Neither Pro Or Anti

The recent announcement of the UK Government to reimpose a nationwide lockdown has prompted a slew of recrimination with many posing the question of why these additional measures were not enacted sooner. Among the many responses that were given one that seemed particularly egregious1 was that the leader of the opposition had suggested a national ‘circuit-breaker’ lock in line with the SAGE, the Scientific Advisory Group for Emergencies recommendation, prior to the governments most recent suggestions and as such the government could not be seen to be following the leader of the oppositions lead.

I would argue however the partisanship that appears to have divided those who have argued for measures to contain the virus and those who have argued for the so-called herd-immunity approach betrays an inability to engage with many of the factors that have led to the virus spreading and perhaps more importantly what should form part of a coherent, just and fair response.

In an October article entitled the “The Lockdown Left: Socialists Against Society” the ever opportunistic Spiked magazine gleefully poked fun at what they called the ‘Lockdown Left’2 who apparently consist of the Labour Party, trade unions and various media personnel. Among their crimes is cheering for the “draconian” measures enacted within the coronavirus act and calling for a national lockdown for reasons that apparently expose their “callousness and misanthropy”. Supposedly what is at the root of the lockdown left’s call is not public health and safety but “a precarious, de-unionised workforce on hand to maintain their standard of living”.

As crass, and suggestive as the Spiked article was it does appear to speak to a reality in which lockdown has become conflated with a particular political persuasion, the anti-lockdown marches and various grassroots groups springing up around them are among other things fixated around freedom and what is felt to be an increasing lack of it. This is not without context, the coronavirus act restrictions on free association are indeed a cause for concern and somewhat worryingly recent changes seem to have moved to restrict the freedom to protest3. Similarly the fines levied against those found in contempt of the rules have also had a chilling effect on various protest events with trans pride being prematurely shut-down due to the speakers being targeted with fines this despite the fact that the event largely observed both social distancing and mask wearing.

When asked what alternate measures should be taken many gesture towards the Barrington Declaration which suggested shielding the vulnerable whilst relaxing rules on association on the young, fit and mobile. Whilst  perhaps many might be seduced by the promises of freedom, the declaration seems to speak to an inability to grasp what is at hand, as well as many of those dying from the virus being concentrated within the BAME community, around 59% of deaths also occur among people who are classified as having a disability.

This combined with the existing policies surrounding disability support, particularly that afforded to those in care have lead to a situation that the left-wing film maker’s Prolekult have described as “eugenic” in nature, in their film ‘Camps of Dependece’4. Even aside from this closer examination of the claims made by the Barrington declaration fail to stack up to scrutiny, for example, the much vaunted herd immunity, if applied to a country like the US where there have been over 9 million reported cases of the virus5, less than ten percent of the population currently appear to have antibodies6. Now even if it were true that the virus appears to be far more prevalent in society than is reported by the testing7 this still leaves an incredible number of people who potentially still could be infected by a virus at least 10 times more than influenza with the resulting hospitalizations likely to further strain a medical system which, in various localities has already been pushed to the brink8.

All this leaves the window open for physicians to be potentially confronted by what might have seemed to be morally unacceptable choices and, given the doubts sown on how long-lasting immunity built by exposure to the virus might be9 for reasons that may not even solve the problem posed by the virus.When asked about my own thoughts towards lockdown I generally offer two specific reports. One is a report from April which suggests asymptomatic infection is generally fairly rare10 the evidence for this varies however the general suggestion is that pre-symptomatic transference appears to happen more than asymptomatic transference11. This lends weight to the idea that rapid contract tracing where the venues where an infected person has been are quickly contacted and subsequently the people who have also been at those venues are asked to self-isolate. The other report I offer is adherence to self-isolation, where either upon being asked to self-isolate as a result of being reached by a contact tracer or having received a positive test, an individual abides by the strictures of self-isolation. This, in various reports has been found to be remarkably low12.  A closer look at the support for those self-isolating reveals a significant lack of job support which possibly betrays a reason why many might choose not to follow the guidelines13.

As such, the failure to meet either of these particular conditions in building effective test and tracing capabilities and/or providing adequate support to those required to self-isolate is what has led to the current situation14. Lockdown then is not a solution rather it’s a stalling measure to work towards a way in which we can still live with and eventually suppress the virus, whilst I’m not against it’s implementation as a tool the choice is not as it is often framed a binary one with the continuing reduction of socio-economic life or rampant contagion being the only courses left available.That the question is often phrased as a choice between either the economy or human life is is ultimately a false choice15.

With hospital capacity in various jurisdictions already appearing not to be able to match the number of people who could potentially experience complications16 were the virus able to spread unchecked the resulting hospitalizations and advance care required would drastically impact both, not to mention the ongoing care needed by those suffering from long term symptoms of the virus some of whom have been unable to resume economic activity since their initial infection17. Whilst Reason get’s close in acknowledging the need to implement various measures, such as masks and social distancing whilst still preserving the freedom of the individual so core to the libertarian ethos that underlies the magazine, the lack of incentives for individuals to pursue measures such as self-isolation is notably absent.

The combination of the two alongside occasionally stringent containment methods such as those employed in New Zealand has led to several weeks without community infection18. A similar feat, albeit with some relapses and local infections has occurred in Australia. Whilst unfortunately the initially laudable efforts by Kerala to contain19 the virus appears to have become unstuck20 they still point the way forward, local contact tracing with high stakeholder engagement and strong community support, both economically for workers who are required to self-isolate and socially to prevent what has rightly been pointed out as the exacerbating effect continuously remaining in the same place is likely to have on those who struggle with mental health.

This appears to be how we can live with and eventually suppress the virus, balancing individual autonomy with the requirements of public health without the necessity for stifling top-down restrictions. To be dogmatically anti or pro lockdown misses the goal, to drive down infections, whilst still giving ourselves the options to use the best tools we have to achieve this, the power of our shared solidarity and the creativity driven by our autonomy.

Notes

  1. https://www.politicshome.com/news/article/boris-johnson-accused-of-being-an-opportunist-all-his-life-by-keir-starmer-as-they-clash-at-pmqs-over-circuit-breaker-lockdown
  2. https://www.spiked-online.com/2020/10/19/the-lockdown-left-socialists-against-society/
  3. https://www.theguardian.com/world/2020/nov/03/protest-exemption-set-to-be-removed-from-england-lockdown-rules
  4. https://youtu.be/cJQphVk0FMk
  5. https://www.arcgis.com/apps/opsdashboard/index.html#/85320e2ea5424dfaaa75ae62e5c06e61
  6. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32009-2/fulltext
  7. https://www.theguardian.com/world/2020/apr/17/antibody-study-suggests-coronavirus-is-far-more-widespread-than-previously-thought.
  8. https://www.theglobeandmail.com/world/article-hospitals-pushed-to-the-brink-of-capacity-as-us-faces-surge-in-new/
  9. https://www.thehindu.com/sci-tech/health/long-term-immunity-in-doubt-as-uk-study-finds-covid-19-antibodies-fall-rapidly/article32954603.ece
  10. https://www.cnbc.com/2020/06/08/asymptomatic-coronavirus-patients-arent-spreading-new-infections-who-says.html
  11. https://coronavirusexplained.ukri.org/en/article/und0006/
  12. https://www.theguardian.com/world/2020/sep/11/less-than-20-of-people-in-england-self-isolate-fully-sage-says
  13. https://twitter.com/ScienceShared/status/1322896475555323907
  14. https://www.theguardian.com/world/2020/nov/02/covid-lockdowns-are-cost-of-self-isolation-failures-says-who-expert
  15. https://www.theguardian.com/commentisfree/2020/mar/26/coronavirus-us-economy-health-lives-trump
  16. https://www.politico.com/news/2020/10/16/pandemic-states-virus-rebound-429753
  17. https://www.telegraph.co.uk/news/2020/08/19/long-covid-real-patients-suffer-debilitating-symptoms-months/
  18. https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30225-5/fulltext
  19. https://www.thehindu.com/opinion/editorial/the-mark-of-zero-on-containment-of-covid-19-cases-in-kerala/article31512638.ece
  20. https://www.bbc.co.uk/news/world-asia-india-5343167215.

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