|The UK is going Korean. Having led with a herd immunity approach to this crisis, Prime Minister Boris Johnson is now said to be convinced that South Korea’s “test, trace, isolate” is the model for Britain. That means forcing the rate of transmission down low through the lockdown, and at the same time building a high-grade, intensive infrastructure which can then allow that lower number of cases to be mapped and controlled. It’s an epic u-turn, after the country abandoned all community tracing and testing on 12 March. |
Catching up with South Korea is no mean feat. The Asian country reported no community transmission for the first time on Wednesday, in what is a remarkable success story. It’s capital, Seoul, has ten million people alone. It managed to curb Covid-19 in a dense urban environment without a lockdown because it’s “test, trace, isolate” plan was in effect from the beginning, and thus it was always able to keep on top of case numbers. Building that infrastructure while you are in the middle of a pandemic is a much harder thing to do.
“In South Korea the testing was conducted on a base of well-funded and efficient public services and an effective infrastructure, including widespread digital surveillance,” Professor Jimmy Whitworth, Professor of International Public Health at the London School of Hygiene & Tropical Medicine, has written. “For other countries to emulate this success, much still needs to be done in terms of planning, organisation and logistics.”
As Tae Hoon Kim, a South Korean analyst, has said, South Korea’s high-quality public health service system was “fought for over many years”.
“The irony is that for many years, Koreans believed that having world-class public services was equivalent to becoming more democratic and thus more western,” Hoon Kim writes. “Many were unaware of the widespread privatisation and outsourcing of public services that was taking place in the west at the same time.”
There is no magic wand which will suddenly reverse the short-term error of a Prime Minister who is said to have been resistant to an earlier lockdown because of a “libertarian instinct”, and the long-term error of decades of neoliberal ideology pervasive in UK health services. But with First Minister Nicola Sturgeon and UK Health Secretary Matt Hancock both expected to outline plans to “ramp up” testing today, we need to look to what can be done now.
The first thing is that the lockdown needs to be defended from those media outlets and industry lobbyists who want to pressure government to put profits before lives. We are not even close to being prepared to exit lockdown. In afascinating piece on US lockdowns during the 1918 Spanish Flu, historian Nancy K Bristow shows that we have been here before with serious social forces resisting the maintenance of effective quarantine methods.
“The authorities that resisted this opposition fared the best,” Bristow finds. “Imposing ‘shelter-in-place’ orders, as well as other measures such as public masking and the quarantining of the sick and infected, saves lives. They can do so again, if we can find the courage and the resources to maintain them.”
Second, the current testing regime in Scotland, which works on a two-pronged basis – NHS testing done via the Scottish Government, and community drive through testing, which is run by the UK Government – doesn’t just need “ramped up”, it needs re-thought. It’s not only that not enough people are currently being tested, it’s that there is no integrated system tying together “test, trace, isolate”. This isn’t a numbers game, it’s about having real-time data and the capacity to respond to that data on-the-ground. Sturgeon and Hancock have to announce an action plan explaining exactly how that will work and who the labour force is that is going to do all that work.
As public health professor Devi Sridhar at the University of Edinburgh, who is a member of the Scottish Government’s Covid-19 advisory group, said to the BBC yesterday, the mistakes that have been made have put Scotland and the UK “in a difficult position”
“Now we’ve basically got to put the genie back in the bottle.”
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