Now is not the time?

This post was written before the Sunday Times article on 19th April, and has been slightly changed as a result. The most serious failings of the government were already known to anyone who had the inclination to look. Rather than looking at the time line, this piece looks at the types of mistake made. 

We keep hearing the phrase in the title (without the question mark), particularly but not only from those sympathetic to this government. Now is not the time to talk about what could have been done given hindsight. Instead we need to focus on saving lives.

You could see why this might be true. Resources are finite, and we would rather politicians were focusing on getting things done right now rather than defending themselves over past (in)actions. If you follow this line of thought you might even say that criticism could cost lives.

However there is an alternative point of view, which I find much more persuasive. If the government does not take the time to learn why it made mistakes in the past, it is in danger of making them again. Its natural defensive attitude means that these mistakes have to be publicly recognised at the time. To put it in a slightly more nuanced form, if past mistakes had come from a certain attitude of mind, a certain balancing of priorities, then there is the danger that these will continue to lead the government to make mistakes.

There is a second strong argument for thinking about the past right now, and that is because of calls by right wing commentators that suggest we have been too quick to impose a lock down. (Calls which, of course, takes no notice of the call to leave criticism until a later time.) In my view, and the overwhelming majority of experts, these calls are nonsense and should just be dismissed as another example of theory-based evidence exercises (see Jonathan Portes here, for example). But we know this government is particularly susceptible to arguments coming from this quarter.

We can strongly suspect that too strong a reluctance to close the economy down was an important factor in leading to the fateful delay in imposing a UK lock down. Here is the Prime Minister talking on 3rd February about free trade:

“when there is a risk that new diseases such as coronavirus will trigger a panic and a desire for market segregation that go beyond what is medically rational to the point of doing real and unnecessary economic damage, then at that moment humanity needs some government somewhere that is willing at least to make the case powerfully for freedom of exchange, some country ready to take off its Clark Kent spectacles and leap into the phone booth and emerge with its cloak flowing as the supercharged champion, of the right of the populations of the earth to buy and sell freely among each other.”

It is not hard to imagine how that same sentiment could have translated from trade among nations to trade within nations.

Of course he does talk about what is “medically rational”. But we know that the government ignored what was happening in countries all around them, ignored what many in the UK science community were shouting, ignored what WHO were advising, and planned to champion the idea that we could ignore the virus and allow economic activity to continue.

How many did that strategy kill? There are lots of different ways of doing the calculation: here is just one, powerfully written. But they all lead to the same conclusion. Most of the people who have died could have been saved if the government had locked down just 11 days earlier, when it abandoned its test, trace and isolate strategy. By most I mean something around two thirds or three quarters of deaths could have been avoided. By why just 11 days? We know that the government was warned by the team led by John Edmunds about the scale of possible deaths in the UK 4 weeks before we locked down. If the government had acted then, even more lives would have been saved.

When the government claims that the science changed, what it really means is that they waited until almost every single scientist was making recommendations it couldn’t ignore. It had been ignoring the UK scientists who had been imploring it to do something much earlier, and those in Italy who were saying how can the UK possibly be repeating our mistakes? It is very easy to imagine politicians whose priority was more about saving lives than protecting the economy would have acted earlier. Indeed we don’t need to imagine, because we can see many examples around the world.

Some say we cannot know for sure that the government has made a colossal mistake until a vaccine finally arrives, because a lock down that came too early might lead to dangerous second peaks. This argument doesn’t stand up, because the time before another peak might emerge can give us time to ensure we can control it. Our original attempt to test, trace and isolate didn’t work because not enough resources and subsidiary action was taken to allow it to work. By winter we can ensure that next time this isn’t true, and even if that regime fails we can lock down again quickly. The mathematics of exponential growth in cases means two lock downs imposed quickly always result in less deaths than allowing a delay of weeks before starting just one, which also has to last longer. 

Which brings me to the point of going over the mistakes that the government made now, which is to ensure they are not made again. If this government’s inaction, which led to most of the excess deaths the UK has seen, was influenced by a desire to keep the economy going, then there is a danger that it will end the lock down before an adequate test, trace and isolate regime is in place, or it will fail to take the necessary additional action required to make that regime work. It may even not try that approach at all.

But that is not the only mistake the government made. The second mistake was disastrous for those doctors, nurses and other hospital workers and their patients, and for those in care homes and those they are caring for. We know from his speech on 3rd February (and other information) that the government was well aware of a potential pandemic that could hit the UK. Whatever plans they may have had for dealing with it then, it made sense to take substantial precautionary action in three areas: to ramp up testing capability, to prepare for much increased PPE demand, and to order additional ventilators.

Even with a herd immunity strategy, the idea was to protect the vulnerable and elderly, and for that to be possible meant ensuring that those caring for them were regularly screening for the virus. Those carers would need PPE equipment along with hospital staff. More ventilators would be needed for sure. Whatever action was taken in February appears totally inadequate, as events have shown. As a senior department of health insider described to the Sunday Times:

“We just watched. A pandemic was always at the top of our national risk register — always — but when it came we just slowly watched. We could have been Germany but instead we were doomed by our incompetence, our hubris and our austerity.”

I have no idea how many in care homes have died as a result, or how many medical staff have suffered the same fate because of inadequate PPE. The fact that even now supplies of PPE are inadequate reveals a third failure made by this government, and that is a failure to get things done. That failure may stem from another, which is misplaced arrogance.

Arrogance that we are familiar with over Brexit. After all Brexit is the defining characteristic of this Prime Minister's cabinet. Arrogance that the UK would come to no economic harm while incomes were already at least 2% below what they might have been if the vote had gone the other way. Arrogance over how the UK would cope with a No Deal Brexit, and arrogance that persists with a failure to extend the transition period. The connections with Brexit, as David Edgerton suggests, may go beyond arrogance. It also seems from the Sunday Times article above that preparing for a No Deal Brexit also prevented some pandemic planning and training.

Arrogance, perhaps, that led them to ignore not once but three times the opportunity to benefit from an EU scheme on PPE equipment. Arrogance that led them to think they had no reason to make more precautionary purchases of PPE equipment than they thought they needed to allow for contingencies, or to expand testing capacity. And arrogance that required two studies showing the lives lost by their inaction before they abandoned their do nothing approach.

Let us hope no more lives will be lost because of the failings in our government in the next stage of this pandemic. But can we really trust a group of politicians that failed to act time and again, and whose inactions led to tens of thousands of deaths, to get it right during the remaining months of this pandemic. The signs are not good. Allowing your citizens to die in their tens of thousands because of their inaction is the gravest of errors a government can make, and perhaps the safest path ahead would be for this government to make way for others who are more competent.

But of course this will not happen.