An attempt to share my meta-view of the last 18 months and why despite being constantly enraged by the UK’s pandemic response, I have never been surprised by it.
First published in July 2021.
(Note: This piece follows on from a previous Twitter thread)
As we approach ‘Freedom Day’ with the pandemic surging wildly and the news of a new variant having emerged in the Northeast of England, we are once again having to focus on the immediate unfolding catastrophe, which yet again was completely predicted.
Once again, despite all the evidence available and all the warnings about increasing cases, hospitalisation, long term morbidity and the risk of new variants, the UK government has taken steps that have ensured that these disastrous outcomes will come to pass.
At the beginning of the pandemic, the government and several prominent scientists dismissed the information coming from South East Asia and other countries about this novel coronavirus. They effectively chose to build up 18 months of local evidence that they could dismiss.
The point I am making (through gritted teeth) is: from our government’s multiple previous mistakes, where the current course of action will take us. Yet, we are being driven down the same road again, not for lack of information or warning or most importantly, alternative.
We now have to face the immediate catastrophe because it is absolutely urgent. However, this is what we have been doing all throughout the pandemic, as well as before because a major aspect of the operation of POWER is controlling the frame of reference.
Our news, politics, discourse, and plans for the future are kept focussed on the now, i.e. ‘We’re here now, what do we do from here?’ with little space given to ‘Why are we where we are now?’. Attempts to bring the past (everything before now) are actively discouraged.
There is a deliberate purpose to this. It creates an impression of everything up till this point having happened naturally, unavoidably, in a way that was beyond our control. If it happened because of people, it was a different people, a different time, different standards.
This framing guards the status quo of power. You can’t ask: why are resources and rights so unequal? Why can’t we address these inequalities? It is the kind of framing that talks about the problems of racism while pretending that slavery never happened.
It places us all in the now, as equal players, with equal agency and responsibility. There is no point talking about the past (except when decontextualised bits of the past can support my case or ‘it has always been done this way’), let’s think about what we do now.
In fact, harping on about the past is frankly being obstructive and uncaring about people in the present. This keeps things immediate and urgent and pretends that there is no causality over time by refusing to properly consider the impact of the past on the present.
In a pandemic, this has been disastrous. Because of the timescale an infectious disease operates, the decisions of last week can be directly linked to where we are now. And we can foresee the likely consequences of today’s decisions in a fortnight.
Yet, we are kept in a constant state of dealing with the now. Power determines this frame of reference. Now you little people can go about doing your part: justifying the now, fighting about what exactly we should now, who to blame for now, etc.
Some of you little people, especially in the media, have to help us with an important part of the work: what story should we tell about how we got to now and to justify what we are going to do next? This is what we see created in media and government narratives.
Chaotic Number 10 flags. | Number 10
The worst possible government
There are two key questions through which its response can be considered ‘What do we want to do to/with the country?’ and ‘What are we willing to do for the people?’
The answers to these two questions determined the government’s response from the very beginning and also served to help realise the (lack of) vision outlined by the answer to the first question, i.e. how can we use the pandemic to further our goals?
What we had (and still have) is a government firmly on the side of the wealthy (and contains, or is strongly connected to, many of them) (question 1) and was only prepared to do as little as possible for the public (question 2).
Pretty much the entire pandemic response has been driven by the focus to maximise the profit and minimise the loss to the first group and minimise the spending on the second. Not responding to the pandemic at all was not an option so something had to be done.
But at every step, the measures taken have been halfway ones, which have been rolled prematurely, then reinstated too late, with no significant attempt to put in any infrastructure that could have helped manage the course of the pandemic and protect the public.
At no point in this pandemic have we had mitigations in schools, proper border controls and quarantine or a functioning test, trace, isolate and support system. The support given to schools and disadvantaged communities has been abysmal.
What has happened with healthcare services has been absolutely appalling. With little support, the NHS has been expected to deal with the consequences of the government’s failure to control the pandemic with the breakpoint being ‘when the NHS is overwhelmed’.
If you think this is cynical, please remember that at every point the government had to be pressured into acting, acted late and only really when it was near impossible not to. But at every opportunity it could, it opened up further, no matter how premature and ill-advised.
This has been part of the creation of inevitability.
PM Boris Johnson. | Number 10
The creation of inevitability
At multiple points in the last 18 months, we have reach points where certain actions and outcomes have become inevitable. At each of those points, the NOW frame of reference is strongly reinforced.
Sometimes the inevitability is about immediate action, i.e. we left it so late in October that we had to go into lockdown in November. We let cases rise in December and had to close schools at the beginning of January.
Sometimes the inevitability is about not so immediate action, e.g. we are going to open up, do you want to do it in the summer or in the winter? This is a good illustration of ‘the creation of inevitability’. These are not our only choices, and they are not even equal ones.
When the government and the Chief Medical Officer (CMO), Professor Chris Whitty, talk about inevitable cases, deaths and hospitalisations, very few of these are indeed inevitable. The reality is that they have made them inevitable. We are now being asked to choose between two disastrous options.
Except we’re not really. We don’t have any choice between these options. They are being presented to explain why they are going to do what they are. We are left to fight out which of these is better because fighting it out creates distraction and discord and helps produce more justification.
A notable shift in the discourse over the last few months is the more tacit acceptance of the fact that the answer to ‘what are we willing to do for the public?’ is ‘very little’.
Instead, we are fighting amongst ourselves about which is the least bad option. ‘Look the government is not going to make schools safer, there’s no chance that will happen. So decide, do you want kids to miss more education or do you want to protect them from infection?’
It has become painfully clear that the government is not going to develop a coherent pandemic response strategy and work towards elimination. And it is not really going to put in measures to address those adversely affected by the pandemic.
Professor Chris Whitty. | Number 10
Reopening with irreversible steps
As a public, our fight moved very early from trying to get the government to control the pandemic, to damage limitation. The government’s plan has moved inexorably towards reopening with ‘irreversible’ steps and its actions have directly worsened the pandemic.
These actions have also spawned new variants and the next steps – i.e. letting a more dangerous variant rip through a partly vaccinated population – will create a perfect recipe for the emergence of more variants.
This is a global threat but they remain undaunted.
It is possible that plans for 19 July may be pushed back (again) as it again becomes inevitable to choose this course of action. But we need to remember, this will not be a change of plan, just another hiccup in the inexorable push ahead.
Herd immunity strategy
We are fortunate to have vaccines because we would have been doomed without them. Most of us who are fighting for the postponement of 19 July are trying to buy time for further vaccination rollout.
Because the government is expecting a winter surge and for the virus to be a significant issue for the next year. But it is doing nothing to combat this. Well, that’s not strictly true. What it is doing is pursuing herd immunity through mass infection in children and the young.
There is no consideration for children and the young. Right from the beginning, the government has been pursuing a policy of herd immunity. This was made explicit initially, then withdrawn and denied, but the truth is, it has always been herd immunity.
However, a lot of credence is given to the government saying that it is not pursuing this strategy. This illustrates intentionality and credibility very well. What the government says is taken as credible and therefore it must have no intention to pursue herd immunity.
Even if its actions clearly indicate a herd immunity approach, its lack of intentionality means this cannot be the case. Credibility and intentionality are privileges of power, e.g. the white man who discriminates against his Black colleague did not ‘intend to be racist’. By the way, our government is overwhelmingly composed of white men and non-whites who are very closely allied to whiteness. That is not just an interesting observation, it is a representation of who holds power in our current system.
Given the government’s guiding vision, there has been a lot of work that has been needed to be done to justify and execute this vision. Thus narratives about freedom, liberty, the oppressiveness of masks, the dichotomy of heath vs economy, lockdowns are authoritarian measures, scientists forcing lockdowns, etc. Those who are trying to help are responsible for our suffering, even though they have no power.
This is largely part of the NOW frame and the stuff that little people can discuss and fight about. However, this task would have been considerably harder without the active complicity of many experts – scientists, public health officials, and doctors.
For whatever purpose (see thread), they have worked with the government to justify and at times vociferously defend its actions. They have also viciously attacked colleagues, journalists, and members of the public who have pointed out their errors.
While we usually think about evidence guiding policy, we have seen numerous instances of evidence fitting what is possible, and then being used to justify policies, and I will list just three here. The first one is from early on in the pandemic:
This thread discusses the paper based on the government’s decision on 12 March 2020 not to carry out testing and contact-tracing because the model showed that even near-perfect contact-tracing had little chance of controlling the pandemic over the next 12 weeks. This was based on a minimum time from testing to isolation of 3.8 days. However, in March 2020, it was already possible to reduce this time to 24 hours.
Dr Deepti Gurdasani showed that with shorter durations of this parameter, with even 30-60% contact-tracing, the probability of controlling the pandemic was superior to 80%. This received a lot of flak at the time. We have since concluded that a shorter duration wasn’t modelled because it wasn’t going to happen: the government just wasn’t going to do it. But the decision was made because apparently, it would not be effective to do so.
The second example is COVID in children and the question of schools. Even now with incontrovertible evidence that children get infected and schools drive transmission and children get Long COVID, the voices arguing against this remain strident.
The third example makes this even more troubling. The current model on which the ‘open now or open in winter, better in summer’ argument is being made, actually models children being infected.
Thus opening up in summer is ‘better’ because children will get infected and this will help develop herd immunity for later in the year.
This is complicity and it all contributes to the creation of the inevitability that is apparently forcing these decisions. So, bottom line, whatever happens about on 19 July, our fight is going to be far from over.
Finally, I leave you with some depressing predictions:
- Even if there is a U-turn of some sort on 19 July, these will be horribly fudged. The government will quickly push to open up again;
- There are already calls to stop publishing case numbers, it is likely that there will be attempts to suppress the collection and dissemination of case data;
- Schools will be pushed to move to ‘normal’ in September. Changes have been made to definitions of school contacts;
- Variant reporting will be suppressed further;
- There will likely be attempts to control hospital data and strict gag orders on hospitals to prevent reporting;
- Something similar will likely happen with care homes later in the year;
- Testing will become more limited and harder to access (see plans to charge people for LFDs);
- The push for individual responsibility will move to stigmatisation, demonisation and possibly legal responses;
- ‘People are tired and suffering’ will become a broad coalition of attack;
- The existing shit regarding vaccine hesitancy, blaming people for vaccine hesitancy, arguments about vaccinating children, etc, will get worse;
- Vaccine shortages will be covered up by blaming vaccine hesitancy.
If you have got this far, your ordeal is now at an end.
— AUTHOR —
▫ Dr Hisham Ziauddeen, Psychiatrist, Neuroscientist. Clinical Senior Research Associate, Honorary Consultant Psychiatrist, University Wellbeing and Disability Champion.
GET THEM INVOLVED:
- People could be charged for lateral flow tests from next month, government reveals | The Independent
- Pfizer supply shortage forces Covid vaccine rollout to slow down | The Times
- From masks to self-isolation: which Covid rules will change in England on 19 July? | The Guardian
[This piece was first published as a Twitter thread and turned into the above article on 12 July 2021 with the purpose of reaching a larger audience. It has been minorly edited and corrected, and published with the author’s consent. | The author of the tweets writes in a personal capacity.]
(Cover: Flickr/Number 10. - PM Boris Johnson chairs a Covid-19 press conference. | 12 July 2021. / Licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.)