BY PRABHAT ADHIKARI
The ideas and opinions below are my own and do not express the views of my employer.
The onslaught of COVID-19 (SARS-Cov-2) has uncovered deep-rooted vulnerabilities in the global and local healthcare systems. A great number of lives have been tragically lost to the virus. Seemingly normal activities have been brought to a standstill and individuals have been deprived of social interactions, as lockdown became the norm. With time, the severity of the situation became clearer, governments began taking individual approaches, drawing on international offerings but also homegrown institutions to defend against the virus. Whilst some nations have somewhat escaped the grip of the chaos through vaccination thus far, several governments have chosen to downplay the scale of the issue. For the poorer nations with smaller medical capacities, many have been left waiting in anticipation that adequate support from the Western world and a fair share of the vaccines will soon arrive. Where there has been a strong government response and restriction measures, respite has seemingly only been for pockets of time, with a recurring spike in cases. Success and the prospect of a return to normality on the international front to this day is followed by an air of uncertainty and caution that the situation could yet de-rail.
COVID introduction to the international stage
COVID-19 came as a bitter parting gift to 2019, with the WHO beginning its enquiries into several cases of “viral pneumonia” flagged by the Wuhan Municipal Health Commission in China, in the final days of the year. This soon extended to cases in Thailand, USA, France and the UK by the end of January 2021, all cases with ties to Wuhan. By early March, rapid transmission had seen the number of cases tally to more than 100,000 worldwide and 1 million by April (WHO, 2020). By then, the WHO had formally announced a SARS-CoV-2 pandemic (WHO Director-General, 2020). That trajectory has since continued and has translated into more than 4.2 million deaths as of August 2021 (WHO, 2021).
How early the grave nature of the virus was known to the Chinese authorities and their speed and transparency of response, or lack thereof, is a political question China will have to face in the years to come. This is akin to the controversy in China’s dealing with the original Sars outbreak some two decades ago (Meikle, 2003). Beyond this, the effectiveness of WHO and thereafter the part each government has played in the dealings of their internal epidemics will need to be justified in the eyes of the public, to understand what more could have been done to prevent such an outcome. What futureproofing is required should such a situation arise again will be a conversation for years to come.
The UK Journey
When the initial news of the virus began, fresh from his recent post Brexit election victory and in focus of a planned cabinet reshuffle, the prime minister confided in the Health Secretary Matt Hancock to lead the COVID agenda. Whilst this can be viewed as appropriate delegation, critics have argued that this was a failure in part of the prime minister to recognize the initial severity of COVID. This argument is heavily linked to the view that a lack of prioritization led to UK being on the backfoot on orders of testing kits versus the rest of Europe from the get-go (Perrigo, 2020). For the UK, its first case in the outbreak came exactly two months on from WHO being alerted to the virus. On 31st January 2020, a Chinese national studying at York university and his mother tested positive for COVID, a week after their travel from Wuhan (Wright, 2021).
Fig 1: Daily COVID cases in UK
Source: (GOV.UK, 2021a)
In response to the initial cases, the UK government in collaboration with the government Scientific Advisory Group for Emergencies (SAGE) opted for a gradual step approach of measures of; contain, delay, research, mitigate with a minimal guidance such as “washing hands whilst singing Happy Birthday twice” (GOV.UK, 2020a). However, as cases grew rapidly through March, as seen in Figure 1, the government were forced to bring in more definitive and restrictive lockdown measures. Notably, the UK was the last of its fellow compatriots in the EU going into lockdown measures on March 23rd compared to previous weeks in Italy, Spain & France (Perrigo, 2020). This hesitancy to go into lockdown at the start of the pandemic was seen as the government striving for herd immunity by many, with the hope that self-immunity could prevail through enough exposure of the disease to the population; a claim which the government denies (Yong, 2020).
Figure 2: Timeline of the UK Government Coronavirus Response [March – June 2021]
Source: (Institution for Government Analysis, 2021)
As Fig 2 shows, the government further extended lockdown into May 2020, as the cases and with-it death toll multiplied. The balance between the social and economic impact of isolation versus the safety of the public was an ongoing consideration and the UK public became custom to daily government briefings and case reports. Restaurants and social venues closed, video calls and working from home became common. Furlough was granted for many unable to work under the set restrictions. As the balance tilted after an arguably effective lockdown which Fig 1 indicates, the government eased lockdown, and brought in schemes such as “Eat to Help Out” to boost consumer confidence. Regional lockdowns came into play to tackle bursts of outbreak (Baker et al., 2021).
The interchange of easing measures of differing scales, uptick in cases and thereafter varying levels of regional & eventual national lockdown, became a recurrence throughout 2020 and 2021 as the government struggled to control the fluctuations of the pandemic. There has been much public debate and political turmoil of the government’s double standards on the COVID guidance, with the sacking of chief political advisor Dominic Cummings & most recently the resignation of the Health Secretary himself; an undeniable reflection that the management of the pandemic hasn’t been plain sailing (Craig, 2021).
Figure 3: Vaccinations in the UK
Source: (GOV.UK, 2021b)
*Expressed as population of 16 or over
However, the main difference coming out of the lockdown versus the pre-lockdown state is the level of the vaccinated population. After the end of the third lockdown in Aug 2021, Fig 3 shows that nearly 89% of the population have had their first dose and 73% already at their second doses (GOV.UK, 2021b). Although there have been doubts surrounding the rarity in the link between blood clots and the Oxford-AstraZeneca vaccine, the ability for the United Kingdom to rely on its institutions has been a major plus point and a gateway for relief; a luxury which many countries haven’t been able to indulge (Mancini and Kuchler, 2021).There has been further upswing in the appreciation and importance of the country’s National Healthcare System (NHS) which the prime minister will himself attest to, given his personal fight with the coronavirus. Clap for health workers and the recent 3% salary increase of health-workers are a mere token gesture to the undoubted public heroes of the pandemic (GOV.UK, 2021c). As the UK looks to 2022, and whilst the immediate work for these institutions is far from over, there is hope that the worst is behind us and that a fourth lockdown will not be required.
Economic and Social impact in the UK
You only have to look at the UK’s Gross Domestic Product (GDP) to see the disastrous impact of COVID on the UK economy. The recessional dip come the end of 2020 is evident in Fig 4, with the sharpest drop in UK’s output measure since the beginning of records in 1948, amounting to an annual fall of GDP by 9.8%. Although this wavered with the ease of lockdown and release of pent-up demand, the UK has just started to return to its 2019 position nearly a year and a half later. However, the remnants of the shock is predicted to have hampered further growth of 1%-3% based on reporting from Bank of England (BOE) and Office of Budget Responsibility (OBR) respectively, which is sizeable to the UK economy (Harari and Keep, 2020).
Fig 4: Quarterly UK GDP insight
Source: (ONS, 2021a)
* Index 2019 Q4 = 100
The conservative government has tackled the COVID crisis in what has been an arguably a very non-conservative approach. After years of austerity following the previous shock to the economy in financial crisis of 2008/2009, and perhaps in reflection of this event, the government has offered one of the biggest peacetime packages to the working economy. This has been delivered in various forms of government intervention, with the Coronavirus Job Retention Scheme (CJRS) (or as more commonly known furlough), income support schemes for self-employed and a weekly £20 rise in the Universal Credit Scheme (Francis-Devine, 2021). The Spring budget in March 2021 sets out total government spending out at a whopping figure of £407 billion for 2021-2022. This has been possible given the continued low base interest rates as little as 0.1%, enabling the government to borrow 16.9% of GDP coming into 2021 (Norman, 2021). Although a budget deficit is common and the UK economy has not seen a budget surplus since 2000, the growing scale of the deficit and even-more worryingly a structural deficit, will without doubt be back in the limelight as covid unwinds and the purse-strings tighten once more. The argument for returning to an austerity led policy is even stronger when viewed from a debt perspective, which is an underlying accumulation of deficits over the years. This will tally to 97.1% of GDP by the 2023-2024 year (Norman, 2021). Ultimately the government’s hope is that the short-term protection will avoid another decade of recovery and that the investment will translate into growth for the future and equally lessen the need for increased future borrowing overall. It should also be added that the unemployment rate was mitigated at roughly 4.8% during the majority of lockdown; it is forecast to peak at 5.5% in the final quarter of 2021. The hope here is that this will level as the economy pushes into growth once more (King, 2021).
When considering the sectoral view of COVID, healthcare has undoubtably been under huge strain since the beginning of the COVID Crisis. Low flexibility in the supply of doctors and other healthcare professionals alongside the lower total beds and critical beds availability versus most of the OECD nations, will have had a toll on the strength of the initial UK response. The government recognized and reacted to this shortfall and attempted to add to capacity through the opening of the Nightingale hospitals and purchase of additional ventilators and personal protective equipment (Rocks and Idriss, 2020). The governments good-will gesture of a 3% rise in the salary of NHS staff will have done little to paper the cracks over the weight of burden that has been placed on the NHS workers, given the existing staffing shortages in NHS and social care prior to the pandemic. Furthermore, the NHS faces immediate COVID patients but also the backlog of non-COVID acute & non-acute care which has been put on the backfoot during the pandemic (Thorlby, Tinson and Kraindler, 2020). Worryingly, the current waiting list of patients is at a record high of 5.45 million and with no signs of slowing (Dyson, 2020). Just how far the resilience of the NHS can stretch is yet to be seen.
For the wider industries, COVID has undoubtably had an impact and evidence from the Decision Maker Panel (DMP) suggests firms were projecting 21% lower sales due to the rise of the pandemic, and 70% reporting high or very high levels of uncertainty (Anayi et al., n.d.). The Gross Value Added GVA) sectorial projection shows overturns in the heaviest hit industries such as that of private non-traded services which capture hospitality, sports, and arts industries, alongside resurgence of other crucial non-service industries of manufacturing (NIESR, 2021). Beyond the numbers and top line categories, the business landscape has had to adapt the growth of online versus the quieting high-streets, the rise of local camping and glamping due to international travel restrictions and the silent bars and pubs. On the other hand, business with high workplace flexibility have seen little to no change seen in output such as in technology with remote working perfectly viable (ONS, 2020a).
Figure 5: Sectoral growth in 2020 and 2021
Source: (NIESR, 2021)
Public life in the UK
As for the UK residents, public life has been subject to major change. The risk of transmission and the potential loss of life has been a real concern. Per the UK Government daily data in August 2021, more than 130,000 of UK residents have died through COVID (GOV.UK, 2021d). This has been particularly difficult for those most vulnerable in society; from the elderly to those with underlying health-conditions as months on end of isolation ensued. Ethic inequalities and differences have also been highlighted as an area of attention by the pandemic with data showing a greater risk of minority ethnic communities at risk of death from COVID-19 (Elwell-Sutton, Deeney and Stafford, 2020). Families have missed important life events and close contact with their nearest and dearest have been halted, as social connection has been put on hold for the priority of saving lives.
For the majority who have avoided redundancy, work-life has had to change to remote connections through online Zoom and Teams calls and “you’re on mute” being the daily parlance in the internet workplace. With it, plenty have benefitted from home-working flexibility. On the other hand, lockdown has been a source of loneliness attributing to a decline in mental health, particularly for individuals guided to shield (Steel, 2020). Confinement at home has also seen an increase in domestic abuse and violence, although this has already been rising in the build up to COVID (ONS, 2020b). For parents, adjustments have had to be made to manage childcare as school openings and closings became a frequent pattern. For the students themselves, it has been a hindrance to open access education and may well have had negative and unequal implications to their academic progression (Burgess and Sievertsen, 2020). Whilst we all come to terms with the impact COVID has had on individual elements of our lives, for many, they must first come to terms with loss of life of close families and friends.
The pandemic has exposed the fact that the world is yet unable to effectively deal with a global disaster cooperatively. At a national level, there is also much for the UK to reflect on in its own response to the pandemic, such that it will be better prepared in the future and avoid another reactionary approach. New diseases, terrorism and the consequences of climate change are all potential future threats of concern, for which rapid unified responses will be required. COVID should serve to remind governments that planning for the future, beyond local pollical tenures, is of the utmost priority in order that future responses are swift and effective.
[Mr. Prabhat Adhikari is an Economics graduate from Swansea University currently working in the FMCG market.]