The past week has been a tale of two epidemiologists. First up was Swedish professor Johan Giesecke, whose interview with UnHerd a week ago caused quite a stir. Disarmingly blunt, uninterested in percentage points, Giesecke brushed aside the coronavirus pandemic with words that electrified sceptics and horrified his detractors. “I don’t think you can stop it,” he said, “it’s like a tsunami sweeping across Europe.” The real death toll, he suggested, will be in the region of a severe influenza season — maybe double that at most — so we should do what we can to slow it so the health service can cope, but let it pass.
Then, this weekend, it was the turn of Professor Neil Ferguson to answer the Swede’s critique that his overly pessimistic forecasts had tilted the Government into Chinese-style dirigisme. He cut a very different figure — more cautious, more media-trained, lacking the charismatic heft of the Professor Emeritus but making up for it with precise deployment of the facts and figures. Much as he’d love to be proved wrong, he said, the UK fatality rate of Covid-19 is likely to be 0.8-0.9%, which means that even letting out only the young and healthy will lead to more than 100,000 deaths later this year. We need to prepare for a long fight, a new socially-distanced normal, potentially for years to come.
In theory, theirs is a purely scientific disagreement that boils down to Infection Fatality Ratios, seroprevalence assays, and R0 numbers — and one or other of them will eventually be proved right. But somehow I suspect there will always be enough controversy around how deaths are counted and the economic and health impacts of lockdown to defer that judgement indefinitely. It’s also quite possible that one of them could end up being right in spirit while wrong on the numbers.
Alongside all the metrics, and the vital assessments of the human cost of different policies, where you stand on this wretched virus also comes down to attitude — your world view. Are you more Giesecke or Ferguson? The expert that most resonates is unlikely to be entirely down to your assessment of the science — more likely a complex combination of your politics, your own life experience, your attitude to risk and mortality and your relationship to authority. Perhaps each of us have elements of both instinct within us — but what do they really represent?
What they are not, despite the attempts of some social media voices to make it so, are good and evil. Clearly, both experts are highly accomplished scientists doing their best to understand a complex threat. Likewise, the wider debate around lockdown is not a contest between rational, good people who value life on the one hand and the cavalier and cynical who care only about economics or themselves on the other. If the do-gooder class try to push that narrative, they will simply lose the argument.
There is not even an in-principle disagreement about the sacredness of every human life, despite attempts to slur those in favour of a speedier timetable out of lockdown as “pro-death”. The principle that some level of increase in infection, and therefore more deaths, is tolerable for the wider good is not often said publicly but is already accepted on both sides of the argument. Denmark, the poster-nation for early and stringent lockdown, has now brought back junior schools alongside published modelling that showed what level of increased infection (and therefore deaths) they expected it to lead to. Nobody raised an eyebrow, because the education of children is so obviously a moral good. It’s really a question of where you fall on a spectrum: how much death would you tolerate, for which wider goods?
In UK policy terms, the ‘landing zone’ now lies in the space between these two experts. At the Giesecke end, we would define success simply in terms of ensuring the NHS is not overwhelmed — this means slowing the spread and protecting vulnerable people as much as practically possible but moving to lift lockdown measures and only reintroducing them if the health service is challenged. At the Ferguson end, we would attempt to keep the outbreak at such low levels that we can wage a long-term ‘test, track and trace’ suppression of the virus, with elements of social distancing to minimise transmission until a vaccine is found.
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