After the Spike: Should ‘We’ Do What ‘They’ Tell Us?

April 24, 2020, 10:55 AM UTC

The government is still discouraging any speculation about how it envisages releasing us from the coronavirus lockdown. Any such talk, it believes, would compromise the single message it wants to hammer into our thick heads: stay at home, protect the NHS and save lives. But it has been criticised, even by some of its own supporters, for treating us like children. We’re adult enough, it’s claimed, to start thinking about how restrictions might gradually be eased without it weakening our resolve to do what’s necessary now. But what about that world beyond the ‘spike’ in the pandemic: will we still need to be told what we can and cannot do then, or should we be able to make more of our own decisions

I guess it’s fair to say that when the pandemic first broke out most of us thought it would inflict a sharp, unpleasant shock, that ordinary life would necessarily be turned upside down for a while, that many people would die, but that then everything would quite quickly get back to normal and we could all resume where we’d left off. Certainly that would have been our view if we had followed the lead of the Prime Minister who, you will remember, reassured us that the virus would be ‘sent packing’ in no time at all. It’s not quite working out like that. Instead the virus had a go at sending him packing and now, as he recovers in his convalescent hospital at Chequers, those who have spoken to him there are reported to find him ‘tentative’ in his general outlook. That must be a first. Still, I suppose everyone is entitled to learn on the job.

Now he and the rest of us realise we are in for the long haul. There’s little talk any more about the long, balmy days of summer bringing with them a return of things past. Instead there is only the most ‘tentative’ talk of the lockdown being relaxed bit by bit and even then only where it is necessary to stop the economy from collapsing entirely. As for the ‘non-essential’ aspects of life – forget it. Social distancing and other curbs on our habitual ways of living will have to go on right through those long summer days, through the autumn, the winter and maybe beyond. Or that’s what we’re being told.

On Wednesday the government’s chief medical adviser, Professor Chris Whitty, said: ‘We have to be very realistic. If people are hoping it’s suddenly going to move from where we are in lockdown to where suddenly everything is gone, that is a wholly unrealistic expectation.’ Only a vaccine or effective drugs acting as a cure would ultimately release us, he said, and ‘the probability of having those any time in the next calendar year is incredibly small’. He added: ‘This disease is not going to be eradicated, it is not going to disappear so we have to accept that we are working with a disease that we are going to be with globally for the foreseeable future’. So much for it being sent packing.

This depressing new prospect raises all sorts of issues - not least how we should behave. Up to now we’ve been ‘behaving’ pretty well, if the reported views of cabinet minister are any guide. It seems they didn’t expect us to comply as fully as most of us have to the severe restrictions

The point about this sudden emergency is that it was and still is an emergency in public health. The reason we had to be told what to do – or at least be very strongly guided, with criminal sanctions hovering in the background – was that our behaviour affected not just our own chances of staying well but the health of everyone else. It wasn’t so much that if we broke ranks we stood a risk of going down with the virus ourselves (in which case, our stupid lookout); it was that we would risk passing it on to others. With ‘R’, the re-infection rate, at well over 1 (meaning each of us who got the virus would be likely to re-infect more than just one other person), and given the arithmetic of exponential growth, if we did defy the rules we’d be putting many other lives at risk and exposing the NHS to unsustainable pressure of demand. Hence the slogan about staying at home, protecting the NHS and saving lives. The paramount needs of public health required our compliance and largely we have accepted that.

But how will things be when we settle down into the long future we are now promised when the virus is still very much with us, there is still no vaccine or cure, but ‘R’ has come down to the point where the government is ready to take the risk of starting up the economy again? Or, to put it another way, once the crisis in public health becomes less severe should we still look to ‘them’, the government and the experts, to tell us what ‘we’ can and can’t do, or should we reassert our right to make such decisions, and take such risks, for ourselves?

There are already signs that ‘they’ – that is, not just government ministers but experts in the field and self-appointed gurus – believe that they should go on regulating our behaviour in the long, possibly permanent twilight of the pandemic beyond the spike. For example it has been suggested that when those of working age start being allowed back to work, the ‘elderly’ (or anyone aged seventy or over) should continue to be required to follow the current restrictive regime and, basically, not go out at all.

But why? The answer given is that if such people were to resume anything like their old life of getting out and about, they would be much more likely to catch the virus and much more likely to die of it if they did. It’s possible to question whether those over seventy (like me) are more vulnerable to infection unless they are already of weak health (which of course many of them are not. But it’s also true that people who become infected at that age are more likely to die of it than younger people are. Even so, shouldn’t each ‘elderly’ person be free to make their own decision about whether or not to take the risk rather than be told by ‘them’ what they may or may not do? Many might well take the view: ‘Sod it. I’ve had a good innings. If I can’t get out, life’s hardly worth living. Let’s take the risk.’ Who’s to say that isn’t a perfectly understandable and even sensible approach if the virus is to be with us ‘for the foreseeable future’?

Well, some would certainly say they shouldn’t be allowed to take such a risk and ‘be so irresponsible’. The argument would be that since elderly people do run a much greater risk of becoming seriously ill if they catch the virus, it would add an undue burden on the NHS if they were to be allowed to put themselves in danger’s way. It might be a shame if they can’t see their grandchildren but, sadly, that’s necessary if we are to ‘protect the NHS’. Yet if elderly people exercising such freedom did indeed risk adding undue burdens on the NHS (and it’s hard to deny they might), so what? Smokers have been adding undue burdens on the NHS for decades but no one has seriously suggested that they be banned from smoking as a result – unless they do it in public places.  All illness could be regarded as adding undue burdens on the health service but dealing with those burdens in a free society is what the NHS is there for. Are we to say that allowing grandparents to see their grandchildren) is a burden too far?

To which the reply might be: well it’s not as simple as that. Many elderly people live in care homes. Are they to be allowed to make their own decisions about whether to venture out into the wider world or to have visitors once again calling in to see them once the spike is over? Surely not: it would be the height of irresponsibility because in doing so they might then catch the virus and soon it would be all over their home. Haven’t you seen the latest figures of the virus sweeping through care homes? It’s a fair point. But it still leaves open the question of who, when we reach the ‘new normal’ Professor Whitty has outlined, should decide whether old people in care homes should be allowed visitors or let out on excursions after the long seclusion from their loved ones and the wider world. Is it so obvious that ‘they’, the government and the experts, should be the ones to decide? Perhaps the care homes might be allowed take their own decisions, even if they all end up taking different ones. Perhaps the residents themselves might have a view: after all, when you’ve only got a short while left to live you might have rather strong views about how you want to use the precious time remaining to you.

Or take another example. The idea is going almost unchallenged that when the lockdown begins to be eased in order that the economy should be started up again, pubs, clubs, restaurants and the like will ‘obviously’ have to be forced to remain closed. Why? Shouldn’t they be allowed to reopen (if their owners choose to do so) and for each of us to take our own decisions about whether to go to them or not, knowing full well that in a world where the virus still exists there is a chance we might catch it? Ah yes, say those who want to persist with the government-imposed ban into ‘the foreseeable future’, but that’s a sure fire way of getting a second spike. But how do they know that? The fact is that they cannot be sure. It might well turn out that people will emerge from the current emergency extremely risk-averse. ‘Go to the pub? You must be joking!’ If we were to let the pubs and restaurants reopen and leave it to individuals to decide whether or not to use them, we might well find out that a low take-up by the public would pose no danger of refuelling the pandemic. But – and here’s the point – if it turned out that it did, and the infection rates started to rise once more, wouldn’t that be the point at which ‘they’ should intervene and close the pubs and clubs once again? In the meantime, shouldn’t ‘we’ be left free to use our own nous a bit?

What all this boils down to is a question about the balance between the state acting as protector and individual liberty. We have seen in the last month the public’s willingness to have its own liberties curtailed by the state in the palpable interests of public health. But in a world where an emergency evolves into a new semi-permanent state of equilibrium in which there is one highly infectious disease more than there was before, should we persist with the approach improvised during the emergency, of highly restrictive state control, or should we ‘trust the people’ and try to restore some of the liberties that have had to be suspended?

What’s your view? Let us know.