Some countries have controlled the virus more or less successfully. Some common factors seem to be: a willingness to lockdown and quarantine early, effective tracing, strong social compliance – and a lack of fat people.
The UK is notorious for having a lengthy and debilitating lockdown leading to huge economic damage alongside one of the worst death rates in the world. There are various reasons for the UK’s very high mortality rate. They include: high rates of obesity, a grotesque blunder (in fact a deliberate policy) in releasing Covid infected people into nursing homes early on in the crisis (alone causing 18,000 avoidable deaths), a lack of social compliance with restrictions, and a tendency throughout the crisis to bring in lockdown and border quarantine measures too late – especially relevant is the way that even as Italy was being engulfed in crisis in March 2020 people were still being allowed to travel to France and Italy for holidays and bring the virus back with them. The disaster has been partly due to ineptitude on the part of the country’s leading scientists e.g. Patrick Vallance and Chris Whitty (going for ‘herd immunity’ as the first response) and partly a result of the Prime Minister’s inability to ever be seen to be taking an unpopular decision. A decision to outsource the contact tracing to private companies seems also to have played a part. It turns out, predictably enough, that local officials are more effective than untrained call centre operatives at obtaining compliance with quarantining measures. The figures for the numbers of people who have caught Covid while in hospital are shocking.
The restrictions continue and look set to continue for a considerable period. But it remains a fact that for people outside the high-risk groups Covid 19 is a low-risk disease. Not fun, more serious than flu, but nonetheless one which probably doesn’t justify abandoning normal life and living in caves for 5 – 10 years.
The UK’s response has not been rational. It has been controlled by various shibboleths. These are: the tendency to fetishize the NHS; surveillance and punishment as the primary resource of government; and ‘greed and capitalism‘ as a solution to all problems.
The NHS has very little space capacity. There are not very many empty ICU and acute care beds even at the best of times. The controlling principle (after the early herd immunity gambit was abandoned) has been to control the number of cases reaching hospital. This is still the guiding principle. This has been done by lockdowns and an attempt to trace contacts of those who are infected – simply to supress overall infection rates and control the flow into the very limited number of spare beds in the NHS. 60 million people are being controlled because of a lack of some tens of thousands of spare beds in hospitals.  The regime has been brought in by legislation. There are fines for non-compliance. The police have enthusiastically embraced their role of lockdown policemen – in many cases exceeding their lawful authority and fining people for not obeying guidance. The rate of cases arriving at hospital is being controlled by the kind of surveillance and punishment system outlined as the paradigm of modern societies by Foucault. It isn’t particularly effective it seems (even after weeks of lockdown the UK’s R number is barely below 1 in March 2021 – 0.7-09. on 29/3/21) but it is the paradigm so the solution has been done in these terms.
A second shibboleth of contemporary UK society is the ideological principle that all social problems can be solved by giving enormous sums of money to (often US) multinationals to ‘deliver’ solutions. Test and Trace cost billions and made a ‘marginal’ difference at the height of the pandemic. More recent research has shown that it is isolating by infected people and not by contacts of infected people which makes the significant difference to transmission – thus further calling the whole Test and Trace operation into question. But the important principle was maintained – shovelling huge amounts of public money (in this case borrowed) into private hands.
As Ivan Illich would certainly have understood the actual and needed solution was not one which can be ‘delivered’ in a top-down approach. Sars-Covd-2 is a respiratory virus. How to reduce transmission of such viruses is well-known and simple. While the virus does transmit for a certain period during the course of an infection asymptomatically nonetheless the single key factor would be for symptomatic people to self-isolate. A simple campaign to encourage this – together with financial support for those on low-incomes would probably have been as effective as the entire lockdown and Test and Trace systems in reducing transmission and overall case numbers. But the automatic reflex is a punishment and surveillance system because this is the paradigm of the day. Despite the fact that the rhetoric about reason and democracy – the ostensible values on which UK society is found – would propose instead cooperation and voluntary consent.
The problem of limited bed space in NHS hospitals has an obvious solution: build and operate special field hospitals. We were told (after huge sums had been spent building them – guess what) that there were no staff to run field hospitals. But this isn’t true. They could have been run by a combination of army medics, trainee nurses, fast-trained auxiliary nurses, volunteers, and imported professional nurses (e.g. from New Zealand – were cases are very low). Keeping Covid cases in dedicated large field hospitals would a) have more or less completely removed the rational for lockdown (controlling the flow of cases into the very limited ICU and acute care units in NHS hospitals) and b) massively reduced case numbers of people catching Covid in hospital, thus reducing overall deaths. Why didn’t this happen? Probably because the NHS is a closed shop and it would have horrified the leadership (in Public Health England) to have had a very public demonstration that the NHS is not indispensable, and cannot in fact cope with an epidemic. There is no rational reason why it should be able to cope with an epidemic. But the imagery and mythology – the fetish around the NHS – requires that the illusion of an all-encompassing capacity to save be maintained.
A rational approach to the virus would have been a) to rely on infected and symptomatic people to self-isolate voluntarily, financially supporting those on low incomes b) to have used testing discriminately e.g. to protect nursing homes c) to have built field hospitals and d) to have imposed border controls at the start of the epidemic to reduce the initial wave. Such an approach of course would not have enriched large numbers of people who already have quite enough money. And it would have (and this is the worse horror) and shown people that self-reliance and voluntary cooperation is more effective than top-down solutions involving large state and private corporations at solving problems.
The scale of the disaster in the UK is directly the result of irrational clinging to various fetishistic and totemic poles of the modern paradigm. There is no sign at all that this is going to change in the near future. (Though if Foucault is right – we can expect paradigm shift at some point).