Public Health and Private Contracts: Britain’s Movement Out of Lockdown


Disclaimer: The views expressed within this article are entirely the author’s own and are not attributable to Wessex Scene as a whole

Britain’s lockdown has lost all urgency and authority. As coronavirus becomes more of a nuisance than headline news, save the macabre milestones rounding off each month- 30,000, followed by 35,000, now well over 40,000- butting in as an inconvenient reminder of the nation’s failure to grasp the virus, the lockdown becomes increasingly anaemic.

From the government’s lateness enforcing lockdown, the process has been protracted, and, playing catch-up with the rest of Europe. The government is now eager for the country to open once more. But with track and trace half-functional (and thus as good as useless), the rate of infectivity around 0.7 to 1 according to the Scientific Advisory Group for Emergencies (SAGE), and no security net to combat coronavirus, one has to wonder why lockdown is being eased so significantly.

The short answer is the economy. It cannot be put on hold forever, that much is true, but the mobility permitted by easing the lockdown is to treat coronavirus as a minor threat, not Level 3, as it is currently set by the government on their ‘Alertness Scale’. Not that this artificial scale inspires much confidence at all, what with the movement from Level 4 to 3 being recommended by the ‘Joint Biosecurity Centre’, a recently formed, entirely private entity, operating under data not peer or publicly reviewable. While reported deaths are now declining, after having sat around 200-300 for the last few weeks, the government-led rush to re-open society is to prioritise economy over public health. The illogic of this process is earmarked by this government’s failure in strategy- in its initial response and in developing the essential services to control the virus in the future.

From the moment coronavirus became a risk, the approach of the government sought to mitigate the economic impact in public health policy. The central question was not to review how deadly the virus could be, for which Italy provided one telling example, but to review the potential for the economy to falter were any decisive action taken. Unequipped with the important facts about the virus, the deadly herd immunity strategy was in place until 23 March, where the lockdown was only then necessarily implemented. On the surface, herd immunity is the appealing strategy for any institution concerned about economic downturn caused by a complete shutdown. The confidence placed on this strategy was highly inflated, however, as it was based on the treatment of coronavirus in the same fashion as the flu.

This is the beginning in a liturgy of errors that brings us to today- 40,000+ officially reported as dead. In a sense, it is Britain’s RBM-K reactor moment. Extensive research was placed on preparedness for an influenza outbreak, but a novel coronavirus illness was critically undervalued in terms of potential spread and damage. It would be harsh to call this a scientific oversight. The research was based on novel pandemic illnesses that had impacted the UK in the past, which were often forms of influenza (i.e. Bird flu, Spanish influenza, and so on). Asian countries were more prepared, having dealt with MERS and SARS in the past 20 years. Despite this, the findings of flu pandemic simulations, such as Exercise Cygnus in 2016, still found holes in the planned response to a pandemic which was not addressed by successive governments. Stockpiles to prepare for some kind of health crisis depleted due to government laxity.

The initial strategy of the government, as a result, followed guidelines set out in 2011 in the event of a flu pandemic, suggesting a complete failure in strategy. The confidence in guidelines known to be faulty is quite astonishing, and the lazy assumption that herd immunity was appropriate, even in the face of international consensus to mitigate the virus, suggests a fatal hubris. This meant testing was severely limited where it was thought that the spread of the virus could not be controlled, the deadly result being that 25,060 patients were discharged to care homes before routine testing between 17 March and 16 April. Reliance on outdated guidelines allowed coronavirus to actively enter care homes across the UK.

I find it unlikely that SAGE would be unaware of the flaws in these guidelines, which is why it is important that the minutes to such meetings be publicly released in the near future, and a public inquiry is held into the handling of the crisis. This is especially important as ministers continue to shirk accountability. The tagline “based on the science” behind each political decision is itself a method to detract from government action. As lockdown policy continues to change, it will be said that ministers are “guided by the science”- a public inquiry will reveal the extent to which this is/was the case.

As a result, it is apparent that the UK has been playing catch-up ever since it was clear that flu guidelines were inappropriate in dealing with coronavirus. One can only breathe a sigh of relief that lockdown was eventually instigated; that sense prevailed over-bloated self-confidence. But the lateness with which it was passed has had undeniable consequences, a pattern seen across all countries implementing a late lockdown (United States, Brazil, Italy).

Since lockdown was implemented, the United Kingdom was reporting around 30,000-40,000 cases a week through April, which dropped as May went on, and, as of 21 June, infections per week sit at around 8,000. Transmission is, therefore, still high, yet the messaging emanating from the government does not reflect the actual stage of the country in terms of controlling the virus and overemphasises our preparedness phasing out of lockdown.

This image of preparedness rests on outsourced development schemes. Since emergency procurement measures have been in force, the standard level of competition for government contracts has been waived, and procurement rules sidestepped. One has to ask on what basis contracts are awarded when there is little to no competition between companies vying for these contracts. The government has awarded, in total, £1.7b in contracts with little in the way of results. The track and trace system, for instance, was outsourced to the private company Serco, a public services provider, though they had previously been fined £19m for wrongly charging the government in a previous contract. The initial results are unfavourable. Under Serco’s current manual system, which has employed 25,000 tracers, around 31,000 people were contacted, meaning for each tracer they contacted 1.24 people. Granted it is a new operation, such poor results, in the short-term, does not seem to justify the £45m contract they were awarded, nor does it motivate comfort that public health is in the right hands. It does motivate, in my mind, the thought that the provision of contracts are enough for this government to claim preparedness for the future, with the easing of lockdown based on the promise by these private companies for some service at some point.

Already, these companies are beginning to falter in terms of delivering on the contracts that they have been awarded. In the development of a track and trace app, the government has u-turned from the centralised NHSX system, relying now on existing technology from Apple and Google- the technology already developed for use in other countries. Both are cause for concern regarding data privacy, but as Professor Ross Anderson has said: “I recognise the overwhelming force of the public health arguments for a centralised system, but I also have 25 years’ experience of the NHS being incompetent at developing systems and repeatedly breaking their privacy promises”. Perhaps this is in direct reference to the abandoned NHS IT system in 2013, costing in the region of £11b. Either way, the centralised tracing app can be added to a list of failed government initiatives, between the aforementioned IT system and Universal Credit.

Another company, PestFix, a subsidiary of Crisp Websites Limited, was awarded a contract worth £108m to produce PPE despite reporting net assets of only £19,000. Subsequently, the basis for which lockdown is to be eased- that is, the development of schemes to ensure the control of the virus- rest on contracts spuriously awarded. Shorn of any initial results, the efficacy of these contracts should be called into question- a legal challenge is already being launched against the government for greater transparency.

Though the initial strategy- the herd immunity strategy- was rightly quashed with the implementation of lockdown, its delay has resulted in an excess of deaths, but lessons have not been learnt. Issuing vast contracts do not represent a definitive strategy moving out of lockdown. It may provide personal comfort within the Cabinet, but such comfort and confidence are not diffuse across the public. All the vague public messaging with abstract alertness scales, urged to “control the virus”, whatever that means, are blinkers designed to focus public attention away from government action. The secrecy that the government operates under, being forced, for instance, to release the names of its SAGE members, its new secret “Joint Biosecurity Centre”- how does this instil public trust? This kind of government, one afraid of scrutiny, is the worst kind in times of crisis; with no clear strategy, and afraid to form one in case it backfires.


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