On Sunday, the toll from Britain’s outbreak of COVID-19 surpassed twenty-eight thousand deaths. You don’t need a graph, or to argue about the methodological niceties of how governments count their dead, to understand that the United Kingdom has had a terrible encounter with the virus. Britain has an internationally respected public-health apparatus. In October, 2016, the government ran Exercise Cygnus, a simulation of how a global influenza pandemic would overwhelm the nation’s health system and ravage the economy. Last year, Britain’s National Security Risk Assessment highlighted the risk of a mutated-flu outbreak as one of the worst—and most likely—risks facing the country, as well as the possibility of “an emerging respiratory coronavirus infection” arriving in the U.K. The Department of Health continues to describe Britain as “one of the most prepared countries in the world for pandemics.” And yet. In the weeks after December 30th, last year, when Chinese officials first informed the World Health Organization of a novel coronavirus in Wuhan, the U.K. made no striking plans to respond. Even as the virus tore through Northern Italy, and the British authorities had a chance to see, at relatively close quarters, what COVID-19 could do to a prosperous European society, they dithered. Countries such as Germany, South Korea, and Singapore, which have responded well to the virus, all appear to have followed a similar playbook of mass testing, contact tracing, and collective vigilance. Each nation that has failed is more likely to have its own particular story of what went wrong. We are unhappy in our own way.
In Britain, the most obvious misstep by Boris Johnson’s government was its hesitation to implement a national lockdown to slow the spread of the virus. During February and the early part of March, Johnson and his Cabinet embraced and then abandoned the concept of herd immunity. On March 13th, Graham Medley, of the London School of Hygiene & Tropical Medicine, who is the government’s chief modeller of the pandemic, told the BBC that in an ideal world there would be “a nice big epidemic” among the healthy part of the population. “What we are going to have to try and do, ideally, is . . . manage this acquisition of herd immunity and minimize the exposure of people who are vulnerable,” he said. Ministers quickly denied that this was the strategy, because it entailed the risk of two hundred and fifty thousand deaths, but Johnson did not switch to stringent quarantine measures until March 23rd. There was a directionless, ten-day period in which the virus was able to circulate more or less freely. Soccer matches and horse-racing festivals went ahead. Johnson joked about shaking people’s hands. Thousands of people became infected and later died. The reasons behind this drift are complex and contested. Since the start of the crisis, Britain’s politicians have sworn that they were following “the science,” even when it was clear that they were latching onto concepts, such as herd immunity and behavioral fatigue (in which people would supposedly tire of social-distancing measures), because they liked the sound of them. At the same time, the government’s Scientific Advisory Group for Emergencies, a revolving panel of some twenty experts, and its various specialist subcommittees, also appears to have given advice that was politically viable rather than aimed solely at saving lives.
But Britain’s slow lockdown offers only a partial explanation for what has followed. Germany shut down one day earlier but has had around a quarter of the deaths from COVID体育投注平台-19, among a larger and older population. On March 12th, the U.K. gave up on testing for the coronavirus outside hospitals. By April 1st, of the National Health Service’s half a million front-line health-care workers, only two thousand had been tested. (More than a hundred have now died.) In late March, Jenny Harries, the deputy chief medical officer for England, told reporters that large-scale testing and tracing—as was being practiced successfully in South Korea and Singapore—was not suitable for the U.K. “There comes a point in a pandemic where that is not an appropriate intervention,” she said.
There has been a curious mixture of superiority and fatalism about Britain’s entire response to COVID体育投注平台-19. Officials have maintained that the country has “a perfectly adequate supply” of personal protective equipment, but this has never been the case. Last week, the Royal College of Physicians reported that about a third of doctors performing “aerosol-generating procedures” did not always have access to either visors or surgical gowns. On May 3rd, a survey of sixteen thousand doctors found that forty-eight per cent had bought or obtained pieces of P.P.E. outside official channels. Among the wider population, polls show that around eighty per cent of people believe that the lockdown should continue. This is sometimes taken as approval of the government’s handling of the crisis. But it is unclear how much support for the lockdown derives from fear. During March, the number of patients coming to emergency rooms across England fell by twenty-nine per cent. The number of people who were treated for suspected heart attacks fell by half.
As in other countries, the death toll from COVID-19 has been mapped onto existing inequalities. Residents of the most deprived communities in England and Wales have died from the disease at more than twice the rate of those who live in the wealthiest. Once age and geography have been taken into consideration, patients with Pakistani or black African heritage who have been treated for COVID-19 have died at roughly three times the rate of white patients. While the N.H.S. has not been overwhelmed by the outbreak, in April the country’s care-home system reported three thousand and ninety-six deaths in the space of seven days. After the 2008 financial crisis, public funding for adult social care in England fell by about fifteen per cent and has still not recovered. “We only knew about the first case because there was a sign on the door saying not to go in without a mask on,” an elder-care assistant told the Manchester Evening News last week, about an outbreak in her facility. When she started a recent shift, there were two masks for six carers. The other four wore towels on their faces. “We have to lie to families and tell them they were settled, comfortable and peaceful. We can’t tell the truth because it will break their hearts even more,” another nurse told the newspaper. “They have temperatures which create hallucinations, they are extremely agitated. They see people, animals, they try to grab out.”
Johnson’s government has done its utmost to frame the coronavirus like any other political challenge. Since the election of Tony Blair’s media-savvy New Labour administration, in the late nineties, there has been a sort of manual that British politicians have followed when faced with an insuperable problem. One technique is to invent objective-sounding “tests” for awkward decisions. In 1997, Blair’s chancellor, Gordon Brown, devised “five tests” for joining Europe’s single currency, which Britain somehow never quite passed. Another approach is to declare a bold, eye-catching target and make that the story. In 2010, David Cameron promised that he would reduce the number of migrants coming to the U.K. to fewer than a hundred thousand per year, something that he had neither the means nor the inclination to achieve. On April 16th, Johnson’s Foreign Secretary, Dominic Raab, duly set out the five tests for easing the lockdown, at least one of which—avoiding a second wave of infections that swamps the N.H.S.—seems like a hopeful guess, at best. Last week, the British media feverishly covered the race to perform a hundred thousand coronavirus tests per day by the end of April, the distracting goal set by Matt Hancock, the Health Secretary. (The target was met by putting some fifty thousand tests in the mail on April 30th.) When outlets have investigated the government’s poor handling of the pandemic, they have been accused of bias and misreading the public mood. Last weekend, the Culture Secretary, Oliver Dowden, complained to the BBC about its reporting on the shortage of P.P.E.