‘We cannot sit in our own little bubbles forever’
Professor Robert Dingwall, who sits on the government’s NERVTAG group, discusses the viral panic.
The lockdown is loosening, but life is nowhere near back to normal. As schools and businesses reopen, they are being asked to follow social-distancing rules, keeping everyone two metres apart. But is all of this disruption worth it, particularly as the pandemic recedes from view? Many are also still afraid to go back to work, to send their children to school, and to rejoin social life. Is this fear justified?
spiked spoke to Professor Robert Dingwall to find out more. Dingwall sits on NERVTAG, the government’s New and Emerging Virus Threats Advisory Group, which feeds into SAGE (Scientific Advice for Emergencies). He spoke here in a personal capacity.
spiked: You have said previously that the government has ‘terrorised’ the public over coronavirus. What do you mean by that?
Robert Dingwall: I am using the word terrorised in its literal sense of instilling a sense of terror, a sense of fear about going out into society, a sense of fear about interaction with other people – a sense of fear that has reached levels that are disabling for individuals and for society. And while that may be, in part, the result of the need to take actions in a great hurry at the beginning of the pandemic, it has come to be a profound problem in managing the restoration of anything like normal life as we wind down from that initial crisis.
spiked: Has the government exaggerated the dangers of coronavirus? Is it less dangerous than initially feared?
Dingwall: The level of uncertainty has diminished considerably. At the very beginning, we were dealing with a virus that was entirely new to human populations. We had never seen it before. The nearest thing to it would be the original SARS virus, which was very contagious, very lethal and which was brought under control fairly quickly because of the characteristics of that virus. And I think it was proper at the beginning to think that this might be a comparable threat, which would lead to a very high mortality rate.
As things have turned out, this is still a serious infection, but it is not lethal on the scale of the original SARS virus. It is clear that 80 to 85 per cent of the people who are infected will never need to go near a hospital, and of those who do, most of them will come out alive. Some of them will come out with a very high degree of frailty, and they will need a lot of rehabilitation. But it does mean that I think our view on the proportionality of the response has evolved over the past three months as we have learned more about the nature of the virus itself and what it takes to manage it in the human population.
spiked: We have loosened the lockdown a little bit, but are the current measures still out of proportion to the threat we face?
Dingwall: This is the challenge – working out collectively just how much risk we are prepared to live with as individuals and as a society. The point has been raised that if this disease had been influenza, and we were seeing it for the first time, we would probably be similarly disturbed. On the other hand, over hundreds, possibly thousands of years of human history, we have learned to live with influenza as something that comes around every winter. In some years, it can be quite disruptive, it can bring about quite a lot of serious illness, it can kill a significant number of people. This is just something that we live with as a society. The question is whether this new coronavirus is actually something that we could learn to live with in a comparable way without totally reconstructing everything in an attempt to achieve what is probably a spurious notion of safety.
spiked: One of the means by which the government wants to maintain safety is by keeping people two metres apart from each other all of the time. Is there any scientific value in this?
Dingwall: That science is very much contested. We do have a problem in the sense that, for good reasons, the SAGE advice system tends to be recruited from the biomedical sciences, whose specialists understand a lot about viruses and transmission. On the other hand, with this virus, a lot of the transmission goes through the air. The air is a field of understanding for people in engineering, whose voices and whose research in scientific literature are not well integrated with the advisory process.
You have the biomedical scientists placing excessive weight on experimental research on transmission, which would not be regarded as of high quality by engineers who understand the medium of air through which the virus particles are passing. To do good experimental work on viral transmission, you create very artificial laboratory conditions in order to be able to take the measurements and get the photographs, but actually, in the real world, air is always in motion, it is turbulent, it breaks up the virus particles, it diffuses them. That is how we get a justification for saying that one metre would be as safe as two, and probably still build in a safety margin.
It is also very unusual to be face-to-face with somebody at a very short distance unless you are very good friends with them or you are at a ticket office, or you are crammed together on a train or a bus. Nobody is saying that those sorts of situations do not carry a higher risk – although, of course, they also carry a higher risk of transmitting or contracting other viruses. But if you thought it was at least as safe to reduce the social distance to one metre for most purposes, you could get four times as many people into any given space. This is quite transformative in terms of what businesses can do.
If you also recognise that transient exposures – short periods at a closer distance – are very unlikely to be infectious, you can also encourage people to stop worrying if somebody jogs past them. If you are sitting side by side with somebody, it is very unlikely that any virus is going to find its way in your direction. If you are sitting on a bus, a plane or in airline-style seating, or if you are face-to-back with somebody, like you are in a checkout queue, that is quite a low risk. In some ways it is about educating people about the risks of getting very close to somebody. Curiously, it is probably a bit like educating people about the risks of HIV in the 1980s: you need to be a bit confident about the infection status of everybody that you are getting within, say, 12 to 18 inches for a sustained period.
spiked: You mentioned how transformative it could be for businesses to have just a one-metre rule rather than a two-metre rule. Do you think in general, whether we are talking about the lockdown or social distancing, that the consequences and side effects have really been factored in sufficiently?
Dingwall: Indeed, and again, I would say there has been a learning process. Some of the measures that were taken at the beginning – very traditional public-health measures of quarantine and isolation – do come with risks as well. At some point we get to a stage where the damage to physical and mental health that has been caused by the lockdown exceeds the benefits in terms of disrupting the transmission of the coronavirus.
We also need to take account of the fact that the inevitable economic recession will have health consequences – the so-called diseases of despair that go along with high levels of unemployment and economic inactivity, which we saw a lot of in the 1980s. The damage to health and the death toll that result from these other causes are something that we need to set alongside the death toll from the current pandemic.
spiked: Do you think that these side-effects are being adequately assessed? We know that, for instance, hospital admissions for a lot of other causes have been falling. Are the current data on non-Covid deaths sufficient to give us a clear picture?
Dingwall: These are quite difficult data to interpret. I do not think we will get a full picture for another few months because, arguably, what the pandemic is doing is bringing deaths forward that were likely to have occurred within a fairly short period anyway.
Also, you have described the collateral damage in terms of the strokes and heart attacks that have not been dealt with as well as they would have been in normal times. I did some work on the 2003 heatwave, for example, and the consensus there was that the heatwave had actually killed people who were not otherwise likely to have died. But that did not really emerge until you could see the mortality rates over something like a 12- to 24-month period, rather than looking at the relatively short-term data that we are focused on at the moment.
spiked: There has been a lot of opposition to schools opening up, and even those that are opening are introducing all kinds of social-distancing guidelines. What is your general view on the school situation?
Dingwall: With the schools, we need to disentangle two separate things. First, there is the issue of risk to children, and secondly, there is the issue of risk to adults.
As far as we can tell from the present evidence, children are not a primary means of transmitting this infection in the way that they are for influenza, for which small children are clearly super-spreaders. We do not think of closing the schools down every winter simply because there is an influenza outbreak. If children do get the coronavirus, they seem to be much more likely to be asymptomatic – they have a very mild illness, if any at all. So far the death rate for children under 15 is about one in 5,500,000. There are many bigger risks in children’s lives than coronavirus.
The question then is about the risk to teachers or parents. Parents – at least of primary-school children – are quite likely to be under the age of 45, where their personal risk levels are also very low. Teachers are a more varied group. But they are at no greater risk from being exposed to children than any other worker would be in any other workplace, or that they personally would be if carrying out any other everyday activity. They are just as much at risk from children as they are from other adults.
And I think that when you look at the measures being put into schools, there is again the issue of whether there is a proper sense of proportion here. We are getting quite a lot of public-health theatre that is intended to reassure teachers and parents, but which actually conveys the message that this is all really dangerous. The behavioral-science evidence on that is really quite good – it suggests you should really be quite critical about any measure that is mainly for show. The idea that you will take the kids’ temperatures every morning, that they will be greeted by a teacher in a face mask – it may not seem commonsensical to argue this is unnecessary, but one of the things that social science demonstrates is that common sense is often wrong. These are things that can increase fear and anxiety, even if they are intended to reduce it.
spiked: If you were to try to ‘de-terrorise’ people, how would you put the risks in of coronavirus in context?
Dingwall: We need to be talking more about the relative risks. We need to get away from the drumbeat of deaths that we see every night on the television news. We need many more stories on the people who have had a mild infection and recovered and on the people who have been in hospital and have recovered.
We need to have a discussion about whether to see this virus in a sense as a second influenza, that we accept as an endemic infection in our society. That might mean investing a bit more in the capacity of the health service to deal with the serious consequences, while accepting that most of us, at some time in our lives, will have this infection. If we do not get long-term immunity, we will have it more than once. We may have it as children with a mild infection. We may have it in our 80s, and it is the thing that carries us off. But maybe we won’t necessarily feel obliged to reconstruct our daily lives in a massive way in order to reduce the risks of infection, any more than we do with seasonal influenza.
spiked: Is it comparable to the risk of influenza at the moment?
Dingwall: It is changing. We are understanding more about the virus. For example, it may potentially mutate, as we think some of the viruses that cause the common cold have done. There are coronaviruses which may well be the legacy of similar pandemics in the remote past, which have mutated and become these low-level things that we do not really bother much about. We may get a vaccine that provides a degree of protection, and we may get more effective treatments.
All of these things are constantly shifting. But a lot of what we are seeing is a bit of a societal panic simply provoked by the novelty of this virus. And we have forgotten that as long as humanity has been on this planet, viruses and bacteria have been moving in both directions, between animals and ourselves. For the virus we are a single pool of potential hosts. There is this contemporary idea that nature is totally under our control, but this is a reminder that it is not.
We can probably manage to live with a recurrent infection that will be relatively minor in most of the people who contract it and will have significant consequences for others. The numbers of those who get seriously ill can remain within the capacity of a health system that has had time and investment to deal with it. If we have done that, we may come back and ask how much we really need to restructure everyday life around a public-health model, as opposed to a more social and economic model.
spiked: Is there anything from the current debate that you feel is missing?
Dingwall: Maybe there is not a sufficient voice for the social and cultural understanding of pandemics – that we have been here before, humanity has survived, the world has not been not destroyed. To go back to the Black Death, a third of the population of Europe was probably wiped out and it was a period of major social and economic reconstruction. The influenza pandemic of 1918 may have made some contribution to the economic troubles of the 1920s. But it was not transformative of everyday life in the same way.
I think we need a better discussion about how, as a society, we relate to nature, to the hazards that we share with the natural world. We also need a discussion about how we understand death and whether we can address this kind of social conceit that we could all live forever if only the technology was advanced enough. Some of these deeper issues need to be brought out before we start getting too invested in the question of whether we should repave every pavement in the city centre so that people can walk along them two metres apart.
spiked: Does there not have to come a point where we abandon social distancing and even the milder measures against coronavirus?
Dingwall: I think so. Social distancing will probably decay of its own accord, and it has visibly been doing so over the last few sunny weekends. A society cannot survive with everybody sitting in their own homes, connected by screens.
You can look at the polling evidence which shows widespread support for the lockdown. In some respects, that is because ordinary citizens do not have to worry about how it is paid for. To some extent we can pay for the current crisis much as we did for the two world wars, by issuing long-term bonds and passing the costs on to our great grandchildren.
But we cannot do that indefinitely. We have to get back to something that looks like a productive and sustainable economy that allows people to form friendships, to encounter each other in person, face to face. You wonder how, in lockdown, young people are going to form new intimate relations that will lead to families and children. We cannot sit in our own little bubbles forever.
Robert Dingwall was talking to Fraser Myers.
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