Graham Scambler
At the time of writing, there is no real consensus emerging on how best to respond to what the WHO now describes as the coronavirus pandemic. It is a once-in-a-generation challenge for epidemiologists. But it’s a tough one, and I’m not about to launch into a tirade of criticism. One outstanding question, however, is why the response of the Johnson administration diverged from those commended by the WHO and being enacted in almost all other countries. I have a few observations to make on this and related matters.
We have as yet a paucity of data on the extent and spread of the coronavirus. Certainly in the UK there is a marked absence of data on prevalence and incidence. Experts are making ‘guesstimates’. There is also a shortage of test results (they now seem to be the preserve of hospital visitors, although more are belatedly promised). As so often the UK sits midway between Europe and the USA on such things.
Johnson’s strategy, presented under the rubric of ‘herd immunity’ (a technical term imprudently, but revealingly, now popularised), suggests that eschewing ‘lockdowns’ and allowing the coronavirus to insinuate itself into the population will prove the optimal response in the long term. There would seem to be three immediate problems with this. The first is the inadequacy of the data upon which it is based. Second, it flies in the face of the latest advice from the WHO. And third, it will expose the vulnerable – notably those with long-term and especially respiratory conditions and the elderly (and not so elderly) – to a considerably enhanced risk of premature death. At the time of posting, it seems that the government is on the verge of a U-turn on this policy, rightly in my view, but we will need to monitor the link between rhetoric and action.
But for a sociologist there is much more to say. Herd immunity may be a meaningful technical or scientific term, but it has many overtones. As Wittgenstein insisted, meaning varies by language game. One implication, certainly for sociologists, is that it summons up concepts of ‘Social Darwinism’. Core here is the precept of the ‘survival of the fittest’, as if this ‘natural phenomenon’ must/ought to have its way. Allied to this is a strong suspicion that the likes of Cummings, already known for his fondness for genetics/eugenics and presently Johnson’s puppet-master, would actually welcome a population cull that reduced the numbers of the vulnerable and dependent. And current guesstimates indicate that anything up to a million vulnerable people might die if the government strategy endures for long enough.
More mundanely, it is recommended that we wash our hands in hot soapy water to a variety of possible lyrics, and self-isolate if we experience symptoms that ‘might’ indicate infection. But consider aspects of this and allied counsel. Ok, we can wash our hands, and possibly even stop scratching facial itches or picking our noses. But what about self-isolating? We are told that we shouldn’t get stores in against such an eventuality because this would be ‘panicking’. More importantly, how many people can realistically self-isolate, possibly for months? There are innumerable unsympathetic employers, many of them deploying zero hours contracts, plus other decent employers fearing for their small and not so small businesses, who would not/could not recompense employees who take time off; and then there’s the DWP. Many employees are not entitled to sick pay, which is in any case in the UK at one of the lowest rates amongst OECD countries. Self-isolate and live on what? People simply won’t/can’t follow what is presented to as official advice and Johnson & co know this only too well. Contradictory advice is no advice at all.
It is apparent that the health of the economy is being privileged over the health of the people. They are not of course mutually exclusive. But who precisely is being protected or helped in deference to the ‘health’ of global financial markets? It’s not precariously placed employees. And lurking in the shadows, as ever, are those nomadic casino ‘banksters’ betting on our economic future, disaster as profitable for them as its avoidance.
I have argued that the coronavirus pandemic is functioning as what the American sociologist Harold Garfinkel once called a ‘breaching experiment’. Garfinkel got his students to upset applecarts, to disrupt the normal social order, in order to better understand which rules comprised the social order, and why. The present pandemic is, and will increasingly be, just such an experimental-like disruption to the status quo.
It is already exposing the ‘rules’ of neoliberal governance. Expressed in my chosen vocabulary, it is exposing the cracks and fissures of our class-driven ‘fractured society’. Johnson and crew are first and foremost the agents of capital and are and will defend it even against population health and wellbeing. The NHS has been calculatingly dismembered and progressively privatised by the Tories since Lansley’s Health and Social Care Act in 2012. It is no surprise that they have opted initially for an anti-pandemic strategy that stands to delay a surge in cases, not least by not testing probable cases and deflecting sick people from seeking health care. While it is true that the coronavirus pandemic in full flight is likely to challenge the resources of any health care system (check the situation in Lombardy, Italy), the NHS, as a direct result of Tory policies and cuts, is conspicuously unfit to respond effectively to an imminent crisis of this, or indeed any, kind. Government advisers are neglecting to point the finger here.
As with the NHS, so with many another institution. Social care has been decimated under the Tories: it is simply ‘no longer there’ to support the ailing vulnerable. Consider too our universities, whose experts in epidemiology are being largely sidelined. Their neoliberal business model and its side-effects are also being exposed. UCL is among many universities who have just ruled out face-to-face contact with their student ‘clients’. But to what effect? Their increasingly ‘casual’ staff are already on strike, unhappy with their lack of security, pay, pensions and conditions. Are they now expected, and instantly and off-the-cuff, to construct credible online resources to substitute for normal teaching methods? And how will students react, especially overseas students? The neoliberal model is visibly creaking.
A cull of the vulnerable to suit our governing oligarchy/plutocracy and to deny and disguise the poor state of the NHS is a dangerous game to play. If the cull were to pass a threshold of ‘acceptable mortality’, then its architects will pay a heavy price. In fact, my hypothesis would be that this scenario may well trigger what Habermas presciently called a ‘crisis of legitimation’.
Sociologists have learned to be wary of making predictions. In any event, we do explaining not predicting. But many of our number agree that the days of the present era of neoliberal ‘financialised’ capitalism are already numbered, for all that there is no consensus on ‘what next’. This latest form of capitalism, it is contended, is terminally sick from its excesses: it has gorged on the proceeds of the power it has bought. It is not beyond the bounds of credibility that the coronavirus pandemic will hasten the end at least of the Johnson government, hoist by its own petard, punished on the streets and in the ballot boxes for rating the survival and prosperity of its own above the deaths of many vulnerable citizens; and that this inglorious defeat will be via a legitimation crisis. Enough citizens, and voters, will see at last that the its sociopathic emperor has no clothes.
Edging into the light of today is the fact that we inhabit a society in the UK that is divided by class and class interests: as ever, follow the money. Whatever revisions and adjustments are to be made to Marxian theory, penned so long ago, the reality and bite of class and class struggle is becoming ever more apparent and undeniable.
Graham Scambler is Emeritus Professor of Medical Sociology at UCL.