The Coronavirus CrisisWe Are Right to be Concerned About the Government's Response
Mike Buckley explains how Boris Johnson’s administration has one of the laxest responses to the pandemic compared to other countries and believes it is unnecessarily putting lives at risk.
The Coronavirus is the biggest challenge we have faced in decades and our routines will be disrupted in profound ways. Our lives and the lives of our parents, grandparents and other loved ones are at stake. It is only right that we look critically at the choices made by the Government and those of other countries. The choices they make now will determine whether people live or die. There is no greater test of public policy.
The UK Government is making choices that deviate from the international norm. Among affected nations, the UK is all but alone in keeping schools open, not restricting access to or closing large sporting events and other mass gatherings. In most affected countries – many of which have imposed travel restrictions and lockdowns – there is a clear intention to limit infections and to protect the vulnerable but, in the UK, even the elderly are not currently being asked to isolate, while care homes have had to decide themselves to restrict visitor numbers.
What we don’t know is the rationale behind the Government’s decision to act slowly over the virus or whether it will reduce the number of deaths in the long-term. Opposition parties have asked ministers to explain why there is such a big difference in approach from the UK compared to other countries, but have not thus far received a clear answer.
Governments are not powerless. The choices they are making across the world are having a huge impact on the progression of the Coronavirus. Taiwan has successfully kept it under control using techniques it developed when battling Sars in 2003. China implemented draconian restrictions in Wuhan and the surrounding region and is now seeing cases drop dramatically.
More similar to the UK in size and status, Italy and South Korea both recorded their first cases in January. While both have taken significant measures to restrict the virus, the choices they have made have brought about wildly different outcomes.
South Korea is testing hundreds of thousands of people and using the results to track the infection, find people affected and isolate them. As a result, it has only needed to quarantine a few thousand people and only 67 have died. Its ability to track who has the virus, and their state of health also means that it is able to help hospitals to manage their pipeline of cases.
Italy is testing far fewer people. The result is that it can’t see what’s coming and is trying to curb the movements of the country’s entire population of 60 million people to contain the disease. Millions are locked down and more than 1,000 people have died. The virus has already overwhelmed health services, leaving doctors and nurses to effectively decide who lives or dies, given that there are not enough intensive care beds to go around.
It is Italy that provides the clearest warning to the UK, with the virus having overloaded its health system in less than three weeks. The lack of intensive care beds is of particular concern for the UK because we have comparatively low numbers of these beds per capita – 6.6 per 100,000 people to Italy’s 12.5 and Germany’s 29.2.
what the papers don’t say
We have lost half of our normal hospital beds since 1987 and currently have one of the lowest levels of hospital beds per 1,000 people – 2.3 – according to the Organisation for Economic Co-operation and Development (OECD), compared with 12 in South Korea, eight in Russia and Germany, six in France, 4.3 in China, 4.2 in Scotland, 3.8 in Australia, 3.6 in Italy, 2.97 in Spain, 2.96 in Ireland and 2.77 in the US. The UK now has fewer doctors and nurses per head than almost any developed country. It ranks second-worst with only 2.8 doctors and 7.9 nurses per 1,000 population – both well below the average for the 21 countries analysed. The average number of doctors per 1,000 population is 3.6 and the average number of nurses is 10.1. Switzerland has 18 nurses per 1,000 people – more than double the UK.
While most younger people are only mildly ill from the Coronavirus, those who become seriously ill need ventilation and intensive care to survive. There are more than 4,000 intensive care beds in the UK, but about 80% are currently occupied. Once cases of COVID-19 increase, the NHS will have to cutback on regular surgery and treatment to relieve pressure on intensive care – but there is clearly a limit to how many patients can be admitted into intensive care that will be reached very quickly.
Our chief scientific adviser, Sir Patrick Vallance, argues that the aim is for the UK to build up a “herd immunity” to the virus over time. But the only way to achieve this is for large numbers of people to become infected and it is difficult to see this as the best available response when resources are so stretched and the fact that one in five people may need hospital treatment, with one in 10 needing critical care. We just don’t have the ability to cope with that many people needing intensive care.
It is hard not to see a system made weak by a decade of underfunding and austerity, combined with ill thought through choices like scrapping the nurses’ bursary and the way that migrant workers have been treated through Brexit, leading to a net loss of NHS staff and fear for the UK’s ability to cope with a crisis of this magnitude. It is then also hard to look at the Government’s choice to be one of the most lax globally over mass gatherings, school closures, recommendations to work at home or for the vulnerable to self-isolate and to believe that this can be the best choice for the nation or for those most at risk.
A growing list of experts is calling for the Government to take more stringent action. Professor Graham Medley, Academic Chair of the Scientific Pandemic Influenza Group on Modelling, argues that people need to change their behaviour now, while the number of infections is low, because if we wait until the number of deaths rises dramatically many more will already be infected, some of whom will themselves die a month later. It will be too late.
We have real-time demonstrations of countries where the Coronavirus has been brought under control. We know that there are ways to turn this tide, giving more time to find effective treatments and, at some point, a vaccine. Given what is at stake – not only for those who contract COVID-19 but also for all those who will be denied care for other issues while the NHS is overwhelmed with the virus – it seems extraordinarily foolish not to try.