I was six years old in 1956 when my parents decided to return to Ireland from London, though a polio epidemic was in full swing in Cork city thirty miles from where we lived. They thought we would be safe in our house deep in the countryside and were encouraged by the fact that there were no cases in the nearest town.
As with coronavirus, the polio virus spreads asymptomatically – making it difficult to know precisely where it will strike next. We quarantined but this was less than complete because my father was travelling to-and-fro for work purposes between Cork and London.
Had my parents asked local doctors about the degree of risk in returning home, they would probably have been told that 98 to 99 per cent of those infected with the virus suffered no more than a sore throat, fatigue, a headache, constipation and, in some cases, a pain in the back of the neck. It was only a tiny unlucky minority, most of them young children, who would be crippled for life or die.
Unfortunately, my brother Andrew and I were among this unlucky few. I was diagnosed, admitted to hospital and nearly died. Although I ultimately recovered, the muscles in my legs were permanently weakened and I have a pronounced limp.
In Cork city, the public health officials repeatedly said that there was no alternative but to let the epidemic burn itself out, establishing what would now be called “herd immunity”. Efficient and experienced doctors, they were dismissive of those wanting to isolate Cork city and its inhabitants by cutting rail and road links to the rest of the country. They saw no point in cancelling sports fixtures and forbidding schools to reopen because they were convinced that this would not stop the virus.
Dr Gerald McCarthy, the medical officer of health for the county, said: “If I had my way, apart from isolating in hospital every case detected in its early stages, I would take no other elaborate precautions.” Along with others in charge of combating the epidemic, he was mystified when parents expressed outrage that public health officials appeared to be playing Russian roulette with the lives of their children, even if the chances were high that they would survive unscathed.
What those cool-headed public health officials failed to understand was that a life-threatening epidemic like polio produces sheer terror that anybody managing the outbreak must take into account. People in rural Cork would walk through the fields rather than travel down a road that went past a house where somebody was known to be ill. Police had to deliver food to the doors of some of those infected because otherwise they would have starved.
Medically, the Cork doctors may have been right but they were naïve to suppose that a thoroughly frightened population was going to stand still and let the epidemic wash over them without demanding that the authorities do everything to stop its advance. Fear for their immediate families inevitably trumped concerns about the good of the ‘herd’ or wider community.
Over half a century after the Cork epidemic, the British government and its medical advisers find themselves in something of the same dilemma. They clearly considered “herd immunity”, and going down the same road as Sweden, but they jumped away from the idea when it met with a fiercely negative public reaction. “Our aim,” said the chief scientific officer Sir Patrick Valance on 13 March, ten day before lockdown, “is to build up some degree of herd immunity whilst protecting the most vulnerable”.
Of course, protecting the most vulnerable turned out to be exactly what the government did not do as mass deaths in the care homes demonstrated. Countries around the world were likewise soon denying that they were pursuing “herd immunity” as the phrase became a synonym for state-sponsored euthanasia. Leaving aside the victims in the care homes, critics pointed out that, in addition to those that died, many would be permanently disabled, nor was there in any case, any guarantee that mass infection would confer long term immunity.
The dynamics of epidemics, their lethal ebbs and flows, are unpredictable and complicated involving more than a fixed proportion of people getting the illness.
Yet six months from “herd immunity” being pilloried worldwide as the equivalent of poisoning the wells, Britain may covertly or by default may be adopting just such a policy.
The reason for this creeping volte-face is that while “herd immunity” may or may not be achievable, the alternative policy of lockdown looks more and more like a bad bargain, bringing economic devastation in return for a temporary retreat of the epidemic. It only really works in countries where the state and society are so organised, China or Germany being prime examples, so that they can largely return to normality while at the same time suppressing new outbreaks. It helps if they are islands like New Zealand and Taiwan, but this advantage wanes as soon as full travel links are re-established.
Suppression of the virus only works if its elimination is near total and an effective system is in place to find, test and isolate new cases. Britain is clearly not one of the countries that can successfully do this, indeed, it has inflicted on itself the worst of all possible worlds with enough lockdown to wreck the economy but is still failing to bring the virus under control.
The gravity of this calamity has not really sunk in in Britain, but the extent of the failure is becoming incontrovertible. The government has built up a great edifice of emergency measures and regulations but they are increasingly ignored. Only 18 per cent of those with coronavirus symptoms are self-isolating while just 11 per cent of those told by contact tracers to stay at home obey the instruction, according to a survey of 32,000 people commissioned by the Department of Health.
In other words, Britain has become like many countries about which I have reported in the Middle East and the former Soviet Union, where people only formally comply with official rules. It was both pathetic and frightening to watch Boris Johnson’s address to the nation on Monday in which he pretended to fight the resurgent epidemic by tweaking opening hours for pubs and restaurants and tightening up on the rules for the wearing of face masks.
What is really wrong – and probably impossible to put right at this late stage – is that the government suffers from chronic operational incapacity and, contrary to its winning general election slogan, simply does not know how to get things done, not Brexit, not anything.
The former cabinet secretary Gus O’Donnell pointed out in a lecture this week that all the relevant indices show the Johnson government have done far worse than others in the EU in coping with the epidemic. The figure of 65,700 excess deaths in Britain this year is four times more than in Germany, two-and-a-half times more than in France and exceeds the fatalities in Italy and Spain. O’Donnell says the government has been in “firefighter mode” too long.
In reality, it has been in “panic mode,” and thanks to its bumbling incompetence, there is plenty to panic about.