“It's not the end; it's not even the beginning of the end; but it is perhaps the end of the beginning”. Churchill's famous wartime speech after the battle of El Alamein in November 1942 was an ambiguous rallying cry. After all, by saying it was only the beginning, he was suggesting that there could be worse to come.
Perhaps this is why Boris Johnson, biographer of the great war leader, avoided using that particular epigram when he announced last week that Britain had passed the peak of this epidemic. None of us should be in any doubt that this is a long struggle.
Everything we know about coronavirus tells us that there will be several phases of this pandemic. It comes in waves. Indeed, if the 1918 flu epidemic is any guide, the next wave will be worse than the present one.
This should be kept in mind when assessing whether or not the UK is topping the European Covid Death League, as many have claimed, now that some 27,000 have died. As the UK's leading risk analyst, Sir David Spiegelhalter, pointed out last week, we won't know the final score until after the pandemic is over.
So, at the end of the beginning, what can we reasonably say about how this disease has been handled in the UK so far? Was this an avoidable tragedy for which we were criminally unprepared. Did “British Exceptionalism” lead us to ignore warnings from other countries? How do we compare?
New Zealand, declared total victory against the virus last week and Jacinda Ardern is being hailed as the paragon of Covid management. She adopted the most draconian approach to border control, locking all foreigners out, and then tracked and isolated the few cases that got through.
Only 19 New Zealanders have died. Eventually those borders will have to be opened again, and only then will we see if this remote island nation is capable of defying the virus indefinitely, but it is an impressive result.
On the other side of he world is Sweden, which took the opposite approach: left the borders open and didn't lockdown. It has been regarded as the charnel house of herd immunity by commentators in the UK. But the World Health Organisation is now saying the Nordic state is the “model” for the future management of society.
Certainly, Sweden's mortality curve doesn't look very different from the UK's. (For what it's worth, Sweden has last week recorded 256 deaths per million compared with the UK's 384). Yet the Swedish economy is largely intact.
As for Scotland, we've followed essentially the same approach as the rest of the UK, with minor tweaks, like jumping the gun on wearing masks – even though the First Minister's medical experts said they didn't work.
Scotland's testing target of 3,500 is only a third of the UK's, which doesn't seem to accord with Nicola Sturgeon's hailing of test track and isolate (TTI), as the the holy grail of Covid control.
Closing Scotland’s borders was never an option, but it seems reasonable to suppose that the UK could have reduced deaths in this first wave if it had done so. Had we locked down and banned Chinese and Iranian immigrants from Britain on February 2, as did Jacinda Ardern, this island nation could have had a crack at elimination of the disease.
But here we come up against political reality. None of the academic experts suggested closing he borders in late January. If they had, they would have been accused of racism. We know this because that is exactly what Donald Trump was accused of when he banned Chinese immigrants and later travellers from Europe.
But even without closed borders it seems to many inexplicable that the UK ignored testing. Didn't the World Health Organisation say: “test, test, test”? TTI seemed to be successful in Germany where they were doing 100,000 tests a day nearly a month ago.
The main reason the politicians didn't proceed with community testing was because the medical establishment overwhelmingly opposed it. They regarded it as a distraction. As this column has pointed out before, Professor Jason Leitch, the national clinical director, announced the abandonment of community testing and contact tracing in Scotland in mid-March.
This was because Britain lacked an extensive diagnostic infrastructure, of the kind that worked so well in free market Germany. The pharmaceuticals giant, Roche, played a major role there. The priority in Scotland was to ensure that essential workers were tested, along with those who showed symptoms of the disease.
Perhaps the UK should have set up the infrastructure for mass testing a decade ago. But we are where we are. And Germany is now finding that there has been an uptick in infections and deaths so it may not be out of the Covid woods yet.
The expectation of UK epidemiologists at the start of the pandemic was that 80% of the population would get the disease and that the vast majority would have only mild symptoms if any. So, the idea was to allow the virus to spread in a controlled fashion, protecting the vulnerable, while working to ensure that the health service was not overwhelmed.
This has worked in a fashion. In the end there were plenty of ventilators and intensive care beds. Unfortunately, a lot of people died in the meantime, many of them in care homes.
Old people were expected to die in large numbers from Covid-19, and they certainly have done. Many were moved out of hospitals and into care homes to free up bed space. In those homes they became particularly vulnerable.
Whether and how many died needlessly in this triage process is hard to say. I'm not going to join the hysterics on Twitter who accuse Nicola Sturgeon and Boris Johnson of killing thousands of senior citizens through a callous policy of herd immunity.
All we can say is that old people were not the priority. The fear was that tens, maybe hundreds of thousands of younger people might fall victim to the disease. This was why the Nightingale and Louisa Jordan hospitals, now mostly empty, were set up to receive them. Older people and those with pre-existing conditions were not meant to be cared for in these new units.
Herd immunity is anyway not a policy, it is a description of how a population acquires immunity to a disease when there is no vaccine. Epidemiologists know from long experience that these coronaviruses eventually die out when around 60% of the population is exposed.
But no-one in Government actually advocated letting Covid-19 run rampant. Boris Johnson did not say, before he succumbed to the disease, that we had to “take it on the chin”. The policy was to manage the disease,through social distancing and lockdown.
It is hard conclude that there were any real villains of fifth columnists in Britain's Covid war so far. The country behaved much as in the real war. Mistakes were made, especially over PPE. We were slow off the mark. Ministers were confused about priorities. Some people were neglected. But we seem to be getting there by deploying the Britain’s time-hallowed approach to crisis management: “muddling through”.
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