The Government wants us to get ill – just not too ill

Official policy on Covid-19 is just a series of educated guesses. We may not know for years if it’s right

It is footage that has become infamous from the coronavirus epidemic in Wuhan: residents waking up to find metal bars welded across their doors by police, sealing them into their homes until authorities decide to let them out. China has been widely praised for its Herculean containment effort. It seems to have worked. But alongside the enormous mobilisation of resources and public spirit, there was a hard edge to Beijing’s method.

When our Government says that it cannot contain the spread of coronavirus, it is saying, essentially, that it is either not willing or able to arm the cops with welding torches and that, without them, it cannot keep the population under control for long enough. A vaccine is probably a year to 18 months away. So, No10 says, this is a marathon, not a sprint.

This is one of many assumptions underlying Britain’s anomalous approach to the epidemic. The Government is taking criticism from all sides for not falling into line with other European and Asian countries, many of which have shut down schools, moved early to ban large gatherings and, in some cases, made it illegal for anyone to leave their home without a critical reason. But the bet in London is that countries taking draconian measures early in their infection cycle are going to run out of steam and leave themselves with no tools to manage later resurgences.

Despite examples of containment elsewhere, the Government believes that the epidemic is now so widespread across the world that permanent containment is impossible. The management of it, therefore, is all about timing. If the UK can get into an equilibrium in which the epidemic does not exceed a certain rate of growth, the health system might have a chance of coping.

Currently, however, infection is speeding up rapidly. The British gamble seems to be that the speed can be fine-tuned. If it starts to overwhelm the NHS’S capacity, other measures, like stricter isolation advice, will kick in to slow it down. As this process continues, the idea is that the least vulnerable people get the disease and recover, ultimately developing enough immunity to protect the elderly and ill. At that point, isolation measures can be eased.

If this sounds like a risky operation, it’s because it is. In fact, it looks rather like trying to catch the surf using a broken board and a spreadsheet of sporadic data about the ocean floor and the shape and speed of the incoming wave. This makes one other element of the strategy absolutely critical. The Government needs to monitor the epidemic with monomaniacal focus. If its modelling assumptions about the virus’s characteristics, the behaviour of the population or the capacity of the health service start to look dodgy, it needs to change tack at lightning speed. UK data collection so far has, by all accounts, been excellent, which should give us a bit of confidence.

The need for nimble policy is one possible reason for laying off the welding torch and travel bans. China is close to declaring victory, with President Xi Jinping visiting Wuhan recently to take credit for the work of the country’s scientists and health workers. State propaganda has lauded the inimitable People’s Leader, comparing him to a fantastical “sea-stabilising holy cudgel” from a classic Chinese novel. This may not leave a lot of room for changing approach if a second wave of infection hits as China begins to lift restrictions.

The UK’S approach, however, has its own potentially huge flaws. The most salient is the assumption that it is neither possible nor desirable to stop the epidemic completely. The behavioural science underlying the claim that you cannot get people to stay away from each other for six months or a year is an obvious weak point. Given that this situation is unprecedented in the modern era, how on earth do these behavioural “scientists” know?

What’s more, they seem to be assuming that the Government does not have hard power at its disposal. If it drew on its emergency powers, flooded cities with police drones and threatened jail time for wanderers, we would probably learn to stay put pretty quickly. So what the Prime Minister really means, when he worries about a mood of uncooperative “crisis fatigue” setting in, is that the danger from the virus is not great enough to warrant such a major suspension of liberty.

This relies on a series of educated guesses. Chief scientific adviser Sir Patrick Vallance has made several statements about the virus that other scientists argue are highly uncertain. He has said that it is likely to become endemic, that the population needs to develop “herd immunity” to protect us from recurrent waves of illness each year and that the current fatality rate is around one per cent. These statements are no doubt based on good evidence, but could still be wrong.

For one thing, Singapore, China and South Korea seem to demonstrate that the spread isn’t inevitable. The many deaths we are being told to expect may be avoidable. Even if containment is impossible and the virus recurs, it may have changed form so much that “herd immunity” does not protect us. And the current fatality rate seems to vary wildly. In South Korea, looking just at “completed” infections, 11 per cent of patients have died and 89 per cent have recovered, whereas in Italy, one person has died for every one that has recovered. The difference could be explained by the quality of care (Korea has many more ventilators), age, underlying health or some other factor. As with the virus’s long-term effects, we just don’t know.

Nor can Government scientists be certain about the epidemic’s peculiar features. They think it spreads most within clusters, such as family or church groups, unlike seasonal flu, which spreads in a reasonably linear way across clusters. This means that an infected person on a train is not as much of an obvious infection risk with Covid-19 as with normal flu, and this is the sort of observation that underlies the Government’s models and its timeline. But why the new virus spreads this way, scientists cannot say. That makes it hard to assume it will behave in the way the models predict.

The truth is that it will be years before we know who has called it right. A strategy is not right or wrong based on how many governments adopt it. It is nothing more than a live experiment. All we can do is hope that Britain’s leaders and scientists are getting it right given the nature of the epidemic here and the resources at their disposal. In the meantime, we can all at least do something: wash, wash, wash our hands.

follow Juliet Samuel on Twitter @Citysamuel; read more at telegraph. co.uk/opinion

‘The many deaths we are being told to expect may be avoidable… And the current fatality rate seems to vary wildly’