Of pandemics and people

I spent three days last week in Cambridge, mopping up reading for my Mexico project. One book on my list was a 1960 study by Woodrow Borah and S. F. Cook of the University of California Berkeley, The population of central Mexico in 1548. These scholars had estimated that about 23 million indigenous people lived in Mexico when the Spaniards arrived in 1519. By 1548, their estimates suggest that the numbers had fallen to seven or eight million. About 60 years later not many more than one million Indians survived. The reason was a number of pandemics of diseases to which the people of Ancient Mexico had no resistance. Mexicans now have to worry about another disease.

We spoke to our son Chris in Mexico Monday night. Pasitos de Luz, the charity for which he works provides day care and therapy for children with disabilities. Pasitos will extend the two-week Easter break to a month because the government has ordered all schools in Mexico to do so. As far as I know, this is the first action taken by Mexico’s government to restrict the spread of coronavirus. President Andrés Manuel López de Obrador (AMLO) has taken a rather relaxed attitude to the coronavirus. His statements suggest, rather like Mr Trump’s earlier predictions, that the virus is not terribly serious. He has continued to dispense abrazos (hugs) liberally. There is no plan to restrict mass gatherings and events. Monday was a public holiday (Benito Juárez Day, to celebrate the life of a famous 19^th-century president). In San José, Nayarit, near to where Chris lives, there was a funfair, a livestock and farm machinery show, and a rodeo/dance. Chris and his girlfriend went to the dance. The musicians had a new stock of beer-related coronavirus jokes, Corona being a popular brand of beer.

Chris tells us that the people of his region have heard that the virus does not like hot conditions. Since coastal Nayarit is Hot Country, unlike the big cities of the highlands, the hope is that the heat will kill the virus. AMLO has expanded access to public health care, but not increased funding. He has also created a severe shortage of medicines in the public system. I fear that Mexico is not prepared for the pandemic.

Here in the UK, the government seems to have been rather slow to implement measures to restrict the spread of the virus. Prime Minister Johnson initially declined to convene the government’s emergency planning committee (COBRA). Communications have been slapdash. The health minister has used the term-self isolation to mean two very different things: initially, strict home quarantine for anybody with symptoms consistent with the virus, but later a less rigid recommendation than at-risk groups should avoid unnecessary social contact, for example by not attending clubs and social events, avoiding public transport and the like, for a period of several weeks or months. His loose talk created the impression that the government had recommended a sort of home arrest for the elderly. This week, the Prime Minister encouraged us not to go to pubs, clubs, theatres and the like to reduce social contact. He did not mention cafés, restaurants, hotels, cinemas or museums, but these are also places where social contact occurs. He further announced that if a person in a family has symptoms consistent with coronavirus, the entire family should self-isolate for 14 days. In fact, if another family member exhibits symptoms within 14 days, the period of isolation exhibits increases to 21 days. And if within that period another person becomes ill, for another seven days and so on. Our voluble prime minister did not make this clear.

The rapid imposition of increasing restrictions on social and economic life has exposed, for those who care to see, the consequences of the last ten-years of government policy. The UK used to have a robust public health system to address disease and other health matters. The National Health Service was responsible for public health, which was therefore integrated with the broader health service. No longer. Soon after the 2010 election, the government (having promised not to do so) undertook reforms of the NHS. Amongst other things, responsibility for public health was devolved to local authorities, thus fragmenting the system. Since local budgets have been severely reduced, the funding for public health has been decimated. We also have fewer critical care beds, and fewer ventilators, per head of population that most other advanced economies. In short, our health infrastructure has been run down when we need it most.

The crisis has also exposed the insecurity which many of our fellow citizens must endure. If you stay away from work to self-isolate for the public good, as instructed by the government, the statutory minimum pay is £94.25 per week. In Germany and Austria, the rate is £287.35, in Spain £120.69. In the UK for the first three days, the sick person is paid nothing. Nothing is paid if the worker’s income is below a minimum level, nor are you paid if you are freelance or a “contractor”, as many delivery or Uber drivers are for example (probably in violation of unenforced labour laws). These people have been told to apply for Universal Credit, but this pays nothing for the first five weeks. This is a rule, designed by wealthy politicians, to teach the indigent how to manage money they do not have. Everybody else, so the argument goes, must wait a month (but not five weeks) to be paid when they start a job, so this must apply to benefit recipients as well. I can testify that the same politicians do not apply this rule to the state pension, because pensioners are a key bloc of voters.

The Trump administration in the USA has taken even more damaging steps to undermine the health system. The Centers for Disease control is a national network of extremely capable medical professionals and labs. The Trump administration has cut its budget and reduced the number of centres. Under the Obama administration there was a pandemic planning unit within the National Security Council. This no longer exists. The World Health Organization offered the US government its coronavirus testing kit. The Trump administration rejected the offer, preferring to use a kit developed in the USA, which turned out to be defective. The health system is fragmented. Medical treatment is mostly private, controlled by health insurance companies, and not readily available for those who cannot afford insurance. Public health services are fragmented, and in many states managed by small municipal administrations, whose capacity is limited. A friend, who is a public health nurse in New Jersey, tells me that her manager insisted that the coronavirus was just another flu – after all the White House had told him so – until the first death occurred in a local hospital. Mr Trump has variously sought to discount the virus as no worse than the flu, a Democratic hoax, a foreign virus seeded by European travellers, a Chinese virus and so on.

Monday, on my way home from the village bakery, I met a young Spanish woman from Valencia who works in a local convenience store. She told me that several members of her family now have the disease. Valencia, like the rest of Spain, is in quarantine. The family from whom we rent a house for our vacations in Sagunto, about 30kms to the north of Valencia, are likewise confined to their homes.

Here in Sunninghill the virus is beginning to have its impact. Our village florist tells me that flowers are still arriving from Holland (which supplies almost the entire European market). Because almost all shops in Italy and Spain are now closed, sales of flowers have collapsed and the growers have had to destroy large quantities. The florist is very worried about prospects for her business as restrictions in the UK increase.

Jan volunteers at the Ascot Day Centre, which provides social contact, lunch and services such as exercise classes. It has now closed and is making plans to deliver lunch to its members’ homes. We have two neighbours who live alone and meet the government definition of vulnerable: one is 75 and the other well over 90. Fortunately, a number of neighbours have offered them support. Yesterday, a person I have never met put a note through our door offering support if we need to isolate ourselves.

In short, policies designed to reduce the capacity of the state and to strip public services to a bare minimum have been revealed by the virus to be at least unwise, at most a conscious exposure of us all to unnecessary risks. In my country the situation is, of course, made worse by Brexit. Just as we are suffering the worst national threat since the Second World War, our government remains determined to negotiate our exit by 31 December or leave without any agreed arrangements. I suspect that the leaders of other European countries are far too busy with the current crisis to indulge our whims. The government has decided that we will end our membership of the European Medicines Agency (EMA), which regulates and licenses drugs for use in the EU. We will have our own agency. Now, when a vaccine against coronavirus is developed, it must be licensed before it can be used. The pharmaceutical companies will, naturally, seek to meet the standards of markets with large populations (the EU, for example) rather than the UK (with a much smaller population). We can expect to receive the vaccine later than would have been the case were we members of the EU. “Get Brexit Done” will thus indulge the fantasy of “Take Back Control” so dear to some of my fellow Britons, and the rest of us must suffer the health consequences.

Dear friends, I hope you stay well., Please keep in touch by email.

PS: the Cambridge University Library,  the British Library, the Anthropology Library at the British Museum and the Institute of Historical Research Library have all closed, or will do so later this week. I will be at home writing for quite some time.