Coronavirus: the debate that never was

09/04/2020

On the day that 938 hospital fatalities from Covid-19 in the last 24 hours were announced, I made the mistake of watching the BBC six o'clock evening news on the television.

The Corporation made the record figure its main item but quickly moved on to tell us the "good news" that the prime minister's condition was improving – as if there was some sort of equivalence between the two news items.

After the news of the PM's condition had been repeated five times, and the bulletin had degenerated into a sort of "social workers' gazette", long on human interest and distinctly short on hard news content, I gave up and switched the TV set off. The BBC, it seems to me, has lost any ability it ever had to offer a coherent news agenda, to the extent that one could even call it the Maudlin Times.

That said, the print media isn't much better, although all bar The Sun are at one in deciding on the most important story of the day – the almost certain extension of the lockdown, which will now stretch past Easter probably taking us into May before any relaxations are even considered.

The government has now got itself (and us) in a complete bind. Having rushed in to impose a lockdown after it became clear that the flu plan wasn't going to work on a SARS epidemic, it now has to confront the reality that the moment restrictions are lifted, we are likely to see a resurgence of the illness – assuming that we even see a downturn in the figures, of which there is no sign as of yet.

Total cases reported yesterday were 60,734, an increase of 5,492 cases since the day before, even though data from Northern Ireland, and test data from Charing Cross and Southampton, had not been included. Total hospital deaths are 7,097 on the official reckoning, but almost certainly higher.

As I recall, the lockdown was to be reviewed on 12 April, roughly three weeks after it had been imposed, when it was expected that we should be seeing some signs of the epidemic plateauing.

With that, there had been some slight expectation that there would be some easing, but a nervous government isn't anywhere ready for that yet. If anything, we might see a tightening of regulations and penalties, as the police express their concern about being able to keep the lid on the holiday spirit over Easter.

For the moment, though, it seems that we must be prepared for a stay-at-home Easter by which time, unless the disease trend slackens, we will be seeing a death rate in excess of a thousand a day.

There can be no dispute, however, that the longer the lockdown lasts, the more costly it will become. But what no-one can predict is what will happen on a personal level when people run out of money and credit and are unable to buy food or feed their pre-pay electricity meters.

It may take more than the threat of fixed penalty tickets to keep desperate people indoors. Whether the police can cope with mass civil disobedience remains to be seen, yet I cannot see the Army being called in to enforce public order. That could put us on the brink of revolution.

The big question, though, is how we get out of this situation and return to something approaching normality. For sure, as Pete observes, nothing is ever going to be quite the same again – not for a long, long time – if at all. And, as for the Brussels negotiations, the world in which Brexit was born no longer exists, he says.

Here, there are interesting developments. The EU itself is now of the view that it doesn't have the physical capacity to conclude negotiations with the UK by December. Johnson's plan to seal the deal by then is being described as "fantasy land".

What we need to see is whether a recovering prime minister is forced into an extended period of recuperation and excluded from the decision-making process. For that to happen, there might have to be a degree of formality in deciding on a temporary successor, with even a possibility of the Queen stepping in to relieve Johnson of his powers until he is pronounced medically fit.

Whether Raab – or some other successor – might then see sense is anyone's guess, but it is extremely hard to see how an agreement can be crafted when the post-Covid world will look so very different. And, given that the EU itself has not had a "good" epidemic, it will need a period of retrenchment before it is ready to entertain a long-term relationship with the UK.

Even then, that might be the least of all our problems. Although we are all living in the expectation that, sooner or later, there will be a vaccine to deal with Covid-19, it is by no means certain that it will provide a solution. Disturbing news from Shanghai hints at the possibility that exposure to the SARS-Cov-2 virus may not confer any lasting immunity, and that antibody production in humans can be very low.

That has profound implications for the management of Covid-19. On the one hand, it might not be possible to build up herd immunity in the population. On the other, previously infected people cannot assume they will be protected from re-infection.

Where there is now good evidence from Singapore that when lockdown restrictions are lifted, there is a surge in infection, it becomes clear that a new control paradigm will have to be sought – unless we are prepared to live with an epidemic cycle that claims an annual harvest of human victims.

Furthermore, there is nothing to suggest that Covid-19 cannot coexist alongside influenza, leaving us with the possibility of simultaneous epidemics and even the spectre of synergistic infection – where patients succumb to a deadly combination of both infections at the same time.

Assuming that we cannot live with a lockdown forever, and some semblance of economic normality must return, the government will have to return to the issue of testing and the ongoing isolation of cases and contacts.

This much was hinted at by Whitty on Tuesday when he told the daily press conference that the UK must learn from the German experience, where a high level of testing has been carried out.

One should not necessarily assume, though, that Whitty is undergoing a Damascene conversion. This might simply be an attempt at deflection – the sort of faux humility we get from the technocrats and the elites who prefer to define failure as "learning opportunities".

It is from there that we get the mantra that "lessons will be learned" from the failures, in order to ensure that they are never repeated. It will be some small consolation, however, if our technocrats and politicians learn lessons from a once-in-a-century epidemic, pleading that the mistakes will not be repeated in a hundred year's time.

Speaking of mistakes, there was an interesting intervention from Matt Cavanagh on Twitter, where he comments on the Reuter's report that I reviewed yesterday.

By no means well known, Cavanagh was an Oxford don who, during the periods of the Iraq and Afghani wars, worked as a SpAd for defence secretary Des Browne and then Gordon Brown.

His view of the report is that it has "depressing echoes" of the debate around the British military campaign in Helmand, where the officials and military were affected not only by groupthink but also by group or institutional "momentum", compounded by self-censorship.

It is one of the baleful consequences of politics and politicians being held in such low esteem, says Cavanagh, that the media discourages them from playing their full and proper role in policy formulation, until it is clear the experts are getting it wrong, by which time it is sometimes too late.

Our failure, on the Helmand campaign, he says, was not (as the media always assumed) that we were ignoring or overruling military advice. It was that we failed to challenge it, to interrogate it enough, to expose the differences within the expert community and have a proper debate.

The parallel with the current situation really stands out. You did not have to be an expert to realise that a plan devised for influenza was not necessarily going to work for SARS attributed to SARS-Cov-2, where there was no immediate prospect of a vaccine or any approved antivirals. At the very least, the politicians should have been far more robust in questioning the assumptions made by the experts.

With the epidemic still rampant and many technical issues unresolved, that proper debate cannot be long delayed. Whether our current politicians are capable of having it, though, remains very much to be seen.