We are flying blind. We are like a pilot at the controls of a plane with no instruments, no radar and only thick cloud for company. Is that a mountain ahead or clear blue sky? No one knows. Reading and re-reading the millions of words expounded on Covid-19, the extraordinary thing is how little we know for sure. Shops, bars, restaurants and offices are shuttered; people cut off from normal human company cower behind closed doors ‘working from home’, and the police despatch drones to ‘shame’ those with the temerity to go for a walk in the deserted countryside. But here in the 21st Century all is speculation, guesswork and wild internet rumour.
The UK government insists it is following scientific advice. But the problem is the scientists are divided. In a slump, would we be reassured by ministers saying they are following ‘economic advice’? Not really, because we know enough about economists to know that they fall into different camps with contradictory views about the best medicine for an ailing nation. So, what are the known unknowns about the pandemic?
For a start, more than three months after the emergence of coronavirus from the slaughter markets of Wuhan, we don’t know how many people in Britain have been infected. As of Monday, the total number of cases was just under 20,000 with over 1,400 deaths. That sounds a lot, but the numbers are pretty much meaningless and dwarfed by routine mortality figures. In a bad winter for the flu, such as 2017/18, 50,000 mainly elderly and frail people lose their lives and in an average March overall deaths total around 51,000. So far, at least, the virus has not raised the usual death rate one iota while plunging the country into hibernation.
Our problem is that we have almost no idea how widespread the virus is. Some experts have warned that more than half of the population will be infected; others have put the number much lower. Estimates of the numbers of likely deaths have ranged between 5,000 and over 500,000. And unless and until we carry out widespread testing of the population, we will have to go on guessing.
Monday’s papers were full of stories about the introduction of testing, with NHS doctors and nurses a rightful priority. Mass testing will take even more time, but we could begin by checking a random sample of the population, say 10,000 people of all ages drawn from differing parts of the country. They should be tested in part for whether they have the virus, but more importantly whether they have had the virus and presumably recovered and can go back to work. It would seem that many people who contract Covid-19 suffer only mild symptoms; others appear to have had no symptoms at all.
The results of such a survey would be telling. If it turns out that only a small proportion of the population has been exposed to the virus (say, 5-10 per cent) the lessons to be drawn will be very different if it transpires that many people, perhaps 50 per cent, have encountered the virus and recovered. A low figure for population exposure would suggest that lockdown will have to be extended for much longer and lifted very gradually for fear of triggering another spike in the infection rate, which would again threaten the NHS’s ability to cope. A high figure would suggest that we have far less to worry about because we would be well on the way to developing the fabled ‘herd immunity’ that will stop Covid-19 in its tracks.
But testing for herd immunity is only one of the unknowns. Here are a few others. Does infection with coronavirus and subsequent recovery (with or without symptoms) confer immunity? Can you get it again? And, if immunity is conferred, how long does it last? A few months or a year or two?
We all know that the problem with the flu jab is that it protects against last year’s variant of the influenza virus. Viruses of the corona type have an unfortunate habit a mutating into something new and nasty every year. Will this happen with Covid-19? Are we at risk of a second pandemic a year from now?
Why are children apparently and thankfully largely immune from the virus? Why are men, at a rate of 2:1, more susceptible than women to the disease? What are the real risks for different age groups? As Dr John Lee, a retired pathologist, points out in the current edition of The Spectator, the ways in which hospitals record cause of death have a heavy bearing on the figures. People with coronavirus are dying in intensive care units. But many of these people are old with underlying serious health conditions. So, what killed them? The virus or their cancer or heart disease? Under the current recording rules, the virus is given as the cause of death.
It goes without saying that in Britain, as in much of the world, we run the risk that the cure will prove worse than the disease. With firms closing their doors, with millions being thrown out of work, and with the self-employed losing their livelihoods, we are facing an economic disaster of epic proportions. UK GDP must be heading for a drop of 10-20 per cent at least and that’s with no clear end in sight. We need answers to the coronavirus quiz and fast.
As Guido Pozzi, a professor of macroeconomics at the University of St Gallen in Switzerland, says of Italy’s agony, the only way to find out what to do is to conduct random testing, to get a clearer idea of what percentage of the population is infected. Italy, like Britain, currently only tests people who display symptoms.
“If you don’t have the right data, you can’t make the right decisions,” he says. “There should have been more testing in the earliest stages.”
When this is over, whenever that might be, there will be an almighty inquest into how the British Government – and governments across the world – handled the pandemic. And Prof Pozzi’s point, “garbage in, garbage out” will lie at the heart of the inquiry.
Why didn’t we establish the facts, coolly and objectively, at the outset? Testing a random sample of 10,000 people is not much more demanding than conducting a big opinion poll. Better late than never. We should do it immediately – and so should countries across the world.