Covid is now one problem among many 

Yesterday’s announcement that Australia will re-open its international border in November marked another step in the walk-away from zero Covid.

It’s harder in NZ to appreciate the extent to which this is happening.  In England and Wales, the most recent weekly statistics showed 850 deaths with a Covid linkage (although the fact that deaths were 2,000 above the seasonal average is perhaps of more concern).  But there seemed to be more interest in the latest slimming of Covid-bureaucracy to make it easier for Brits to travel.

This is what living with Covid looks like.  And perhaps another look at the stats (specifically those for 2020 as a whole) might suggest why.

During the year, there were 608,000 deaths in England (and Wales). That is an increase of 14.5% on the 531,000 in 2019 and the highest number since the Spanish flu pandemic of 1918 (although note the population was much lower then).

Not good at all, although thankfully much less than some modellers had projected.

But you need to look at the age standardised rates, which are a better measure because they adjust for the population structure.  They went up by slightly smaller rates from the year before.  

However, 2019 was the lowest year on record.  Ten years before that, normal mortality was at 2020 (ie, Covid) levels.  Go back another decade and mortality rates were significantly higher.

This context has little to say about questions of management and avoidability (indeed it might encourage you to focus even more strongly on them).  But it does perhaps help to explain how actual experience of Covid in one society might feel very different from its avoidance in another.

And it might give a sense as to why many Brits see the issue as one of management based on the weighing of competing priorities.

Of which there are quite a few on the British government’s agenda: including the phase-out of Covid economic support measures; raising taxes to pay for them; dealing with post-Covid market disruptions like the natural gas price spike; and improving public service performance, degraded in the wake of Covid control measures.

There are still plenty of choices about how to manage endemic (rather than pandemic) Covid.

Monica Ghandi, an infectious-disease physician, writing in the Wall Street Journal believes widespread immunity, vaccinated and natural, will bring control and a full return to normal, adding: 

“If we can tamp down the virus’s circulation and reduce its ability to cause severe disease through widespread vaccination, the world will be able to return to normal. Outbreaks of severe disease will occur among populations unwilling to be vaccinated, as we see with measles and pertussis, but mandates can help increase vaccination rates.”

While a Singaporean epidemiologist – as reported by the AP – suspects Covid control will require a more restrictive approach which would: 

“… successfully combine vaccinations, sustainable testing, and contact tracing with community hygiene measures and safe distancing into an effective system that works.”

One possibility is that the British experience of sweeping controls – with their inconsistencies and imperfections – coupled with miserable outcomes has deepened the gap between those who believe the answer is always more and better controls, and those who want a clear and simple framework within which to make their own decisions. 

At root, however, policy in the UK, Singapore and Australia is being driven by empirical pragmatism, and the connection is abandonment of hopes of Covid elimination.  Differences between their approaches reflect, inter alia, differences in their starting points and public expectations.

So one might guess that the UK is going to rely more heavily on vaccination and less on border control and aggressive public health measures than Singapore.  But neither seem risk-averse in trying options to permit productive and creative life to flow freely.  

Time will tell if these approaches are more successful (and popular) than the New Zealand government’s intolerance of Covid risk – and how they impact on the evolution of the NZ public’s attitude.

2 thoughts on “Covid is now one problem among many 

  1. There is always more deaths in winter the cold damp conditions bring on the flu and those complications. This winter has started early in the UK. For the last 18 months with all the isolation, the excess deaths from those winter illnesses were decreased because people didn’t catch the circulating bugs. People forget that everyone dies sooner or later.
    What one really needs to look at is the deaths of people under say 70 who don’t have the comorbidities. If they aren’t fat, or diabetic or a smoker or have cancer, but are fit and healthy, then those deaths are of concern. But for some reason, other than a few anecdotal cases, there is no mention of these numbers. It may be conspiracy theory, but I suspect it is because the numbers are very low.

    Like

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