In England 19 July is “Freedom Day” when most covid-related legal restrictions will be lifted in England. This was first trailed a couple of weeks ago, when the government billed it as a major step forward in the battle against he virus, and delighted lockdown sceptics, which include a substantial number of Conservative MPs. Alas it looks like heavy going for the government.
Freedom Day was originally billed for 21 June, but the government lost its nerve. At the time I defended this postponement, based on the government’s narrative that we were experiencing a race between the virus and the vaccine, and that the extra four weeks will allow the ever increasing number of vaccinations to slow the progress of the virus. Alas for my understanding of epidemiology. There is no sign that the level of vaccinations is having much impact on the spread of the new Delta variant, which is following a similar exponential path to the Alpha variant in the Spring. There is no sign of the vaunted herd immunity, so beloved of lockdown sceptics. Delta may be just too contagious.
Instead the government’s strategy, as originally explained by the new Health Secretary Sajid Javed, is to let the disease rip, and rely on the vaccine to keep people out of hospital, and so limit the stress on the health system. Mr Javid made no attempt to deny that infections would continue their exponential path, up to 100,000 a day and beyond. Reckless as this sounds, this is perfectly logical, and even shows a degree of leadership in the face legions of people urging caution of some sort or another. There has to be an endgame, and ours is based on a high level of vaccination, using the more effective vaccines, such as Pfizer, Astra Zeneca and Moderna. We only have to look at Australian, where Delta is breaking out into a population with a low vaccination rate. Australia had managed the disease by keeping people out, but failed to focus on the endgame, and messed up its acquisition and roll out of vaccines as a result.
But the government’s strategy had clearly not been thought through. This was evident from one of the goverment’s core arguments: “If not now, when?”, whose logic I find unfathomable. They seem to be hoping that the disease will burn itself out before the busy winter season, but it looks just as likely to make things worse. Two big problems have emerged. The first is the use of face masks. Some people can’t be vaccinated; others will derive less protection than the norm; many more (I have to include myself) are far from sanguine about catching the virus, even though double vaccinated. Even most vaccine sceptics have understood that some efforts need to made to protect the vulnerable – they just don’t want the tail to wag the dog, as they see it. Where this has come to a head is on mask-wearing. As we have better understood the virus, our appreciation of the effectiveness of masks in stopping the spread has grown. It seems sensible to most people to continue to require people to wear them in those public spaces which vulnerable people will find it hard to avoid. This does not include pubs and night clubs – but surely does include public transport and most shops. And the government yet wants to drop all legal requirement to wear a mask, and at first suggested that such matters could be left entirely to personal discretion. One Tory MP (admittedly not a minister) suggested that freedom from mask wearing was essential to getting people using public transport again – his argument seemly was that if we ignored the disease our worries would cease. Slowly but surely the government is being forced into retreat on this; by this morning they were suggesting that operators should use their powers to enforce mask -wearing on public transport. But the messaging has been fatally mixed.
And them came a problem with the NHS covid app, which pings people who have come into near contact (within 2 metres for 15 minutes) with somebody who has tested positive and tells them to self-isolate for 10 days. The government said that it was going to leave this in place until mid-August, when double-vaccinated people would asked to do a test instead. They weren’t very clear on why this delay was being instituted – I suspect it simply takes that long to change the app and test it. But the consequences look worrying if infections are likely to reach 50,000 a day next week, and 100,000 a day not so long after that. The opening up was supposed to help the economy to get moving again, but the projected volume of people being told to self-isolate will hit it right back down again, remembering that these self-isolation requests will tend to cluster in particular workplaces, the disease being what it is. The government’s response has been to suggest that it would de-sensitise the app, so that fewer people would be pinged – within one metre for 30 minutes, say. As a response to the virus becoming more contagious this is nonsense – it leads to the question of what they are hoping to achieve by keeping the app in being. And it points to an easy answer to the government’s “If not now?” question. Then again, if the government wants to let the disease rip and peak before the winter comes, won’t the app just slow things down? Unlike mask-wearing it looks an inefficient way of trying to protect the vulnerable.
The government have clearly thought a bit harder about ta third issue – the effect increased infections will have on the NHS. The link between infections and hospitalisations – and that to ICU usage and deaths – has been weakened but not broken. Hospitalisations for covid now seem to be doubling every month, and we can expect that to increase after the loosening up. The levels are nothing like those experienced in previous peaks, but the NHS is fragile. Backlogs are massive; there are press reports of staff leaving, exhausted after the pressure placed on them over the last 18 months. Given the quality of the government’s ability to think things through elsewhere, there must be a degree of scepticism that they have got their calculations right.
I am more sympathetic with the government on another widespread criticism: that loosening up increases the chances of a new and deadlier variant turning up. With the virus rampant in the rest of the world, where vaccination is woefully slow in many places, what happens in Britain will make little difference. Besides, scientists are reporting that new variations are repeating. The possibilities of new variants for a simple thing like a virus must be limited, so maybe the chances of a significantly more dangerous new variant are not as high as some people are making out. That’s a bit speculative, of course.
So the government is facing a sticky few months, when it will continue to be on the defensive. Other issues loom. The government plans to withdraw the fiscal support it is giving to the covid-stricken economy. This is bound to lead to hardship and criticism; it is also likely that the economy will start to slow as well.
A government that was well-led and with a core of first-rate ministers would command a lot more confidence. But this government cannot seem to think anything through properly and lurches from one crisis to the next. It will be determined not to reimpose lockdown. Twice before it has thought it could wether the storm without reversing course, only to U-turn in the end. What odds would anyone offer that this does not happen again?