Boris Johnson Confronts a Swedish Obsession
(Bloomberg Opinion) - Whenever you hear politics affecting pubs in the UK you know they are serious. With coronavirus infections and hospital stays on the rise, Boris Johnson is preparing new lockdown rules, including turning off alcoholics and restaurants in the north of the country. This has sparked a bitter debate in his cabinet, party, and the public about whether his caution costs too much.
As is so often the case with this pandemic, Scotland was the first to close pubs and restaurants for a 16-day “circuit break” to contain infection, although the Scottish infection rate is still well below English cities like Manchester, Liverpool and Newcastle. The new measures for the north of England seem to reflect the Scottish lockdown only with no time limit.
Johnson now has to sort of choose between Scotland's vigilance and Sweden's looseness in fighting the virus. The first approach would anger a vocal section of his Conservative Party who believe the Prime Minister's bans were misguided and ineffective. This could also weaken support for Tory in northern England, a former Labor stronghold that helped secure Johnson's election victory in December.
On the other hand, if he gave in to pressure for a laissez-fair Swedish approach and cases continued to grow, the National Health Service could be overwhelmed. He would be held responsible for every loss of life. If the measures of Scottish First Minister Nicola Sturgeon proved more effective, the political damage would be considerable.
The calculations for Johnson are not enviable. He has always defended his Covid strategy by saying that he is following the advice of government scientists. That defense looks shaky. First, the advice doesn't seem very good. Local locking doesn't work. Union leader Keir Starmer points to increased infection rates in 19 of the 20 areas in England that have been subject to special restrictions for two months. Either enforcement needs to be improved or the rules need to be changed. Over-center political decisions did not help.
Second, scientific opinion is increasingly divided. A new study by scientists at the University of Edinburgh concludes that England's lockdowns prevented the NHS from breaking through but prolonged the epidemic and increased the total number of deaths in the country.
Thousands of biologists and medical professionals have signed what is known as the Great Barrington Declaration, which is a compelling argument against bans: children are not vaccinated; People with cardiovascular diseases are not treated in a timely manner. Cancer screenings are delayed and mental health problems are on the rise. All of this will mean more deaths in the future, they argue.
Sunetra Gupta, the Oxford University epidemiologist who questioned the Imperial College model that informed Johnson's first lockdown, is one of the authors of the statement. The problem is figuring out what to do instead.
The recipe by Gupta and her co-authors, endorsed by many Tories, is effectively the Swedish herd immunity strategy, dismissed as impractical and morally offensive at the start of the pandemic. The signatories argue that while most people should live their normal lives without restrictions, those at highest risk of developing a severe form of the disease can be shielded, a policy they refer to as "targeted protection".
Not everyone agrees that this is desirable. A number of dissenting scientists note that herd immunity to coronaviruses declines over time. And there are great practical challenges in separating the vulnerable. The Barrington Declaration also does not mention the possible effects of "Long Covid", the persistent virus aftermath that is proving to be debilitating for many affected.
Nor does it address the nasty ethical problems in a policy that isolates part of society (which my colleague Andreas Kluth recently raised). "Ethically, history has taught us that the very idea of separating society, perhaps even with good intentions at first, usually ends in suffering," wrote Stephen Griffin of the Leeds University School of Medicine.
Gupta has argued that a certain level of "cross-immunity" from exposure to other coronaviruses lowers the threshold for herd immunity. In this case, getting there may be easier than originally thought. But the fact that we are still discussing herd immunity six months after the first wave of pandemics shows how little we have learned about Covid-19.
Much of the science about immunity and the spread of the virus is unexplained. Even Anders Tegnell, the celebrated architect of the Swedish approach, says it is too early to judge whether his experiment has been successful. He didn't rule out new restrictions as cases increased in Stockholm last month. The Swedes, whose health systems creaked at the first peak of the virus, have tacitly taken action such as: B. Reinforced tests that they originally avoided.
In the absence of definitive scientific answers, it is the duty of politicians to find a mix of strategies that offer us both freedom and protection. Tegnell believes that containment policies must be sustainable if the disease persists - which most lockdown rules do not.
In the UK, support for lockdowns is still strong but is declining as the economic levy clears. Still, Johnson can't really take the Swedish route. The UK's lack of a functioning mass testing system, overstretched healthcare system and lack of confidence in the government's Covid management suggest this is not the time to rip the virus.
The best Johnson can do now is something that Sweden and Scotland did well and he did badly: make a clear plan and explain it. People cannot decide how to live with the virus until they know what to expect from their government. So far this has mainly been a guess.
This column does not necessarily reflect the views of the editors or Bloomberg LP and its owners.
Therese Raphael is a columnist for Bloomberg Opinion. She was the editorial page editor of the Wall Street Journal Europe.
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