international analysis and commentary

The British approach and international consensus

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The UK’s initial response to the coronavirus emergency appeared effective. Despite its high degree of interconnectedness with the global economy, the number of cases remained low in February. The government appeared highly transparent and competent in its communication efforts. Prime Minister Boris Johnson emphasised how his actions were wholly guided by specialist advice, and gave statements flanked by the government’s Chief Medical Officer Chris Whitty, and the government’s Chief Scientific Advisor Patrick Vallance, leaving them do much of the talking.

The government set out a four stage plan to save lives by flattening the peak of the outbreak and allowing the National Health Service (NHS) system to cope. Initially the government would seek to contain the outbreak. It would then shift to delaying the spread of the disease, while carrying out research and mitigating its consequences. Chancellor Rishi Sunak unveiled a budget of £30bn, pledging that the government would do “whatever it takes” to support the economy to counter the outbreak.

However, as the number of cases in the UK climbed in mid-March and other countries around the world implemented ever stricter measures, the UK began to look like an outlier. On Thursday, March 12th, Johnson announced that this was the “worst public health crisis for a generation”, that many families would “lose loved ones before their time”, and that the UK was moving to the delay phase. However, it was unclear what the government would actually do to delay the spread of the virus. Its only concrete measures were telling people with symptoms to stay at home, advising those over 70 not to go on cruises, and advising that school trips should be stopped. The government asked companies able to produce equipment needed to keep severe patients alive to do so, prompting many to ask why it had not done so much earlier.

Prime Minister Boris Johnson during the 12th March press conference

 

Strikingly, the government initially rejected public health measures taken around the world, such as closing schools and banning mass gatherings. This was not Johnson’s personal choice. After belittling experts for any Brexit-related matter, he now claimed to put his faith solely in their advice. The Chief Medical Officer and the Chief Scientific Advisor argued that many of the measures taken by other countries were unlikely to be effective, and that it was too early to act. They also maintained that the aim was achieving a degree of “herd immunity”. The idea was that it would be possible to manage the outbreak so that large numbers of healthy people would be infected and develop immunity to the virus, while “cocooning” vulnerable groups and keeping the overall number of infections below the capacity of the NHS. This, in theory, would allow the UK’s population as a whole to be more resilient if the disease came back in winter.

The appeal of this relaxed approach was dual – as in theory it would minimise both the death toll and economic disruption. However, it was sharply at odds with most of Europe and the world, and came under criticism both domestically and internationally. The UK’s strategy assumed it would be possible to micromanage the number of infections while allowing the NHS to cope. This assumption seemed highly dubious given the evidence from Italy and elsewhere, where a large number of hospitalised patients need intensive care, placing extreme strain on health systems. Moreover, the “herd immunity” strategy seemed not to take into account the possibility that the virus would mutate, and that people might catch the disease a second time.

On Monday, March 16th, under mounting public pressure, the UK undertook a sharp policy shift. Johnson warned that the country was approaching the peak of the outbreak quicker than initially expected, and that “without drastic action cases could double every five or six days”. Whereas the previous week the government had maintained that the UK was four weeks behind Italy, it now said it was more likely to only be three weeks behind. As a result, Johnson announced a range of social distancing measures. He urged the population to stop all non-essential contact and travel, to work from home if possible, and to avoid mass gathering and social venues such as pubs. He also advised vulnerable individuals to self-isolate. On March 17th the government announced a £330bn pound package to support the economy, and on March 18th announced the closure of all schools until further notice.

According to the Financial Times and The Guardian, this sudden change in approach was taken after modeling based on novel data from Italy revealed that a very large number of those admitted to hospital would need intensive care, and that the government’s existing strategy based on mitigation and herd immunity would result in 260,000 deaths as a result of the NHS not being able to cope with the number of expected patients.

Nearly 500 cases of coronavirus have been confirmed in London as of March 19.

 

It appears almost certain that the UK will be forced to take more drastic measures to counter the outbreak in the coming days and weeks. The restrictions announced by Johnson are voluntary and are unlikely to be very effective. Some people, young and old, will still go to pubs and restaurants unless they are closed by the government. Others may simply not be able to afford to stay away from work even if they are ill, unless the government sets up income support schemes. Johnson is likely to have to embrace an approach that is both more coercive and more economically interventionist. Tough times lie ahead: the NHS is already under strain and has a lower number of intensive care beds per capita than many other countries. By European standards, the UK also has a lower number of police to enforce public health measures such as lockdowns, posing challenges especially in a metropolis like London.

So far, Johnson has proven averse to cooperating with the EU. But the more severe the pandemic, the more politically acceptable it will be for the EU and UK to cooperate in acquiring medicines and medical equipment. Negotiations over a UK-EU trade deal are on hold as officials cannot physically meet, and talks are unlikely to be concluded by the end of transition period in December 2020. Indeed, it seems increasingly likely that the UK government will seek an extension to the transition period. Brexit now seems like a sideshow.