Professor Chris Whitty, the government’s chief medical advisor, has just assured us that the latest deaths from the coronavirus are all among over-60s with underlying medical conditions. But how many over-60s, over-70s, and over-80s do not have some underlying medical condition? Whitty is really reassuring us that the casualties are old.
And for our cost-benefit accounting policy makers, the old are expendable, a bed blocking burden on the NHS. Which, presumably, is why our government, unlike any other, has put its faith in the alternative ‘herd immunity’ paradigm of epidemic control, according to which we should aim for 60 or 70 per cent of the population to be infected by the virus so that their immunity guards against further spread and future outbreaks.
As part of this strategy, the elderly will be ‘shielded’ while the rest of the population gains immunity. How? By being isolated – i.e. locked down – at home. And if they display symptoms and need care? Well, according to health secretary Matt Hancock on the Andrew Marr show this morning, carers can still assist so long as they keep at least two metres away.
Government ministers and spokesmen appear on an hourly basis to inform us that the emergency measures taken in other countries are unnecessary, and that their own policy is based on ‘the best scientific advice’ and ‘the best scientific evidence’. But why is ‘the science’ in Britain so different to that in the rest of the world? The answer, it seems, is that the British government has privileged access, through its Cabinet Office ‘behavioural insights team’ to the resources and modelling of behavioural science.
These tell us that instead of drastic containment measures enforced by government, we achieve more cost-effective results by overcoming the ‘behavioural barriers’ that prevent us from washing our hands fifteen times a day and cause us to touch our faces fifteen times an hour. That way, the spread of the virus can be slowed, the resources of the NHS not overwhelmed, and ‘herd immunity’ developed.
It’s not that lock-down would not be effective (witness China), or that it would be too costly (although of course it would), but that according to behavioural science, it could not be sustained for long. Only interventions that change people’s ‘preventative behaviour’ and enable them to overcome their ‘biased decision-making’ are effective in the longer run.
Anthony Costello, former director at the World Health Organisation and current director of the UCL Institute for Global Health, has pointed out that since we know little of people’s immune responses to Covid-19, it is dangerous to trust to herd immunity, and the cost in casualties, particularly among the old and vulnerable, could potentially be much higher than if drastic containment action were taken. But this is clearly a risk the British government, keenly conscious of the need to minimise economic disruption, and minimise costs, has decided to take.
So, while Macron has advised the elderly and infirm in France to stay at home ‘as far as possible’, closed schools (because ‘our children and our youngest, according to scientists, are the ones who seem to spread the virus the fastest’), banned public gatherings, closed restaurants, and promised to ‘massively increase hospital capacity’, we still dither. The time ‘has not yet come’, according to the models of the ‘behavioural insights team’. In the meantime, the elderly are advised not to go on cruises, and we are told we should all keep washing our hands.