Viral epidemics have been part of human civilisation for centuries. Black Death in the fourteenth and Plague in the seventeenth, are only the most famous but there were many more local outbreaks. Europe found that transmission started in ports like Venice and Marseille and spread inland following contact with ships bringing cargoes from the East. The concept of quarantine was developed in these ports specifically to isolate suspected carriers of disease. Time and distance were effective in combatting pestilence, long before science knew its cause was viral.
When plagues hit major cities like Milan, Paris or London, rich people fled to the countryside, the rural population was spread more sparsely and the risk of contagion was lessened by distance from other people. The poor of course could not afford to leave the cities and they suffered proportionately more during a city epidemic. People knew dense city living increased the risk of catching disease, so keeping away from others was instinctive. Today we call this ‘social distancing’.
Have we lost this instinct? Perhaps the ready availability of public health support has led to a belief that we no longer need to heed the importance of distance in staying well and avoiding contagion. Why else would the government encourage us back to work, school and into restaurants, pubs and cafes before the virus has been tamed? This is surely counter-intuitive as the mounting infection rate in September suggests. Sweden has managed to handle the virus better only because it has a much smaller, more sparsely spread population, where social distance is more easily practised.
This is not to criticise the government for trying to protect our economy, equipped with data that suggests Covid 19 is only a threat to a retirement generation, a non-productive sector of the economy. However is it really wise to encourage crowds, whether for work or pleasure, when the best medicine is simply distance? The young, who have a cavalier attitude to infection, thrive on social contact so they will need a convincing reason to embrace social distance as a mantra. A fine of £10,000 is meaningless if you are burdened with student debt and have no job or income!
The combined message from the Chief Medical Officer and Chief Scientific Advisor is that the virus is spreading fast and crowds are to blame. Politicians who eagerly encouraged us back to offices and pubs did so in the belief that the epidemic could be managed through testing to isolate infection. Testing has failed to offer the safety net it was designed to fulfil, so the only option now is distance. Thus we must revert to what our ancestors knew worked, isolation.
Keeping offices, schools, and pubs open is not conducive to reducing deaths, but is a compromise. Therein lies the risk. The prime minister has been accused in the past of wanting to ‘have his cake and eat it’. It is axiomatic that you can’t have your cake and eat it; it is also true you can’t encourage crowds and at the same time reduce infection. Science is once again left speaking truth to power, only power doesn’t want to hear, especially when the economy is at stake.
The new three tier system is an attempt to contain the rapid spread, but even the top tier permits restaurants to remain open in an attempt to offer the hospitality industry a ray of hope. The next fortnight will be critical but it is unlikely that the introduction of localised lock-down will really halt the virus, it will at best slow it and delay its progress. This is at best a coping strategy not a coherent policy, is this the best we can hope for? We need to regain our instinct for isolation as the only effective way to stay safe, but has it been lost over generations of improving hygiene and sanitation?
Garry Honey is a SAMI Associate specialising in risk decisions in governing bodies. He focuses on the way risk at board level is a business enabler, and on the interface between risk and futures thinking.
Written by Garry Honey, SAMI Associate and founder of Chiron Risk
The views expressed are those of the author(s) and not necessarily of SAMI Consulting.
SAMI Consulting was founded in 1989 by Shell and St Andrews University. They have undertaken scenario planning projects for a wide range of UK and international organisations. Their core skill is providing the link between futures research and strategy.
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