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Excessive caution comes at a price
Written by Alex Massie
25 February 2021
The problem with experts is not that we have had enough of them but that the damned experts cannot agree with one another. If this were not so, the path forward might be easier at any time and, especially, now. For we are being reminded all over again that it is rather easier to enter lockdown than to leave it. And since it is not so very easy to enter lockdown, with all the restrictions on liberty, stress and misery it entails, that is saying something.
For much of this emergency, Devi Sridhar, professor of public health at the University of Edinburgh, has seemed the most influential academic expert in Scotland. She has fluently and plausibly made the case for what has become known as the ‘Zero Covid’ strategy. We should have moved much faster and much more decisively a year ago, but it is not too late, even now, to squash and squeeze the virus. Other countries, notably New Zealand, appear to have done so; Scotland can too.
Professor Sridhar appears to have the first minister’s ear. If Nicola Sturgeon remains reluctant to talk of ‘Zero Covid’ it is, nonetheless, an ambition she appears to share. That helps explain an otherwise apparently paradoxical reality: the virus is less prevalent in Scotland than elsewhere in the United Kingdom, which is precisely why Scotland’s emergence from lockdown must be slower, more tentative, more blinking-in-the-sunlight, than the liberation advertised and planned elsewhere. It is because we have come so far that we must stay wrapped up a little longer.
There is a logic to that, even if it is one unlikely to be welcomed by many and least of all by those involved in enterprises that have traditionally depended on customers to thrive. But if this is an ambition that cannot quite dare to speak its name, it might be wiser to level with the public. For otherwise, there is ample risk that the first minister, and her government, will try public patience beyond what it can reasonably be expected to endure.
And, as it happens, there are other experts too. Appearing before a Holyrood committee – not that one, the Covid one – on Thursday, Mark Woolhouse, professor of infectious disease epidemiology at the University of Edinburgh and, like Professor Sridhar, an advisor to government, disputed any suggestion that Scotland was ever close to eliminating the virus last summer. Reported case numbers might have been low; actual case numbers were likely rather higher. More significantly for our current purposes, “there appears to be no route, or at least no route that any country in the world has found, to get from where Scotland is now to where New Zealand is now. There’s no route there.” There might have been a year ago, but that was then, and this is now.
I am not an expert on these matters, but the Woolhouse thesis seems more plausible to me than Professor Sridhar’s exhortations. What is ideal is not always what is possible, and it is a mistake – a political mistake, I mean – to forget that.
All of which leaves us in a somewhat unsatisfactory position. This is a new normal to which we are all now drearily accustomed and the first minister’s announcement of her preferred route out of this winter shutdown was, I am afraid, rather unsatisfactory too. Yes, “data not dates” but if this is so, then what data and on what date might such numbers be realistically achievable?
Late last year and in the early days of this, the first minister acknowledged that the approval and deployment of multiple vaccines offered “light at the end of the tunnel”. Since then, however, and despite the undoubted successes of the vaccination programme, that light shines only a little brighter than it did eight weeks ago. The tunnel sometimes seems to be getting longer faster than the light gets brighter. In such circumstances, we may run very fast without getting anywhere appreciably useful.
And yet what is the point of inoculating the population if doing so does not allow for changes in policy? The suggestion that even a modest liberation – for level three restrictions are not the stuff of sunshine and dancing or the tripping of any light fantastic – must be postponed for another couple of months sits ill with the proclaimed success of the vaccination programme.
One may think this even while accepting that the first minister’s caution is not wholly misplaced. But the threat of new variants of the virus, while plainly real, cannot sensibly be used as an excuse for prolonging the population’s incarceration. We must deal with matters as they are, not as they might be. Where appropriate that might require new but local lockdowns amidst a more general return to something like the old normal.
For current policy is predicated on saving lives, not actually eliminating the virus. By the end of this month, something close to two million adults in Scotland will have received their first – and most significant – dose of vaccine. Current evidence suggests this will have a dramatic effect on rates of hospitalisation and death. From which it follows that while the virus will still be “out there” and some people will still perish as a consequence of contracting it, neither the health service nor society will be overwhelmed by it.
No-one wishes to be so blunt as to talk about an acceptable number of deaths but, deep down, we all know there must be such a number even if we might quite reasonably disagree on what it is. This, after all, is the approach we take to any number of other diseases or conditions. We know the health impacts of certain commonly enjoyed habits yet we do not prohibit – on any kind of universal basis – the consumption of tobacco or alcohol and nor do we mandate the taking of exercise at a level which might, if insisted upon, improve public health. We do not do so because, on balance, the price of such liberties, even if measured indirectly, is considered sustainable and appropriate. In like fashion, most of us do not, if we are honest about this, think it unconscionable that the NHS applies a quality of life, cost-benefit analysis when it comes to pursuing new or expensive treatments for certain classes of patient.
So, when Matt Hancock suggests that, in time, we must hope that Covid becomes something like, if still more serious, than the flu he is, I think, reaching an accommodation with reality. It is not as we might like it, but those are the terms of engagement nonetheless.
For all that Nicola Sturgeon has often shown an impressive grasp of detail and a fluent ease of communication these past 12 months, it is still the case that we do not, I think, know how she sees the endgame or what she would consider a success. Current policy, and current levels of ambition in terms of lifting restrictions, make plenty of sense given the current circumstances but, perhaps, rather less if we imagine the circumstances that may apply in four weeks’ time, let alone by the end of April.
Just as decisions on when to enter lockdown should be made before it is apparent you really, really need to lockdown so we may yet come to appreciate that it can be possible to prepare to leave lockdown in advance of the numbers justifying the decision to do so. If those numbers change then so must the policy, but present trends are, I suggest, more encouraging than the first minister allows. There is space for hope. And if there is light at the end of the tunnel, there is also some imperative to move towards it as rapidly as possible. No-one wishes to advocate recklessness, but excessive caution comes at a price too.
About Beyond the Street and Alex Massie
We are all guilty of being too inwardly focused sometimes, especially as we navigate these changed times. It is all too easy to be caught up in the problems close to home, and for overarching trends to pass us by.
To remedy that short-sightedness, Charlotte Street Partners has enlisted the ingenuity and talent of the writer and commentator Alex Massie. As our new correspondent at large, Alex will look at the bigger picture for us each week. We have challenged him to come up with something a bit different: broad, lateral thinking, thematic insights and a more global perspective.
Alex is a freelance journalist and commentator based in Edinburgh. Not only is he Scotland editor of The Spectator, but he also writes a political column for The Times and The Sunday Times. He features regularly on the BBC as a political commentator and has written in the past for The Telegraph, Politico, The Washington Post, the Los Angeles Times, The New York Times, the New Statesman, The Observer, and TIME magazine, among others. He was also the Washington correspondent for The Scotsman and assistant editor of Scotland on Sunday.
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