‘Stay the fuck home’. A less effective means of gaining general co-operation from the instinctively anti-establishment would be hard to imagine. How about you get the fuck out of my face? Our more formal UK government messaging has plumped for the ‘will-no-one-think-of-the-the-children’ emotional arm-twist of ‘Stay Home, Protect The NHS, Save Lives’. This appears at the foot of the rash of notices that has appeared all over my own rural region requesting people to approach a farm gate on a public path as they would open heart surgery, and disinfect or wear gloves before touching. After a day slapping cows’ backsides (I am hazy on the details of the profession!), it would be too much to expect farmers to take responsibility for their own biosecurity, and wash their own hands before dining.
The Government was almost begged by a large proportion of its citizens to imprison them. Their slogan (from the same people who gave us the infamous Brexit slogan-on-a-bus, a pledge they are now in a position to fulfil, but won’t) was taken up as a clarion call by the more rule-based sector of society. Cyclists, runners, walkers out for their ‘permitted’ daily exercise were branded ‘selfish’ for being out too long, too often, in too great a number. “Stay at ‘ome” grumbled one farmer, virtually the only person I saw all day. Inner city types sunbathing in parks were shamed by widely-shared long-lens Daily Mail pictures. You could almost see the Facebook squawk from space. Go for a run, you might as well stab a nurse.
Now after the second of two 3-weekly reviews, Boris Johnson announced on Sunday that we will begin to ease certain measures. The red border of the old slogan was replaced by green, the message now ‘Stay Alert, Control the Virus, Save Lives’. Facebook is furious again. Too soon. They’ve invested heavily in the notion that lives are lost in the act of leaving the front gate. Was the government lying then, or now? Some parents are adamant that their kids won’t return to school this side of a vaccine. I hate to break it to them that that could be years away, or never. The technology, RNA vaccine, is new, and carries no guarantees.
If ‘lockdown’ were a drug that deferred deaths but cost billions, rendered people unable to work or study and had significant further side-effects on physical and mental health, we’d want some clinical trialling done. Compare control groups with and without the intervention, before administering it en masse. Particularly if the only way to get off this addictive substance was another pharmaceutical intervention not even developed. If we shortcut that trialling process, then got something wrong, the consequences for society and confidence in vaccine in general would be catastrophic. But many people are vowing to stick with one untrialled intervention until another comes along, which they’ll seemingly grab both-fisted.
We didn’t have the luxury of trialling, of course. We had to do something to prevent health services being swamped. The government’s early plan was ‘herd immunity’ – a perfectly respectable concept already poisoned by anti-vaxxers, now finished off by attachment to Tory policy. I have learnt to be careful in my use of the term, to try and avoid those knee-jerk associations. Governments the world over, meantime, were administering ‘lockdown’ instead, in varying doses. Our own government, particularly influenced by Neil Ferguson of Imperial College and a vocal sector of our medical profession, did a swift one-eighty and announced our own resort to this new wonder-drug – in lower doses than France, which in turn took less than Italy and Spain. Sweden opted to be the control group.
But the longer we administer it, the more severe the side effects: the relationship is not linear. It’s not just a cold-hearted trade-off of lives for money. Lives are directly threatened by the effect of lockdown on mental and physical health, and economic downturn. Poorer countries tend to have worse healthcare. And in not circulating socially, the ‘learning’ process by which immune systems adapt to the common pathogens in the population is turned off – immunity is not gained solely by noticeable illness, and it isn’t inherited. A newborn gets a starter dose of antibodies through the placenta and in colostrum; after that, you’re on your own.
There are some offsetting benefits. There will be fewer road deaths, while some 40,000 excess deaths annually are due to air pollution – a cost in lives we don’t hear much uproar over; the uproar there is reserved for Greta Thunberg. The unprecedented clear air at the moment will save a significant number of lives, additionally improving outcomes in those catching Covid. And of course if the health service is less swamped, we get better outcomes generally. I must declare a competing interest here: my daughters are respectively on and near the front line. So the longer lockdown proceeds, the less they are threatened, but the longer till we meet again. My eldest soundly rejected my suggestion we meet up outdoors – despite agreeing the risk was minimal, she has seen too much suffering to contemplate bearing the burden of passing it to me, however remote.
There are two fundamental outcomes for a novel virus: eradication, or herd immunity gained through infection/vaccination. Much is made here of New Zealand’s success in eradication. They hit it hard and early; had all nations been able to do the same at a similar stage, we could conceivably be looking at global eradication now. Instead, New Zealand’s victory could prove Pyrrhic. For all the successes or failures of this or that government, the world has gone past the point of eradication. Each nation is surrounded by others; collective fate is sealed by the actions of the worst, not the best. Herd immunity is not a policy but an inevitable – and desirable – consequence of infection. Clumsy, poorly-led governments are moving slowly towards it, at great cost of suffering and lives. Those nations with the best early responses may yet have to bite that bullet, if a vaccine cannot be found, or remain sealed.