Monday, 2 November 2020

The height of absurdity


How quickly time flies. It was just over a week ago that I suggested that the ‘Welsh’ Conservatives needed to be careful in their criticism of Drakeford’s firebreak, because their words would come back to haunt them when, eventually Johnson was forced to follow suit. It happened sooner than expected, but given that the announcement was made on Halloween, using the word ‘haunt’ looks rather more prescient than it ought to. It’s not the first time that loyal supporters of Johnson have gone out and robustly defended a policy only to find that it’s changing as they speak – and we can confidently predict that it won’t be the last. Somehow, his ability to use them as cover and leave them looking complete fools is a lesson which they seem incapable of learning.

The man himself was describing a further national lockdown in England as “the height of absurdity” just 10 days before announcing it, although by next week he’ll probably deny ever having said such a thing. The real absurdity, though, isn’t that England finds itself in a second lockdown but that, even now, the lessons from the first have not been learned, and government action is so inadequate that a third lockdown early next year is highly probable. Unless steps are taken to make test, trace, and isolate work properly, all the lockdown will achieve is a delay. And the test and trace system is currently a complete shambles. Most attention is focussed on the numbers of people being tested and traced, but that isn’t the real objective of the system – it is to isolate those who are, or may be, infected. Even if they managed to get the number of people traced up to 100%, unless those told to isolate then do so the exercise is pointless. Isolation seems to be the forgotten part of the system, but it’s actually the most important. Testing, tracking, and tracing does not prevent a single infection – it’s the isolation which does that.

There was a report a few days ago about the outcome of police enquiries into almost 6,000 people identified by UK Border Force as needing to self-isolate after arrival in the UK. Of those, only around three-quarters were abiding by the rules. 380 were not traced because they had given false details, and another 629 could not be spoken to ‘because they were out’. New arrivals in the UK are in a different category to those identified by the tracking staff, but it’s a reasonable assumption that similar issues exist. The truth is that self-isolation is largely optional and unenforced. Trying to ‘enforce’ it by imposing large fines on those caught is missing the point. Punishing the few who are caught doesn’t stop infections. Those countries which have most successfully controlled the virus have done much more to ensure that people actually do isolate themselves, and England is failing, badly, on this element. And, despite the Welsh track and trace systems being better and more effective than the English system, the Welsh government’s performance on ensuring isolation looks no better. Unless this is addressed before the end of the lockdown period, the virus will simply start to spread again.

There are two things which could be done to ensure greater compliance with the self-isolation requirement, and neither of them involve fines. Facilitating compliance with the rules is likely to be much more effective than punishing non-compliance. The first is to ensure that no-one loses out financially by following the instruction to self-isolate. And the second is to requisition some of the temporarily closed hotels and let people move into them for the necessary period, ensuring not only that they are properly isolated but also that their needs, including medical needs, are met.

The first of those is simply a matter of money. The Chancellor, time and again, has shown a willingness to create enough money to launch headline-catching schemes, but has always stopped short of spending enough to ensure that they are effective. It’s the worst of all worlds – huge expense to underachieve rather than spending a little more to get the job done properly. Their aversion to the possibility that anyone might get something to which he or she is not ‘entitled’ prevents them from ensuring that everybody else gets enough to do the right thing. Without proper financial compensation, people who are going to lose out, particularly if they’re already among the lowest paid, will find it difficult to comply with the need to self-isolate. Fining them doesn’t help.

The second would need to be voluntary; obliging people to leave their homes and stay somewhere else (even if it’s a nice comfortable hotel paid for by government) for two weeks does not sit well with our attitude to freedom. But other countries have taken the step, some of them only for new arrivals to the country, but others for domestic cases as well. It’s been suggested by one of the advisors to the Scottish Government as a response to the finding that many, or even most, new infections are happening in people’s homes. The question we should be asking is whether there is really an effective alternative which does not leave large numbers of carriers of the virus wandering around infecting others.

We can already be reasonably certain that some 10,000 to 20,000 more COVID deaths will be recorded between now and the end of the year, just from those already infected. How much higher than that the number goes – and for how long into next year we will continue to see high numbers of excess deaths – depends directly on reducing the level of infections. If governments aren’t prepared to take the necessary steps to stop transmission more or less completely, they should stop pretending that doing so is their objective, and admit that they’re only trying to slow the virus’ progress such that the NHS can cope.

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