Covid-19 Relaxation: Confusion Reigns Again

In another example of obfuscating what could have been communicated with much more clarity, we are now in the throes of the “relaxation period”. The UK government messaging, as we have become accustomed to in this crisis, is confusing. How can we navigate this confusion to uncover some foundation of logic?

From the beginning the crisis the policy of the UK government seems to have had two goals:

  1. There is no certainty a vaccine will be discovered, and therefore, return to ‘normality’ can only be achieved building herd immunity – assuming that the virus does not mutate and that the antibodies that are developed following being infected with covid-19 remain active in the body for a long period of time.

  2. “Protect the NHS” – given stretched resources at the best of times, protecting the NHS has become the government battle cry of the pandemic. The measures put in place are aimed at managing the patient’s load on the health service.

Some of the specific characteristics of covid-19 contribute to the challenge faced by any public health response. It may take up to two weeks for people that become infected with the virus to show symptoms, and possibly the majority of people do not exhibit any symptoms at all. This is well known and makes it near impossible to measure the actual prevalence of the disease in the population. The only hard numbers are the number of people that have tested positive, and the number of hospital admissions. Given that the number of people that have tested positive may not represent the true penetration of the pandemic in the general population, hospital admissions are the only truly reliable statistic.

The government is faced with the dual pressures of a spiralling economic depression and an increasingly fed-up population, vs the pressure of maintaining guidelines that will protect the capacity of the NHS. Any relaxation strategy needs to take these opposing forces into account, and like the controlled release of steam using the valve of a pressure cooker, slowly reduce the pressure on the population, regulating it such that the load on the NHS will not grow too quickly. Due to the 2-4 weeks lead time from being infected with Covid-19 and possibly requiring hospital treatment, the authorities can only assess the efficacy of new relaxation guidelines a month after they are issued.

This is the policy followed by the UK government given these two contrasting constraints. The policy seems biased towards managing hospital capacity as a primary priority, with the economy playing second fiddle. This is a political decision.

I cannot help thinking that the lack of clarity of the guidelines is deliberate. The other alternative is too unsavoury to contemplate. There are benefits for the government in pursuing this policy. Issuing confusing guidelines is likely to increase the numbers of new infections. At a time when the current number of new infections is declining this will continue the slow growth towards building herd immunity. The current UK government does not have the moral courage to say that increasing infection rates in the population is its chosen relaxation policy, although it may hold the view that this is the best course of action. Moral cowardice is its own punishment, and sooner or later, the chicken will come home to roost.

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