EXIT STRATEGY?

The UK is beginning to wonder how we come out of Coronavirus quarantine.

Given the numbers of people still dying in the UK and how far we are from a vaccine being available, this may seem premature.

On the other hand it is way behind schedule.

Government has had a mixed game so far, engaging in a series of reflex reactions in response to the unforeseen consequences of the last announcement; overly casual at first and then Draconian. Then realising they had killed the economy and reaching for a bag of Keynesian measures abandoned since the 1970s.

We are left in a civil liberties wasteland, subject to the vagaries of each Constabulary’s interpretations of  swiftly passed and poorly scrutinised emergency legislation, with a stalled economy and no apparent consideration of how we get out of this.

Covid-19 is a serious, indeed fatal, disease and I have no desire to see SARS-CoV-2 spread. We couldn’t cross our fingers and hope, but what we are trying to achieve has not always been clear. Government has been both too bluntly honest and casually economical with the truth.

‘Herd immunity’ reduced people to ‘herd animals’ and they didn’t like the idea. Add to that the problem that such immunity is normally built up through vaccination and we don’t have any vaccine and it became apparent the phrase actually meant; catch it and survive. Which may work, but we didn’t know the mortality rate (getting a better idea now), we don’t know if or how many people retain immunity after first infection and it accepts an unknown number of deaths.

The government put ‘herd immunity’ out of sight for a bit and changed the emphasis to quarantine. Quarantine and ‘Flattening the curve’ was about reducing the numbers needing hospitalisation and intensive care at any one time to below the numbers of beds and staff available to treat them. It still accepted there would be deaths, but in manageable numbers and hoped survivors would be immune.

It appears Intensive Care Unit (ICU) availability is currently above demand, but to simply return to ‘as you were’ risks letting things run their course with no idea of how many people have had the disease and acquired immunity, and overwhelming the hospitals in phase 2.

We do however, need to find a way back to economically productive activity very soon, or accept a dramatically different way of ordering the world, a conversation I suspect no one is ready for at the moment, if ever. We shouldn’t accept, as certain leaders suggested, that the economy is the only consideration but it has to be a serious component of debate.

So what should we do?

The risk of dying from the disease if you are under 45 and have no underlying health problems is very small. Eleven out of the total c15,000 who have died in the UK so far fit those criteria. Each death is a tragedy, but in the greater scheme of things Government cannot destroy the future prospects of the whole country in a strategy which is not in any event saving everyone.

If we protect the older and vulnerable members of society while restarting the economy in a phased manner we can avoid the worst excesses of a major depression which itself may kill many people in the long term, and do just as good a job if not better of saving those who catch the disease.

As someone nearer the end of life than its beginning and with a tendency to heart arrhythmia, my self interest tends to favour the current UK strategy. But I am very concerned with what months of economic stagnation and the concentration of health services on one task may do to the future prospects, health and lifespan of the majority in the UK.

In a Utilitarian view have we so far got the balance right? The answer to me is a clear ‘No’.

I do not want to sacrifice anyone, least of all me, to this disease but we have to find a better way out of our current predicament than closing Britain for another eighteen months or so until a vaccine is produced. The Government is spending billions on supporting businesses and people laid off from work. How much better it would be to get the majority back into productive enterprise and channel some of that money into supporting the vulnerable in a selective manner. This doesn’t mean locking us away and forgetting about us. It means priority supermarket deliveries, support where required from social services and volunteer organisations, and phased reintegration with rigorous mass testing to monitor the spread of the disease and assess the possibility for further relaxations.

The NHS ICU facilities would of course remain for anyone, vulnerable or otherwise as required, but we could move to a more sustainable regime for the long term.

We need to move away from a climate of fear and start thinking about sensible ways we can learn to control and live with this until we can produce a vaccine and defeat it.

We also need to remember all the places in the world that don’t have our economic and infrastructure advantages, and consider how we can make ourselves more able to help the people in them, as well as helping ourselves. ‘No man is an island’ and in this case we really are all in it together.

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