Chris Johns: If this is to be the last lockdown it must work

Zero-Covid debate highlights tough decisions awaiting every country

The zero-Covid debate: a vanishingly small number of countries have, more or less, succeeded with such a strategy.

The zero-Covid debate: a vanishingly small number of countries have, more or less, succeeded with such a strategy.

 

When confronted with difficult questions the standard political trick is to provide an answer to the query not asked; speak a truth unconnected to the interlocutor’s original enquiry.

When asked if taxes are to rise, ministers say: “In all sincerity I have to tell you most candidly that the sun sets in the west.” The conversation can be that silly, but is usually harmless.

Maybe the truth is too sensitive to be voiced; it may not be known. “I don’t know” is not, politically, an acceptable rhetorical device. Career exile awaits. Scientists can be more circumspect than politicians. But there are plenty of us who remain comforted by our lack of doubt.

“Pretence to knowledge” was a Nobel acceptance speech given by Friedrich von Hayek more than 40 years ago. It was about how social scientists can do great harm by pretending they know more than they do. As he put it in his book The Fatal Conceit: “The curious task of economics is to demonstrate to men how little they really know about what they imagine they can design.”

Zero Covid

I’m reminded of this when observing the ‘zero-Covid’ debate. A vanishingly small number of countries have, more or less, succeeded with such a strategy. The vast majority have not. Zero Covid is a bit like communism: true believers say the reason it doesn’t exist is because few have actually tried it.

What do we mean when we debate zero Covid? How long are the restrictions, the border ones at least, to apply? The answer: for as long as it takes. What if that means forever?

Whether or not zero Covid can be made to work anywhere else, New Zealand is going to be faced with tough choices. Covid, according to the UK’s chief scientific adviser, is going to be with us “forever”.

Zero-Covid countries might have to decide between opening up or writing off their (foreign) tourist industries. If zero Covid is the strategy, and coronavirus does circulate forever, borders either have to remain closed or tightly controlled for a very long time.

Zero Covid demands effective test, trace and isolation (TTI) policies. Neither Britain nor Ireland has ever been able to get all three operating properly. Not least isolation: by all means quarantine visitors but it’s equally important to do so with domestic infections.

The focus on visitors should be matched by a realisation that if high numbers, indigenous or foreign, are neither tested or isolated, the efficacy of TTI and shutting borders is greatly reduced.

The UK’s chief medical adviser is one scientist willing to pose the question: what do we do once the pandemic is over, but coronavirus still circulates? ‘Over’ doesn’t mean an ending similar to that of smallpox, a virus traced back to the third century BC and one still circulating as recently as 1977.

The last known person to die of it was in 1978 and she had been vaccinated. Smallpox was declared eradicated by the World Health Organisation only in 1980. Eradication began in the 1950s.

Imagine one possible outcome: vaccination works. ‘Working’ means keeping people out of hospital, not virus-free. Our health systems have spare capacity, but are not empty of Covid patients. Covid circulates but most people do not end up in hospital. But some do. What happens then?

What choices will we make if this is how things develop? Does anybody know? Equally, we have little idea what we will do if things turn out better or worse than this. Perhaps nobody knows.

A professor of public health at Edinburgh university this week said she expected travel restrictions to last “for a year or two”. If Covid is forever, what is expected to change after two years?

Perhaps that’s when the whole world will be vaccinated? It would be helpful if we knew what ‘restrictions’ means in practice. A closed border is a restriction, as is a vaccine passport, as is a rapid-testing regime. Each has very different implications.

We have no idea if or when the Government will one day be unable to borrow enough to keep the economy going, but, the longer this goes on, the more likely it is that we will find out. It would be better if we didn’t.

Plan

Once spare capacity is restored to the hospital system, what are we going to do? Is there a level of disease incidence that will trigger opening up of the economy? Or is the decision to wait for full vaccination? The future of the Border? Are vaccine passports a plausible alternative? Is there a plan, even a contingent one?

If this is to be the last lockdown it has to work. What does ‘work’ mean? We can’t repeat the experience of last year: ending restrictions just leads to Covid resurgence.

This suggests we don’t get any opening up of the economy until everyone is vaccinated. If it takes years to vaccinate the whole world, as seems possible, border controls, at least, have to stay strict for years: tourism is a thing of the past. It’s a view: not mine, but it’s a view.

One that means lots of people have to think about alternative careers. I’m still more optimistic than this but we do need a plan.

Maybe there are no answers. Maybe it is too much to expect politicians to break the habit of a lifetime. Now would be a good time for unusual candour. Obfuscation, today, isn’t harmless. Hard choices await.

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