Is UK actually in the top five for COVID-19 deaths?

Coronavirus is a global pandemic. And while it is quite right that we should focus on the NHS and the British tragedies and heroes of this crisis, it is easy to forget that the other 99 per cent of humanity are also involved. Yes, we have heard all about the origins of the virus in China, the unfolding drama in Italy and Spain, and the daily absurdities from the White House, but I still find it very hard to get a fix on the bigger picture.

That is partly because different countries are at different stages of the epidemic, and partly because data is recorded and then reported in different ways, often to score a political point about our own or other governments. Large parts of the world are still going largely unreported. What happened after those pictures a few weeks ago of a chaotic lockdown in India? After the hunger riots in Nairobi slums? When the dead bodies piled up on the streets of an Ecuadorian city? And what is the progress of the epidemic that was running out of control, causing mass casualties, in Iran?

We are not being told what is going on in the mega cities of Lagos, Sao Paulo, Mexico City and Mumbai. Most of Planet Earth seems to have disappeared. And that matters – not just for humanitarian reasons, but because we still have are so many gaps in the knowledge of how this virus operates and what is required to defeat it.

An example of how the international data can be misleadingly oversimplified came in a report last week of how Britain was now in the top five nations for recorded deaths from COVID-19. I have no particular brief for this government, and suspect that they have made some bad, avoidable, mistakes. But such accusations are meaningless in the absence of information on deaths per head of the population; deaths in relation to infection rates; the age profile and therefore years of life lost; and deaths in excess of the underlying trend. (Much comment still seems to assume immortality, forgetting that 1,600 people die in the UK every day from heart failure, cancer, car accidents, other illnesses and, of course, simple old age.)

What is potentially more informative than morbidity league tables – which make sense only when scientifically interpreted – are insights from the different strategies and tactics employed in around the world. The differences reflect the fact that different scientists have different views, and that different politicians are making different judgements about how to act on the evidence.

The big strategic argument is between those favouring suppression of the virus by cutting the rate of infection well below one – using lockdowns and the closing off of large sections of the economy – and those arguing for a weaker, mitigation approach to minimise disruption. After a damaging couple of weeks of prevaricating, when “herd immunity” was entertained, Britain is firmly in suppression mode. But total suppression is impractical except in remote, low density communities such as New Zealand, which is now down to two cases, both isolated.

The subsidiary issue for those choosing suppression is whether to rely on the crude, sledgehammer approach of lockdown, causing immense economic harm, or the more surgical approach of testing and tracing, as in Korea and Taiwan, or some combination of the two, as in Germany. But that kind of surgical approach requires a degree of foresight, planning and organisation which Britain lacked (and still lacks).

Then, within the lockdown approach, there are varying degrees of draconian. In Paris and Milan, permits are required to leave your house; walking and cycling are not indulged as they are in the UK. In that light, I am rather grateful that we have an instinctively libertarian prime minister. My nearest brush with authority has been the sighting of a drone checking that, miles from anywhere and everyone, my wife and I were not indulging in proscribed activities such as sitting down or sunbathing. Had Theresa May still been around, I suspect Britain would have had issued curfews and internal passports by now

There is an even more liberal approach, however, which is to accommodate rather than suppress the virus. At one extreme there are the virus deniers in the nastier and weirder parts of the former Soviet Union, such as Belarus and Turkmenistan; the nastier and weirder parts of the US, as in the Republican Deep South; and, of course, in Bolsonaro’s Brazil. This is almost certainly where Donald Trump would like to be, had he not channelled his anti-scientific, populist instincts into promoting alternative vaccines like the injection of disinfectants.

There are sensible governments which are not in denial but believe they can avoid the extreme economic pain of lockdown. One is Japan, where life and business continues much as normal, save for in a few regions where mounting infections are forcing the government’s hand. The Japanese do not challenge the epidemiological orthodoxy but they seem to have developed a variant of the Taiwan/Korea model, for the most part successfully clamping down on localised clusters.

A case nearer home is Sweden, which has not followed the other Nordics in a lockdown model. Shops, cafes, workplaces and schools for those under 16 are open, and people still mingle in Stockholm.

I listened in to a Zoom seminar this week organised by the Institute of Global affairs at LSE in which Scandinavian experts were trying to understand how this social democratic country (every right-winger’s nightmare of a “nanny state”) should have ended up taking the most extreme libertarian position in Europe. The response from critics was that they were muddled. The more generous answer is that they really believe in suppression but are relying on self-discipline, solidarity and common sense, rather than coercion and legal sanctions. So far, the profile of the disease and deaths appears not dissimilar from the UK in per capita terms.

Where international experience and devolved government (as in Scotland) is so useful is in testing out the various routes out of lockdown over the next few months. These routes tell us a lot about national tastes as well as the applicability of social distancing. The civilised Italians started with bookshops and children’s clothes stores. The Trump-loving state of Georgia is apparently giving priority to massage and tattoo parlours. Perhaps Britain will start with garden centres?

These are details best settled on the basis of comparative experience and technical advice. The public will expect a common sense approach to gradual relaxation where social distancing can be maintained: outdoors, on beaches and mountains, for example; or where “unnecessary travel” doesn’t actually involve meeting anyone.

To get there, the first requirement is for the government to be transparent about the trade offs between some weakening of the suppression strategy – necessitating a degree of risk – and the fearsome, collateral damage to our economy and society which would result from maintaining the status quo.