The year 2020 was dreadful for many people in almost every country.
In the UK, over 70,000 families have lost loved ones to COVID-19 – one of the worst death tolls in the world. And an unknown number are suffering from ‘long COVID’ the after-effects of infection, which can still be serious months later. The economic impact of ‘social distancing’ (the technical term for lockdowns and other restrictions) in response has been huge: the UK economy has contracted by approximately 14%. When the pie shrinks, of course, many people’s slices shrink with it; and unfortunately this is particularly true for those who are already struggling financially. For many people this has meant loss of jobs or income which they could not afford to lose.
The have also been some positive – and very important – developments in 2020. In the US, President Trump was not re-elected despite his best – and worst – efforts. There are now several effective vaccines against the virus. And the UK no longer faces the prospect of a no-deal Brexit.
Against this extraordinary backdrop, what can we expect from 2021?
Anyone attempting to make predictions at the beginning of 2020 was setting themselves up to fail because the impact of COVID-19 took all the pundits by surprise. And for many countries, not least the UK, COVID-19 remains a major unresolved problem in 2021.
And since, as we have learned, policy choices have an enormous impact on outcomes and given that we have a government whose policy choices are extremely difficult to predict, 2021 will be another year when predictions are likely to be far from the truth.
Nevertheless, we can learn a lot from what happened in 2020; and it is clear that for the UK to have a more successful 2021, we need the government to follow three simple guidelines which for most of 2020 it did not:
- listen to the science;
- think big picture; and
- invest to protect lives and livelihoods.
Listen to the Science
The UK has some of the best scientists in the world, and this applies as much to the fields of virology and epidemiology as it does to other fields. The work of the team at Oxford in producing a new vaccine is a remarkable success.
And so the government has no shortage of scientific advisers. As a matter of course, it has access to SAGE (the Scientific Advisory Group for Emergencies); during 2020, in addition, another group of scientists, independent SAGE, came together to make sure that scientific advice would be heard by politicians and by the public even if it was politically unpalatable.
Both groups have made it very clear that the government has relaxed restrictions too far and too fast and that it has been consistently too slow in imposing and reimposing them. Both SAGE and independent SAGE called for a circuit-breaker lockdown in September, and Independent SAGE has made clear that the virus is currently running dangerously out of control and a new national lockdown is urgently needed. As a recent SAGE memo states:
“It is not known whether measures with similar stringency and adherence as Spring, with both primary and secondary schools closed, would be sufficient to bring R below 1 in the presence of the new variant.”
And yet, there are powerful figures who believe that the government has listened too much to the science, and have attempted to find ‘alternative science’ to shift government policy still further from the scientific recommendations.
Rishi Sunak, for example, convened a special briefing for Boris Johnson at which the renegade scientists – all in favour of strategies based on herd immunity through infection – Professor Sunetra Gupta and her Oxford University colleague, Professor Carl Heneghan, along with Andres Tegnel from Sweden were all present. They are all outside the scientific consensus. The only mainstream scientist in the room was Professor John Edmunds of SAGE.
The problem with herd immunity through infection, rather than through vaccination, is simply this: the virus kills about 1% of those it infects. Achieving herd immunity would require at least 60% of the UK population to be infected – that is around 40 million people – and this would result in around 400,000 UK deaths. That is far more than were killed by the Spanish ‘flu a century ago and very nearly as many as were killed in the whole of the Second World War.
As The Times reported,
“The speakers that night included Professor Sunetra Gupta and her Oxford University colleague, Professor Carl Heneghan. Gupta says they were each given 15 minutes in which they argued that a lockdown was unnecessary at that point: the virus could be allowed to spread with lighter controls if those most vulnerable to serious illness were protected. Gupta says herd immunity could be achieved ‘in the order of three to six months’….
It was a huge call for the prime minister, but on that evening — Sunday, September 20 — he decided to side with the opponents of an immediate lockdown.
Just as in the first wave in March, Johnson would delay the lockdown and ignore warnings that the consequences would be disastrous for both the economy and people’s lives. ‘I don’t have sympathy for the government making the same mistake twice,” said a source on the Sage committee. “We told them quite clearly what they need to do for it to work. They don’t do that … It’s been wishful thinking all the way through.’”
Here are the actual numbers of deaths from COVID-19 in the UK during last year.
The reason for showing the modelled line, which appears to add no new information, is that while deaths are perhaps the most important number (and the only number that we know with any degree of precision), levels of infection are very important to understand. And since we have a reasonable understanding of the dynamics of the virus, if we know the number of deaths on day 30, for example, we can estimate the number of cases on day one.
The chart below summarises the progress of the virus in terms not just of deaths but an estimate of cases of varying levels of seriousness. The vertical axis in this chart uses a logarithmic scale for two reasons: first because exponential growth looks like a straight line on a logarithmic scale; and second because it shows number of cases as well as number of deaths, and they differ by a factor of a hundred. Using a logarithmic scale makes it possible to see both in a single chart.
Looking at it this way, you can see clearly how the first lockdown sharply reduced the number of cases, and after some delay, the number of people dying. It is also clear that sending the schools back on first of September caused the number of cases to rise and again, after some delay, the number of deaths.
The modelled impact of the hypothetical January lockdown assumes both that it happens immediately and that it is as effective as the spring lockdown was – and as SAGE said, this may not be true.
Back in March, Stephen Powis, the Medical Director of National Health Service England commented that keeping the death toll from coronavirus under 20,000 would be a “good result.” We are long past that point, and it is doubtful whether the final death toll will be less than 90,000 even if we move immediately to lockdown. Without strict lockdown, border controls, functioning Test, Trace and Supported Isolation, and an accelerated vaccine roll-out, 2021 could see more deaths than 2020.
According to The Times, Sunak’s motivation was that “some economists” were saying that a second lockdown would wreak havoc with the UK’s economy. It is of course true that lockdown prevents an economy from thriving – and so does an unchecked virus. In fact, the economic consensus was that it was also better for the economy to take the short-term hit in order to contain the virus rather than to allow it to spread further and need longer and stricter restrictions later. And by now, of course, we can see in the data that this is true – there are no examples of countries which have managed to protect their economies without protecting their populations from the virus.
So Sunak was not balancing an economic consensus against a scientific consensus; he was using pseudo-science and pseudo-economics to justify an illusory idea that he could strike an optimal ‘balance’ between the interests of the economy and the health of the population.
Think Big Picture
How can an intelligent person make such a foolish – and lethally dangerous – policy recommendation? The most likely explanation is that he was focusing on a small part of the picture and failed to see the wider implications of what he was pushing Johnson to do.
He could see the part of the picture where lockdown caused economic damage, but he missed the rest.
His fear for the economy led him both to argue against strong distancing measures and to be cautious about providing the kind of financial support that the population needed in order to be able to comply with distancing (in particular self-isolation) requirements.
Naturally, the result was that the growth rate of the virus began to rise again, and as we said above, we are now at the point where another national lockdown is only way to prevent loss of life on a scale which should be quite unacceptable in any democratic society.
And the end result is not only large numbers of needless deaths but more economic damage than necessary – in fact, more than most other countries have experienced.
Protect Both Lives and Livelihoods
So for 2021, although the UK faces many challenges, the clear short-term priority for government should be put to protect both lives and livelihoods. This means a fundamental change in mindset – most importantly discarding the idea that there is some kind of ‘balance’ to be struck between the health of the economy and health of the population.
In March, we set out a three-point plan, which for a short time the government appeared to be following. Unfortunately, since the government has lost control of the virus, that plan has become relevant again.
And of course, when the virus is finally brought under control, the government should not succumb to the temptation to introduce another round of austerity on the supposed grounds that “there is no alternative.”
Longer term, we set out five key actions which the UK should take to ensure that we move towards the kind of society that is fit for 99% of the population to live in, rather than continuing the drift to mass impoverishment. 2020 has clearly shown the vital importance of the first two actions:
- a democratic reset to make it an enforceable legal duty of the government to formulate policy so as to protect the interests of its citizens; and
- fact-based policy – and this, of course, means following the science.
If you want to help those politicians who do support these ideas and apply pressure to those do not, please sign-up and join the 99% Organisation.