The publication of an open letter signed by 1000 citizens, including members of our scientific and healthcare community poses a political problem for whoever is in government in the coming weeks and months. The signatories are demanding that the Government doubles down on repressing the coronavirus with a view to hunting it to extinction io the island of Ireland. They argue that all the sacrifices made up to this point will be undermined or thrown away if the control measures already in place are relaxed and if there is a second wave of infection or a series of such waves.
There is a problem with this appealing strategy. It requires, as the authors fairly acknowledge, that the whole island, north and south, takes the stronger measures they recommend. By implementing a totally effective test and trace strategy (if such there be), they envisage that the island can be made coronavirus free in a matter of weeks or months.
Thereafter, the whole island would have to cocoon itself by restricting all overseas travel in a way that would prevent travellers or returning travellers from re-importing the infection. Quarantine restrictions would have to be applied in some shape or other. As long as the coronavirus was lurking abroad and, particularly, in Britain, we would have to quarantine those who cross the Irish Sea or take ferries to France, or who fly into Ireland and test them. But tests will not deal with a person who has just sustained an infection and who is, in its early stages, asymptomatic.
Take a lorry driver who travels from Germany to Ireland crossing through Britain or an Irish lorry driver who earns his or her living in back and forward trips out of the country. He or she becomes infected somewhere. There are no symptoms at all. Then the driver returns to Ireland and travels in public transport. Another passenger is infected but remains asymptomatic and passes it on to someone who starts a new cluster of infections resulting in hospitalisations.
Tracing to extinction is futile. The source will never be identified with certainty. There will always be a capacity for untraceable flare-ups unless all travellers from countries with coronavirus of all kinds are not merely advised to quarantine but made to quarantine. We cannot end all travel to Britain or Europe.
If Spain and Italy and France are opening up as holiday destinations, are Irish people free to go there? And what must they do when they come back? How long do we have to wait for Britain to become coronavirus free? Is Northern Ireland to become a no-go zone for the rest of the United Kingdom?
We are told that politicians follow the science. But what is “the science”? If the present relaxations do not produce a second wave of infections, how will science explain that?
Some apparently rational epidemiologists posit the notion that resistance to infection is far more widespread than the mere herd immunity of those who have been infected with coronavirus and have developed antibodies as a consequence.
They believe that infections, measured by the R number, have reached a ceiling and have declined in cities such as Dublin and London without mass herd immunity based on the part of people who have been infected and recovered. And they ask why infectivity has declined in cities where the great majority of people still have not been infected. Is everyone who has not contracted coronavirus equally vulnerable? They think not.
Is the decline of cases in Dublin wholly dependent on the control measures introduced? Is the “dark matter” resistance explanation proposed by some experts credible? Are we all equally vulnerable in genetic terms? Have we developed resistance by past infection with corona-like viruses. The jury is out.
Educating myself as best I can from the online sources, I come to the view that “the science” does not exist as an authoritative unitary understanding of the epidemiological risks of coronavirus. Whether we can live with it as a small risk off-set by economic factors is still not clear. All of us, including scientists, have to be humble in confessing the limitations of our understanding.
We do know the economic, social, and health costs of lockdown are real. The precautionary principal applies to them as well. We simply do not know whether a short intensification of lockdown can make Ireland coronavirus free in a sustainable way. The present programme of graduated relaxations has not yet produced a spike.
Politicians have to engage in a process of risk arbitrage. That is the “science” of democratic politics. Of course there is a temptation on the part of commentators (and with social media and on-line anonymous commentary, “we are all commentators now”) to prepare invulnerable pulpits for future “I told you so” sermons. The thankless task of decision-making and responsibility-taking is handed to the few to be judged by the many. Damned if you do and damned if you don’t.
If you have the time to spare, I suggest reading or re-reading on-line Theodore Roosevelt’s great Sorbonne speech on republican government, civic virtue and the enormous difference between the “man in the arena” and his critics. It’s a rewarding and valuable experience.