Chinese doctor in the UK: Presumed words of surrender were exactly what Britons needed to hear

Following the escalation of the Covid-19 pandemic, Europe has become the epicentre of the outbreak, with individual governments each coming up with their own containment measures. However, earlier this month during a televised interview, UK chief scientific adviser Sir Patrick Vallance announced a shift in the government's coronavirus strategy from a "contain" to a "delay" phase. The rationale for this included some belief in "herd immunity", a concept that suggests that if a large part of the population get the disease, recover and become immune to it, the country will have less risk of suffering from future outbreaks of the disease thereafter. This announcement sparked fierce debate and people speculated if the UK government was about to throw in the towel and allow the coronavirus to infect people via natural selection.

In practice, "herd immunity" implies that the government does not actively intervene in contact tracing, virus testing, and mandatory quarantine. Instead, by keeping mildly infected patients on voluntary self-quarantine at home whilst allowing the young people to move freely and maintaining a certain extent of social distancing, the government hopes that society undergoes the gradual process of developing immunity to the virus. However, this policy comes with a high risk: at present, many characteristics of the coronavirus remain unknown, and its effective spread among the masses, as well as its mutation processes, remain unclear. We also do not know if the susceptible community will shift from the old to the young. An inability to achieve the targeted proportion of immune persons in a community within the stipulated time will spin the outbreak out of control, leaving authorities helpless should that happen.

Following massive debate after Sir Patrick's announcement, he immediately retracted his claim and said that "herd community" was but a scientific discussion and does not refer to actual policies. Yet, his speech does not seem to be a mere slip-of-the-tongue - it reflects certain attitudes of the UK government and the preventive medicine field. The reason behind Britain's adoption of delay strategies instead of containment strategies undertaken by China lies in its considerations of its national circumstances.

Firstly, the monetary costs and societal costs of powerful containment measures are extremely high. Imposing mandatory quarantine, locking down cities, or limiting work require a huge amount of social resources, economic capital, and labour costs. Strong containment measures may control the outbreak relatively quickly, but the virus still exists in society. With the population generally susceptible to the virus, once these tight containment measures loosen up, the outbreak could quickly see a resurgence. Should that happen, the huge efforts and costs previously exhausted would come to nought.

Interestingly, the UK's National Health Service (publicly funded healthcare system) has been running at a high cost for a long time. Should the outbreak see a surge in patients in a short span of time, the UK healthcare system - already overwhelmed - will be dealt another big blow and could even become paralysed. Under the assumption that the number of infected persons stayed the same, delaying the time that medical interventions reach their peak reduces the pressure on the healthcare system as much as possible. This also increases the share of medical resources per individual, in turn increasing the individual's chances at survival.

Secondly, containment measures are incompatible with societies that uphold individual freedom and would attract great resistance. The entire British society holds itself to the standards of individual freedom and any form of governmental intervention with the people's private lives have always drawn great resentment. Some citizens do not trust the government, and are even rebellious to the point of doing things against the government's wishes. A sudden enforcement of strict containment measures might breed societal resistance and might not be widely supported, putting the government in an unenviable predicament.

The UK prime minister has been honest from the beginning, saying in a statement on 12 March, "It is going to spread further and I must level with you, I must level with the British public: many more families are going to lose loved ones before their time." He also said that the government's plan would focus on delaying its spread, thereby minimise suffering. These words may seem like the UK is surrendering to the outbreak, but they were exactly what the British needed to hear.

Shortly after these words were spoken, London underground stations became less busy and many shops were deserted. When the people saw that the government became helpless, they began to help themselves, with some companies and research organisations voluntarily implementing "work from home" schemes. At the same time, the public lowered their expectations of governmental policies, forming a public opinion atmosphere that ironically had the effect of pushing the government to adopt more active policies.

Under such circumstances, the UK government has recently implemented tougher policies such as shutting down schools, hotels, bars and so on, and requested that people keep a social distance of more than two metres. It also called for young children not to live with the elderly as much as possible, and recruited tens of thousands of retired medical staff back into service. It even preempted the possibility of a lockdown on London, which has turned out to be a self-fulfilling prophecy with the lockdown announced by the UK prime minister yesterday*. At present, crowds can no longer be seen in London, and many people have long decided to help themselves by staying at home. Only time will tell if the people's cooperation and the government's policies will have an effect.

Note:

*UK Prime Minister Boris Johnson announced yesterday that the government was imposing strict measures to ensure that people stayed at home "at this moment of national emergency". These measures would be in place for at least three weeks. He said people would only be allowed to leave their home for very limited purposes:

- shopping for basic necessities, as infrequently as possible;

- one form of exercise a day - for example, a run, walk or cycle - alone or with members of the household;

- medical need, to provide care or to help a vulnerable person; and

- travelling to and from work, but only where absolutely necessary and cannot be done from home.

In addition, he said that the government would:

- close all shops selling non-essential goods, including clothing and electronic stores and other premises including libraries, playground and outdoor gyms, and places of worship;

- stop all gatherings of more than two people in public - excluding people one lived with;

- stop all social events, including weddings, baptisms and other ceremonies, but excluding funerals.

The unprecedented steps represent the most dramatic and widespread restrictions on the movement of people the country has seen in peacetime.

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