Professor Peter Watson: We need to see the exit



Professor Peter Watson

A journey of a thousand miles is said to begin with a single step. I suggest a journey needs a destination. Without this the traveller is lost.

COVID-19 has paralysed this country and indeed the world. It threatens our economy, collective life, family life and how we as human beings exist and interact. This wasn’t unexpected. Many experts have written papers and books warning of this risk. Bill Gates in his TED Talk from 2015 titled “The next outbreak? We’re not ready” has been shared widely online in recent weeks given the impact of COVID-19. He told us this would happen. He was, and not for the first time, correct.

I do not criticise the four nations’ response in the United Kingdom or that of any other country. The efforts in Westminster and in Edinburgh are relentless, our Prime Minister is recovering from the virus and our First Minister looks understandably tired but remains at the helm.

We cannot alter the past; we can make decision for today and we can shape the future. Steve Jobs said that sometimes when you innovate, you make mistakes. It is best to admit them quickly and get on with improving your other innovations.

As all economists know there is value in a mistake because this leads to improvement. So, let us not criticise our politicians. Let us encourage their efforts and let us innovate.

All of this begs the question, what now? Our present strategy of lockdown and social distancing comes from modelling by epidemiologists. These models are best-guess scenarios built on assumptions.

What the models produce depends upon the assumptions made. The policy which follows relies upon the model. Models produce a wide range of outcomes. The spread of disease depends on stopping infections. Social lockdown and social distancing will cut the spread of disease and prevent our health resources becoming overwhelmed.

The argument is that it is better to be South Korea rather than Lombardy. The first stage is to flatten the curve through social distancing and lockdown. This, if it works, means that those requiring medical attention do not exceed the capacity of the healthcare system to provide that.

The next stage is to understand that to contain this pathogen we must identify those infected by testing and trace who they had been in contact with. This is all to stop the pyramid of contagion.

It is pointless to be critical of government over the failures in testing. This is simply a learning curve which we must accept. We must make every effort on testing. Social distancing, testing when it can be rolled out and the production of adequate masks is a priority. Keeping the population at home offers the chance of temporality bringing this situation under control. But what is the endgame? What is the exit strategy?

We know little about this virus. Social distancing and lockdown may see the pandemic ebb, but could it return?

If social distancing and lockdown are relaxed will we have further outbreaks? Will this lead to periodic social distancing and selective lockdown? Will this virus survive the summer, or will this have no effect?

The next question is for those who are tested and shown to have immunity. How long will they remain immune? We await accurate testing and we need to build the data which will allow us to model outcomes and measure risk.

Is the endgame about accumulating herd immunity or is it simply awaiting a vaccine which could be 18 months or more away? We surely cannot be in lockdown for another year?

We can say with some certainty that the legacy of this pandemic will be life-changing for us all. Jobs and businesses will be lost, and the economic impact will bring recession if not depression. There will be destabilising forces in our cities and society, and we will not return as individuals or society to the point we were when this all started. There will be an effect on mental health and there will be an effect on those in our society who are or who perceive themselves to be at risk. A new normal awaits us.

Finding a way out of social distancing and lockdown and attempting to restart the economy, finding something like normal life, with schools and universities open, may ultimately come down to providing individuals with an understanding of risk and encourage them to make educated choices.

Whether we know it or not we make risk-based assessments every day and in everything we do.

While the risk of dying in a road accident in any year in the UK approaches 1 in 20,000, the lifetime risk is 1 in 240. We all use cars and buses and cross the road accepting these risks. We take steps to tackle the risk to mitigate it. Seat belts in cars, controlled crossing points on our roads, speed limits and warning signs.

Some people smoke, some choose not to. We adapt to risk and gain confidence in assessing it when we take it. There will be longer-term consequences from the current crisis. We may continue to use hand sanitiser and we understand the importance of washing hands for 20 seconds.

We may find working from home more commonplace. Conference and video calling may well stay as part of everyday life. Endless waiting lines in GP surgeries may be ameliorated by doctors telephoning and consulting by phone, FaceTime or Zoom.

Newspapers which have seen yet another decline in those buying hard copy editions may struggle to regain that readership with more of us reading online. The use of cash will decline further.

The willingness of most of the public to act on the instructions of government for the good of the many may have positive outcomes. There is also danger from those who lead us and who do what they do in the name of crisis.

We have a history of passing legislation on the hoof to deal with a perceived urgency or to answer a special interest lobby. We have rushed laws through on dangerous dogs, environmental issues and most recently the attempt to abolish the right to jury trial in Scotland albeit apparently temporarily.

Politicians can propose change cloaked in a paternalistic guise. Freedoms lost are never easily regained. Our protection is democratically elected parliaments who scrutinise, amend or vote down ill-conceived laws albeit proposed for noble reasons.

Finding an exit strategy will give us a destination. Understanding risk and how to control it will depend upon testing and a greater understanding of this virus. Those who are shown to have immunity may have a badge of access denied to those who do not.

The consequence may be greater social isolation for some and a greater sense of inequality for many. The importance of finding an effective vaccine rises by the day. But we need to see the exit.

Professor Peter Watson is legal adviser to the COVID-19 panel of scientific and medical experts convened by the Scottish Police Federation.

Tags: coronavirus



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