Covid-19 lockdown highlights Britain’s public health policy

by Colin Fox, SSP national co-spokesperson 

· Britain is in a dark place today, one it has never inhabited before. The Government’s ‘lockdown’ leaves an old world behind for ever. Nothing is ‘normal’ now. These measures would be extraordinary even in wartime. Take the emergency economics for example. This was a Government who claimed there was no money left to borrow after it bailed out the banks.

That fiction has been jettisoned by this pandemic. Now it’s spend, spend, spend. It has borrowed £330billion to help businesses survive the next three months, to cover 80 per cent of UK PLC’s wage bill, to refund season ticket travellers’ losses incurred whilst self-isolating and to defer all mortgage and rent defaults. Although it has rather blotted its copybook by failing to provide support thus far for five million contractors, the self-employed and those in the gig economy!

Comfort zone
Nevertheless the enormity of this commitment reveals a great deal. Not least that the UK state was the only element of British capitalism capable of seeing the economy through this ‘national emergency’.

The situation would be unimaginably worse and the civil unrest uncontainable had it not. Britain’s economy must wait until the acute public health emergency has passed.

Conflicts like this do not play to the strengths of the political Right. Unparalleled state intervention and egalitarianism are not values they like to advocate.

Out of their comfort zone politically they also get things wrong. And as the progressive public health expert Professor Allyson Pollock points out the Tories started this emergency in the wrong place.

Comparing the approach taken by China, Hong Kong, Singapore and South Korea for example, who quarantined infected patients immediately, Italy, Iran, Spain, the USA and the UK all allowed the virus to spread throughout the entire population.

That is why the morbidity rates are so much worse. Allyson Pollock’s central charge is that the important public health specialism has been a casualty of the Left/Right conflict within the UK clinical community over the past 30 years.

‘The Government’s actions on Covid-19,’ she writes, ‘sheds light on the catastrophe unfolding economically, socially, and health wise. We can see the lack of public health input and the decimation of the speciality and expertise in communicable disease control prior to and after the Health and Social Care Act 2012… our government has failed to learn from and apply the meticulous lessons of the China WHO report that fundamental to tackling Covid-19 is “extremely proactive surveillance to immediately detect cases, very rapid diagnosis and immediate case isolation, rigorous tracking and quarantine of close contacts”.

The UK outbreak is being centrally managed rather than centrally coordinated, with insufficient foot soldiers on the ground. This, combined with the devastating cuts to community-based communicable disease control and its fragmentation, has created a perfect storm.

The Government has not applied the lessons from the H1N1 epidemic that the advice of operational public health experts be incorporated alongside that of modellers.’

Her conclusion is that this outbreak could have and should have been handled much better. She indicts global capitalism and the travel industry in particular for making pandemics like this much more likely and more difficult to contain. Who then is it at most risk of dying, she asks? The rich and poor equally?

Certainly not. Dietary inequalities effectively incubated this virus just as it did with Asian flu and Swine flu before it. Population density skews morbidity rates further because the poor are unable to isolate themselves effectively, something patently easier in rich suburbs than in cramped urban ghettoes.

The UK Government’s approach to this epidemic is to rely on isolation for the next 12 weeks. Expected morbidity rates will therefore be high.

Scottish Public Health Chief Catherine Calderwood calculates that ‘each of the patient deaths reported so far will have been in contact with 1,000 other people. And the people in Intensive Care Units across Scotland today will have been in contact with 500 others over the past fortnight.

We are where Italy was two weeks ago’ she warned inferring Britain too is heading toward 10,000 deaths.

Key workers
Given the magnitude of this calamity when Nicola Sturgeon said at her 23 March daily press briefing: ‘I have no problem with people asking questions’ uppermost among them surely must then be ‘When did she know her public health plan compared so badly to the ‘proactive surveillance’ used in China? And was she herself not slow to acknowledge the terrible risks this failed strategy ran?’

But perhaps the most profound question of all this health emergency poses is who is really more essential to Scottish society; is it our key workers, nurses, carers, supermarket staff and food producers?

Or the overpaid bankers, yuppie lawyers, highland hoteliers and narcissistic TV ‘celebrities’?
Let’s hope the answer to that question is remembered when this emergency is over. For it speaks to the kind of society we now urgently need to build.