There is an eerie sense of deja vu that the nightmare we experienced in March may be repeating itself. With the fears of an impending second wave, the dreaded R rate on the rise and strict restrictions being imposed, it all seems like we haven’t really made any progress in defeating the virus. The government has a monumental task this coming winter. They must balance the crisis of a peak in cases with the needs of a country that has suffered so dearly economically and socially.
The new “rule of six” – the latest measure to be implemented by Boris’ cabinet – limits how many people can socialise together at any given time. This reduces the maximum legal social gathering drastically from 30 to just 6. The government hopes this will reduce the spread, especially among young people, and will prevent a sharp peak from hitting the UK. Whilst the data does suggest that the R number has crept above 1 (estimated at 1-1.2 in England as of this week), it would be a mistake to directly compare the situation we are in now to how things were back in March.
The R number peak for March was calculated to be above 3 by Imperial College London. This means that although cases may be rising currently, this rise is far more gradual than before. The government is clearly concerned that if nothing changes then the epidemic will come back in the coming weeks and months. This however, is not at all a surprise and was always going to happen, even if it has happened a little earlier than expected.
The rise in cases must also be placed into context regarding risks to health. Overwhelmingly, it is now young people who are contracting the virus. Young people are at a much lower risk of becoming seriously ill. In places such as universities, where young people are held together and their socialisation is mostly limited to people of a very similar age, there is considerably less risk of the vulnerable being exposed to the virus than if young people are living in multi-generational households. Therefore, a level of herd immunity among students may be achieved without putting people at significant risk.
Some experts have warned that a spread of cases amongst young people will lead to a spread in the wider community and older, more vulnerable people will start catching the virus. Of course, as the number of cases rises, the risk of this does increase. However, this risk must be contextualised properly – we are not in the same position as we were in March. The NHS is equipped with sufficient PPE, sufficient ventilators and an excess of ICU beds. Furthermore, doctors now have some treatments that are at least partially effective, including the drug Remdesivir which reduces the median recovery time of hospital patients by 4 days and acts to reduce 14-day mortality rates of patients by 4.8% .We also now know which people are vulnerable to the disease. We know they should be shielded from transmission and that we cannot make the catastrophic error of discharging sick, elderly patients into care homes.
The result of all these improvements is outlined by Professor James Naismith of Oxford University, who said “We know that medical treatment and scientific advances have improved significantly, thus even with infection rates as bad as March and April, there will be many fewer deaths.” This must be taken into consideration when deciding what measures are necessary to control the epidemic. The R number has a long way to go before it hits pre-lockdown levels and even then we would not be facing the same mortality rates as we did in March. It must be put to the government whether all of the current measures, including the new “rule of six” are warranted.
The fact that the NHS is in a far better position to deal with peaks in cases is important to note because that was the Prime Minister’s primary focus at the start of the crisis. His message was “Save the NHS.” By this, he meant that the country had to prevent the NHS from being overwhelmed and prevent a shortage of beds/ventilators. It is obvious that the government knew then that this was going to be a terrible period of suffering and of unfortunate and untimely deaths. Boris even said in his speech announcing lockdown, “To put it simply, if too many people become seriously unwell at one time, the NHS will be unable to handle it – meaning more people are likely to die, not just from coronavirus but from other illnesses as well.”
It is probable that, alongside the usual flu season and a backlog of patients, the NHS does come under immense pressure this winter. However, given the improvements already made and the time government still has to prepare, surely it would be possible for the government to avoid an overrun NHS using more targeted and less severe measures, like banning care home visits?
This sort of response to a viral pandemic is a new phenomenon. The Hong Kong flu, otherwise known as the 1968 flu pandemic, was a brutal outbreak of the influenza virus. It killed between 1 and 4 million people worldwide . COVID-19 deaths are currently at around 920,000. Whilst COVID-19 has far from run its course, these two outbreaks are comparable in terms of order of magnitude. The response to the 1968 pandemic was almost non-existent, face masks were used sparingly and social distancing was not even introduced on a small-scale. Unlike the 1918 Spanish Flu, which was over a century ago and came at the end of a horrific World War, the 1968 pandemic is still in living memory of many of our parents and grandparents, and did not come at a time of a crippling global crisis. We have to ask, why is the response to the coronavirus pandemic so different? Have European governments panicked in the face of social media videos of Italian hospitals and inflated epidemiological models such as the disgraced Prof. Neil Ferguson’s?
Social distancing measures do help to stop the spread of the virus, but only with regards to buying time. The only way for these measures to prevent the virus taking its course through the population is if they continue indefinitely until we have an effective vaccine. Although there is hope a vaccine may become available in the New Year, there is no guarantee. If we are to continue with this level of government regulation for the foreseeable future, the level of damage to the economy, education and the nation’s mental health will only continue to grow. Moreover, there could be lasting effects on the public’s relationship with authority. After all this, the social distancing measures could only have achieved a prolonging of the pandemic, especially if by the end of Winter the virus has spread comprehensively through the population. So ironically the measures could lead to more harm being done in the long run.
Boris and his cabinet have shown that they are driven by public opinion: you only need to look at the absurd number of U-turns they have performed during this crisis to see the effect of public pressure. It is now time for the public, and young people in particular, to start demanding that the Government makes decisions where all age-groups are fully considered and the risk is looked at alongside the other needs of a now-struggling country.