Broken Britannia Sleepwalks as the Pandemic Worsens

Photograph Source: Boris Thaser – CC BY 2.0

We are in a country where ministers priorities are “protecting” us from 60 migrants arriving on a dinghy rather than protecting the 200 of us likely to die from COVID each day. It’s utterly absurd.

– Adil Ray

Since mid-August, as many people in the UK have been dying from Covid every 2 weeks as usually die from flu in a year: that’s approximately 1,400 fatalities.

The UK now has one of the highest per capita infection rates in the world: 4 times higher than Germany, 9 times higher than France, and 25 times higher than Spain. Last Thursday the UK recorded more than 50,000 infections in a single day, a higher number than the figure for Germany, France, Italy, Spain and Portugal combined.

The government delayed vaccinating secondary school students, and by the start of October 1 in 20 UK schoolchildren were Covid-positive. The majority of UK Covid cases comprise unvaccinated under-18-year-olds.

Already, before winter exerts its grip, the NHS is struggling to cope with hospitalizations – 1 in 5 ICU beds are occupied by Covid patients, at a time when the NHS is facing a backlog of more than 5.7 million delayed cases, many requiring surgery. Urgent cardiac or major bowel surgery, say, can’t be conducted because these patients will need to be in an ICU for the initial part of their road to recovery.

Boris “BoJo” Johnson, ever the incompetent but upbeat carnival barker (nicknamed “Bertie Booster” in some social media circles, after the hapless Bertie Wooster in P.G. Woodhouse’s Jeeves novels), has done virtually nothing about the pandemic since abandoning nearly all Covid restrictions after proclaiming “Freedom Day” on 19th July.

Like most Tory MPs, BoJo is hostage to the libertarian wing of his party, which resulted in only one Tory MP (the former prime minister Theresa May, who is diabetic) wearing a mask in the crowded chamber during last week’s Prime Minister’s Questions in the Commons.

One such headbanging libertarian Tory MP, Des Swayne, a bank manager before entering politics, declared masks to be completely “useless”, prompting one political commentator to observe that Des is just the kind of guy who would relish having open-heart surgery with an unsanitized saw.

The soaring number of Covid cases is primarily a problem for England, since Scotland and Wales– led much more competently by their respective chief ministers, Nicola Sturgeon (Scottish National Party) and Mark Drakeford (Welsh Labour)— have from the start, unlike BoJo, adopted an unflamboyant but more effective “best practices” model for dealing with the pandemic.

Herein lies the rub for BoJo and his fellow Tories.

Experts are generally agreed that there are 2 approaches to managing diseases that can develop into a pandemic: (1) tech-based methods (as in the futuristic insertion of a fluorescent protein gene (GFP) into someone’s DNA that will make their harmful bacteria glow under UV light (thereby facilitating the detection and potential elimination of the bacteria); the current “vaccination alone can take care of the Covid pandemic”, etc.), and (2) community-based approaches (where health is viewed broadly in terms of social conditions, such as public health measures to mitigate risk, housing, poverty, sanitation, education, inequality, work conditions, nutrition, etc.).

The community-based approach is typically augmented by the so-called “Swiss Cheese Model”, according to which optimal risk management can be likened to placing multiple slices of Swiss cheese (with their characteristic holes), one behind the other, so that the risk of a threat becoming a reality is reduced by the differing layers forming a compound shield. No one layer offers complete success, but when conjoined they reinforce each other.

Obviously both approaches are needed in the case of a major pandemic such as Covid, but the crackpot Tory notion that vaccines alone will take care of everything related to Covid, so that all else becomes mere “personal responsibility” (aka a free for all), is tragically irresponsible.

Vaccination alone will not keep Covid in check, as the UK has shown.

Immunological studies estimate that individuals immunized against Covid would lose about half of their defensive antibodies every 108 days or so, necessitating booster shots. The UK had a successful vaccine roll-out early on, but “immunity loss” over time has meant that a larger section of the population has now become vulnerable. Vaccination is essential for reducing infection rates, hospitalizations, and the incidence of mortality, but it needs to be accompanied by an array of public health measures.

The hope that the successful vaccine roll-out would buy the UK an extra couple of years or so as it dealt with the pandemic is turning out to be misplaced, largely because the Delta variant is much more contagious than its precursors.

Moreover, logistical problems are exacerbating this “vaccination only” approach.

As hospitals deal with growing numbers of Covid cases, NHS personnel are being pulled-back from facilities administering booster shots to work in their increasingly burdened hospitals. The administering of booster shots is slowing down as a result.

The Tory mantra is that we have to learn to live with Covid. Well yes, it is increasingly likely that we will have to, as Covid gives more conclusive signs of morphing from a pandemic into an endemic phenomenon (like the flu).

But it is a big and fallacious leap to say that “living with Covid” obviates the need for responsible public health measures (such as the measures taken when dealing with major flu outbreaks).

On 9 Sept 2021, SAGE (the UK government’s expert advisory body on Covid) was “very clear” that acting early was the best line of defence against Covid.

As happened during the major Covid surge in September 2020, the Tory government ignored SAGE.

“Clearly” the members of SAGE believe that what is happening now in the UK is largely preventable.

BoJo has however from the beginning played fast-and-loose with advice from his medical and scientific experts. Like Donald Trump, he’s always put political expediency above anything these qualified individuals have said to him.

At the very least, given SAGE’s advice, the government should now make mask wearing in public places mandatory again, especially on public transport, as well as mandating the cancellation of large indoor gatherings, and compelling companies to reintroduce the policy of allowing employees to work from home where possible.

Faced with Bertie Booster’s flippant approach to the pandemic, public health chiefs in England have departed from BoJo’s official guidance and are recommending immediate so-called plan B protective measures to deal with the Covid surge.

At least a dozen directors of public health (DPHs) have asked residents in their areas to reinstitute mask-wearing and working from home as protective measures.

The sad thing is that money is no longer the problem (the Tories have under-funded the NHS since they came to power in 2010) —even if the Tories made emergency funding available to the NHS as of tomorrow, there just aren’t enough personnel or assets immediately in place to improve or mitigate the situation. For instance, the NHS currently faces a shortage of 39,000 nurses. Hospitals have beds, but not the staff to deal with patients who could occupy these beds.

Last week, the Royal Cornwall Hospitals Trust declared, in a

much-publicized critical incident, that it had 25 ambulances waiting outside hospital Accident and Emergency rooms, carrying patients needing emergency treatment with nowhere for them to go.

The NHS lacks capacity needed to deal with the rising demand for its services during the approaching winter (this pattern occurs every winter, but will now kick-in at an unprecedented level), especially if the existing Covid surge takes another leap.

Even before the pandemic the NHS was experiencing cracks that the Tories did not fix.

Pro-Brexit Tories claimed mendaciously that Brexit would free-up money that had previously been sent to the EU as part of the UK’s membership levy, and that this could now be used to fund the required fixes. No such extra money has been forthcoming (at least not in the amounts touted by the Brexiters), and these clefts are widening as the pandemic takes its deadly course.

The Tory Plan A, relying on vaccination alone to allow society to function without restrictions, is palpably past its sell-by date.

It may already be too late for a Plan B, involving the reintroduction of a modicum of restrictions, in which case crucial decisions will be needed in the UK in the coming weeks.

However, as the director of a medical institute at Oxford University, Professor Jim Naismith, said: “In a democracy, politicians – not scientists – take these decisions”.

As some speakers of American English would say to Professor Naismith: “You betcha”.

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