9 – Dangerous times call for a sure-footed government.

by Paul Joyce

“What is Government for?” Probably everybody has their own answer to this. But, even before the Covid-19 crisis most people would have said that Government should try its utmost to keep citizens safe. As Dr William Hanage, professor of the evolution and epidemiology of infectious disease at Harvard put it, “The most fundamental function of a government is to keep its people safe. It is from this that it derives its authority, the confidence of the people and its legitimacy.”

“Keeping people safe” means understanding risk and then managing it. In preparing for risk you need first to recognise something as possible, then assess its likelihood and impact, and finally prepare for it.  In terms of preparation from 2010 to 2020, and in terms of implementation from the beginning of this year, the evidence that the UK government has developed and is using a good understanding of risk is mixed.

The government’s understanding of risk in the early stages of the pandemic this year was at odds with the advice of the WHO and led to a UK response that was distinctly different from many other countries in Europe and elsewhere. The government was slow to appreciate the risk the pandemic posed in terms of impact. And maybe, early on, those who were taking government decisions, and some or all of those advising them, thought they understood the risk so well and thought they knew exactly what to do to get through the pandemic, that in a sense they acted as if there was very little risk.

The WHO declared coronavirus a “Public Health Emergency of International Concern” on 30 January. Its Director General recommended that governments “review preparedness plans, identify gaps, and evaluate the resources needed to identify, isolate, and care for cases, and prevent transmission.”  Just a little more than a month later, the Director General expressed concern about what he called “alarming levels of inaction” and declared a pandemic.

On that day, just over a month later, the day a pandemic was declared – March 11th  – some governments had already placed restrictions on international travel.

For example, the governments of Australia, Denmark, Finland, and New Zealand were banning arrivals to their countries from some regions. The UK government did not place restrictions on international travel; it did not ban arrivals of travellers from some regions; and it also chose not to screen or quarantine travellers on arrival. Perhaps UK government decision makers had been advised travel restrictions were pointless?

Back in late 2018 the UK Government’s Scientific Pandemic Influenza Group on Modelling proposed the following planning implication: “Assume that screening, either on exit from countries/regions, or on entry to the UK, will not have any significant benefit for considerable cost and disruption.” The UK decision not to screen arrivals in 2020 might prove to have been a very risky decision and certainly not one following the precautionary principle.

Like a number of other countries, the UK government initially did have a policy on testing and a policy of tracing the contacts of people that had been diagnosed as having Covid-19. But, as the table below shows, the daily rate of testing in the UK was relatively low.

Then, testing in the community was stopped with the introduction of a lockdown on 23 March. The limited extent of testing and tracing coupled with the lack of measures on international travel meant the government had underestimated the risks, taking a quite passive approach to responding to the coronavirus.

Table: New tests for covid-19
Country Daily testing rate

(Tests per 1,000 people)

Norway 10.033
Germany 7.171
Slovenia 6.548
South Korea 6.471
Italy 4.274
Sweden 2.466
Portugal 2.257
Netherlands 2.242
Denmark 2.217
Finland 1.949
New Zealand 1.700
France 1.648
United Kingdom 1.154
Poland 0.465
Data is for 22 March 2020, apart for France which was 24 March 2020
(Source)

Between the end of April and the middle of May there was a drop in the numbers of people who thought that the UK government had handled coronavirus “very” or “somewhat” well. No doubt this was in part because many people had become critical of the government’s ability to deliver enough PPE to hospitals.  It was also probably caused by public concern about the ability of the government to assess and manage the risk implications of strategic decisions about to be made for leaving the lockdown.

Proposals to relax the lockdown were presented in the Prime Minister’s statement on 10 May. Three or four days later, more than half (54%) of those polled by YouGov on 13 and 14 May thought the government had gone too far in its ideas for relaxing the rules – only 29% thought the balance was about right. And, when asked on 18 May, half of those polled by YouGov were opposed to the Government’s intention to open schools in England for some year groups from 1st June – only 35% supported it. Clearly, by this time some members of the public were carrying out their own risk assessments and risk management because they had lost faith in the Government ability to do so.

In the weeks and months ahead, we will need our government to use good judgement about the development of an infrastructure and workforce to “test, trace and isolate” and also good judgement about easing the lockdown.  So, the slump in the UK public’s confidence in government’s handling of the pandemic has occurred at a critical time when we are by no means “out of the woods”.

If there has been a weakness in how government does risk assessment and management, what is it? It may be that the government’s technical skills in risk assessment and risk management are weak. But its attitudes to risk could be the bigger issue. Looking over what has happened, I wonder if government has had too great a propensity to choose high risk options. Since Boris Johnson became Prime Minister, in July 2019, he has taken one very large risk after another in order to “get Brexit done”. He has been bold. Indeed, it is hard to think of any other Prime Minister who so frequently launched his or her Government forward on what looked like desperate and risky gambles. The attempt to prorogue Parliament is just one example. The pursuit of a general election at the end of 2019 another. Not all of these gambles worked out, but, strategically, the December election led to the Johnson government’s ability to bring about the leaving of the EU at the end of January. His first 6 months had been both very successful and full of risky Government behaviour.

It is tempting to label the UK’s approach to the coronavirus in the early months of this year as a form of reckless entrepreneurial behaviour. Reckless entrepreneurs assume that the best economic results are obtained by taking high risk strategic options. So, they have a big appetite for risk. But responding to the coronavirus by taking big risks was not what the WHO had in mind. From January onwards the WHO recommended aggressive containment of the virus. It was specifically calling on governments to test, trace and isolate individual cases. One of the earliest examples is from January when Dr Maria van Kerkhove from the WHO Department of Diseases and Zoonosis Unit said: “… our recommendation is to ensure that individuals can be identified quickly, and isolated quickly. Tested quickly, cared for, and managed, so that they can prevent any further transmission.” (WHO Emergencies Coronavirus EC Meeting, 22 January 2020).

My guess is that the British public are closer to a model of entrepreneurship for the government that is about mobilising resources to meet needs effectively and to do so in way that brings about national social and economic growth. In normal times this means things getting better every year for the people of Britain.  In the present times of this emergency we need a sure-footed and agile government that acts competently and mobilises society to keep everybody as safe as possible.

It is clear, though, that Covid-19 needs a different approach to risk from the one the Government has learnt from Brexit.

 

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