A Test Of Resilience

I’m no expert on viruses, pandemics and health. I’ve a limited understanding of civil contingencies, emergency planning and resilience from my time with the police and from leading the city council (or as I remember it, the stuff of nightmares). You may have read enough on Covid 19 by now, or quite sensibly are choosing not to dwell on it. If so, scroll on.

I’m no expert on viruses, pandemics and health. I’ve a limited understanding of civil contingencies, emergency planning and resilience from my time with Sussex police and from leading the city council (or as I remember it, the stuff of nightmares). You may have read enough on Covid 19 by now, or quite sensibly are choosing not to dwell on it. If so, scroll on.

As much for my own benefit as anyone else’s, I’ve tried to think through where we are now, and balance the risks of what are clearly differing approaches to the pandemic.

Doing nothing is not an option. Left unchecked the virus will spike, health and public services will be overwhelmed, people in high risk groups will die in significant numbers and the economy and infrastructure will suffer critical damage with supplies of essential goods threatened. Consequences would be dire.

Most countries have, in varying degrees and via different measures, imposed restrictions on travel, gatherings and even going to work, the aim being to slow or stop the spread of the virus as far as possible. Even where infection rates are currently low, like Canada and New Zealand, measures have been tough and quick.

The argument against this is that with pandemics there is a risk of a second wave of infections, when lockdown measures can’t be sustained, with even greater levels of infection. People can’t work from home, have their kids home from school, avoid socialising and public events for more than 2 or 3 months, and even that is unprecedented and untested on a large scale. What will that level of isolation and inactivity do to people’s mental health and family relationships?

Here the strategy seems to be to allow a controlled spread of the disease, with widespread infection over an extended period whilst protecting vulnerable groups. Any “lockdown” measures are restricted to the peak of the epidemic. This allows the economy and “normal life” to continue as far as possible, and the theory goes that the population will develop a “herd immunity” to prevent a disastrous second wave in the winter.

Of course, with testing limited to those hospitalised, we will never know for sure if we’ve had it and therefore have developed an immunity. We won’t know the extent of infection and therefore the mortality rate will seem higher than it is in reality. As was said at the No 10 press conference this week, there may be ten thousand or more people infected in the UK at the current time. It’s a strategy replete with risks.

This is based on expert advice but doesn’t seem to match the global consensus amongst experts, or indeed World Health Organisation advice. To be fair this is the first global pandemic of this scale in living memory, well beyond SARS or Ebola. It’s been modelled and mapped, but every virus is different and mortality rates – the number of those infected who go on to die – seems to vary from 1-3% of those infected overall, to 15% of high risk groups infected. There may be no right answers, and every approach is still going to lead to hugely difficult choices on where to focus limited resources, bluntly who lives and who dies.

What seems clear to me is that by limiting the spike of infections now we buy time. Time to manufacture more respirators, create more hospital capacity, allow for scientific research into the genome of Covid 19, more time for the pharmaceutical industry to develop treatments and ultimately a vaccine. And most importantly time for our health services to cope.

Ultimately, the best advice I’ve seen is to behave as if you have the virus, and try not to spread it.

It’s not just the Covid 19 patients, but those who needed hospital treatment ordinarily, who will place pressure on a system where NHS staff are as likely if not more to get ill. Like all of us, they have no immunity to this new virus. I support the mandatory use of capacity in the private health sector, at cost to the government, as a way of growing overall capacity quickly in this national emergency.

Most people infected, particularly those under 60 with no underlying health conditions, will experience a mild illness and recover. What causes me most concern is the secondary effect of the pandemic. How resilient are we to deal with this? A decade of underfunding public services and local government, alongside the departure of many EU workers due to Brexit, has stripped out any “slack” in the system. What will happen if 20-30% of police officers, NHS staff, bin crews, care workers, food supply chain staff and others are ill at the same time? Coping with that may be possible for a month, maybe two, but how sustainable is it in the longer term?

People here are still out, doing the “keep calm and carry on” routine, eschewing the masks worn by many elsewhere, dismissing it as “just another flu” and talking about overreaction. Surveys show that alarmingly, many have not altered their handwashing habits at all. Sometimes British exceptionalism is dangerous not just foolish.

However, we’ve seen from the panic buying of the past week just how far the “Blitz spirit” is likely to turn out to be illusory. It’s really a wartime propaganda myth that masked some pretty lawless behaviour, if crime stats from the 1940s are to be believed. For a population used to supply on demand, shortages and privation may bite hard. There are people who phone 999 when their pizza is late and lose it entirely when KFC runs out of chicken. For others this will bring out the best in our community spirit.

Behind the headlines on the virus, the hit to the markets in the past week has been up there alongside the 1987 crash and the 2008 crisis. That won’t just matter to traders in Canary Wharf, it will hit jobs and families already suffering from a decade of austerity. Its likely foodbanks will see longer queues and fewer supplies to hand out.

Politicians don’t normally say things that people don’t want to hear. This week they have, most shockingly Boris Johnson’s stark warning about “losing loved ones”. There are trying to prepare people for something bad, possibly worse than they are saying now.

This isn’t a pandemic that will bring about some apocalyptic end to society as we know it, but it will combine with other pressures to have a significant impact. Once we get to the other side, things are probably not going to be exactly as they were before this virus emerged. We will probably see thousands of people die from this, and another recession, and maybe some consequences no one has really understood or foreseen yet. It’s going to be very tough, collectively and individually our resilience is going to be tested, but we will get through it.

Author: Warren Morgan

@warrenmorgan

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