Pages

2 April 2020

It Was Always Going to Be Horrible.’ Britain’s Former Top Emergency Planner on COVID-19

Alex Evans, David Steven

Bruce Mann is one of the most experienced emergency planners in the world. As the former director of the British Cabinet Office’s Civil Contingencies Secretariat, he was in charge of Britain’s planning for and response to emergencies and disasters. He coordinated the U.K. government’s response to the 2009 swine flu pandemic and the 2007 outbreak of foot-and-mouth disease, and played a key role in creating Britain’s Emergency Planning College. We caught up with him last week.

Mann didn’t pull his punches. “A pandemic virus tops every country’s risk register,” he told us, warning that the crisis has barely begun to unfold. “If football is a game of two halves,” he said, “we’re still in the first ten minutes.”

Political decision-makers are grappling with incredibly difficult dilemmas and trade-offs, as a public health emergency runs alongside an economic one. While President Donald Trump has been heavily criticized in recent days for focusing too much on the economic risks of the pandemic in the United States, in his usual inept way, Mann’s reply when we asked what single aspect of the crisis was keeping him up at night was striking: “The economy and employment, no question, because what is being done is novel, and there is little previous analysis and planning which decision-makers can draw on.”

Mann highlights the extent to which governments are feeling their way, drawing on their own experience but also copying and learning from each other. This has led to a rapidly tightening lockdown in countries around the world, which has surprised Mann in how swift and draconian it has been.

Mann questions the British government’s own response, but not from the direction you might expect. While many believe that Prime Minister Boris Johnson has acted impulsively and contrary to the evidence, Mann argues that its decisions have, in fact, been heavily influenced by scientists and other experts. But he wonders whether there are times when politicians need to trust their gut and make decisions more intuitively.

Mann was also uneasy about the weakness of the international response. The United Nations was slow off the mark, while the World Health Organization was inconsistent in its messaging in the early days of the coronavirus outbreak. Mann wonders why the U.N. has not taken a stronger lead. And he believes that international financial institutions, like the World Bank, and the G-7 and G-20 could be playing a greater role.

Below is a lightly edited transcript of our conversation. It took place on March 20, so it does not take account for some more recent developments, in particular Britain’s imposed lockdown.

Alex Evans: How well do you think Europe is responding to the COVID-19 pandemic? What is working well and what isn’t?

Bruce Mann: First point: This is what we foresaw when doing reasonable worst-case planning in the U.K. We’re seeing why a pandemic virus tops every country’s risk register, because the medical, economic and societal impacts are so serious.

But second, we did not fully understand the psychological dimensions. These are hard to cover in a national plan, although you’ll see coded references to things like panic buying. And we have seen panic buying, but also a strong community reaction and mutually supportive behavior, particularly in societies with strong reservoirs of social capital. There’s also a psychological angle to the reactions of governments and other institutions, especially as countries have moved rapidly to draconian measures such as locking down whole societies.

Each country is making its own judgments in the face of an emerging crisis and is working from different parameters, including the availability of science and its understanding of that science, differences in demography and differences in culture. But while countries have adopted different strategies, they are also imitating each other, for better and for worse. When this is over, we will need to assess why different countries adopted different strategies and whether strategies were adapted to the challenges each country faced.

Evans: You didn’t expect countries to adopt such draconian restrictions so quickly?

Mann: No, I didn’t expect them to be so draconian. We will need to track lockdowns over the coming weeks to see if they can be maintained. Aside from people getting bored, there are known side effects in terms of mental health and people’s safety and well-being. The economic damage of total lockdown will be significant, especially in states with weaker economies like Italy and Spain.

Evans: Do you think the economic risks have been underestimated?

Mann: Yes, by several of the big investment houses and economic commentators. They have already been more serious than we expected. Economists are already forecasting a significant reduction in GDP in the U.K., even before accounting for the knock-on impacts from a prolonged lockdown across most industrial nations.

The damage to world trade, to GDP and to employment will be large, even before we consider secondary impacts such as the changes in oil prices. Around the world, people will suffer serious harm and die because of the damage to economies caused by lockdowns, although this is the best strategy we have at this stage. But lockdowns will eventually need to be eased to mitigate economic impacts, which is why we need to track data on infections constantly and do the modeling so that the effects of lockdowns, and of eventually easing restrictions, can be understood as quickly as possible.

David Steven: The U.K. government faced pressure from all directions to act faster, while Chinese experts were here in Italy yesterday criticizing our lockdown for not being tough enough.

Mann: China is trying to justify its own actions. I abhor President Trump’s rhetoric, but he is tapping into justified concerns about the way China initially handled the disease and the risks it ran with animal husbandry. China is improving its image positively, by providing aid to other countries, but also in a more negative way when it publicly criticizes other countries’ strategies.

Evans: The U.K. is yet to announce a lockdown. How do you assess its strategy?

Mann: For the U.K., I think the question is the extent to which you must be led by the science or to which you must make political judgments instinctively. I believe that the U.K. government has access to the world’s best scientists, epidemiologists, virologists and mathematical modelers. We have had several emergencies, including two foot-and-mouth outbreaks, where scientists and mathematical modelers have been highly influential in the government’s thinking. They have again been instrumental in shaping the national response to COVID-19.

But we will need to debate whether it has been more effective to follow the science, as the U.K. has been doing, even if this leads to a different strategy from other countries, or whether it is better to make instinctive judgments as several other countries did.

Steven: We are, of course, still only in the early stages of the pandemic.

Mann: People talk about football being a game of two halves, but we are still in the first 10 minutes of the first half. This is just the first phase. More modeling will be needed to manage future phases. Countries cannot stay locked down until a vaccine is available without devastating their economies and societies. Each country will have to fine-tune their strategies, drawing on models that help them understand what might be second, third and fourth waves.

The big risk is the quality of the underlying data. For completely understandable reasons, it is not possible to trust the data on the number of cases reported to the WHO. Even countries collecting a lot of data on infections may not be able to track the epidemic as it grows, with clinicians needing to focus on keeping people alive.

It is only when we can do mass testing that the availability of data will explode, if it’s logged effectively. That’s when countries will truly be able to trust the data.

Evans: You have talked about differences in national strategies, but also how strategies are spreading informally from country to country. But to what extent are international institutions influencing the way national actors respond to COVID-19?

Mann: We have not seen the same level of global leadership for COVID-19 as has been mobilized for previous crises. That has surprised me, although we don’t yet know whether this will have a significant impact on the progression and mitigation of the disease.

In the early days, the World Health Organization’s messaging was inconsistent, with some of its experts favoring Singapore’s strategy of widescale testing and isolation of symptomatic people. This is where the message of “test, test, test” has come from. But others supported more radical and coercive models of social distancing, which has led us into lockdown territory. Countries have also been skeptical of advice from the WHO—or at least, they were in the early days, because they thought it should have been faster off the mark in China.

Steven: What about more broadly across the international system?

Mann: I am surprised that the United Nations is not playing a greater role, across the various components of the U.N. system—and indeed that it did not mobilize across the system in the early stages of the emergency, even if only to promote preparedness measures, as it did under David Nabarro a decade ago for pandemic planning and then again for Ebola. [Nabarro served as a U.N. pandemic coordinator and later as special envoy on Ebola.]

Evans: Beyond the public health emergency, we now have an economic crisis, a jobs crisis, a financial crisis and potentially a refugee crisis. We often talk about state fragility but are we now being confronted by systems fragility. Do policymakers have the bandwidth they need to respond, or do global and national decision-making structures risk being overwhelmed?

Mann: I absolutely agree this is an issue: A pandemic touches on all aspects of society and how we organize, at home and internationally. The capacity of the international system has clearly been degraded since the financial crash of 2008. The G-20 and G-8 [now the G-7] and the international financial institutions were very active then, but we are yet to see the same level of response from these platforms.

If we look beyond the U.N. system, one obvious source of leadership would be the United States. This isn’t a point about President Trump, as I am not sure any American president would currently be in a position to provide the leadership that the world needs. As a result, we seem to have a fragmented economic response across the U.S., U.K. and the eurozone. The international system urgently needs to step up, especially if weaker countries are going to survive.

Evans: Have national governments lost capacity to plan for and respond to an emergency of this kind?

Mann: This is the worst event on any country’s risk register: It was always going to be horrible.

The tide of a pandemic rises so quickly that important decisions must be taken very quickly in the early days of an outbreak. The workload is very high, but over time I would expect it to decrease somewhat. I would be skeptical of any suggestion that mature democracies lack capacity to collect evidence, make policy and flow decisions to senior decision-makers in a way that will lead to an effective response.

But countries are still only starting to work through the cascading consequences of the virus, for example the results of closing schools, which will have many secondary impacts. They are also facing much greater economic damage than was planned for. A huge amount of work will be needed to protect incomes and ensure firms survive.

Evans: Can I ask you about the community level response to the outbreak? What’s going well, what still needs to happen, and what do central and local government need to do to help?

Mann: Central government is limited in how it can support resilience at a community level, especially as the challenges faced by different communities vary from floods, storms and power cuts in rural areas to terrorism in urban areas.

It’s an oversimplification to say that more rural groups, or those in small towns, have stronger social capital. Major urban centers have church, sport and other types of groups, although there are fewer things to coalesce around than in rural or town communities. But what we concluded in central government—before we launched the Community Resilience Initiative, which I’m sorry to see didn’t get very far before being sidelined by the financial crisis and budget cuts—was that for more built-up areas, you have to work harder to tap into the right ideas and networks. No one size fits all. Each community must be addressed individually to identify its challenges and the seeds from which resilience networks can grow.

So effective community resilience is really about the convening power of local governments, not central government, whose role will always be very limited. It is local government which is best placed to identify and connect communities that are thriving or faltering and implement appropriate responses. And that can be done at relatively little financial cost. Unfortunately, the financial crash reduced the capacity of local government, and much local authority work disappeared between 2011 and 2015. But it’s heartening to see communities independently coming together to support each other in tackling COVID-19 where local governments cannot. There are lessons there which I hope can be drawn when the pandemic is over.

Steven: So where do we go from here? How are countries going to be able to lift their lockdowns?

Mann: We need rapid progress if we’re to limit the economic and social impacts of the virus. Medical science, particularly genomics, has advanced significantly since the 2009 pandemic. There are new channels of exploration. The really interesting stuff is being done not only on accelerating a vaccine, but also on improving treatments, creating better testing kits and ramping up testing capacity. We need medical progress to ease the lockdowns and restore normal life before the vaccine.

Evans: What issue is keeping you up at night regarding the COVID-19 outbreak?

Mann: As a planner, the economy and unemployment, no question. The health and social effects can be modeled, and plans were in place, albeit they will have needed to be adapted to fit the circumstances of this emergency. But on the economic side, what is being done is novel, and there is little previous analysis and planning which decision-makers can draw on.

Alex Evans is the founder of the Collective Psychology Project. David Steven is the founding director of the Pathfinders for Peaceful, Just and Inclusive Societies. They are both senior fellows at the New York University Center on International Cooperation.

No comments:

Post a Comment