 On March the 6th, the first UK death from coronavirus was reported. By March the 12th, when Boris Johnson gave his first big press conference flanked by Patrick Vallance and Chris Whitty, that number had only risen to 10. However, by this point, there were over 1000 people who had already died from the disease in Italy, and Britain's lackadaisical approach to the pandemic put it out of step with most of its neighbours. To justify their relaxed approach, the government had cited behavioural science and the concept of herd immunity. The day after that press conference, myself and Aaron Bostani acquainted ourselves with the theory's guiding government policy and assessed whether Boris Johnson's government were making a terrible mistake. We've done what can be done to contain this disease and this has brought us valuable time, but it's now a global pandemic and the number of cases will rise sharply. Indeed the true number of cases is higher, perhaps much higher than the number of cases we have so far confirmed with tests. And I've got to be clear, we've all got to be clear, this is the worst public health crisis for a generation. Some people compare it to seasonal flu, alas that is not right. Owing to the lack of immunity, this disease is more dangerous and it's going to spread further. And I must level with you, level with the British public, more families, many more families are going to lose loved ones before their time. But as we've said over the last few weeks, we have a clear plan that we are now working through and we're now getting on to the next phase in that plan because this is now not just an attempt to contain the disease as far as possible but to delay its spread and thereby minimise the suffering. From tomorrow, if you have coronavirus symptoms, however mild, either a new continuous cough or a high temperature, then you should stay at home for at least seven days to protect others and help slow the spread. That was Boris Johnson at a press conference yesterday. When I watched that actually, I mean I'm not particularly reassured whenever Boris Johnson tells me anything but it was I think a political master's stroke that every time Boris Johnson comes out at the moment, he's flanked by the government's chief medical officer and the government's chief science officer because then whenever there's a difficult question, he can pass it on to them and it seems like, oh actually maybe we are being led by scientifically driven evidence-based people. Which is definitely the impression they're trying to give. Actually the press conference was quite explanatory in ways. I think the problem was that over the next 12 to 24 hours it seemed like, oh actually maybe there would have been some tougher questions that the journalist there should have asked when it became apparent that maybe whilst what they were suggesting in the short term sounded plausible, it wasn't necessarily enough. I mean we should get up now actually what the, so what it means that we're now in delay phase is that some new measures are being implemented which weren't implemented before and they are that as you heard Boris Johnson say there that if you've got a continuous cough or a fever you should now self isolate for seven days. And also they're advising those aged 70 or over not to go on cruises and advising against international school trips. Now my response and I think many people's response was like aren't people doing that already? Like I would have been quite surprised if up to yesterday there were still 70 year olds with a mild fever going on a cruise ship given that seems to be the most common place to incubate and spread this disease. I mean are people still going abroad? I mean I just find that kind of weird. Something that's undeniable is that the government aren't denying this is that their response is kind of out of step with most other countries who are in a similar situation to us who have a similar level of cases. Ireland for example has fewer cases than us per the population and they've already closed schools for example. And the government are being very explicit in the fact that they are taking a more relaxed approach to shutting stuff down and a couple of the justifications for that and we can look at now. So one of them is behavioural science. So it's this idea, it is a bit sort of like the kind of stuff that gets put in books at airports. So it's this idea that you might think that a policy will do this thing but actually counter-intuitively it could have the opposite effect. So examples of this, you might think that shutting a school would mean that less people would get the virus but actually if you shut the school then the kids go home then they hang out with their grandparents so this stuff came out of a book, right? I mean David Halpern wrote a book called Nudge which is like airport reading, free economics kind of stuff. Exactly, and as we mentioned on Wednesday show the Nudge unit was created in 2010 to advise David Cameron it was part of his big society so it was the idea that the state doesn't have to do that much to achieve social policy outcomes. What it has to do is little things, little things to try and nudge people which is why it's called nudge in the right direction and big things that the Nudge unit is famous for is sending out text messages to say you need to do your tax return. It actually works for me. That does make me do my tax return on time but protecting the population from an epidemic is kind of different from trying to get people to return their tax forms on time. They also do that thing where you put like a bee in a urinal and then people don't mess and they piss on the bee. Because they're aiming, yeah. That's a nudge. Yeah, so that's the kind of... We're talking about different levels of seriousness and the costs of if it fails are slightly bigger in this case. Well, no, but they would say, look, you know, every year the economy spends £150 million on cleaning toilets and that could be saved through this tiny, you know, behavioral change. Yeah, I mean, obviously I think I've got no problem with them putting bees and spiders in urinals. Which means that you target your piss but I don't necessarily think that should be qualification for then managing. That is honestly one of the most famous examples. I'm not sort of saying that to be a little nudge unit. The other... We'll go through behavioral science or those aspects of it in a bit more detail. Also, the other one is epidemiology and this is I think the more serious argument which is to say that if you have a lockdown, so what other countries are doing is, you know, trying to have quite serious social distancing measures already to try and stop people catching the disease from people who have it, especially people who have it and don't know they have it. What the government are saying is that actually we don't want to stop everyone getting the disease because we need enough people to get the disease enough young, healthy people to get the disease that society develops some herd immunity. I want to stick with the behavioral science first. This is the idea that if you take what seem like obviously good measures, it could have unintended consequences. So someone who explained this this morning was the chief scientist Sir Patrick Valance on Radio 4. He was asked, you know, if other countries are canceling huge sporting events, if, you know, as you said, you know, the chief scientist said yesterday there might be 10,000 people in the population that have coronavirus and don't know, or I mean 500 or so people know they've got it. So it could be 10,000 people who have it. So say if we know that this many people have coronavirus, why are we encouraging people to go into these big spaces and hang out together when Ireland, when France are not doing that, when they've canceled it? Sir Patrick Valance said is that actually, look, if you cancel the rugby match, which is outdoors, so there is some chance that people will catch it, but you know, it's better that they're outdoors, they would watch it in the pub. And if they're watching it in a pub, you've got a closed space, you've got a warm, closed space. It's like lots of, lots of capacity for passing on the illness. You know, it's one of those things where the, the moment he says it, it sounds reasonable. Then you think for five seconds, you're like, well, what if you just canceled the match? People are going to still watch the match in pubs as well. Well, yeah. Exactly. What do people do before they go to a rugby match? They go to the pub. What do they do afterwards? They go to the pub. And how do they get there and back on incredibly packed trains or buses or whatever. So. And when you go into the stadium, you're patted down, etc. Yeah. And to be honest, a lot of, when I hear them talk about these, you know, these behavioral science, oh, but if you did this, something else would happen. It does sound a bit weak. If you, if you tell people not to go into school, then people won't be able to work in the health service because they'll be looking after their kids. Well, there's an easy fix to that. What if you say school will only be open for people who work, for the children of people who do essential jobs and then you tell everyone else that they can stay off work. I think that's wise. I mean, it's sort of like that's a simple fix. So instead of saying, we're not going to close the schools because then healthcare workers might have to take time off work. So we're just not going to do it. We're just not going to bother at all. If you said, okay, well, that is a genuine problem. We should accept that. Yeah. So logistics workers, social care workers. Yeah. So what should you do? You should say school is only for people whose parents do essential jobs and everyone who's not doing the essential job is welcome to miss work and stay home and look after their kids. So that's the behavioral science has, but it's saying that the reason Britain are doing things differently to other countries is because we are better at behavioral science than them. So whilst France might think they're doing a smart thing in terms of banning sporting events, actually the French people are just going to gather in pubs and give it to themselves there. I mean, Belgium have banned pubs being open. So I don't think it's a particularly strong argument. The other argument the government are making is about epidemiology. It's a study of the spread of diseases and in particular herd immunity. So what they're saying is if we shut down society too early, if we lock people in their homes, then by the time when we let them out, because not many people will have ever had the disease and not many people will have become immune to it, then at that point you'll get a second epidemic, just as big as the potential first one and maybe next winter, so sort of in an unideal time. It's quite a complex idea and the best I've seen it explained was yesterday on Newsnight by Professor Graham Madley. So he's a professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine and academic chair of the Scientific Pandemic Influenza Group on modelling. So a guy with many credentials to his name. This virus is going to be with us for a long time. We're going to have an epidemic and then it will become endemic and join in with all the other coronaviruses that we all have all the time but don't notice. We're going to have to generate what we call herd immunity. So that's a situation where the majority of the population are immune to the infection. And the only way of developing that in the absence of a vaccine is for the majority of the population to become infected. Ideally, if I could, what I would like to do is to put all the more vulnerable people into the north of Scotland and keep them there, everybody else into Kent and have a nice big epidemic in Kent so that everyone becomes immune and then we can put people back together again. But we can't do that. So what we're going to have to try and do, my dear, is some kind of manage this acquisition of herd immunity and minimize the exposure of people who are vulnerable. Clearly a very intelligent guy. And the point he's making is that, you know, what we want to happen to damage or to limit the deaths that happen from coronavirus and to limit, you know, the government seem to be quite concerned about inconvenience or economic damage. We'll talk about that later as well. The second one is for all the... to develop herd immunity by enough young, healthy people getting it and then recovering from it and then being immune from it that, you know, society becomes, as a collective, less liable to epidemics. But the problem is one that you don't want everyone... even though you ultimately want a large proportion of the healthy population to get it, you don't want them all to get it at the same time because that could overwhelm the health system if the disease does become serious. The other problem, and I think this is the major one, is that he has sort of... this seems to be the model guiding the government. But even though the government can't do what he has hypothetically suggested, which is to put all the older people in the north of Scotland and all the younger people in Kent to share the coronavirus around there, they don't seem to have done... obviously they can't do that, but they don't seem to have done anything really to separate younger people who they don't seem to mind at all. So, you know, they haven't suggested how they are going to... I mean, how certain are we that people don't get coronavirus twice? From what I've read, they seem fairly confident. I mean, it would be insane for them to have developed this whole policy system if they didn't have some confidence about that. The claims are... its mutations are very slow, etc. So there's not very many concerns about that. But, I mean, again, if there was a mutated version, could that compromise somebody's immune system if they'd had the other variant, etc.? I mean, I haven't seen many people complain. So, as I was saying, because we're not epidemiologists, we're going to be talking about the various debates that people are having to know about this year. Yeah, we're synthesizing the information. We're journalists. And as far as I can tell, there aren't any big dog credible scientists saying, our big concern with this strategy is that actually people maybe can get coronavirus twice, three times, four times. No one said it's completely stupid. They've just said it's potentially riskier than it would need to be. So, we're just synthesizing information. We're going to go to now someone who is a genuine expert. So this is... he was on Newsnight last night, very intelligent fellow. Anthony Costello. He is an ex-director of the World Health Organization. And he's not so sure about this strategy. He's not sure about the government strategy to let all the young people get coronavirus so that we develop some sort of herd immunity. Unlike other countries, the UK strategy aims to build herd immunity by allowing the steady spread of COVID-19. The government argue it will block a second peak in several months' time. Here are eight questions about this herd immunity strategy. One, will it impair efforts to restrict the immediate epidemic and cause more infections and deaths in the near term? Evidence suggests people shed virus early, and those without symptoms may cause substantial spread. This argues for policies against mass gatherings for school closures and for strict national and local measures for social distancing. Two, he's saying, will it weaken containment systems, testing, screening, radiography, isolation? China built a robust nationwide system of mobilised community workers for identifying cases, promptly isolating contacts and treating vulnerable people promptly to contain the outbreak. Three, does coronavirus cause strong herd immunity or is it like flu where new strains emerge each year needing repeated vaccines? We have to learn much about COV immune responses. That's actually referring to what you were talking about, Aaron. So he is saying that we don't know enough that you couldn't develop a slightly different strain of coronavirus. And then whilst we're, you know, all immune to the current strain of COVID-19, you get COVID-19. I know it's not how it works, but COVID-19.5, and then you're able to get that. I mean, the point is if 40% of the global population gets it, statistically, it's quite likely there's going to be a mutation, surely. I know they're saying it mutates very slowly. You get degrees of mutation and different sort of velocities, et cetera, with regards to different viruses. But I mean, 40% of 7.5 billion people get it. There's going to be mutations, presumably. Yeah. Well, I mean, I'd say the main argument there is that and I think his conclusion we'll get to in a moment is that even we don't know at the moment, right? And we don't have a high degree of certainty and so why take this incredibly high risk strategy? Four, he says, doesn't this herd immunity strategy conflict with WHO policy, World Health Organization policy? After the announcements of this being a pandemic, Dr. Tedros, director general of the WHO said the idea that countries should shift from containment to mitigation is wrong and dangerous. So this is the idea that the government have now said, ah, fuck it, everyone can get it. We'll just try and make it as least disastrous as possible. Wait, so repeat that line again. The idea that countries should shift from containment to mitigation is wrong and dangerous. From containment to mitigation, the thing is, you know, we had the Harvard professor of epidemiology, Mark Lipsitch, said that 40% to 70% of the global population is going to get it in the mid-medium term in the next couple of years. That's been repeated by Frowler and Angela Merkel, you know, probably the most sober, serious, honest politician amongst the major European politicians. So I mean, how do you contain that? I understand the containment strategy in so much as you only have so much healthcare capacity, so many hospital beds, so you don't want to overburden that system all in one go. But in terms of actually containing the virus so that not many people get it, I mean, I don't see how that, or are they sort of insinuating there that it can be contained until there's a vaccine within the next 12 to 18 months or what? Do we shut down the global economy for 18 months? Well, so I suppose that's what the stories are refusing to do effectively, right? They don't want to shut down the economy to minimize deaths. The WHO have been very, if you read their reports, they've been very complimentary about how China and Taiwan and South Korea have dealt with it. And they've dealt with it by saying, we just need to stop this virus dead and take quite serious action to make sure that doesn't happen. Pour tons and tons of resources in it. You had, I think, 40,000 people went from different regions of China to work in Wuhan. So you had a mobilization of resources which is completely unheard of in the European countries, which is why they were quite effective at stopping the spread. And that does just give people more time to understand what's going on. No, I get that. But the second Wuhan goes back to business as usual, let's say in two months and then you have tourists there and you have the spread of infection, you have social institutions at schools, workplaces open again, it's going to happen all over again. Well, that's the government's argument. Can I just say, I'm not saying I agree with the government, but it might be that, you know, maybe in terms of, if you're, from a utilitarian perspective, you want to absolutely minimize deaths, you say, look, we're just going to have to shut down society for 12 months, 18 months until there's a vaccination. I get that. But the WHO, by attacking, or people who are disagreeing, people in positions of power and knowledge with regards to the healthcare profession, disagreeing with the government. That seems to be their implicit argument, but nobody's actually saying that. Well, so it's next week, kind of answer to you, which is helpful. So he says, shouldn't we wait to see the China situation? They've contained the epidemic after seven weeks of intense national effort. Will their strength and systems not contain outbreaks quickly? What is their herd immunity? So he's saying, look, potentially it will be the case that China get a second burst of it. And maybe next time around, they'll have to go for a strategy which looks like what the government's current strategy is. But why would we not wait to see? Which kind of makes sense to me. Number six, without an all out national mobilization plan for social distancing, are the UK government behavioral and NUD strategies really evidence-based to flatten the peak or simply based on models? And on the precautionary principle, shouldn't we go all out to snuff this UK epidemic out with national mobilization at all levels using all possible preventative measures, whether evidence is strong, uncertain, or weak and worry about herd immunity when we have more evidence? Can we freeze that for a sec? The question would be, isn't there an opportunity cost? If you're deploying those kinds of resources, if you're shutting down parts of the economy to such an extent that you can do that, to what extent are healthcare workers? We've got 4 million people in this country waiting for operations. We've got people who've got cancer, onset cancer, and they need to have that cancer removed. We've got elderly people who need just care. They need to be looked after and cleaned and visited, etc. So you might have people who are suicidal. They have mental healthcare workers who need to see it, etc. So there's an opportunity cost. If you deploy all these human resources into this one thing, do you see what I'm saying? Again, why is there not that sort of conversation? This is where I worry, actually, because what you're saying is we could make a decision as a society that we're willing to take the risk and we're willing to take the risk because the economic costs and the costs not related to coronavirus of implementing a shutdown would be too high, so we might as well risk a few people's lives. There's two alternatives. That's one of them. The other one is that you literally shut down the running of the modern economy, which means under the neoliberalism society, basically people don't leave their houses. You only have absolutely critically important jobs carrying on, etc. And then you say, well, we're just going to wait for a vaccine in 12 to 18 months. And yeah, we're going to take a contraction of GDP by 25, 35%. Those to me seem the two things you do. I'd say there's a middle ground, right? So a middle ground would be that this is like Tijuana doing or even what Italy is doing in a way is so you implement quite extreme social distancing measures and then you could in a graduated way bring life back to normal and see how it goes. So if you implement social distancing measures at this point, then potentially you could say, well, we were never confining health workers to their homes anyway. We were never confining a bunch of people who work in essential services to their homes. Then sort of like, if it seems like you've got it under control, then you let this part of the economy start again. So you start to start again and you do it slowly in a controlled manner. So you're fairly confident that you're not going to get that overwhelming spike. That may be the case, but like I said, the government is saying, we'll take this as Boris Johnson so charmingly puts it on the chin. That's not a known solution. It seems to me there are two quite plausible solutions with high sort of degrees of certainty as to what they would mean. So the government's sort of sort of conclusion here is, things will carry on maybe two to four hundred thousand people will die. That's what they're doing. And then you could say, look, you know what? We want to keep deaths down to fifty thousand or below. This is what we're going to do with the economy. This thing in the middle, it might work. It might not work. You'll have economic contraction. Then you go back to life to normal. Then you have economic contraction again. I mean, but the government haven't been honest about saying that what we're willing to accept is two hundred to four thousand. That's what I mean. People die because they're saying that if you just keep having wave after wave after wave, the older people will die. But what they haven't suggested is how they're going to separate the old people, et cetera, et cetera. We'll just go to the final one and then I want to go to a graph. So the final tweet, vaccines are a safer way to develop herd immunity without the risks associated with the disease itself. Is it ethical to adopt a policy that threatens immediate casualties on the basis of an uncertain future benefit? And I want to go out this graph because this graph was again on news night. They said they got it from the Lancet. I think this really just helps you understand all the different theories. So we've got the red graph or the red line, sorry. It's showing you on the Y axis, you've got cases being reported on the X axis, you've got months since transmission established. So this red line, that's showing if you get exponential growth and the virus gets out of control and 60% of society get it all at one time. Obviously, you don't want that because health services get overwhelmed. So this is an opportunity to protect older and more vulnerable citizens. We should also know it's not just older people, it's also people with disabilities or people with suppressed immune systems. If it all happens that quickly, there's no time to protect the vulnerable fundamentally. The main concern with the red line is that loads of people die. In the red phase, people aren't being isolated, so that's the whole point. We could just decide that we're going to let it continue. All the young and healthy people who are the people who form can continue with a few sniffles and a bit of a cough. Some people barely notice they've got it. The economy would continue as it had been, and then a bunch of people who are economically inactive anyway die. So that would be the sort of ultimate neoliberal capitalist we value capital and we value wealth over everything else. That's what you do. You wouldn't have any controls whatsoever. The green option is to say you slow it down. You slow down the spread. Ultimately, again, you're looking at 60-70% of the population getting it before they develop herd immunity. You slow it down with measures like social isolation and then that means that the health service is never overwhelmed. You have the chance to sort of separate older people and more vulnerable people from the ill population and then you limit casualties. That's the green one. The blue one, this is what the government is saying they want to avoid. In a few cases, that's when you have absolute lockdown. So you have absolute lockdown. Cases go down to zero. But then because you can't lock people in their homes forever, you have to let them out again. At the moment you let them out, there is still coronavirus around even because some people still have it in the community or because there's still a global pandemic going on. And then because no one's got herd immunity, you then get another epidemic situation. So the point being that all those months that you spent lockdown were pointless. So disagreements about the government response are fundamentally the government say they're on the green line and they're avoiding the blue line, which is what they say countries like Taiwan who've had a more shut down system of doing. But then what people like, I've forgotten his name already, Anthony Costello, so he was the guy who was the next director of the World Health Organization. What they're saying is actually this is fine in theory, but what the government have implemented would actually put us on the red line because he's saying if you've got 10,000 people who currently have coronavirus in this country and you're not really doing anything to separate anyone, then you are very close to getting to this completely overwhelming outbreak. So he's saying the government are putting us or the government are definitely risking putting us on the red line and given that, you know, if you're looking at this graph and you say what's the best outcome, the green line? What's the worst outcome is the red line? So then you thought you'd aim somewhere between the green line and the blue line and the British government seem to be aiming somewhere between the green line and the red line. So can I ask you, given that their voter base is older voters, why would they be front-loading several hundred thousand deaths almost on purpose? Yeah, so that's what seems very... I mean, there's Chris Giles, I think from the FT was tweeting precisely that. He was saying like, even if hypothetically this makes sense, there's a sort of time lag. So it could be that in two years we look back at the government policy and say, oh, that was kind of clever because we had more deaths in spring 2020, France had more deaths in spring 2021. But the point is, and this is what Chris Giles, this is I think economics editor at the Financial Times, he was saying that if we have a period where, because France is in lockdown, they have 500 deaths in April and because we don't have lockdown, we have 2,000 deaths in UK, then the government are going to struggle to continue with that particular policy, right? So there is a concert, so you're right, front-loading the deaths could be a big problem. A strategic comms nightmare. Look, I'll be like, look, tell the telling the political editor of the Daily Mail that we'll be giving it six months. More deaths now for less deaths later, it's never been a particularly good slogan, especially when the whole idea that there's going to be less deaths later is somewhat disputed.