As the pandemic gears up for round two, the political consensus on combating it continues to erode. Over the summer we saw the breakdown of the ‘four nations’ coordinated approach across the United Kingdom. Now dissent boils away inside the Conservative Party.
Senior figures, including Sir Graham Brady on this site, are calling on ministers to do much more to account for the negative consequences of lockdown – in terms of other health issues, mental health, and more – in the anti-Covid utility calculus.
Now the data used to justify Boris Johnson’s hard pivot away from his newly-minted tier system towards a second full lockdown is coming under attack. According to the Daily Telegraph, the Cambridge University data used to sell the policy is weeks out of date, and Ross Clark points out that much of the evidence apparently underlying the move is not publicly available.
Fraser Nelson also takes the Prime Minister to task for failing to set up a ‘red team’ of experts to challenge the assumptions of his advisors. By limiting himself to one source of expert information, this argument runs, Johnson leaves himself unable to weigh alternatives or choose between plausible options, and exposes himself to extreme political danger if he defies his advisors.
But ranged against this tendency are those who argue that ‘Covid deaths’ isn’t the best way to understand the public health consequences: and that hospital capacity is.
Once lockdown started to bite, there was no shortage of people going sour on the phrase ‘protect the NHS’. Should it not, after all, be there to protect us? But the central point, as we explained at the time, was making sure that the number of serious cases remained within the capacity of the Health Service to treat. The alternative was catastrophe.
Whilst the data about deaths is not clear, and dogged with disputes over definition, models and projections, hospitalisation data is publicly available on the Government’s dashboard. It shows admissions climbing steadily since the start of September, on a trajectory that would see the UK hit the first peak well before Christmas.
But this doesn’t tell the whole story, because patients and beds are not evenly distributed across the country. Much in the same way that the UK still has a housing crisis despite there being lots of stock in the wrong bits of the country, a surge in cases could overwhelm the NHS locally or regionally without the top-line figures showing that NHS England had toppled completely.
Furthermore, some lessons have been learned from the first wave, especially about the human toll of delayed treatments, surgeries, and the rest of the NHS’s normal business. As Bernard Jenkin recently noted, there is now much greater recognition that Health Service ‘capacity’ must include these things, rather than just focusing on whether or not it can treat every coronavirus patient.
But maintaining sufficient slack in the system to do this, during the months when the NHS undergoes its annual ‘winter crisis’, requires a more assertive response to the pandemic, not less. This looming squeeze on capacity from other causes also explains why the decision can’t be based purely on the basis of Covid admissions – even if the latter are declining, there will be a crunch if bed vacancies are falling faster.
Ultimately, the Government is paying the price for how badly it has handled public messaging during this crisis. From the early insistence that hand-washing would be sufficient to mixed messaging over masks, from trying to force people back to the office to shutting everything down, and from fighting with Manchester over a few million before turning on the taps for a UK-wide furlough scheme, ministers have lost at least a little chunk of the public with every u-turn. Scoffing at the prospect of forcing businesses in the South West to shut to fight the virus in the North, days before appearing to do just that, exemplifies the problem.
This has created a fertile atmosphere for those suspicious of today’s strategy, and it isn’t just the commentators and hacks taking advantage. Another political life for Nigel Farage will be far from the worst consequence of the Government continuing to get this wrong. But it’s one we can do without.