Britain is now experiencing a second wave of coronavirus infections having ignored repeated scientific advice to implement basic public health measures. By the end of October 2020, the UK became only the ninth country globally to reach a million Covid-19 cases. Over 55,000 people have died, the highest number of deaths in Europe. The UK is the fifth country globally to pass this grim milestone. The second wave arrived because of the British government’s adherence to ruling class interests of guaranteeing the profits of the capitalist economy at the expense of human health. Government scientists are predicting that the Christmas relaxation of restrictions will lead to a third wave in the new year. CHARLES CHINWEIZU reports.
The worst affected areas are the north-west and north-east of England, where there are high levels of deprivation, unemployment, poverty-pay and overcrowded sub-standard housing, and significant populations of black and other ethnic minorities, who in turn are more likely to be found in occupations where they are exposed to the virus. Combined with a lack of support for people who test positive to isolate and prevent infecting others, this means that the virus has become endemic in these areas. The prevalence of low-paid, temporary, gig-economy work means there is little incentive to isolate – only an estimated 19% of those required to isolate have done so. No amount of testing or contact tracing can overcome what are structural problems which require not a medical or scientific solution but a political one.
First wave
England and Wales accounted for 28% of excess deaths among 21 European countries during the first wave of the pandemic between February and May 2020; the UK as a whole is now estimated to have over 70,000 excess deaths. An Independent SAGE report COVID-19 and Health Inequality confirms that people from lower socio-economic groups, living in more deprived areas, in lower paid jobs were at greatest risk of hospitalisations and death from Covid-19. Between 1 March and 31 May 2020, 45% of Covid-19 hospital patients were from the most deprived 20% of the population of England. The burden of lockdowns, school closures, homelessness, and restriction on NHS services also fell disproportionately on disadvantaged and vulnerable groups, and the death rate in the most deprived English neighbourhoods was 128.3 deaths per 100,000 compared to 58.8 deaths per 100,000 in the least deprived. There was a similar pattern in Scotland and Wales. Ethnic minorities are much more likely to be socio-economically deprived and/or to live in more deprived neighbourhoods, and so were also disproportionately affected by Covid-19 and pre-existing inequalities, related to the austerity measures implemented by both Labour and Tory governments for decades.
Second wave
The government’s rush to reopen the economy in July 2020 before adequate public health measures were in place, led inevitably to the spike in Covid-19 cases and their spread across the country. A University of Warwick study found between 8% and 17% of newly detected Covid-19 infection clusters emerged a week after the government’s ‘Eat Out to Help Out’ scheme began on 3 August 2020, and a decline in new infections in areas with high participation, a week after the scheme ended. By mid-September there were 6,000 people being infected daily; three weeks later, there were 14,000 daily new infections.
The government ignored advice from SAGE (Scientific Advisory Group for Emergencies) on 21 September to immediately impose a 14-day national ‘circuit breaker’ or face a ‘very large epidemic with catastrophic consequences’. Chancellor Rishi Sunak however persuaded Prime Minister Johnson against this due to economic considerations. Instead the government extended its patchwork strategy of local restrictions, with pub curfews, the ‘rule of six’ from 14 September, and tighter rules from 22 September in Lancashire, Merseyside, parts of the Midlands and West Yorkshire, which were changed weekly. At the end of September, at least 16.6 million people in the UK were in local lockdowns including 1.9 million people in Wales (60% of the population), 1.8 million in Scotland (32%) and 12.4 million in England, mainly in the North and the Midlands. Local leaders in these areas with higher levels of deprivation continued to request local decision making, locally controlled Test and Trace systems, and financial support for everyone who needs to self-isolate.
Hospital admissions began rising exponentially in all age groups, even before students went back to universities causing another spike in university towns. There were 586 hospitalisations with Covid-19 in England on 18 March 2020 (the first day of recorded figures); on 6 October there were 524 daily admissions with the figure doubling every 14 days, so Britain was very close to the first wave situation of early March. Despite the failure of the regional approach the government persisted, and on 12 October imposed a three-tier ‘Covid alert’ system, keeping pubs open if they served a ‘substantial’ meal. Scotland, Wales and the North of Ireland also imposed a patchwork of restrictions with little to no coordination or communication between the four nations and their leaders. Scotland implemented a two-week ‘circuit breaker’ on 9 October around the school half-term, and a full shutdown of pubs across the central belt, where infection rates were highest, then a five-tiered system on 16 October. But on 20 November, the deteriorating situation forced First Minister Nicola Sturgeon to move 11 western areas into the highest tier for three weeks until 11 December. Wales had to introduce a two-week national lockdown ‘firebreak’ from 23 October to 9 November. Local lockdowns had previously been in force in 17 areas of Wales.
The regional approach with pub curfews has also been tried and failed in the Netherlands, Italy, Ireland and France – infections keep rising due to contact between people, communities and regions. By 25 October there were 96,000 people getting infected every day and the UK had gone from 500,000 cases on 4 October to one million cases in one month. On 31 October, the government announced a 4-week lockdown to begin on 5 November. The incompetence and infighting at the heart of government led to this announcement being brought forward, causing yet another spike as people socialised one last time. The government had lost control of the virus and the second lockdown is an admission of its catalogue of failures.
Chris Whitty, England’s Chief Medical Officer, had already admitted on 12 October that the Tier 3 local lockdowns would not be enough to restrict the virus on their own. This begged the question what the government would do when the second lockdown was lifted on 2 December. According to SAGE, the virus can only be controlled if at least 80% of an infected person’s close contacts are reached within 24 hours. ‘NHS Test and Trace’, run by private corporations Deloitte and Serco, has failed to do so. Test and Trace is only reaching 60% of close contacts of people who tested positive for Covid-19 within 24 hours, and only reaching 85% of those referred to Test and Trace; the performance is worse in areas with the highest rates of infection. The World Health Organization (WHO) does not recommend lockdowns, but has consistently advised to test people, trace their contacts and ensure all those who are infected and their contacts are supported and quarantined.
Liverpool mass testing
In early November, Liverpool became the first city in England to roll out mass testing of its population for Covid-19. All people living or working in Liverpool including 11 to 18-year-olds in schools, were offered regular and repeat testing at one of 19 army-run test centres whether they had symptoms or not. Rapid diagnostic (lateral flow and LAMP) tests are being used in addition to the more accurate PCR test. Liverpool can carry out 50,000 lateral flow tests and 14,000 PCR tests a day. The government plans to roll this ‘pilot’ out nationwide starting with high prevalence areas, to test 10% of an area’s community each week using lateral flow tests.
Well-founded reservations have been highlighted by experts over the limitations of the rapid diagnostic tests, how personal data will be handled, infectious people who test negative getting false reassurance from a supposed ‘clean bill of health’, and unnecessary isolation for non-infected people who test positive (the false positives). Nevertheless, this mass asymptomatic testing is a positive development if part of a comprehensive test and trace strategy. It should be used not as a diagnostic tool to inflate test numbers, but as a good mass surveillance snapshot of infection, where epidemiological surveillance and observations such as symptoms take precedence over the actual test result. Specificity of the rapid tests is very high (99.6%) meaning false positives are rare (0.4%) and can be and are mitigated by repeat testing with PCR to confirm the positive result. The main concern is the false negatives (as high as 43%). More than 100,000 people in Liverpool had been tested by 24 November with over 700 asymptomatic carriers found. The plan is also to test 1.2 million university students between 3 and 9 December, prior to them travelling home. With tens of thousands of NHS staff off-sick or self-isolating, routine asymptomatic testing is now urgently needed.
The announcement on 23 November that three households, whatever their size, can form a ‘Christmas bubble’ from 23-27 December, is a recipe for a further wave of Covid-19 infections. The government is desperate to shore up its popularity and distract attention from its current internal chaos; ending the second national lockdown across England on 2 December regardless of the continuing high infection rates expresses that intention. Infections in January 2021 will soar as a consequence; many more will die.
Vaccination – no silver bullet
In an effort to manage growing opposition to its handling of the pandemic, the government is talking up plans for a vaccination programme starting in December 2020. It regards vaccination as a way out of the coronavirus crisis, rather than sorting out test, trace and isolate. However, presenting vaccination as an easy solution is a dangerous strategy: it will be used as a pretext to relax restrictions and social distancing. Even so, the government has only ordered about 40 million doses of the Pfizer/BioNtech vaccine, which will cover only 20 million people, and universal vaccination will not happen until the end of 2021 at the earliest. WHO chief scientist Soumya Swaminathan warns it would take four to five years before the pandemic was under control, and vaccines were no ‘magic or silver bullet’. While the British and other imperialist governments have quietly bought up the vast majority of future supplies of Covid-19 vaccines, the WHO has to rely on a charity initiative called the COVAX Facility for ‘developing’ nations to vaccinate their populations.
Great Barrington Declaration
The capitalist governments’ corrupt and inept response to the pandemic has given fuel to right wing forces who push a narrative of ‘casedemics’, ‘false positives’, hoaxes and anti-vaxx conspiracies. The most organised right wing position is codified in the Great Barrington Declaration published on 3 October 2020. It argues for actively encouraging the spread of the virus as a means of achieving ‘herd immunity’ while adopting ‘focused protection’ of those deemed vulnerable. However, when those who care for vulnerable people are included, up to 40% of the UK population would need such ‘protection’. The Declaration emerged from a gathering in Great Barrington, Massachusetts, hosted by the American Institute for Economic Research (AIER), a neoliberal think tank, which is also the registered domain name owner of the website publishing the Declaration. It is ‘embedded in a Koch-funded network that denies climate science while investing in polluting fossil fuel industries.’ (Nafeez Ahmed, Byline Times). Those advancing the Declaration want to shore up capitalism by forcing healthy workers back to work and marginalising those who are a drain on capitalist profits – the elderly and vulnerable. Millions more would die if this approach were adopted, and it has been condemned by the WHO.
