Covid inquiry: Controversial lessons from Sweden highlight UK's lack of urgency to learn its own – John McLaren
Given that the current UK Covid inquiry is thought unlikely to report before 2027 and the Scottish one has only just appointed its chief executive, what lessons might be worth learning sooner, in case some similar sort of health crisis occurs? A recent paper by ‘libertarian’ economists, published by Liz Truss’s favourite think tank, the Institute for Economic Affairs (IEA), found that lockdowns had very little impact on fatalities.
It suggested lockdowns prevented only 3.2 per cent of US and EU deaths in the first wave of the pandemic. However, the report has faced strong criticism on a number of grounds, not least the looseness of its definition of ‘lockdown’ – ie, any form of government policy that consisted of a non-pharmaceutical intervention – and its limited choice of studies to review. Furthermore, it was not published in a scientific journal and therefore not peer-reviewed. As a result, the findings of the study seem to have been almost predetermined by the methodology that the academics decided to use.
The IEA report does usefully highlight the difficulty of undertaking such an exercise; there is a myriad of circumstances that need to be adjusted for in order to determine what the impact of something like a ‘lockdown’ has on the death rate and, looking wider, what the net benefit of such a policy might be.
On the one side, there is the type of lockdown itself, whether it is enforced or voluntary, how widespread, how Draconian, how long. Even then the ability to assess and compare is complicated by special factors like residential care for the elderly. Clearly, care homes are an area where mistakes were made and there remain relevant questions about what is the best social structure for protecting the elderly in such circumstances and how this might be funded.
There is also the question of the degree to which national cultures affect the effectiveness of alternative lockdown measures. The Swedes may follow advice closely, others may not. Even within the UK, there was a palpable difference in public attitudes moving from Scotland, more hardline, to England, less so.
And that is the easy bit. On the other side, the hard bit, is trying to understand and measure the negative effects of a lockdown that offset its positive ones. These include the impact on mental health, education, NHS activity, lost income and jobs.
One other area where economists have a role to play is in helping calculate what a ‘reasonable’ price per life or death might be. Before anyone starts to put pen to paper, this is standard practice amongst governments worldwide, especially in relation to medical costs. If the health budget were unlimited then a lot more lives could be saved or extended, but it is not, which means some form of rationing needs to be imposed and some methodology used to apply it. Indeed, Chris Whitty, in his evidence to the Covid inquiry, recognised that the UK Government was overly reliant on scientific advice, with too little attention paid to economic advice on the costs of lockdown to the economy and society.
Meanwhile, in Sweden, the government published its initial Covid inquiry report in February of last year. This was while the pandemic was still ongoing but has the great advantage that initial recommendations can be made very early in the event of a recurrence. Amongst its findings, the report concluded: “The choice of path in terms of disease prevention and control, focusing on advice and recommendations which people were expected to follow voluntarily, was fundamentally correct. It meant that citizens retained more of their personal freedom than in many other countries.”
This was a contentious finding and one very much based on a society’s perceived attitude towards such personal freedoms. As a result, Scottish and UK conclusions may differ. Furthermore, questions remain over the right of any government or parliament to impose policies that severely constrain personal freedoms. For example, should the installation of a cross-party government be a requirement before such lockdowns are put in place or should some non-political, expert organisation take the lead in any such future emergency reaction?
Another interesting finding of the Swedish report relates to issues like the policy of ‘work from home’. It states: “The measures introduced have often been better suited to a well-educated middle class, well placed to protect themselves from infection, navigate the healthcare system and work from home. Different measures may be needed to safeguard the lives and livelihoods of groups with more limited options.” In other words, the degree of stress and discomfort experienced by poorer, less mobile, more crowded households would have been significantly greater than for those households who were better off, had better jobs and bigger houses. This should be taken into account in any future policy.
These are important questions that need to start being answered now, already late in the day, rather than in three or four years' time. Instead, across the UK, governments seem to be happy to put the pandemic behind them and get back to ‘normal’. This is an unwise approach. The point of the Swedish Commission’s early report was to ensure better management of the next crisis affecting health and society, which could be an even more infectious and deadly disease.
Covid was a warning that our lives and our preferred lifestyles are much more fragile than we had imagined. This threat should be a constant in our thinking and that of any government now, just as global warming is. More preparation and funding of prevention measures now will lead to the retention of greater freedoms should a similar event occur, as well as to a more equal application of restrictions across society.
John McLaren is a political economist who has worked in the Treasury, the Scottish Office and for a variety of economic think tanks
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