On 22nd February, the government published its four-step roadmap to ease restrictions across England and provide a route back to a more normal way of life. Each step was to be assessed against four tests before restrictions ease, starting with the return of schools on 8th March. The Prime Minister was clear that the decision at each stage would be based on data not dates, and the government would move cautiously to keep infection rates under control.
Step four of the roadmap was to remove all legal limits on social contact and it was hoped that they could reopen closed sectors of the economy. The target date for this was 21st June. In fact, on 14th June the government announced that there would be a further four week delay and the new target date would be 19th July. It seemed clear this week that the Prime Minister is now minded to stick to the date of 19th July although he is getting advice from some of the scientists and other doctors that the rate of infection is rising too fast.
While the statement on 22nd February did say that the government would move cautiously to keep infection rates under control, they also said the decision would be based on data not dates and in my opinion that’s not true. When Step four was delayed by four weeks on 14th June at that point most of the data was highly positive as a result of the successful programme of vaccination. The number of hospitalisations is a fraction of what it was in January. Indeed, in January Covid-19 was the number one cause of death in this country. It has now fallen to the number 26 cause of death, at only 1% of total deaths. There are no excess deaths today, probably the most reliable estimate of actual deaths due to Covid-19. The top 12 causes of death are all connected with smoking and the single best advice that the government and doctors could give to the general population is to stop smoking. It is to the credit of the government that we have such a successful vaccination programme, considerably better than any of the EU member countries, because the government provided some seed money back in March 2020 when the Oxford University team asked Mr Hancock for support. That was one of his better decisions in his otherwise shameful record as Health Secretary.
The number of cases is rising but the average age of those affected is just 29 years old. One reason why the number of cases is rising is because the number of tests continues to rise. That is one of the few things that Donald Trump understood about this crisis - the more you test the more cases you will discover. The virus does not affect the young particularly badly and that is why hospitalisations have fallen so much. Also, the young have not yet been vaccinated but that is happening quickly which means that the number of cases will soon fall. Now that Sajid Javid has replaced Hancock, I believe we can look forward to a different kind of prioritisation in the management of the crisis. The crisis is now as much of an economic crisis as a health one and Javid is a successful businessman, experienced minister and a former Chancellor of the Exchequer who resigned from that role on a matter of principle, something Hancock wouldn’t understand.
Some scientists and epidemiologists seem to think we should aim to get rid of Covid-19 but countries like Australia that have closed their borders and enforced strict quarantines are still finding the so-called Indian variant has turned up. It seems probable to me that just as influenza circulates every year usually with new variants, so it will be with Covid-19. The emphasis should be on demonstrating that we have highly effective vaccines, encourage everyone to take the vaccines, and root out the evil machinations of those who spread false information, particularly in the disadvantaged community, that these vaccines are somehow dangerous.
I have often blogged about the problems of the NHS and I find it bewildering that something that is so flawed both in its fundamental principles and in its operation is seen as a sacred cow that cannot be touched or changed by government. However, various governments’ attempts to reform it have always had the disastrous opposite effect. What we need in this country is to replicate the competitive insurance markets that are successfully practised in countries like Germany where there is a principle that those who can afford to, should take insurance for their health, and pay enough for it to subsidise those who cannot afford to do so. When people say they love the NHS what they really mean is that they love doctors and nurses and other key staff who work on the frontline but much of the cost of the NHS is not them but the enormous bureaucracy that sits around and above them, much of it as a consequence of those previous so-called reforms. Much of Johnson and Hancock’s strategy was apparently to protect the NHS while the NHS is there to protect us.
I have made disparaging remarks about the epidemiologists. Hancock and Johnson often said that they are guided by the science. This is rarely true because the science is not clear. There is significant disagreement within Sage on a regular basis between the scientists as to what is going on. Their position has moved on many occasions as new evidence presented itself or is properly reviewed. I believe the epidemiologists should be under the same scrutiny as economists, but just as economic forecasts are usually wrong so are the forecasts by the epidemiologists. In some ways my analogy is not perfect because we have regular reviews of our economic performance, but a new epidemic does not come along every year. One thing is certain - that either this one will come along every year and/or a new one will present itself in the not-too-distant future.
The damage that has been done to the economy is enormous and many businesses have already closed and many more are on life support which may indeed be withdrawn by the government. The Treasury and the Department of Health need to prepare an economy that can respond if the virus does flare up again. The issue of homeworking is not something the government can simply leave to individual businesses though I do not mean that it should set the rules. But we do need to understand that some employment legislation will not be fit for purpose in the new environment of hybrid home and office working. I am concerned about those individuals who want to continue working from home having got used to some of its advantages like not having to commute, like saving money on transport and food, and having more time with their families. All of these things may be desirable, but it almost certainly means that their employers are losing something, whether it’s the creativity that comes from people working closely together, or whether it’s the culture that can be developed in teams and certainly not over Zoom. Indeed, I would expect some employers to say that if people are not prepared to come into the office to work in the cities, then maybe they will find alternatives are much cheaper in India.
The U.K.’s successful researching and licensing of vaccines and getting them delivered rapidly was indeed well done but I know that Dame Sarah Gilbert, one of the leaders of the Oxford team, was motivated by the desire to develop it quickly and will have learnt lessons with her team of how it could be developed and rolled out even more quickly next time. She and others should be supported in that endeavour. It is clear too that we need more capacity in vaccine production and key areas like PPE. We have made one important step which is to allow challenge trials, again ahead of other countries, and if we had had that in the first place, we perhaps could have had the vaccines several months earlier and if the production facilities had been in place, perhaps we could have all been inoculated by the end of 2020. In other words, we should not be resting on our laurels because we had a comparatively successful vaccine programme. We should be targeting an even more successful one for the next time.