The government’s current emphasis on personal responsibility and showing “common sense” once again displaces blame for their ineffective response to covid-19, says Simon Williams
On 17 March last year, writing in BMJ Opinion, I argued that the UK government’s focus on avoiding handshakes (along with handwashing and other hygiene measures) as a means to prevent the spread of coronavirus placed too much responsibility in the hands of the public at the expense of quick, decisive, and effective policy. We now know that the decision to delay lockdown ultimately cost many lives. However, 14 months later, we yet again find ourselves in a position where the government is attempting to shift attention away from its slow and indecisive policies and onto the public through a “personal responsibility” rhetoric, which this time includes a focus on the need for “caution” when hugging.
On 17 May this year, the health secretary, Matt Hancock, attributed a majority of hospitalisations in Bolton to vaccine hesitancy, while a senior government minister was reported to have referred to those refusing the vaccine as “idiots” who could “ruin it for everyone else.” These comments were reported on the same date that significant policy restrictions were eased to permit much more indoor socialising.
More recently, on 25 May, it was reported that a “stay local” advisory was put into place in eight “hotspot” areas in England, where B.1.617.2 (the so called “Indian variant”) is rising. Here, once more, the emphasis is on the public taking responsibility to be “cautious” in these areas, despite the government rolling out a national easing of restrictions only a week earlier.
Of course, maximising vaccine uptake is crucial in order to curtail the pandemic and protect us against the virus, including its new variants. However, this focus on vaccine hesitancy and exercising caution detracts attention from the fact that the B.1.617.2 variant should never have been allowed to spread as readily or quickly as it has done in the UK in the first place. A number of prominent scientists argued that India should be placed on the travel “red list” before the government finally took this step on 23 April. Moreover, with cases of B.1.617.2 reportedly doubling each week, it appears as though, as has been the case throughout the pandemic, the test and trace system is so far failing to nip any emerging local outbreaks in the bud.
In March last year, I argued that “the government’s rationale for holding fire on more extensive and mandatory social distancing policies seems to be their belief that people will not be able to sustain compliance over the long haul,” and that there was a lack of strong, transparent evidence for this assumption. We now know that this assumption was mistaken, and that adherence to covid measures by the vast majority of the public has remained remarkably high throughout the pandemic. This is in spite of the government’s regular casting of blame onto the public through the “don’t blow it” narrative, as seen at various points, through November, December, January, and March, for example.
Research I’ve worked on, as well as that of others, suggests that one of the major factors determining adherence to covid-19 measures is trust in government. Paradoxically, rather than encouraging uptake, attributing the rise and impact of B.1.617.2 to vaccine hesitancy among affected communities might become a self-fulfilling prophecy if more people decide to delay or decline vaccination as a result of a growing distrust and dissatisfaction in the government’s handling of the pandemic. Indeed, a body of research shows that one of the major reasons behind vaccine hesitancy is a lack of trust in government.
To complicate matters further, Prime Minister Boris Johnson’s narrative of exercising “caution and common sense,” while simultaneously opening up (“taking the next step”), is another example of the “mixed messages” that many have been confused by throughout the pandemic. This confusion, which myself and colleagues have referred to as “alert fatigue,” partly stems from a disconnect between the government’s deeds and words. In this case, it’s playing out in the permitting of more activities (hugs and holidays), while their risks are being simultaneously emphasised (of course, the problem is that in a pandemic, individual and collective risk are interlinked). A lack of clear and upstream communication, as we saw in the case of the recent “stay local” guidance, does little to help the public’s understanding of, and trust in, government measures.
I’ve argued before that there is no such thing as common sense in a pandemic. For many it would be “common sense” to want to hug friends and family again at the first permitted opportunity to do so. Instead of common sense, we need to be led, or at least strongly guided, by uncommon science. The science is uncommon because it’s based on emerging and rapid research on a novel and quickly mutating virus. Indeed, with so many covid-19 known unknowns remaining, is it realistic or fair to expect people to make fully “informed decisions” about the “risks” of hugging and indoor mixing?
We know far more about covid-19 than we did a year ago, and the speed and effectiveness of the UK’s vaccination programme is a considerable boon. However, the new unknowns of B.1.617.2. suggest that decision making is still operating under considerable uncertainty and that, consequently, a precautionary approach is as necessary now as it has been throughout the pandemic.
Pandemic policy should not need to rely too heavily on luck, yet after the policy failings of the first and second waves, the UK public, eager to return to normality, will be rightly concerned that it might not even be a case of “third time lucky.” If, as appears to be happening, we experience any significant rises in covid-19 rates, it will not be due to the public’s inability to take personal responsibility. Instead, it will once more be a consequence of the government’s failure to learn from its previous policy mistakes, as well as others’ policy successes.
Simon Williams is senior lecturer in people and organisation in the School of Management in Swansea University, and adjunct assistant professor in the Department of Medical Social Sciences in the Feinberg School of Medicine at Northwestern University, Chicago. Twitter @drsimonwilliams
Competing interests: none declared.