Who would have imagined that, in the middle of the coronavirus pandemic, I would discover that I am non-binary? We are in an extremely important phase of the pandemic at the moment; the nightmare of the first wave is subsiding and we are entering the lull before the probable second wave comes towards the end of the year. We have, perhaps, three months or so, to plan and prepare for the winter onslaught. We need to have fortunately bought a period of grace in which we might, if we work cooperatively and diligently, be able to limit the damage that the next wave of the virus will do.
It is not very likely that any vaccine or effective treatment will be available in time so we need to make other contingencies. Having our health service capacity enlarged is already well under way but this needs maintained and we need to start addressing non-coronavirus morbidity as well. Contact tracing needs developed but, vitally for this to work, we need to have low levels of infection as we go into the next phase. If our base rate of infection is too high then any track and trace system will be unable to cope and be ineffective. At the same time as all of this we need to restart our economy and society and find new ways to co-exist alongside the coronavirus, at least in the medium term. This creates a tension between the desire and need to open-up society and the economy and the worry and caution promoting prolongation of the lockdown.
This is increasingly being argued as if it were a binary choice: open or continue the lockdown – the economy or public health – money or lives !
Those wishing to relax the restrictions correctly remind us that without manufacturing there will be no consumption, without wealth there can be little health. The point out that if we continue the shut down then people will die as the death rates from poverty start to rise. They will also point out that failing to treat many conditions, for which we do have effective treatments, will cost us in avoidable deaths over the years to come. They will stress the adverse effects that a closed society will have on our mental health and the long term sequalae we might expect from this, as well as the horrific prospect of a “lost generation” of children and young people deprived of an education at the most vital time of their development. They will show us all of these numbers and tend to minimise the risks of a second wave. They will tell us we must gird our loins and forge a new way ahead out of this pandemic and advise us not to listen to those advising caution as they are just cowards afraid to take the necessary steps en route to victory.
On the other hand, those appreciating the danger of a second wave will point to all the dangers we ignore at our peril. The recent localised spikes and outbreaks when restrictions have been eased. They will correctly let us know that the likelihood of a vaccine is far from certain and extremely far from being close at hand. They will point to how poorly we have coped with following the rules and advise us that we can’t trust tour fellow citizens to take the degree of care necessary – ‘It is bad enough that they don’t take care of their own health but they also jeopardise the health of everyone else.” Correctly they will point out our great ignorance of many aspects of this disease – which groups are vulnerable? what behaviours are the most risky? What strategies reduce my risk? They will argue these are all largely unknown and, as a consequence, any opening up is cavalier and reckless.
Alas, these positions are often seen as binary opposites and people and politicians are taking their positions on either one side or the other. Debates are largely about whether one or the other approach is correct. Facts are massaged to support one case or another while other facts are generated to show the danger of the opposing view. At a time when we should be trying to understand, debate and work out an effective strategy we are treating this like a political hustings – denigrating everything the other side offers as stupid, at best, and possibly evil, at worst, while proclaiming themselves as our only saviours.
This is not a binary choice. We need to release some of the restrictions so we can build up our strength and armamentarium for the next round of the fight but we must also be vigilant and careful so as not to give away any ground or be caught of guard. If the analogy is a door, then it is indeed time to unlock it, but there is no need to leave it open. We can start to return to our work, our schools, our hospitals and our shops but not in the way we did before. We can start to consider non-essential activities to get some recuperation but these need to be different to how they were before We can’t suddenly start long-distance travel or tightly packed mass events. This is a period of respite not a victory party. This is also our time to try out new ways of living that might prove better in the long term: a time to find pleasure in smaller scale more local events; a time to review if our supply chains need to span so far across the globe or whether we could be more self-reliant; a time to see if there are ways that the ecological benefits we have seen through reduced consumption could be made permanent.
No matter what the politicians tell us, it is not ‘A’ or ‘B’, not their way or their opponent’s way, it is a mixture of both. What we require to do now is to find out just what ratio is needed. This is difficult and we may find that our present politicians are not up to the job and that we need new voices. It will not be easy but, as they say, ‘If you can’t ride two horses at the same time you shouldn’t be in the circus”