Reflections on the Virus
Episode 1.
Politics and Language
The devil makes work for idle hands is an apt saying for the situation many now find themselves in. With fewer distractions – I apologise in advance – I am compelled to spend some of my time reflecting on the impact of the pandemic. I’ll start today by making one general point and one obvious one.
First, the general point. The current COVID-19 emergency has much to interest students of politics. In the first place, does it demonstrate that authoritarian regimes are able to tackle a pandemic rather more easily and efficiently than liberal democracies? For example, China’s eventual crackdown was much more severe than anything that could be contemplated in a liberal democracy. Likewise, Michael Baum, writing in the Spectator, puts South Korea’s success down to its willingness and ability to act in an authoritarian manner.‘Health authorities…had warrantless access to the credit card and phone data of its citizens, including location data. So what we might regard as breaches of civil rights are part of the country’s success story’.
Moreover, given the origin of the virus, what does it tell us about our relationship with non-human nature and, indeed, our relationship with each other? Is the pandemic a product of globalization? What does it tell us about population size and density? What does it tell us about risk and about the balancing of competing interests in public policy making.
Perhaps the most significant factor for students of politics is the role of the state. Ironically, in the United Kingdom, the arrival of the virus has achieved, in terms of the state’s reach, more than even the most ardent Corbynite could have dreamt about. Not only has the state intervened to shore up the economy – by, most notably, agreeing to pay a significant part of the wages of those (the majority) economically disadvantaged by the health emergency – it has also taken unparalleled measures to control our everyday movements.
To some extent, the reliance on the state seems to have created, amongst some at least, a passivity which belies our status as citizens. Any relaxation of the lockdown, the first stages of which were introduced at the beginning of May, was bound to be imprecise requiring choices, responsibility and common sense. The reaction seems to suggest that some are very nervous about exercising these qualities. A consequence of the ‘nanny’ state some might argue.
Next, the obvious point. I am conscious how many words and phrases not heard before the end of February – a matter of barely more than two months – have become so entrenched within popular discourse that it is as if they have been around for a long time. COVID-19 and coronavirus are the obvious ones. COVID-secure, social distancing, self-isolation, the R rate, personal protective equipment (PPE), lockdown and Nightingale Hospitals are other examples. Our changing lives, in what may come to be characterised as the COVID era, are being accompanied by a changing language.
Reflections on the Virus
Episode 2.
Masking the Truth
The current crisis has raised significant questions about the use of evidence, particularly statistical evidence (on which see Episode 3). One evidential dimension concerns the use of anecdotes. Anecdotal evidence is the use of selected instances of an event to either support or refute a claim. During the pandemic, the use of anecdotal evidence has occurred, in particular, when discussing death rates in care homes, and the use of Personal Protective Equipment (PPE) in healthcare settings.
On care homes, it is not surprising that death rates have been higher than in the general population. Much of the media-inspired debate has been anecdotal, focusing on particular care homes where death rates have been high. Often, little context is provided. The fact that two-thirds of care homes have apparently been untouched by the virus has not been considered newsworthy, partly at least because it does not support an anti-Government narrative.
Concern about the availability PPE has been a constant theme expressed by the medical profession, care home staff, the media, and opposition politicians. The provision of PPE has undoubtedly been a challenge, not helped by the fact that the Government did not have a readily available stockpile, and there has, not surprisingly, been huge international demand for it.
Without wishing to minimise the potential deadly consequences of the absence of PPE in healthcare settings – and the desirability of ensuring that everyone who needs it can access it – much of the debate about PPE has been conducted through the use of anecdotal evidence. That is, a small number of highlighted cases where PPE has been absent or in short supply has been extrapolated by some to make the claim that the Government is failing to provide PPE in general. In order to justify that claim, of course, it is necessary, through empirical research, to demonstrate that PPE is absent or in very short supply in a considerable number (a majority) of healthcare settings. There is no conclusive evidence that that is the case, although the provision of PPE has been justifiably raised as an important issue.
On a related theme, the use of face coverings in general, and masks in particular, has become a regular topic of debate. Unlike public authorities in other countries, such as the United States, the UK Government has resisted the urge to compel the wearing of masks in public places. In some parts of the world – particularly the Far East – the wearing of masks was commonplace even before the coronavirus outbreak.
Like other areas of the COVID-19 crisis – and, indeed, like many other areas of public policy – the case for an against the wearing of masks is complex and not amenable to media soundbites and Government slogans. In the UK, the Government – following scientific advice – has repeatedly stated that the benefits of using masks is not proven. To cloud the issue, this conclusion is at least partly a product of a concern that making the wearing of masks compulsory would increase demand thereby resulting a shortage for healthcare workers.
So, what is the truth about the benefit of wearing masks? Well, it strikes me that those – an increasing number – who choose to wear masks are doing the right thing but not necessarily for the right reason. That is, I suspect that most people choose to cover their mouth and nose because they think it protects them against contracting the virus (some of course might be more altruistic than I am suggesting). However, they would be wrong (in most cases).
The reality is that only the hospital grade masks – FFP2 and 3 to use the correct terminology – have a respirator that acts to protect the wearer pretty comprehensively against contracting the virus from others. Surgical masks, and other homemade face coverings, on the other hand, may have a benefit in preventing the infection of others if the wearer has the virus, but they do relatively little to protect the wearer. In addition, the evidence suggests that those who wear masks are more likely to touch their face thereby adding to the risk of contracting the virus.
The new UK Government advice (although not a compulsion), in the first stages of the post-lockdown era, is to use face coverings in shops and public transport. This advice has been issued partly, no doubt, as a psychological device to encourage people to leave their homes more. The downside is that the use of masks might encourage complacency and risk taking which will make matters worse.
Reflections on the Virus
Episode 3.
Lies, Damned Lies and Statistics
Undoubtedly the biggest area of controversy in the coronavirus crisis has been the use of statistical evidence relating to death rates.
We are regularly told now that Britain has the highest number of deaths from COVID-19 in Europe and the second largest, after the United States, in the world. That may or may not be true. Countries have different ways of recording deaths and there are varying degrees of accuracy. In Italy, for instance, there is no national figure for deaths in care homes, whereas Britain now records all sites of death in the daily figures. The British Office for National Statistics (ONS) is considered as one of the best compilers of data in the world and this might have the effect of inflating the difference between death rates in the UK and elsewhere. It should be noted that the figures provided by the ONS attribute deaths to the virus if it mentioned as a possible cause on death certificates. In contrast, the figures provided by the Government require a positive test for coronavirus.
One other issue is the sensitivity of the tests for the virus used. The more sensitive, and accurate, they are the more deaths are going to be associated with the virus, and vice versa. In addition, finally, can we really trust the data from closed authoritarian countries such as China where the deaths per-millions is remarkably, and some would say unbelievably, small?
Finally, of course, the full impact of COVID-19 is not yet known. The experience of other viruses suggests that a second, or even third, peak might be even more severe. At the very least, we will have to wait until annual excess death rates are compiled.
If it is the case that the UK does have the highest death rate in Europe, then we can look for possible reasons. One might be a failure to utilise testing earlier and in a more widespread fashion. Other countries, particularly South Korea and Germany, did just this and their lower death rates might be explained by the rapid action taken. On the other hand, Italy has done a lot of tests and yet still has a high death rate in comparative terms.
Another reason for varying death rates, not one that it’s possible to blame the Government for, relates to density of population. The denser the population, the easier it is for the infection to be transmitted. Here, the UK is at a significant disadvantage. The population density of the UK is 275 people per sq. km. At the other extreme, the population density of Australia is 3 people per sq. km, and in New Zealand it is 18. In Europe, the UK has a higher population density than Sweden, Spain, Ireland, France, Italy, and Germany – we are, in other words, a crowded island as I’m sure you have recognised for yourselves! In addition, the density of population in urban areas is hugely important. It is no surprise at all that death rates have been highest in New York City and London, two of the most densely populated urban centres in the world.
Raw international comparisons are not particularly helpful though. We must also, of course, take population size into account. The UK’s population (of 67m) is bigger than Italy (60m), Spain (46m), Belgium (11m) and France (65m) so a greater number of deaths might be expected in the UK. The Population of the United States is 330 million (broadly equivalent to the combined total of the five most populated countries in Europe). In the second week of May, the total deaths attributed to COVID-19 in these five European countries (more than 120,000) was 50% higher than that of the USA.
As the UK Government’s scientific advisers have regularly said, the key indicator of the virus’s impact, in the UK and elsewhere, will be excess deaths (the difference between normal rates and those during the COVID crisis). Although all deaths from the virus are very tragic, and the pain and suffering of the victims and their families and friends should never be underestimated, some perspective is needed here. Having the daily death rates flashed on our TV screens tends to disguise the fact that, in normal times, people die every day too, and in sizeable numbers.
So, in 2018, a total of 616,014 people died in the UK, that’s 11,846 per week or 1,687 a day. Now, this year’s death rate will undoubtedly be higher. And much of this can be explained by COVID-19. However, the annual excess death rate is important because it is a sad fact that some (maybe many) of those whose deaths are attributed to COVID are likely to have died anyway during the year. In this context, I find it baffling that some seem to express surprise and shock that the death rate is much higher in care homes than anywhere else. Of course it will be! Those who go into care homes tend to be elderly and also tend to have underlying health conditions, making them extremely vulnerable to the virus.
One other factor here is that the lockdown itself will not be neutral. That is, excess deaths this year are likely to occur as a result of the lockdown. This will be a product of an unwillingness of people to attend hospital with other medical complaints, the diversion of health resources to cope with the virus and the economic impact of the pandemic (among which is possible future cuts in health spending). This illustrates how risk assessment is a crucial part of public policy making, and how the public is, surprisingly and somewhat inconsistently, risk averse when it comes to COVID-19.
The Government claims that protecting public health ought to take precedence over the health of the economy and personal liberty, and most people seem to agree with this assessment. But is this the right approach in the case of COVID-19, given that it is a disease which hospitalises relatively few and kills even fewer, and where the lockdown may result in considerable excess loss of life? I am not, here, of course, suggesting that nothing at all should have been done to tackle COVID-19 (no government in the world has adopted this strategy) but carefully weighing up the costs and benefits of a strategy which puts tackling the virus above anything else might lead to a more balanced approach.
Comparing the risk-averse approach to the virus with the approach taken with other risky activities is instructive. In the UK in 2018, over 10,000 and nearly 2,000 deaths respectively were caused by alcohol and drugs and by road traffic accidents. Many more are linked to air pollution, much of which derives from vehicle exhausts. And yet there is no serious proposal to prohibit alcohol or motor vehicles and the public is prepared to risk continuing to drink alcohol and to drive. The Government even deems it appropriate to wait for several more decades before prohibiting the use of petrol and diesel-powered vehicles (and is therefore prepared to accept many future deaths because of the economic benefits it produces).
Reflections on the Virus
Episode 4
The Politics of COVID-19
In his acceptance speech for the Nobel Price Prize he was awarded in 2007, Al Gore, the former American Vice President, made the claim that ‘The climate crisis is not a political issue, it is a moral and spiritual challenge to all of humanity’. The reason why Gore does not see climate change as a political issue is presumably because he thinks it is a ‘no-brainer’. In other words, he thinks that climate change will damage everyone’s interests because it will destroy the planet. It is therefore in everyone’s interests to do something about it and fast. In other words, there is no political decision to be made.
Lurking beneath this interpretation of Gore’s claim is the assumption that politics is predicated on the existence of differences. These differences might be about interests (self-interest) or they might be about values (what we think are important objectives for society irrespective of our particular interests). Politics is there defined as the process by which groups representing divergent interests and values make collective decisions.
Now, the claim that climate change is not a political issue is of doubtful veracity partly on the grounds that it does not affect everyone in the same way and, at least for the currently living, there is not a threat to human existence. That is, acting on climate change, particularly when doing so has significant economic consequences, is not necessarily in everybody’s interests or not to the same degree.
What of the current pandemic? Is there a case for saying that coronavirus is not a political issue but merely one that requires the objective expertise and judgment of scientists and medical professionals? Listening to Government Ministers claim, as they often do, that they are merely following the science certainly gives credence to such a claim.
What it would require for politics, defined in the way I have done so above, to be absent in the coronavirus crisis is for it to threaten everyone in similar ways, and for acting on it to be consistent with universally held values. A useful parallel is the common threat often said to exist in the event of war. In Britain, for instance, the country’s internal politics was put on hold during the Second World War and there was no General Election between 1935 and 1945. It is no accident, perhaps, that war-time metaphors have been regularly used in the pandemic crisis. Thus, we are ‘at war with an invisible killer’ and healthcare professionals are on the ‘front line’ against it.
Of course, war between sovereign states is predicated on the existence of conflict between them and, as the nineteenth century Prussian general Carl von Clausewitz memorably pointed out, war is ‘the continuation of politics by other means.’ Given that the present pandemic is a global threat and sovereign states have been, for the most part, supporting each other in fighting it, there would seem to be a stronger case for regarding it as being above politics, similar, perhaps, to an attack on Earth by aliens as envisaged by science fiction writers.
It would be wrong, however, to regard coronavirus as a non-political issue. There might be a case for regarding it as such if it threatened all humans with the same outcome (death). This is clearly not the case. Indeed, for most people, COVID-19 is pretty harmless. For the young, in particular, it barely registers. For other, particularly the elderly and those with underlying health conditions, it can and has been deadly. As a result, competing interests do exist. The action taken against it, in most cases some form of ‘lockdown’, does not serve everyone’s interests, and it serves some people’s interests much more than others.
Protecting people from the virus inevitably conflicts with some interests and values. Crucially, of course, there are acute economic costs which will be played out in declining standards of living in the future. There are also impacts on human development, not least in the case of the shut-down of schools and universities. Children’s future prospects, and particularly those from poorer backgrounds, are, it is said, likely to be damaged by their inability to access formal education. The negative psychological effects of social isolation should also not be underestimated.
Values, too, are under attack and not least the limits placed on freedom deemed necessary to control the transmission of the virus. It is one of the fundamental articles of liberal faith – exemplified by the political philosophy of John Stuart Mill – that the state should not intervene to prohibit ‘self-regarding’ actions (those that affect the individual alone), irrespective of the risks the individual is willing to take. A counter argument here would be that anyone deliberately flouting the lockdown measures is behaving, as Mill would put it, in an illegitimately ‘other-regarding’ fashion since the potential consequences – of further spreading the infection – will affect others negatively. A possibly useful compromise (one which is close to the strategy of the Swedish Government) is to self-isolate those who are likely to be particularly vulnerable to the virus whilst allowing others to behave as relatively normal, thereby preserving at least some of their liberty.
The politics of coronavirus requires a balancing of the interests and values involved. The debate surrounding schools is instructive. The Government has proposed the gradual reopening of schools but this proposal has met opposition from some teachers and parents as well as the medical profession. It is important to recognise that all of these actors have (some) competing interests which they will seek to defend and added to the equation are the interests of children (not always the same as their parents) which are probably more likely to be ignored.
The state’s role, in a democratic pluralist political system, is to seek to balance the competing interests that are articulated. Crucially, it cannot, if a fair compromise is to be achieved, prioritise the interests of one group over another, seriously disadvantaging the interests of others, unless a failure to do so is to put one group at serious and substantial risk.
Reflections on the Virus
Episode 5
Is this 1945 all over again?
The similarities between our present, COVID-19 dominated, situation and that pertaining in the run-up to the 1945 election is fascinating.
Then, as now, the country was faced with a significant external threat. The parallels are heightened here by the war imagery currently being used by politicians and the media. Fighting the virus is a war against an invisible enemy and the battle is being fought on the front line by doctors and nurses rather than soldiers.
Then, as now, the Government’s response was to use the full power of the state to tackle the threat. Then, as now, the state intervened in the market economy necessitating huge increases in public spending. Then, as now, significant restrictions on personal liberty were instituted and largely accepted by a population that recognised the greater importance of defeating the enemy.
Not only this. There are also great similarities with the party leaders. Then, as now, the Government was led by a flamboyant and charismatic leader whose rhetorical flourishes were a strength but whose grasp of administrative detail left something to be desired. Moreover, Johnson, like Churchill, is regarded as a maverick by some in his own party, preferring to be above party politics. This last point applies particularly to Churchill, who served in both Liberal and Conservative Cabinets in peace time as well as Coalition, or National, governments during the two World Wars. Johnson, like Churchill, though, is much more popular with the Tory rank and file than he is with the party establishment. Moreover, he has not come across as a ‘natural’ Conservative – in his roles as London Mayor and as Conservative leader – particularly when it comes to state intervention.
One is also struck by the similarities between Keir Starmer and Clement Attlee. Both were elected to succeed far left Labour leaders (George Lansbury in the case of the latter and Corbyn in the case of the former) but were themselves more moderate and pragmatic. Starmer, like Attlee, lacks the charismatic flamboyance of his main political opponent but, like Attlee, he is methodical and, as you would expect from a lawyer, is capable of a detailed grasp of his brief. Starmer’s forensic demolition of the Government’s proposals to ease the lockdown was a striking illustration of this.
I would contend, too, that Starmer understands very well the similarities between the current political situation and the run up to the 1945 election. In a remarkable, but little commented-upon, broadcast to the nation on 11 May, Starmer drew direct parallels. ‘We are’, he said, ‘living through the biggest threat this country has faced for a generation’ and ‘when this is over, I’m determined we will build a better society…because after all the sacrifices and loss we cannot go back to business as usual…we cannot go back to a society where we do not invest in our public services…We must go forward with a vision of a better society’. Starmer in 2020 or Attlee in 1945? Difficult to tell!
We should not take the parallels too far perhaps. For one thing, Starmer has little experience of high office whereas Attlee, by 1945, had been Labour leader for ten years and Deputy Prime Minister for half of that time. Moreover, unlike Churchill, Johnson did not become Prime Minister as a result of the crisis but won a General Election fair and square in ‘peacetime’.
Of course, it is in Starmer’s interests to draw parallels with the aftermath of the Second World War because Labour secured a commanding majority at the 1945 election. There are, however, significant differences. There was little that Churchill could do to prevent an election in 1945, but it might have been a different story had he remained in office and stole Labour’s thunder on social reconstruction. By contrast, the Conservatives will be in office for a few years after the pandemic crisis has waned, and Johnson may not be judged entirely on his Government’s handling of it. Had an election been due sooner, the result could have been very interesting.
Far and away the biggest difference is that the sacrifices of the Second World War were, of course, that much greater. In addition, the demand for change in 1945 was based on a determination not to return to the poverty and unemployment of the 1930s. Whilst the pandemic has revealed, to some extent, the debilitating effects of inequality in British society, general standards of living, even taking into account the economic consequences of the lockdown, are infinitely higher than they were in the 1930s.
Robert Garner 