In the late 1980s, the biggest medical puzzle of the day was how to design an HIV vaccine. Dozens of well-funded laboratories were on the case and a solution seemed within the grasp of researchers. Thirty years on and there’s no HIV vaccine. This sobering fact ought to bring us up short. We want to believe that a treatment for Covid-19 is just around the corner. But we must steel ourselves that a vaccine, as the head of the Wellcome Trust warned, is not a given.
While no expense should be spared to find a vaccine, the UK government must also display the wherewithal to design an administrative system to support and enable the public to live with this threat. That means getting the basics right. So far the signs have not been good. In Britain, everywhere you look you see a state overstretched and driven by politicians’ panic rather than careful planning.
Compare this with democracies as different as Taiwan, Australia, Germany and South Korea. They have kept their death tolls low by using a combination of physicial distancing, tight travel restrictions, mass testing and contact tracing. The spread of the disease has been mapped and programmes run to identify not just those who are sick but those they’ve been in contact with. What leaders in these countries have not done is make over-the-top claims that they are getting on top of a problem when it is plain they are not. The health secretary, Matt Hancock, said we’d have 100,000 tests by the end of the month. Mr Hancock is on course to miss his target by a large margin. In his defence, the prime minister had gilded the lily more extravagantly than he had.
There do not seem to be coordinated, sustained efforts by the government to ramp up capacity to meet the challenge posed by coronavirus. Test kits, reagents, swabs, personnel, personal protective equipment have all been identified as bottlenecks. The longer we take to get mass testing and contact tracing going, the longer Britain is stuck in lockdown. That is why Simon Clarke did little for public confidence when he said it was not his job – despite being the local government minister – to press council health workers into a contact tracing programme.
Ministers need to level with the public over the shortfalls and blockages. The NHS, the Department of Health and Social Care, and devolved administrations should be publishing what PPE is being distributed and how far this falls short of what is required by hospitals or by how much it exceeds their need. This is about being accountable, not a finger-pointing exercise. There should be no reason for doctors to wear ski goggles instead of masks, and nurses using cagoules rather than protective gowns. In Italy, healthcare workers experienced high rates of infection and death partly because of inadequate access to PPE. Here the death toll of such staff has risen past 100. Clarity needs to replace ambiguity when dealing with matters of life and death.
If ministers respond imaginatively to the coronavirus crisis, they will have a chance of reversing a decade of decline. They need to change tack. They must shed ideas of British exceptionalism that saw them waste chances to purchase kit and protective equipment on the global market, as well as harbour delusions that “herd immunity” was a way out of the pandemic. We must look to other nations to see what works, and copy it. At some point ideology will intervene – usually to the detriment of the country. Conservatives have done great damage by finding succour in Ronald Reagan’s wrong-headed declaration that “government is not the solution to our problem; government is the problem”. What the pandemic has taught us is that our health depends on each other. The fight against a virus is necessarily collective – and a creative government acting decisively needs to lead it.