Sajid Javid, the health secretary, had a bad weekend, issuing a grovelling apology after failing to realise that his Twitter message urging people not to “cower” from Covid-19 could cause offence. The verb “cower” leads to the noun “coward”, which is how thousands of people who have suffered bereavement or have shielded saw themselves being insultingly described.
Javid may be right in principle – if clumsy in language – to inveigh against indefinite “cowering” from Covid, now that the risks are reducing. But it is his government’s mixed messages and lurches from crisis to crisis that are failing so miserably to give people the confidence they need to come out of hiding.
After five years in the cabinet, I learned how easy it is to cause offence. And Twitter isn’t the best medium to communicate complicated messages and nuance. But what is being lost in the denunciation of the minister’s insensitivity is that he may have been trying to say something important.
Amid the communication failures, misjudgements and confusion, the government seems to be taking a distinctive approach to Covid-19 based on the uncomfortable fact (or probability) that the pandemic may continue in some form for years: a forever war. If that is the case, we have little choice but to find a way of “living with Covid”, even if that involves lifting restrictions amid rapidly rising infections.
There are, of course, so-called libertarians who have always regarded many of the pandemic-fighting measures as an intrusion on their civil liberties and who saw higher deaths and disease as a price worth paying to avoid the economic and other costs of pandemic control. This individualistic and antisocial approach is quite separate from what I call the fatalist view, which now lies behind the government “strategy”.
There are three main sources for this. The first is that even in countries such as the UK and Israel, which have been highly successful with mass vaccination, acceptance of the jab plateaus. There are those concerned that vaccination may pose more risk than protection in their individual circumstances (although The Medicines and Healthcare Products Regulatory Agency say the benefits far outweigh any risks). There is also considerable uncertainty about offering the jab to small children who contract the disease but do not suffer much from it themselves. There is also a hard core of anti-vaxxers and a softer core of sceptics who just ignore appeals and inducements to take the jab.
Secondly, even those of us who are double jabbed could potentially still suffer serious symptoms, although the likelihood is far lower. There is no absolute protection from the possibility of contracting and suffering badly, or even dying, from Covid.
A third factor is that this virus is spreading and developing new mutations. One of the most appalling failures of policy in rich countries has been the refusal to rise to the challenge of vaccinating the world. As a result, the virus will now spread with minimal control through Africa as it has through parts of Asia. There is already an Epsilon variant to join the Delta variant and the potential for others beyond that. Unless we choose to become a hermit state like North Korea or New Zealand, the UK cannot avoid it.
The implication of these trends is that we have to choose indefinite bouts of lockdown and isolation (with the enormous economic costs and the collateral damage in mental illness and interrupted schooling) or else accept that the balance of cost and risk of Covid has changed. Inevitably that means cases among the unvaccinated and unsuccessfully vaccinated will rise. So far, ministers seem to be choosing the latter option but have found no means of communicating the change in risk which has led to their new strategy.
The government could start by spelling out some of the consequences of trying to live without Covid. Australia and New Zealand were once seen as exemplars of good practice. But they have produced their own nightmare of total isolation from the world and the cruel consequences for their nationals stranded indefinitely overseas. China has also “succeeded” in beating back the virus but its draconian response to every outbreak and its self-imposed isolation depend on a level of social control which would not be accepted in the west. By contrast, Sweden, which has been treated as a public health pariah for its less restrictive measures, is now looking to be ahead of the curve.
Equally, ministers have to be straightforward about the implications – some of them quite uncomfortable – of trying to live with Covid rather than without it. The first is that we need to promote vaccination more aggressively. It is absolutely right that vaccination should be made a condition for work in settings where transmission is a particular risk as in care homes. France has gone further than the UK and we should be studying their experience carefully.
Nor do I see any objection in principle to asking for proof of vaccination or of a negative test, for admission to well attended “superspreader” events. There are practical problems around fraud and enforcement, and no one should be excluded from essential services like shopping for food. But nightclubs, music festivals and football matches are not essential services and could be subject to controls where it is practical.
And the next big vaccination event – an autumn booster combined with winter flu jabs for the vulnerable – should already be planned with GPs and chemists, and signalled to the rest of us. The impression among double jabbed individuals that they are “done” needs to be diluted.
Allied to the objective of returning to “normality” as quickly as possible is an urgent need to change the mass isolation policy currently operating (for those who choose to observe it) through the NHS app. The government is seemingly improvising from day to day but slowly realising that testing has to replace group isolation in the workplace and in schools. The same should apply to those who find themselves “pinged”.
Just as isolation for those who really have Covid, and testing for those who might, is key, mandatory masks are a critical part of the policy for the rest of us. I have never understood the strange psychology of those who have lived with major restrictions for months on their freedom to work, travel and socialise but absolutely draw the line at the very minor inconvenience of wearing a mask in enclosed spaces. If we are to progress to “living with Covid”, masks become more rather than less essential and moreover will be important for general public health: reducing the transmission of coughs and colds in the winter months.
“Living with Covid” isn’t the same as “letting it rip”, though it may well involve, for a while, growing numbers requiring medical attention, albeit with minimal fatalities. There was, earlier in the pandemic, a lot of planning around better cooperation between the NHS and the private sector, a real effort to separate facilities for Covid patients from those undergoing other treatment, and considerable other improvements in the way the NHS functions. With those measures in place, the NHS should not be “overwhelmed” even if it is stretched.
Opposition parties and other critics of the government have settled into a predictable routine of always calling for more caution, less speed and extreme risk-aversion. That may have been the right response earlier in the pandemic and it broadly reflects public opinion. But after 16 months it is right the government leads us away from lockdowns as a reflex to each new chapter in the Covid story.
To do that, ministers will need to foster a different kind of proactive state, with tough controls to facilitate normal life rather than to confine us from it. Insisting on masks, incentivising vaccination and making rapid tests the norm are all a part of that approach. Yet this government seems to have neither the political appetite nor the competence to deliver it. The fact that the leader of the opposition has now endorsed Covid vaccines or negative test certification for big events suggests he has grasped that we are now in a new world.
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