Friday, 30 October 2020

A Covid surge wouldn't be the best Christmas present


Wales’ First Minister has supported the idea that the four administrations within the UK should develop a common set of rules governing the Christmas period. The idea seems to have started with the Lib Dems (which ought to be surprising given that they claim to be the party of federalism, both in internal party matters and for the UK as a matter of policy: federal freedom for each administration to make its own decisions as long as they all make the same decision seems more than a little odd). Whatever, in principle, the idea is sensible; but then keeping the four administrations aligned would have been sensible throughout, if only one of the four hadn’t decided that it was going to make rogue and reckless decisions and expect the others to follow.

And that brings us to the problem with the proposal – how do we decide which set of rules suits all four administrations if the position in relation to the virus is different? Minimising the premature loss of life would suggest that the common regulations should be as stringent as those set by the worst-placed administration at the time, whilst maximising opportunities for family gatherings would suggest that they should be set according to the needs of the best-placed administration at the time. In practice, though, we know that one of the four administrations – the biggest – will simply set its rules and expect the others to follow. Their idea of a negotiated agreement looks more like the dictation practice which I remember from my school days.

There’s still two months to go and a lot could change in that time, but, as things stand, falling in line with England doesn’t look like the smartest idea either Mark Drakeford or the Lib Dems have ever had. With its lackadaisical approach to taking action, England is currently suffering the worst surge anywhere in the UK. One study estimates that the number of infections has now reached 100,000 per day, and is doubling every 9 days – a rate of progress which would see a million infections per day by the end of November if more drastic action is not taken. Official figures are unlikely ever to record that sort of level – to record a million positives per day would require doing several millions of tests per day, well beyond any foreseeable capacity. Long before then, they will reach a point in England where most cases are simply going undetected.

Perhaps Johnson will come to his senses and act before England gets to that point, although his current stubbornness isn’t a good sign. It looks, rather, as though he’s resorted to a policy of herd immunity by inactivity. With a population of 56 million in England and a rate of infection of 1 million a day by the end of November, the number of people infected by Christmas would exceed the threshold (believed to be somewhere between 60 and 80%) at which herd immunity (if contracting the virus actually delivers immunity at all – currently a very large unknown) kicks in; there’d be few people left to infect. It’s no longer inconceivable that that is the deliberate policy of the English government. Any vaccine would be too late to have any impact.

There are two major problems with a policy of herd immunity. The first is that big unknown mentioned above – does contracting the virus actually deliver immunity at all, and if so, for how long? The second is that – and this is something that advocates of herd immunity aren’t very forthcoming about – pursuing such a policy in the absence of a vaccine necessarily results in a substantial number of premature deaths. That’s the way nature works; the vulnerable succumb and those that are left are those who withstood the onslaught. It’s not easy to put a precise number on it, of course, and numbers are very impersonal and abstract in any event: we're dealing with real people and real families here. Early indications were that around 1% of those contracting the virus died of it. Assuming that only 60% of 56 million are infected before the spread of the virus is checked, that would result in around 336,000 premature deaths. If the rate of 1% has been overstated because of undetected infections, and if we now know enough about treating patients to be able to reduce the death rate, then even if those two factors halved the number of premature deaths, we’d still be looking at reaching a total of 168,000 – more than an extra 100,000 from where we are today – in England over a period of a few months. And that's using the optimistic assumptions set out above  other scenarios are calculable.

I find it hard – extremely hard – to believe that even the current English government would seriously opt for such a policy, but their actions to date are not very reassuring. If they haven’t formally opted for that approach, they seem to be drifting into it almost by accident and paralysis. So, whilst I agree in principle with Drakeford about having a common approach over Christmas, Wales should be extremely wary about committing to following England (which is what it effectively means) unless and until the English government changes course. Otherwise, we’ll just be opening the gates once again and the pain of the current lockdown will have been wasted.

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