WESTMINSTER REFLECTIONS: Sir Bernard Jenkin MP writes on meeting the challenge of Coronavirus
The coronavirus pandemic has reshaped politics, economies and societies. People can no longer go to restaurants or visit their loved ones, and millions have learned how to work from home. Millions again are without work at all, relying on state largesse to buy food, pay rent and support their families. But responding to this pandemic will require more than just a behavioural change from citizens – the state will be fundamentally reshaped for the duration of the crisis too.
This is because of the immutable facts of the virus: it spreads from each infected person to somewhere between two and three others under normal conditions. This type of exponential spread explains the severity of the economic and political response in the earlier phases of the pandemic. Ten infected people will themselves infect up to thirty more. But one thousand infected people will infect up to a further three thousand. Flooding healthcare systems beyond any reasonable capacity would therefore only be a matter of time. The only mechanism available to break that cycle in prosperous, crowded and city-based economies was to impose a total lockdown – limiting people’s ability to travel outside their own homes.
This world comes with its costs – mental, social and economic. The task for governments now is to see how they can best manage them: allowing society to open up as much as possible without a catastrophic surge in cases. This is the test I referred to in my previous column, of whether suppressing the virus could become a truly sustainable strategy. The problem is simple: how do we allow people to leave their own homes without increasing the spread of the virus? We have a blueprint from successful case studies around the world, such as South Koreaand Taiwan.
This is why there is the conversation in the UK around wearing PPE in public spaces and maintaining social distancing in public. But whatever the conclusions are, there are certain challenges that we know any state across the world will have to rise to meet. Unless they are willing to risk massive casualties, hospitals being overrun and millions of workers off sick, and therefore far more deaths and harm than directly caused by the virus, all of the world’s governments will be looking at the same set of issues.
The first is the rate of testing. The UK has done an admirable job in recent weeks, increasing testing from a paltry 10,000 per day to around 100,000. The prime minister recently announced that the target for the end of May would be 200,000 each day – nearly 1.5 million per week. That is just over one in every 300 people every single day. According to some studies, even this enormous number will not be enough to catch the disease spreading in the population. But even assuming that it is, when scaled to the population of Europe and North America, that equates to a testing capacity of over three million individuals every single day. The implications for international supply chains are immense. The capacity to produce reagents and equipment will have to be expanded by orders of magnitude – factories will have to be repurposed and employees retrained. Coordinating this across countries will be vastly more effective than each state attempting to secure its own domestic industry. Such cooperation, however, will not be easy to achieve.
The second challenge is the ability to track the contacts of infected people. As the strategy is to keep the new cases down while allowing others to move around more, we must be able to effectively identify newly infected people and isolate them at home. As each infected person must have caught the disease from someone else, the better societies get at this, the lower the number of new cases will be. This necessity has led international conversations about tracking applications, loaded onto people’s phones, that allow tracking of where they are and who they have been near. But there are obvious problems with relying on smartphone apps: what about people who do not download them? Moreover, what about the people who don’t have smart phones at all? Given that the elderly will be over-represented in both of these groups, those who most need the app are disproportionately likely not to have access to it.
Making up for these shortfalls, we must also have huge numbers of manual, human contact tracers as well. One paper estimates the number needed at approximately one in one thousand – 65,000 in the UK and one million between Europe and North America. This recruitment is itself a colossal task: hiring, training and filling out the paperwork for hundreds of thousands of new employees in a matter of weeks. This number may be found to be too high, but the principle remains.
Confronting coronavirus is the most consuming task before world governments in living memory – and the changes made will have repercussions for years. But unless they are willing to take enormous risks with their citizens’ lives, however unpleasant it may be, this path will have to be taken.