Tackling the virus


There are three government models for tackling the pandemic.

The first is to give priority in all policy matters to curbing the spread and reducing the death rate from the virus through strong national action. The UK and most other governments tried this in the spring. The problem with this approach is that as soon as governments relax the virus spreads again, leading to pressures to shut down more of the economy for a second or successive times. The concentration of resources is difficult to sustain for long periods, leads to unwelcome deaths from other conditions that can go untreated or may be exacerbated by the policy, and merely delays the spread of the pandemic itself.

The second is to see the problem of public health as one for local government. Patterns of infection and pressures on health services vary widely within the same country, so why not have a menu of possible actions for local government to adopt as they see fit? This is the US model, where State Governors led the responses to the virus, drawing on Federal resource and law where needed. The UK has also been moving more to this model in recent weeks with a three tier approach to lock down.

The third is to trust people and free institutions within a democracy to make their own decisions about how and whether to protect themselves from possible transmission. Government sets out the dangers and passes on national and international knowledge about the threat and the spread. Government also provides support for those who wish to shield themselves, offering the ability to work from home, to have home deliveries and help with technology to switch more of their lives to on line. Governments can message that people need to keep their distance from possible infection, wash their hands and reduce their risk through their choice of travel and work patterns.

Forming hybrids of these approaches is complex. Devolved and local governments often want a say but do not want to take full responsibility. They may wish to lock down, but see it as an opportunity to demand other policy initiatives and resources from central government. Some wish to play politics with it, to try to shift blame onto national government and cast them in a poor light.

My advice is to keep working away on a wide range of actions that can tame the virus and make living with it less dangerous. The medical teams are now coming up with a wider range of drugs to treat the severe forms of the disease, and the death rate in intensive care is dropping. More can be expected from improved understanding of the disease and from trials of better treatments. More knowledge and communication about how the disease spreads should lead to more people opting to take precautions voluntarily, to reduce the risks to themselves, which should help.

It is difficult to see a Test and Trace scheme which can guarantee success as democratic governments hope. Delays in testing and getting results, imperfect recoding of who was present in an infected location, false results from tests, and reluctance by some to self isolate owing to the difficulties it poses for their lives mean it is not the silver bullet some seek.

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