The UK and Covid19
The Economist published a lead article on Britain and Covid19. By and large, the piece attempts to be an indictment of Boris Johnson’s leadership. For The Economist, England had “the wrong kind of prime minister”: “Mr Johnson got the top job because he is a brilliant campaigner and a charismatic entertainer with whom the Conservative Party fell in love”. The main criticism of Johnson is that he did not lock the country down earlier, therefore going in the direction some scientists (in particular, Professor Neil Ferguson of the Imperial College) thought was best.
Yet perhaps Johnson should be held accountable for lack of other measures that did not include a lockdown. For example, for a long time, people entering in England weren’t tested but just asked to go through self-quarantine. The idea that locking England down a week earlier would have spared it half of its casualties is certainly a powerful criticism. Perhaps Professor Ferguson is right, but his views should be taken with more than a grain of salt.
The piece has however some interesting considerations, worth sharing and pondering.
1) Centralization and decentralization
In the pandemic, centralization of decision-making was widely praised and many people considered, for example, the “divided governance” of the emergency, between Washington and state government, as an additional risk factor. The Economist on the other hand points out that: “the government has wasted the most precious commodity in a crisis: time. In a federal system, like America’s, the central government’s failings can be mitigated by state and local authorities. In a centralised system, they cannot.” So, perhaps federal, decentralized systems are not necessarily performing worse in the emergency than centralized ones. Switzerland and Germany (a most successful state in coping with Covid19) are federal systems too.
2) The NHS
The NHS was not “overwhelmed” and went through “a swift reorganization” to cope with increased demand. I wonder how this happened and if perhaps it is an assessment that could be generalized: that is if hospital networks actually performed better than expected also in other countries and instead what failed was “public health”, i.e. the complex set of measures that were put in place to combat the epidemic.
The Economist argues that:
Delays in fixing ppe supply chains, promoting face coverings and increasing testing capacity were clearly errors at the time. Despite the urging of the country’s scientists and the World Health Organisation, by the middle of April Britain was still carrying out just 12,000 tests a day, compared with 44,000 in Italy and 51,000 in Germany. Because most testing was reserved for hospitals, care homes struggled to find out which of their residents and staff were infected. Competition for ppe was fierce, so they also struggled to get the kit they needed to protect their workers. The government is not solely to blame. The pandemic made new demands on the system. Some crucial bits of machinery did not work. The publicly owned company which supplies the health service with ppe failed. Public Health England, which was responsible for testing and tracing, failed.
This complements the strong criticism of Public Health for being “horrendously bureaucratic” on the Daily Telegraph. Matt Ridley soberly explained that “The decisions by Public Health England not to go out to the market for testing, protective equipment and logistics, to cease testing almost completely in March and to send people to care homes from hospitals affected by the virus – these were just bureaucratic bone-headedness”.
The Economist faults the government for not mobilizing the private sector strongly enough for testing (a point also raised by Terence Kealey) and points out that failures in the supply of PPE were actually due to public procurement mistakes (just google PPE Covid UK and a list of disasters will appear on your screen).
It will take time, I think, to assess what went well and what went wrong with Covid19 – and it will take a better understanding of the virus and the illness it creates. Yet I think the idea that “you need bigger governments to cope with the pandemic” will look more and more like an oversimplication. Indeed, it is almost certain to look like a very expensive oversimplification, as it will be used as an excuse to increase government budgets substantially.