No, that is not an error in the title. I wish to reflect on how we should react when the next pandemic arrives. The Government would appoint an appropriately led task force of eclectically chosen experts to be responsible for drawing up the plan of action and for coordinating its implementation. This is different from the present UK situation where government ministers formulate the plan based on information from advisers. The task force would be constituted as a separate entity responsile to the Government, with authority to make decisions and accountable for its actions . Sub-groups would be formed for data gathering and analysis, testing, provision of personal protective equipment, contact tracing, etc.
The plan would be based on experience of past pandemics but since every virus has different effects on people it would be assumed that some differences in the approach would be needed.
As the pandemic progressed, the efficacy of measures being taken in the UK and in other countries would be assessed. To illustrate how this might be done, I use data from the present context. Tables 1 and 2 show cummulative deaths per million people, i.e. the death rate, for selectd countries on 22 May 2020 from this source. These columns represent the two main objectives of keeping down the death rate and limititing risk to the economy.
Table 1 is for the top 10 countries (with a small number of small European companies excluded) ranked for death rate. In the ‘Risk to the economy’ column, ‘√’ indicates that restrictions have been such that they represent a serious threat to the economy. ‘Low’ indicates that the restrictions are unlikely have such an effect. This is a very rough metric used to develop an argument. Table 2 is for a selection of other countries that have lower death rates.
The task force would note that although the objective of avoiding the NHS being overwhelmed has been achieved, the UK is not performing well in relation to other countries. We are close to the top of the league for death rate and are in a lockdown that will seriously affect the economey. While the validity of this data needs to be challenged, it raises lots of questions.
Although Sweden has a high death rate, how has it managed to have a relatively low level of lockdown? Why are the top ten countries for death rate (Table 1) all European and North American? From Table 2, what is the reason for the relatively low death rates in Germany, Denmark and Norway as compared with other European countries? They use contact tracing. Can that explain the difference? Why do the countries below Norway in Table2 have very low deaths per head? Why have South Korea and Taiwan scored well on both objectives? How did Singapore, that has a very high population density, keep the death rate down?
Turning to questions about actions to be taken, should the process of raising restrictions on activities be based on data? That is, would it be better to restrict those activities that are known to be have higher risk of infection and allow more freedom in areas where the risk of infection is lower? When a local spike in infection occurs should it be controlled by testing, tracing and isolation (TTI).
The Covid-20 Task Force would use the answers to questions of this type to inform refinements to the plan. As well as a central role, it would also coordinate the efforts of people around the country. i.e. it would seek to mobilise the intellectual capital of the nation in limiting the effect of the virus. This article by Andreas Kluth gives very interesting information about the situation in Taiwan. It appears that that country achieved such mobilisation – an example of very good problem solving.
The response to Covid-20 would be based on the principle that complex problem solving, like any other skill, should be addessed by people who are good at it. Risk is high when the consequences of unsatisfactory outcomes are severe and where innovation is needed i.e. where one cannot rely only on past experience. A pandemic is in this category. This calls for problem-solving skill of the highest order – see my two previous blog posts and this paper.
Is it still too late for the UK to apply a Covid-20 approach to the Covid-19 situation?