The UK Compared With Other Countries on the Pandemic

Photograph Source: Philafrenzy – CC BY-SA 4.0

As I write (the weekend of 30-31 May), the UK’s death toll from the COVID-19 pandemic has reached 38,489. Even the rightwing Financial Times regards this figure as an under-estimate, and says the actual toll is 60,300.

The Murdoch-owned Sky News reports that the UK’s population-adjusted COVID19 death toll has now overtaken Italy’s:

UK: 543 deaths per million
Italy: 539 deaths per million

The prime minister’s office used to include this comparison in its daily slideshow on the pandemic, but stopped doing so a couple of weeks ago— anything to avoid making the Tories look bad.

The UK’s death toll is now the highest in Europe, and the highest in the world after the US.

The pandemic not being over, certainty is in no way possible about outcomes, though even a rule-of-thumb approach indicates that some countries and regions have responded better to the pandemic than others.

The countries or regions generally praised for having the best practices in their responses are Germany, New Zealand, South Korea, Taiwan, Vietnam, and the Indian state of Kerala.

On the other hand, the UK, US, and Brazil are widely regarded as having delivered messy and hugely incompetent responses.

Kerala is an especially interesting case– with a population of 35 million, it had, as of the end of May, 1088 cases of Covid-19, 9 deaths, and no community transmission. There have been more fatalities among Keralites residing in the US (29)!

Kerala has a GDP per capita of only $2,688/£2,200. By contrast, the UK (with double Kerala’s population, GDP per capita of $40,450/£33,100) has reported just below 40,000 deaths, while the US (10 times Kerala’s population, GDP per capita of $62,308/£51,000) has over 100,000 deaths, and both countries have rampant community transmission.

Of the 28 Indian states, Kerala has the highest Human Development Index (HDI), 0.784 in 2018 (0.712 in 2015); the highest literacy rate, 93.91% in the 2011 census; the highest life expectancy, 77 years (exceeding that of Tennessee, Kentucky, Arkansas, Oklahoma, Louisiana, Alabama, West Virginia, Mississippi, and the District of Columbia); the lowest infant mortality; and the highest sex ratio, 1,084 women per 1,000 men.

Since its formation in 1956, Kerala has for most of that time been ruled by a democratically elected communist party, with a focus on land distribution, educational reforms, and a decentralized public health system.

Three days after reading about the virus outbreak in China, and before Kerala had its first case of COVID-19, Kerala’s health minister K.K. Shailaja met with her rapid response team. To quote The Guardian:

“The next day, 24 January, the team set up a control room and instructed the medical officers in Kerala’s 14 districts to do the same at their level. By the time the first case arrived, on 27 January, via a plane from Wuhan, the state had already adopted the World Health Organization’s protocol of test, trace, isolate and support.

As the passengers filed off the Chinese flight, they had their temperatures checked. Three who were found to be running a fever were isolated in a nearby hospital. The remaining passengers were placed in home quarantine – sent there with information pamphlets about Covid-19 that had already been printed in the local language, Malayalam. The hospitalised patients tested positive for Covid-19, but the disease had been contained”.

Kerala’s pre-pandemic measures helped when COVID-19 arrived– clinics and a registry for respiratory disease (a major problem in India) already existed. When the disease came to Kerala, each of its 14 districts was required to dedicate 2 hospitals to COVID-19, while each of Kerala’s 10 medical colleges set aside 500 beds, the wards having separate entrances and exits.

Those in at-risk groups– health workers, police, and volunteers—were tested regularly. While tests in the US and UK took 7 days to process, Kerala managed to do this in 48 hours.

In the expectation that there will an influx of Keralans returning home for their summer breaks from the heavily infected Gulf states (where large numbers of Keralans are migrant labourers), Kerala’s schoolteachers are now being trained to be contact tracers, and plans are being made to requisition hotels if hospitals are overrun.

Kerala will probably be placed by Trump on his list of “shithole” places, but it shows him and his supporters that there is simply no substitute for proper planning and a government reacting adroitly to events.

The contrast between what Kerala has managed to do, and the bizarre, because completely incompetent and negligent, responses of the US and UK is simply alarming.

Kerala, with vastly fewer resources, set out to save lives as its highest priority, while the US and UK swept these lives casually to the side.

The government of BoJo Johnson lurches from one promised “target” or “5-point plan” to another, with no thought given to adequate implementation, since it is clear that these targets and plans are somehow always “aspirational”.

The briefing rooms of BoJo and his ministers must reek of burning rubber, as one screeching U-turn after another is announced to reporters. The latest involves a £624/$760 visa surcharge foreigners working in the NHS and social care sectors have to pay to use the NHS themselves.

At the last prime minister’s questions before parliament’s late spring recess, Boris had been clear in his exchanges with the Labour leader Keir Starmer– the controversial fee was justified because of the financial contribution it made to the NHS, which BoJo estimated at £900m/$1,097m.

No mention was made of the real motive for the surcharge, namely, the “hostile environment” for immigrants created by the Tories in an attempt to pander to the anti-immigrant bloc in the Conservative party itself, as well as the xenophobic voters who provide the party with much of its base.

Two of the ICU nurses who helped get BoJo through the critical phase of his hospitalization when he contracted the virus are from overseas, and he even named his new-born child after one of them.

But BoJo is no stranger to such acts of brazen insincerity—surely it was more useful for the foreign nurses to not be fleeced by the organization they work for than to have the latest child of the priapic prime minister named after one of them?

This time, though, the vigorous pushback from all opposition parties and several of his own MPs was too much, and BoJo announced the next day that the surcharge would be abolished for NHS workers and care staff. At the same time, all other staff who worked for the NHS, such as delivery drivers and messengers, would still have to pay the surcharge.

Another decision made much too late is the imposition of a 14-day self-quarantine on all passengers flying into the UK, due to take effect on 8th June.

This should have been done in mid-February, with the quarantining of skiers returning from high-infection ski resorts in the Italian and Austrian Alps—so that together with a lockdown, also introduced too late at the end of March, a real difference could have been made in reducing the death toll and economic damage.

Also introduced much too late was a proper testing protocol. Early delays mean the UK has conducted a mere 10.13 tests per 1000 people, the lowest rate in western Europe. Italy’s rate is 32.73, Ireland’s is 31 and Germany’s is 30.4. Despite having only 103 COVID-19 fatalities to date, Australia’s testing numbers have been double the relative size of the UK’s.

Another fiasco involved the “test, track and trace app” said only a few weeks ago to be the key to easing lockdown restrictions, but which has now gone AWOL, as BoJo himself is prone to do.

The much-touted “test, track and trace app” (BoJo pledged to have a “world beating” test-and-trace system by mid-May) is no longer mentioned in the daily briefings on the pandemic– it became clear that this out-sourced operation was not training enough people to manage the system properly. The latest update says key elements of the app would not be fully operational until the end of June.

Meanwhile BoJo has decreed that most schools must reopen on the first day of June, app or no app.

As in the US, the death toll in care homes has been substantial and not really taken adequately into account. Numerous elderly patients in hospital with COVID-19 symptoms were released into care homes without being tested.

BoJo’s hapless health minister, Matt Hancock, simply lied when he said at a briefing that a “protective fence” had been placed around care homes. Unfortunately for him, he was tripped-up by his own paper trail. The UK government’s advice until at least 15 April: “Negative tests are not required prior to transfers / admissions into the care home”.

All this is on top of the failure to have adequate supplies of PPE for staff in hospitals and care homes, and the constant delays in developing satisfactory testing capacity.

Too little is done, too late, and the outcomes have been disastrous. Brits are having to endure a government in chaos, running its pandemic strategy (though in truth there isn’t one) like the proverbial headless chicken.

Hogging the headlines has been the revelation that BoJo’s chief adviser, the Rasputin-like figure Dominic “the Dom” Cummings, who many say is the de facto prime minister, drove his wife and young child 260 miles to his parent’s country estate a few weeks ago, while he and his wife were having COVID-19 symptoms.

The excuse made by Cummings is that he needed childcare in case he and his wife were found to have the virus.

The Dom’s parents are in their 70s and thus in a high-risk group for the virus. Cummings is a publicly declared eugenicist, so he should be commended for sticking to his principles on this issue by putting his own parents on the eugenics chopping block at the earliest opportunity.

What Cummings did was an obvious breach of the lockdown restrictions, though BoJo and several Tory ministers leapt to his defence—BoJo contending that Cummings behaved “reasonably and legally”.

There was however one bit of good news for BoJo.

A London police investigation into his relationship with an American “IT entrepreneur” Jennifer Arcuri, for whom he had been doing financial favours (to the tune of public funds worth £126,000/$154,000), and taken on foreign trips in BoJo’s capacity as mayor of London, had been postponed, conveniently for BoJo, until after last year’s December general election.

This week the police announced it was no longer pursuing this investigation. Luckily for put-upon Londoners, the London Assembly (dominated by the Labour party), which has oversight of the Metropolitan police, decided to continue the investigation on its own accord.

Clearly the London cops, already very controversial for their harshness towards minorities (among other things), opted for an easy life on this issue and punted the ball upstairs to their bosses in the Assembly. As police spokespersons usually say: we await developments regarding this case.

Kenneth Surin teaches at Duke University, North Carolina.  He lives in Blacksburg, Virginia.