Anthony Browne is MP for South Cambridgeshire and a former health editor of the Observer
“Not Britain’s finest hour” blares out this week’s Economist, echoing the accusation from opposition politicians that we have one of the highest death rates in the world as a result of government bungling. It is an easy accusation to make, not least because the UK does rank high in the frequently published death rate league tables. But the reality is more complex.
For a start, you must be careful with the data. We have about the most comprehensive Coronavirus death reporting in the world, with other countries using more restrictive definitions. Some just count those who died in hospital, who tested positive for coronavirus. In contrast, we are counting deaths in all settings, where coronavirus is mentioned on the death certificate, often by a doctor who did not treat the patient.
The Spanish government managed to cut its official death rate almost to zero overnight by changing the calculation. In contrast, Belgium has one of the highest death rates per million because it has the most honest data.
There are also many factors that meant we were particularly vulnerable to this pandemic. We are one of the most densely populated countries in the world, and that crowdedness makes it easier for the virus to spread. Bustling metropolises act as accelerators for the infection – just think of the millions of people crammed cheek by jowl on underground trains and busses every day, as well as the packed pubs, theatres and concerts.
London, New York and Paris have all taken a heavy toll. Germany – which has had a much lower death rate – does not have such teeming cities. Our national housing shortage means that compared to most countries we have more overcrowded homes, increasing infection rates. In Scandinavia, this is not an issue.
Despite being an island, we are far more internationally connected than most countries. Heathrow is just about the busiest international airport in the world, and London has more international visitors than any other city on the planet. This meant that rather than having one “patient zero” who started the outbreak here, scientists have estimated we had over 1,300.
Most were people coming from half-term breaks in Spain and Italy, where the pandemic was rampaging unknown at the time. That means the UK suffered 1,300 simultaneous outbreaks, spread across the country, making the onset the pandemic more rapid and difficult to control. Germans, by contrast, are more likely to take their winter half-term breaks in Switzerland and Austria, which were much less affected.
Many of the other accusations remind me of the joke about a traveller who asks for directions, and gets the reply: “Well, I wouldn’t start from here.” The UK did not start this pandemic with a big diagnostics industry, making it more difficult to ramp up testing. We had only one company that produced medical ventilators. We had outsourced most of our PPE production to Asia. All this was fine in peacetime. But in a global pandemic that stretched supply chains around the planet beyond breaking point, it meant we quickly suffered shortages.
The Government started stockpiling supplies even before the pandemic reached the UK, but global shortages had already set in. Compared to most countries, we have higher rates of medical conditions linked to high death rates, in particular obesity and Vitamin D deficiency (caused by lack of sun).
East Asian countries in particular benefited from having had in effect dry-runs with other epidemics, such as Sars and Mers. It meant their systems and population were far more prepared, and knew exactly what to do when lock down happened. A more willing population made it possible for many of these countries to have more extreme lockdowns than us. We had no such dry runs, and our pandemic preparations were based on a flu outbreak, which has very different characteristics.
Much other criticism has proved the old adage that the wisest person in the world is an opposition politician with hindsight. It ignores the fact that we have never had this pandemic before, and politicians had to make decisions based on extremely partial knowledge.
Neil Ferguson, the former government epidemiology adviser, said recently that if the Government had done lockdown a week earlier it would have halved the total number of deaths. Whether or not that is true, he certainly wasn’t advising the Government of that at the time. Politicians can only make decisions based on what they know when they make the decision.
The whole defeatist narrative also misses out the many successes. We started with shortages of ventilators, but that was sorted. We had shortages of PPE. Sorted. Shortages of intensive care beds. Sorted. Shortage of testing facilities. Sorted. We now have by some measures the most comprehensive testing regime in the world.
The major concern early on was that hospitals would be overwhelmed as they were in Italy and elsewhere, but the NHS rapidly arranged so much extra capacity (not least with the Nightingale hospitals) that it coped admirably. We are the first country to produce a clinically-proven treatment to reduce the death. There is a high chance that we will be the first country to produce a clinically-proven vaccine.
There is a bad tendency in this country to talk ourselves down, and try and find the worst in us. We have been hit bad by this pandemic, and clearly there are many lessons to learn. But we started with many disadvantages, and have had many successes.