{"id":50332,"date":"2021-05-26T17:17:34","date_gmt":"2021-05-26T16:17:34","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=50332"},"modified":"2021-06-01T16:46:40","modified_gmt":"2021-06-01T15:46:40","slug":"the-uks-coronavirus-policy-still-places-too-much-responsibility-and-blame-in-the-hands-of-the-public","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2021\/05\/26\/the-uks-coronavirus-policy-still-places-too-much-responsibility-and-blame-in-the-hands-of-the-public\/","title":{"rendered":"The UK\u2019s coronavirus policy still places too much responsibility\u2014and blame\u2014on the public"},"content":{"rendered":"<p class=\"standfirst\">The government&#8217;s current emphasis on personal responsibility and showing &#8220;common sense&#8221; once again displaces blame for their ineffective response to covid-19, says Simon Williams<\/p>\n<p><!--more--><span style=\"font-weight: 400\">On 17 March last year, writing in <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/03\/17\/uks-coronavirus-policy-places-too-much-responsibility-in-the-hands-of-the-public\/\"><span style=\"font-weight: 400\">BMJ Opinion<\/span><\/a><span style=\"font-weight: 400\">, I argued that the UK government\u2019s 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 <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/05\/18\/martin-mckee-what-went-wrong-in-the-uks-covid-19-response\/\"><span style=\"font-weight: 400\">many lives.<\/span><\/a><span style=\"font-weight: 400\"> 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 \u201cpersonal responsibility\u201d rhetoric, which this time includes a focus on the need for<\/span><a href=\"https:\/\/www.theguardian.com\/world\/2021\/may\/10\/government-advise-caution-when-hugging-allowed-england\"><span style=\"font-weight: 400\"> \u201ccaution\u201d when hugging<\/span><\/a><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">On 17 May this year, the health secretary, Matt Hancock, attributed a majority of hospitalisations in Bolton to <\/span><a href=\"https:\/\/www.bbc.co.uk\/news\/uk-england-manchester-57154219\"><span style=\"font-weight: 400\">vaccine hesitancy<\/span><\/a><span style=\"font-weight: 400\">, while a senior government minister <\/span><a href=\"https:\/\/metro.co.uk\/2021\/05\/17\/vaccine-refusers-are-main-threat-to-final-lockdown-freedoms-14594569\/\"><span style=\"font-weight: 400\">was reported<\/span><\/a><span style=\"font-weight: 400\"> to have referred to those refusing the vaccine as \u201cidiots\u201d who could \u201cruin it for everyone else.&#8221; These comments were reported on the same date that significant policy restrictions were eased to permit <\/span><a href=\"https:\/\/www.gov.uk\/government\/news\/further-easing-of-covid-restrictions-confirmed-for-17-may\"><span style=\"font-weight: 400\">much more indoor socialising<\/span><\/a><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><span style=\"font-weight: 400\">More recently, on 25 May, it was reported that a \u201cstay local\u201d advisory was put into place in eight \u201chotspot\u201d areas in England, where B.1.617.2 (the so called \u201cIndian variant\u201d) is rising. Here, once more, the <\/span><a href=\"https:\/\/news.sky.com\/story\/covid-19-muddled-messaging-about-indian-variant-hotspots-risks-a-mess-with-potentially-very-serious-consequences-12316519\"><span style=\"font-weight: 400\">emphasis is on the public taking responsibility<\/span><\/a><span style=\"font-weight: 400\"> to be \u201ccautious\u201d in these areas, despite the government rolling out a national easing of restrictions only a week earlier.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Of course, maximising vaccine uptake is crucial in order to curtail the pandemic and <\/span><a href=\"https:\/\/www.nature.com\/articles\/d41586-021-01274-7\"><span style=\"font-weight: 400\">protect us against the virus<\/span><\/a><span style=\"font-weight: 400\">, 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 <\/span><a href=\"https:\/\/inews.co.uk\/news\/health\/indian-variant-cases-new-covid-strain-uk-figures-latest-news-963434\"><span style=\"font-weight: 400\">scientists<\/span><\/a> <a href=\"https:\/\/www.thetimes.co.uk\/article\/indian-covid-variant-20-000-allowed-to-entered-uk-from-india-l7q608tgf\"><span style=\"font-weight: 400\">argued<\/span><\/a><span style=\"font-weight: 400\"> that India should be placed on the travel \u201c<\/span><a href=\"https:\/\/www.gov.uk\/guidance\/red-amber-and-green-list-rules-for-entering-england\"><span style=\"font-weight: 400\">red list<\/span><\/a><span style=\"font-weight: 400\">\u201d <\/span><a href=\"https:\/\/news.sky.com\/story\/covid-19-when-the-governments-opaque-green-amber-and-red-list-decisions-dont-match-the-data-12309430\"><span style=\"font-weight: 400\">before the government finally took this step on 23 April<\/span><\/a><span style=\"font-weight: 400\">. Moreover, with <a href=\"https:\/\/www.bmj.com\/content\/373\/bmj.n1315\">cases of B.1.617.2 reportedly doubling each week<\/a>, it appears as though, as has been the case throughout the pandemic, the<\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/05\/17\/covid-19-what-should-we-do-about-b-1-617-2-a-classic-case-of-decision-making-under-uncertainty\/\"><span style=\"font-weight: 400\"> test and trace system<\/span><\/a><span style=\"font-weight: 400\"> is so far failing to nip any emerging local outbreaks in the bud.<\/span><\/p>\n<p><span style=\"font-weight: 400\">In March last year, <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2020\/03\/17\/uks-coronavirus-policy-places-too-much-responsibility-in-the-hands-of-the-public\/\"><span style=\"font-weight: 400\">I argued<\/span><\/a><span style=\"font-weight: 400\"> that \u201c<\/span><span style=\"font-weight: 400\">the government\u2019s 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,\u201d 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 <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/01\/07\/pandemic-fatigue-how-adherence-to-covid-19-regulations-has-been-misrepresented-and-why-it-matters\/\"><span style=\"font-weight: 400\">high throughout the pandemic<\/span><\/a><span style=\"font-weight: 400\">. This is in spite of the government\u2019s regular casting of blame onto the public through the \u201cdon\u2019t blow it\u201d narrative, as seen at various points, through <\/span><a href=\"https:\/\/www.bbc.co.uk\/news\/uk-55122266\"><span style=\"font-weight: 400\">November<\/span><\/a><span style=\"font-weight: 400\">, <\/span><a href=\"https:\/\/hansard.parliament.uk\/commons\/2020-12-08\/debates\/9B72D51F-0542-4BAB-9ADE-A70195F52064\/Covid-19VaccineRoll-Out\"><span style=\"font-weight: 400\">December<\/span><\/a><span style=\"font-weight: 400\">, <\/span><a href=\"https:\/\/inews.co.uk\/news\/politics\/covid-vaccine-update-matt-hancock-public-advice-over-80s-latest-834531\"><span style=\"font-weight: 400\">January<\/span><\/a><span style=\"font-weight: 400\">, and <\/span><a href=\"https:\/\/www.gov.uk\/government\/speeches\/health-and-social-care-secretarys-statement-on-coronavirus-covid-19-1-march-2021\"><span style=\"font-weight: 400\">March<\/span><\/a><span style=\"font-weight: 400\">, for example.<\/span><\/p>\n<p><a href=\"https:\/\/www.medrxiv.org\/content\/10.1101\/2020.11.17.20233486v1\"><span style=\"font-weight: 400\">Research<\/span><\/a><span style=\"font-weight: 400\"> I\u2019ve worked on, as well as that of <\/span><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S2666776221000387#bib0007\"><span style=\"font-weight: 400\">others<\/span><\/a><span style=\"font-weight: 400\">, suggests that one of the major factors determining adherence to covid-19 measures is trust in government. Paradoxically, rather than encouraging uptake,\u00a0attributing the rise and impact of <\/span><span style=\"font-weight: 400\">B.1.617.2 to<\/span><span style=\"font-weight: 400\"> vaccine hesitancy among affected communities\u00a0might 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&#8217;s handling of the pandemic. Indeed, <\/span><a href=\"https:\/\/psyarxiv.com\/h87s3\"><span style=\"font-weight: 400\">a body<\/span><\/a><span style=\"font-weight: 400\"> of <\/span><a href=\"https:\/\/www.nature.com\/articles\/s41467-020-20226-9\"><span style=\"font-weight: 400\">research<\/span><\/a><span style=\"font-weight: 400\"> shows that one of the major reasons behind vaccine hesitancy is a lack of trust in government.\u00a0 <\/span><\/p>\n<p><span style=\"font-weight: 400\">To complicate matters further, Prime Minister Boris Johnson\u2019s narrative of exercising \u201c<\/span><a href=\"https:\/\/www.gov.uk\/government\/speeches\/pm-statement-at-coronavirus-press-conference-14-may-2021\"><span style=\"font-weight: 400\">caution and common sense<\/span><\/a><span style=\"font-weight: 400\">,\u201d while simultaneously opening up (\u201ctaking the next step\u201d), is another example of the \u201c<\/span><a href=\"https:\/\/bmjopen.bmj.com\/content\/10\/7\/e039334\"><span style=\"font-weight: 400\">mixed messages<\/span><\/a><span style=\"font-weight: 400\">\u201d that many have been confused by throughout the pandemic. This confusion, which myself and colleagues have referred to as \u201c<\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/02\/19\/the-public-arent-complacent-they-are-confused-how-the-uk-government-has-created-alert-fatigue\/\"><span style=\"font-weight: 400\">alert fatigue<\/span><\/a><span style=\"font-weight: 400\">,<\/span><span style=\"font-weight: 400\">\u201d partly stems from a disconnect between the government\u2019s deeds and words. In this case, it\u2019s 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, <\/span><a href=\"https:\/\/news.sky.com\/story\/covid-19-muddled-messaging-about-indian-variant-hotspots-risks-a-mess-with-potentially-very-serious-consequences-12316519\"><span style=\"font-weight: 400\">as we saw in the case of the recent \u201cstay local\u201d guidance<\/span><\/a><span style=\"font-weight: 400\">, does little to help the public\u2019s understanding of, and trust in, government measures.<\/span><\/p>\n<p><span style=\"font-weight: 400\">I\u2019ve argued before that there is <\/span><a href=\"https:\/\/www.bbc.co.uk\/programmes\/p091q34n\"><span style=\"font-weight: 400\">no such thing as common sense in a pandemic<\/span><\/a><span style=\"font-weight: 400\">. For many it would be \u201ccommon sense\u201d 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 <\/span><i><span style=\"font-weight: 400\">uncommon science<\/span><\/i><span style=\"font-weight: 400\">. The science is uncommon because it\u2019s based on emerging and rapid research on a novel and quickly mutating virus. Indeed, with so many covid-19 <\/span><a href=\"https:\/\/www.bmj.com\/content\/371\/bmj.m3979\"><span style=\"font-weight: 400\">known unknowns<\/span><\/a><span style=\"font-weight: 400\"> remaining, is it realistic or fair to expect people to make fully \u201cinformed decisions\u201d about the \u201crisks\u201d of hugging and indoor mixing?\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400\">We know far more about covid-19 than we did a year ago, and the speed and effectiveness of the UK\u2019s vaccination programme is a considerable boon. However, the <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/05\/18\/will-the-indian-variant-b-1-617-2-delay-englands-lockdown-roadmap\/\"><span style=\"font-weight: 400\">new unknowns of <\/span><span style=\"font-weight: 400\">B.1.617.2<\/span><\/a><span style=\"font-weight: 400\">. suggest that decision making is still operating <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/05\/17\/covid-19-what-should-we-do-about-b-1-617-2-a-classic-case-of-decision-making-under-uncertainty\/\"><span style=\"font-weight: 400\">under considerable uncertainty<\/span><\/a><span style=\"font-weight: 400\"> and that, consequently, a <\/span><a href=\"https:\/\/www.bmj.com\/content\/bmj\/369\/bmj.m1435.full.pdf\"><span style=\"font-weight: 400\">precautionary approach<\/span><\/a><span style=\"font-weight: 400\"> is as necessary now as it has been throughout the pandemic.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Pandemic policy should not need to rely too heavily on luck, yet after the policy failings of the <\/span><a href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/05\/18\/martin-mckee-what-went-wrong-in-the-uks-covid-19-response\/\"><span style=\"font-weight: 400\">first and second waves<\/span><\/a><span style=\"font-weight: 400\">, the UK public, eager to return to normality, will be rightly concerned that it might not even be a case of \u201cthird time lucky.\u201d If, as appears to be happening, we experience any significant rises in covid-19 rates, it will not be due to the public\u2019s inability to take personal responsibility. Instead, it will once more be a consequence of the government\u2019s failure to learn from <\/span><a href=\"https:\/\/www.bmj.com\/content\/372\/bmj.n284\"><span style=\"font-weight: 400\">its previous policy mistakes<\/span><\/a><span style=\"font-weight: 400\">,<\/span><span style=\"font-weight: 400\"> as well as others\u2019 <\/span><a href=\"https:\/\/www.nature.com\/articles\/d41586-020-01248-1\"><span style=\"font-weight: 400\">policy successes<\/span><\/a><span style=\"font-weight: 400\">.<\/span><\/p>\n<p><b><i>Simon\u00a0<span class=\"il\">Williams<\/span><\/i><\/b>\u00a0<i>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.<\/i><em>\u00a0Twitter\u00a0<a title=\"https:\/\/twitter.com\/drsimonwilliams\" href=\"https:\/\/twitter.com\/drsimonwilliams\" target=\"_blank\" rel=\"noopener\" data-saferedirecturl=\"https:\/\/www.google.com\/url?q=https:\/\/twitter.com\/drsimonwilliams&amp;source=gmail&amp;ust=1622116929714000&amp;usg=AFQjCNHP0gOPd-hNXslSTDzAd4a-IqbOmQ\">@drsimonwilliams\u00a0<\/a><\/em><\/p>\n<p><b>Competing interests: <\/b>none declared.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The government&#8217;s current emphasis on personal responsibility and showing &#8220;common sense&#8221; once again displaces blame for their ineffective response to covid-19, says Simon Williams [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2021\/05\/26\/the-uks-coronavirus-policy-still-places-too-much-responsibility-and-blame-in-the-hands-of-the-public\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":419,"featured_media":50333,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[],"class_list":["post-50332","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-guest-bloggers"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - 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