Covid & Getting the UK Back to ‘Normal’

China, the WHO, herd immunity, and planning a return to normal

There has been much debate in the media and online about the morality of the UK’s original herd immunity strategy as well as how and when society can return to a ‘new’ normal.

The U.K. should have acted faster on social distancing, stopping international travel, and advising on the use of non-medical masks in crowded places. This would have helped us flatten the curve early on. Now we are in a lockdown until at least the end of May.…at least.

Covid is with here to stay and we need to learn how to live with it. Most developed nations’ chief medical advisors have stated that 60%-80% of the population will eventually get infected with Covid, leading to herd immunity.

Thinking about how we can get back to normal while living with the virus is not callous or capitalist, it is sensible. Studying how countries like Taiwan and Singapore have managed to flatten the curve of Covid infections without closing their economies and societies is very important. This will be even more critical us as we learn to manage what will likely be subsequent flare ups of the virus over the next couple of years.

The research from Imperial College, that the UK government and now most of the world relies on, highlights that the aim is to flatten the curve not kill the virus outbreak. Unfortunately, the virus is out of the bag globally and can’t be put back. The actions of China and the WHO early on in this crisis made containing and killing the outbreak impossible.

From the very start of the UK outbreak scientists said we need to focus on flattening the curve to avoid health system overload. If you understand statistics, a flattened curve means the same number of people get the illness, but fewer sick all at once. This is a recognition that stopping the outbreak is not possible, but managing it is. The curve also demonstrates that the only way society will return to normal is for herd immunity through the spread of the virus and recovery and/or a vaccine.

The WHO is led by the former Minister of Health of Ethiopia, a dictatorship, where he reportedly oversaw and covered up three Cholera outbreaks. While he is a public health expert, he is not a medical Doctor. The WHO ignored the experience and advice of Taiwan who reported the outbreak early on and banned Chinese travel. The WHO was against travel bans that appear to have really helped some countries slow the spread. The WHO also praised China’s response all while China blocked WHO scientists on the ground for two weeks from visiting the epicentre of the virus. Sadly, due to questionable leadership, the WHO’s slavish praise of China, and some poor decisions early on, one can’t take the WHO’s advice uncritically anymore.

Going forward countries will need to invest more in their own pandemic monitoring and work with democracies to develop alternative monitoring and response organisations. Perhaps there is a role here for the G7.

The COVID virus can’t be quickly contained. The WHO and China made that impossible. If China had closed the city of Wuhan early, restricted travel during Chinese New Year, and allowed the WHO earlier access, the outbreak could have been localised. If the WHO had not downplayed the risk, advised against travel bans from China, and had pushed for outside scientists to access Wuhan, perhaps they could have slowed the spread of the virus internationally. Unfortunately none of this happened. Now, almost every country on the planet is infected.

Unless every human goes into lockdown for 14 days simultaneously, which is not realistic, the virus is with us.

When it comes to the UK’s current lockdown, it is not without social, medical, and economic costs. Remember all the commentators during the recent election screaming on social media about years of Tory austerity resulting in 100,000s of preventable deaths. These same voices are criticising the UK government for planning a way to get the economy and society out of this current deep freeze.

The question I now pose to them is — if stress, isolation, poverty, and unemployment caused deaths under the Tories, won’t these same forces, that are amplified during lockdown, lead to even more deaths?

This week, the NHS came out and said they are worried that people are avoiding required care due to Covid. This is something I did early on. I cancelled a scheduled cancer screen to avoid going into a potential Covid hotspot. The NHS noted a serious drop in A&E visits, more than expected from a lockdown. They suggest that people may be taking medical risks and avoiding seeking care rather than risking infection from Covid in a hospital. The BBC has also reported that most cancer patients have stopped their cancer care which can only lead in increased cancer mortality.

This current lockdown carries a great cost to society. Discussing ways to minimise these costs is not only responsible, but required.

While public servants continue to get paid, many people in society are not and government benefits are not fully replacing their lost wages. Public servants are also most likely to retain employment, while many businesses will struggle to continue on in a lockdown for an indefinite period, which is what some of those against planning for how we live with the virus appear to espouse.

How long can government afford even the limited supports being offered today? What about those who are not eligible for the current supports?

The UK government also needs to consider how poverty, joblessness, and isolation from a prolonged lockdown will impact social order in cities. A long hot London summer is ripe for social unrest and looting with mass unemployment, social isolation, and shuttered businesses. It is not unreasonable to expect riots and looting. Ignoring this risk is not responsible. The UK does not have enough police to manage the situation, just remember the chaos from the London riots of 2011.

How long will people living in inner flats live in isolation before there is unrest?

When thinking about how and when to reopen society some questions to consider are:

• If we had to lockdown for one year to ‘kill’ the virus would you do it?
• What about a lockdown for 18 months until we get a vaccine (if there even is one)?
• Or how about a slow opening up of society in early June with social distancing, contact tracing, and isolation of sick and vulnerable people meaning work can recommence and you can go out and socialise with some social distancing still in place?

Which of these three options would you choose?

Before you decide, don’t forget that for the first option to work the rest of the entire world would have to do the same at the same time or any sick future traveller at Heathrow would spark a UK outbreak all over again. That really leaves an 18 month lockdown, assuming a vaccine can be developed, or the slow reopening of society learning from the Taiwanese and South Koreans.

The slow opening option enables the economy to recover, people to socialise with some social distancing rules still in place, reduces the spread of the virus, and enables those needing Covid and non-Covid care from the health system to get it. It also prevents long-term negative economic impacts like joblessness, bankruptcy, poverty, and debt and early deaths from these factors. The government also avoids amassing enormous levels of debt.

Given we can’t kill this virus, we will need to learn to live with it in a way that minimises death and illness, social disruption, and economic breakdown. Planning for this is not reckless, it is essential. Here is hoping sensible minds within government and civil society start focusing on that.