Bernard Jenkin MP was Chair of the House of Commons Public Administration and Constitutional Affairs Select Committee 2010-2019, and is nominated to be Chair of the Liaison Committee. He is MP for Harwich and North Essex.
The real question for now is how to exit the lockdown without reigniting the pandemic. With Parliament now back, this should be front and centre of scrutiny conducted by it and its committees in the weeks and months ahead.
It is all too predictable that MPs get drawn down the path led by the most immediate public concerns, and by peoples’ understandable fear and anger, about the difficulties of scaling up testing, about who has failed to do what, and who is to blame.
But if Parliament wants to help the nation out of confusion, it must lead a different kind of debate. While it is crucial for them to do so, MPs and peers should not limit itself to categorising the types of damage caused by the lockdown, and criticising the Government for mistakes that are being made by governments almost everywhere.
The central problem of any plan will be finding a model for society that starts to restore our freedoms and the economy but, as above, without leading to mass deaths from Covid-19. A remarkable but somewhat neglected paper published last month by Harvard University’s Safra Centre for Ethics, entitled “When can we go out?” addresses these questions, and asks: is there a feasible alternative to a lockdown, and what does it look like?
The Government’s thinking on this topic so far has been divided between those who are determined to “follow the science” as an authority for their actions, and those who are calculating the negative effects on the economy and their consequences.
“The science” is a continuing and turbulent debate but, hitherto, Ministers have given the impression that they are accountable to the advice that they are receiving from scientists, rather than to the public or to their own judgement. This is not sustainable – but neither can the science be ignored. What is needed is a synthesis of these different forms of knowledge so that politicians can exercise informed judgement.
Great leadership must draw on all forms of knowledge – technical, theoretical and practical – and that is what makes this paper different. We do not want our country to be run by scientists any more than we want it run by economists or bankers. We want leaders who can exercise judgement, and the authors invite judgement about the choices between the three options.
“Freeze in place” keeps the lockdown, but this has horrendous economic consequences. When modelled for the US, it would cost around $15 trillion.
The alternative, “Surrender”, is simply to release the measures in their entirety. In the US, “Surrender”, would result, when modelled, in the direct deaths of two million people over a period of months, and a total collapse of the public health system, as well as tens of millions unable to work due to sickness, resulting in terrible economic damage regardless.
When mapped onto the population of the United Kingdom, the figure comes close to half a million dead (as predicted by an Imperial College paper). This would lead to a much greater social, economic and political crisis. The Harvard paper uses the dollar value conventionally assigned to the loss of statistic life by economists of $5-10 million. On that basis, “Surrender” costs even more than “Freeze in Place” – and taking either of these options here would also transform this health and economic crisis into a crisis of our politics too.
So what remains? The paper recommends an option it calls “Mobilise and Transition”, involving a transition to a partial re-opening of the economy over time, but combined with an enormous effort to mobilise state resources into increasing pandemic resilience.
These two terms are critical to any so-called exit strategy. We must have a plan for the “transition” into something more stable than the current lockdown, and we must also have a plan to “mobilise” the resources necessary to achieve it.
There has been much published recently on what such a transition would look like in practice. The so-called Traffic Light System to Reopening by Gerard Lyons and Paul Ormerod of University College, London, suggests that we stagger opening the economy according to various indicators of viral spread.
The authors suggest a ‘red’ phase allowing family visits and limited shop openings; an ‘amber’ one permitting private car travel and restaurants reopen, and a ‘green’ one, containing a return to normal in areas such as international travel.
This echoes the approach of the American Enterprise Institute’s paper, “A Roadmap to Re-opening”, published in March, and of the Tony Blair Institute for Global Change’s recent report, “A Sustainable Exit Strategy”, both of which recommend a similarly phased loosening of pandemic restrictions, but without addressing in detail what needs to happen to control the pandemic.
In so much of the discussion, this approach has filled a void in the UK debate so far, and the Government is beginning to reveal that they understand this.
Talking about the mechanics of re-opening the economy is important in order to understand how and in what order different sectors of the economy can recover. However, such a discussion assumes we can loosen the restrictions while also having in place the public health infrastructure and policies for the whole of society that will prevent a second spike in infections. But that is the daunting challenge we cannot yet meet.
The most helpful way to think about meeting it so to consider the so-called R number (the average number of people one infected person will themselves infect).
If this number is below one, the number of cases goes down. If it is consistently above one, the disease will spread to the entire population. In the words of Carl Bergstrom, Professor of Computational Biology at the University of Washington: “There’s really not a middle ground. It does one of two things: either you get it under control, and it goes back down to very low levels… or it’s out of control and it keeps getting worse and worse until you get a very large fraction of the population infected.”
So if we re-open the economy, even in a phased way, without keeping R below one, we will merely create a slower form of the disastrous “Surrender” scenario described above.
To keep R below one thus far has taken a national lockdown and the deliberate spreading of fear about the virus. To contain R below one, while opening up, will not be attractive to advocates of a small state.
The task is to reduce how easily people infect each other with Covid-19, despite being far freer to move around and socialise than currently. This requires, in the US or UK, “national government to achieve within three months the sort of pandemic preparedness it took Taiwan five years to develop.”
This is why there is now a debate about whether people will need to wear PPE at all times in public. The scale of the requirement for PPE means that the state will have to be much more involved in the supply chain. There will have to be a comprehensive plan for contact tracing and testing, by which the recent contacts of infected individuals are themselves tracked down and either tested negative or isolated.
To collect high-quality data on where ill people have travelled, and who they have been near, phone apps or similar technology to those used in South East Asia must be widely accepted, and personal data used far more freely than we would normally find acceptable. In order to contain a disease that would otherwise spread freely, we will have to increase daily testing to levels capable of catching outbreaks we would otherwise have no idea about.
No longer would testing be limited to hospitals or symptomatic patients: analysis from E. Glen Weyl (one of the Harvard paper’s authors) and Divya Siddarth, both of Microsoft, suggests that, scaled for the UK, we would need to test not 100,000, but 300,000 people per day if we can accurately identify likely infected people. Otherwise, the testing rate would have to be closer to 18 million per day. Given that we are currently managing less than 20,000 per day, we cannot achieve this any time soon.
When considered together, successfully delivering these public health policies would require a level of Government intervention in the market, or “in society” and intrusion into our private lives, of a magnitude never before seen in the democratic West outside the two world wars.
Whole industries would have to be created or expanded and directed by the state. Huge sums of money would be spent, and tens if not hundreds of thousands of workers would have to be retrained. We would have to accept restrictions on civil liberties for an indefinite period.
Parliament’s role in this area must be to encourage strategic thinking, raise reasonable questions and help the government avoid errors in the planning and execution of its strategy. None of us is blame-free in this current crisis. No Commons Select committee has held an inquiry into a flu pandemic in the past 10 years. What work was done in the Lords makes no reference to the need to stockpile PPE, or to lock down households, or for the NHS to stop doing virtually anything else, in order to prevent a catastrophic spread of the disease.
This was because the prevailing assumption was that the virus would be a more familiar ‘flu – reflecting the fact that some possibilities are just so far beyond the imagination, or so terrible, that the possibility of catastrophe is simply passed over. That would explain why the 2016 results of Exercise Cygnus were glossed over or ignored.
This is why I have been saying in public and private that Parliamentary scrutiny can and should be seeking to encourage the maximum of openness and transparency. If Parliament and its committees can foster a positive atmosphere in which frankness about all relevant facts is welcomed, then MPs and the public can have more confidence that truth is being “told to power” and the right decisions being made.
We will only successfully leave the lockdown if we can work together and carry public confidence with us.