While the lack of beds and staff plight are all too real, what hospital doctors and nurses see on the wards does not reflect the average experience of Covid-19, writes Professor Robert Dingwall (pictured)
The reports from UK hospitals over the past few days have been truly worrying. Nobody should doubt the reality they are facing or the suffering of seriously ill patients and their families.
Worrying infection rates and daily death tolls, while not to be ignored, are not the only way to understand this pandemic and our attempts to beat it. After all, there is real hope for the future thanks to the creation of new vaccines.
But we still need clear heads if we want to let go of the restrictions that cripple normal life. Above all, we need to dispel the current mood of fear and the arguments of those who live off that fear.
Covid-19 is neither a conspiracy nor a joke. We were right to be concerned in spring 2020. Now we must begin to move on from that and call for a plan to dismantle current government controls in line with the ongoing vaccination program.
The first thing we need is perspective. While the lack of beds and staff plight are all too real, what hospital doctors and nurses see on the wards does not reflect the average experience of Covid-19.
ICU footage looks dramatic on television, but as the government's chief scientific adviser Sir Patrick Vallance noted last March, most people go through the infection and calmly recover in the community, not on wards. Desperate and angry voices from hospitals appeal to our feelings, but they must not dominate our way of thinking. Crisis management is not the same as planning.
Then look at the vaccination program and what it can achieve. My medical colleagues expect that the average risk of death for the population from Covid-19 will decrease to that of a healthy person between the ages of 16 and 60. In other words, very little indeed.
What precautionary measures can we stop when we vaccinated everyone at highest risk by the end of February? Which restrictions will be lifted? And when we have completed Phase 1 by vaccinating everyone at above average risk in late March or April, what are we going to stop? These are important questions, but there are still no answers
All of this can be done quickly. Around 80 percent of the risk reduction is achieved by vaccinating the country's first four priority groups, that is, all those over the age of 70, about 13 million people. The government hopes to achieve this by the middle of next month.
It's a game changer. In a vaccinated population, Covid-19 usually means a few days off and very rarely leads to serious illness. It will go completely unnoticed at times.
Chris Whitty, the chief medical officer, points out that we expect 7,000 to 10,000 deaths from influenza in an average year. According to reasonable calculations, the vaccination program should bring Covid deaths below this level and make Covid less fatal than the flu.
Most of us got it from time to time, but we shook it off and got on with our lives. It certainly wouldn't make sense what kind of restrictions we're seeing now.
We do not lock society up against colds, seasonal influenza, or other respiratory viruses because we accept the occasional inconvenience of infection as the price of living our lives the way we choose and enjoying the benefits of an open society.
In the same way, a vaccinated population does not need a test, trace and isolate, vaccination pass or special border controls. We can make a bonfire out of face masks and hug whoever we want.
And that is a choice that will be available to us from next month. The only question is how soon do we choose to capture it?
Most of us got it from time to time, but we shook it off and got on with our lives. It certainly wouldn't make sense what kind of restrictions we're seeing now
Then why do the restrictions and bans seem endless? In part, it's the result of misunderstandings, including confusing Covid and fear of Covid.
There is also pressure from commercial and other interests that have evolved to take advantage of the pandemic that now have an interest in maintaining alarm and fear.
Most importantly, we cannot think beyond a world of lockdown as the focus on hospitalization and death has completely skewed our understanding of what Covid means as an infection going forward.
Our anxiety levels have grown high, partly as a conscious act of public order, partly as a result of the constant supply of bad news. This is a great threat to our future and our ability to grasp it.
What precautionary measures can we stop when we vaccinated everyone at highest risk by the end of February? Which restrictions will be lifted? And when we have completed Phase 1 by vaccinating everyone at above average risk in late March or April, what are we going to stop?
These are important questions, but there are still no answers. And make no mistake, we will only see such a schedule if there is active pressure to achieve it.
Even the chief medical officer has indicated that a number of restrictions and controls may last longer, perhaps well into next winter. Its main concern appears to be managing winter demand for the NHS (although I believe this can be done with increased investment in health care and a modest improvement in current respiratory infection monitoring systems).
Also, remember – many groups work well with the controls and want them to be maintained for as long as possible. Some of these groups are obvious, including the suppliers of masks, disinfectants, visors, screens, and other devices used for controls, as well as the people whose jobs are wrapped in them.
Closing Test and Trace would be a big deal for some companies, including those that supply the chemicals and services in question.
Covid also has its medical winners and losers as various disciplines compete for their share of NHS resources. This was a good time, for example, for those in virology, behavioral science, and mathematical modeling.
For many areas of science, Covid research funds were an important safeguard against the uncertainty of future funding from European research programs. Research groups are like small businesses, and cash flow is critical to keeping coworkers' jobs alive.
Yes, Long Covid is a problem, but it shouldn't be confused with promoting Long Covid's fear of keeping funding going.
Even creepier is the Zero Covid faction, those who believe we need to keep the pressure on the virus until it is completely eliminated. Their campaign program often results in calls for permanent restrictions and controls to ensure that no one in the future has a respiratory infection that could cause them to die.
Such people are really in the business of immortality, a deal for Hucksters, not scientists.
While relatively few advocate this goal, its goals are tacitly shared by many well-meaning individuals who have not pondered the implications of defending bans, restrictions, and controls beyond their justification.
As Dr. Mike Ryan, director of the World Health Organization's emergency program, noted that societies should focus on recovery rather than chasing the "moon shot of extinction."
In the end, this is a question of democracy. Chris Whitty rightly urged the country to consider what deaths could be tolerable in exchange for a return to the life we led in 2019.
This is not an issue for any group of experts – scientifically, medically, ethically or even sociologically. However, if citizens are to properly debate this, we need to go beyond fear-ridden emotions to understand the real but modest risks associated with an open society and a thriving economy.
Robert Dingwall is Professor of Sociology at Nottingham Trent University and a member of several government advisory groups. He is writing here in a personal capacity.
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