptable to require the fully vaccinated to isolate for any reason whatsoever, unless they actually have CV, as there is no other release trigger than vaccination available.
For months scientists have emphasised the damage caused by lockdown, particularly to children in a massive and possibly long -term way: many people have become frightened, skewing their behaviour. The economic effects are long-term and will be painful. Yes, the young can still catch CV and can die from it – but the odds are very low indeed and there are far more risky daily activities accepted in the normal course quite rightly: learning to assess and take risk is fundamental education. It is to be hoped that resilience will grow out of CV more than diminish for the young – but it would help if they saw good adult examples instead of fear in the eyes and sucking of teeth around relaxing restrictions. Certain scientists believe the damages of lockdown are considerably greater than Covid caused damage: the only real measures of CV effects are cases (now fairly irrelevant given the rate of testing and its predominance in the unvaccinated), hospitalisations and deaths. But the medical effects alone of denying medical assistance to so many during the pandemic are tragic: Sajid Javid, now Secretary of State for Health, has just estimated a backlog of 13 million untreated or undiagnosed patients, including swathes of cancer patients.
The biggest driver of draconian restrictions has not been the number of deaths. The test of “living with Covid” perhaps is not some arbitrary number of deaths, many of which are of people on the verge of dying anyway. The real worry and test have been that the NHS must not at any cost be overwhelmed, which perhaps defines the level of deaths to be lived with. It has not been overwhelmed.
RISK-LIVING IS LIVING
Nobody argues that vaccines are failing, on the contrary. Indeed, in the Financial Times of 12 July, the head of private equity in Europe for Blackstone is quoted as saying that it is the UK’s pro-business environment and confidence driven by the rapid UK vaccine roll-out that are among the UK’s attractions for investment, as the private equity world piles into the UK. UKGOV is right to decide now that legal restrictions must go, and it is for individuals to decide now the level of CV risk they will accept and what mitigants and disciplines they will self-impose, such as mask-wearing and going to crowded places like night-clubs. No doubt some will be more thoughtful towards their fellow humans than others. Some scientists and others want lockdown restrictions to stay but they offer no real alternative freedom option as they are driven by risk aversity. That aversity will hold back all human development, and it is the ability to live with risk and, if necessary, learn and adapt when mistakes are made that really make people succeed. They argue that individual choice affects not just the person but those around us, particularly as infection may be passed. But all human behaviour and activity affects other people, sometimes adversely; nothing new with CV.
Counting CV infections needs perhaps to no longer be a public exercise on a daily basis, so that people stop obsessing. Vaccination passports may be needed, not because they have some intrinsic merit; but because so many people fear CV is carried by others and may forego an activity (e.g., at social place) unless made comfortable that it is reasonably safe. Businesses and organisers may impose behavioural requirements as a condition of public participation, to maximise customers for example. People who choose not to have vaccine may miss out: but that will be a consequence of their choice, the exercise of their freedom, which must be respected. It is not unusual for people to suffer adverse effects from their free choice, the great liberty and privilege of a free society. For some people, vaccination may not be a real option for say health reasons and these people need special care: not a problem unique to CV.
Those who accuse UKGOV of recklessness or similar crimes in experimenting with the return of freedoms only have a point if UKGOV is acting in bad faith and without a reasonable basis. There are plenty of scientists as well as economists and social commentators who consider the decision justified. Indeed, if not now, then when, is a good question. The approach of loosening restrictions is reflected throughout Europe. If much of the UK public is nervous and fearful of becoming free, so much more is leadership to defeat fear required at Government level.
BITING THE NHS FUNDING BULLET – A GOLDEN OPPORTUNITY
If the NHS is never to be overwhelmed but is to continue to serve people with conditions other than CV, or in the case of another pandemic a new disease, is not some major change required? After all, a winter CV or flu surge is touted as a real possibility and lockdown must surely not be a real option again. Perhaps “covid only” hospitals are needed, like the nightingales but with fuller ICU competence? Being pandemic-ready generally with the necessary health preparations will add seriously to health budgets. Even pre-covid there was never enough money for the NHS: its capacity to gobble cash, and its special politically untouchable status, created by abuse of emotion attaching to this institution, is legendary and never ending. Social care is to be allied closer to the NHS and the cost of that is still unknown as is the detailed policy. What is certain is that the cost of the two together on an ongoing basis is simply unaffordable if it is all to be funded out of taxes, when all other public services and financial stimuli necessary to kickstart the economy and poorer regions are taken into account. This is particularly so as UKGOV is overspent and overborrowed due to its bail out of the economy due to the pandemic.
Few would argue that certain European countries do not have superior health care services, for example outperforming the UK on cancer treatments; and France and Germany, to name just two comparable economies, fund their health care with a combination of taxpayers’ money and insurance, that is private funds. While the dedication and selflessness and kindness of so many individuals who work in the NHS is unquestionable, as an institution it cries out for improvement. Many a health worker deserves better remuneration, and that in turn would attract more capable people into the service, and so improving working conditions and care quality. UKGOV has the perfect opportunity to open up the debate about how to fund UK healthcare and needs to have the courage to persuade the public that an all-party discussion is urgently required with no options off the table. With the right communication, will not the public see the wisdom of this? Those who see the NHS as a political weapon will cry that this would be the start, or continuation of an ongoing process of privatising the precious crown jewel that is the NHS and will resist such a debate. But they will not be serving the long- term interests of the UK. The deification of this man-made colossus is a massive error. A funding answer which combines the public purse, with private sector money, and the ingenuity of the financial services industry is urgently needed and is the only solution if the UK is to have first class modern health care for all citizens and provide more appropriate rewards for healthcare workers. To this end dogma has to be consigned to trash.
Funding wellbeing – including for the aged, the mentally ill and those who cannot provide for themselves – is perhaps, with education, the biggest challenge and opportunity facing the UK. For it to be a forbidden topic, an elephant in the media room, is both cowardly and stupid. The subject needs the dedication of the most creative minds, the most morally aware influencers and the cooperation of all people. The media, traditional and virtual, need to embrace the topic. Getting an answer that works will benefit all people in the UK, and all those who work in the NHS and care sector. The hand to mouth approach, moving from crisis to crisis and never-ending cries for more money that has characterised the financing policy, is a proven recipe for failure. Have Boris Johnson, Rishi Sunak and Members of Parliament with decent values got the necessary honesty and bravery to confront this issue, or will they muddle along in the weeds like their predecessors, of whatever political hue?
