LONDON — Boris Johnson’s lesson from coronavirus: You can lose control of the message even faster than you can lose control of a pandemic.
The U.K. has been something of an outlier in terms of its response to the crisis. While many countries and cities worldwide have gone into lockdown, shutting schools and public meeting places, the U.K. has so far eschewed such measures.
Moves to ban mass gatherings are afoot, and many organizations, including the country’s football authorities, have taken matters into their own hands. But so far, the U.K. has been — or appeared to be — behind the curve — and the public have noticed.
Partly this is because the virus is in a more advanced stage in Italy, Spain, France and other European countries. U.K. experts insist there is international scientific consensus about what measures work — just minor differences about when and how to apply them.
But amid deep public concern, the apparent lack of action — coupled with public criticisms from several health experts — has fueled fears that Boris Johnson’s government is being dangerously lax. While the real picture is more complicated, the situation has already spurred Johnson to organize daily press conferences to keep the public informed — and stay on top of the message.
Mixed messages
It’s not as if Johnson and his government aren’t doing anything. Far from it.
There has been a comms problem, no more so than around the concept of “herd immunity.”
A thorough contact tracing program for early cases has helped keep the total number of infections in the country relatively low, government officials say. Since Friday, everyone with even mild symptoms has been told to stay at home for seven days. More measures are planned, with instructions expected in the coming days and weeks for entire households to stay at home if just one person is symptomatic; and to the over 70s and the medically vulnerable to self-isolate for — potentially — as long as four months.
But there has been a comms problem, no more so than around the concept of “herd immunity.”
On Thursday, a blog by ITV’s Political Editor Robert Peston flagged the epidemiological concept. “The strategy of the British government in minimizing the impact of Covid-19 is to allow the virus to pass through the entire population,” Peston wrote.
Shoppers queue in a busy supermarket in London on March 14, 2020 | Justin Tallis/AFP via Getty Images
The idea quickly caught the public imagination — and not in a good way. The supposed strategy seemed to be in line with comments Johnson gave on TV two weeks ago — in a clip that went viral — where he said that “one of the theories” was that “perhaps you could take it on the chin, take it all in one go and allow the disease, as it were, to move through the population, without taking as many draconian measures.”
Social media memes quickly spread comparing Johnson to Lord Farquaad from the film “Shrek,” who held a contest rather than rescue his desired princess himself. “Some of you may die,” the feudal lord says. “But it’s a sacrifice I am willing to make.”
The U.K.’s Chief Scientific Adviser Patrick Vallance said on Friday that herd immunity would indeed be “an important part of controlling this longer term” but that around 60 percent of the population would need to be infected for it to have effect. Journalists quickly started to do the math, extrapolating from international mortality rates how many deaths this would equate to.
Vallance’s response, while accurate in itself, coupled with the government’s apparent caution, left the impression the U.K. approach was laissez-faire: Simply let most people get the virus and wait for herd immunity to take hold.
The backlash forced Health Secretary Matt Hancock to tell the BBC on Sunday: “Herd immunity is not our policy. It’s not our goal. Our goal is to protect life and our policy is to fight the virus and protect the vulnerable and protect the NHS.”
To some extent the episode is a case study of the complexities of epidemiological theory colliding brutally with the 24-hour news cycle, social media, and deep levels of mistrust in politicians.
“The golden rule is to show that the government is in control and being open and transparent and available to answer questions” — James Sorene, CEO of the Britain Israel Communications and Research Centre
Downing Street officials acknowledge the whole thing could have been handled considerably better. From Monday, daily press conferences will be led by either Johnson himself or another minister, speaking alongside expert advisers.
Officials said ministers have been struck by how quickly the “herd immunity” issue had caught fire and that it was an example of the kind of message problem daily press conferences are designed to avoid.
One former government comms official said they should have been quicker to act.
“The golden rule is to show that the government is in control and being open and transparent and available to answer questions,” said James Sorene, CEO of the Britain Israel Communications and Research Centre, who ran the Department of Health’s press office during the swine flu pandemic of 2009. “[Government] should have said [two] weeks ago that it would hold weekly or twice weekly press conferences and more if necessary.”
Sorene also said the “drip drip” of information without full details was problematic. For example, the government has made clear that part of its strategy will involve self-isolation of the over 70s and those with underlying health conditions for several weeks, but details are yet to be formally confirmed, leaving millions of Britons in the dark.
“The drip drip of articles, interviews, briefings to select journalists doesn’t cut it. It might work with normal political stories but it’s dangerous in a pandemic,” Sorene said.
When to shut down?
Meanwhile, public health experts continue to express concern about the U.K.’s approach, and calls for wider shutdowns are likely to grow louder.
A pedestrian wearing a protective face mask walks down Oxford Street in London | Glyn Kirk/AFP via Getty Images
“I don’t understand how their strategy is going to delay [the spread of the virus.] The WHO I know, from my contacts there, are extremely worried about this,” Anthony Costello, a former director at the World Health Organization told BBC Radio 4’s “Today” program on Monday.
Johnson — and all his ministers — say they are being “led by the science.” The strategy has been informed by a committee — frequently cited by Johnson in his public appearances — called the Scientific Advisory Group on Emergencies (SAGE).
Its membership changes depending on the crisis in hand, but the government declined a request from POLITICO to publish the current list of advisers, saying only that it includes “epidemiologists, clinicians, virologists, mathematical and statistical modellers, molecular biologists and social and behavioral scientists.”
Heavy emphasis has been placed on behavioral analysis which suggests that, if hardline shutdowns are introduced too early, people will become “fatigued” and begin ignoring public health advice before the outbreak has run its course, reducing the government’s overall ability to protect people.
Not everyone is convinced.
Former Health Secretary Jeremy Hunt said on Thursday he was “surprised and concerned” by the fact mass gatherings had not already been banned and asked to see the modelling analysis behind decisions driven by the “fatigue” factor. The government said on Saturday that “modelling and data considered by SAGE in future will be published.”
In response to concerns about a lack of action on shutdowns, government scientists say they are concerned that strict containment measures also carry risks, both that the virus will come back more aggressively once life returns to normal and also that Brits will tire of isolation and start ignoring the advice.
“It’s crazy not to be contact tracing. And the only way to do contact tracing is to know who’s actually infectious. And to do that you have to test” — Devi Sridhar, professor and chair of global public health at the University of Edinburgh
“If you suppress something very, very hard, when you release those measures it bounces back and it bounces back at the wrong time,” Vallance told the BBC’s “Today” program on Friday, explaining that the government hopes to avoid a new infection peak during autumn or winter months when the NHS is under more pressure from ordinary seasonal infections. “Our aim is to try and reduce the peak, broaden the peak [over time], not to suppress it completely, because the vast majority of people get a mild illness.”
Vallance also rejected the notion that behavioral insights were taking precedence over epidemiological and medical expertise. “[It is] absolutely not the case that behavioral science takes predominance, but of course it’s an important consideration,” he told Sky News.
Testing times
Others have attacked the U.K. government’s decision to no longer test those self-isolating at home and instead focus testing resources on the most serious cases in hospitals.
“It’s crazy not to be contact tracing. And the only way to do contact tracing is to know who’s actually infectious. And to do that you have to test,” Devi Sridhar, professor and chair of global public health at the University of Edinburgh, told POLITICO.
She said that lessons learnt from South Korea, China and Singapore all point to the high contact tracing seen in these countries. In contrast, the U.K. is advising those with a high temperature or a cough to stay at home and not be tested, which Sridhar likened to advice that is given for people who have the flu. “I think if we let this spread like it’s a seasonal infection, we will have a lot of deaths, a very overrun health service, and people affected in all ages,” said Sridhar.
However, Professor Sheila Bird, formerly program leader at the MRC Biostatistics Unit, Cambridge University, described the policy as “sensible” because it “means that [the] U.K.’s monitoring is to be mainly in respect of more serious COVID-19 cases.”
Transport Secretary Grant Shapps, also speaking on “Today,” defended the U.K.’s approach, saying it was about using resources where most effective and insisting that the country “is carrying out more tests than any other country in the world” other than China and Italy.