Learning to Live With the COVID Virus and Extreme Inequality

Used over a year ago by right-wing commentator John Redwood to denote a new modus vivendi for global capitalism, ‘learning to live with the virus’ has been an idée fixe of the Johnson government for the last few months. Its analogue ‘opening up society’ was symbolised on 19 July on ‘Freedom Day,’ when Boris Johnson was isolating after his double-vaccinated Health minister Sajid Javid contracted COVID. As minimal public health precautions were made discretionary, England’s High Streets could return to “the bustle” which Johnson had prematurely announced after the first wave of the COVID virus.

Herein lays the central contradiction in which the Johnson government is entangled; to legitimate itself to voters and politicians, the state needs to promote continued economic growth, much of which involves people exposing themselves to each other and the virus. Yet to suppress an infectious disease that can exponentially reproduce and has claimed over 4 million lives worldwide, decreased exposure to others, especially indoors, is essential.

Coming from government ministers, the ubiquitous ‘we must’ that precedes ‘learn to live with the virus’ is a directive to get back to ‘normality,’ meaning no compulsory masks or social distancing, and returning to workplaces. Such messages also signal that economic self-interest has returned as a principle of government policy. The idea that egotism drives prosperity, social harmony and happiness harks back to 19th-century British liberalism. ‘Opening up’ means that the state can support the profit motive by encouraging consumerist individualism which inevitably undermines public health. Indeed, the ‘eat out to help out’ campaign in August 2020 made increasing exposure a matter of civic duty but had to be abandoned one month later as case numbers increased.

The key to making ‘opening up’ not appear irresponsible is the appeal to the national ‘success’ of COVID vaccines with the double vaccinated having infection rates three times lower than the unvaccinated. However, the vaccinated still contract coronavirus, become ill, spread infection, and according to a CDC study 2% die. New variants of COVID are proliferating, and some of these are 20-50% more transmissible than the original strain for which the vaccines were designed. Added to this is the firm possibility of future vaccine-resistant strains, as demonstrated by a modelling study by Simon Rella and colleagues who predict their emergence, even when a high proportion of the population is vaccinated. These scientists argue that only through ‘implementing acute non-pharmaceutical interventions (i.e. strict adherence to social distancing) for a reasonable period of time’ will infectivity be reduced.

Johnson’s vaccine nationalism ignores the fact that this is a pandemic, and access to vaccines is very low in many countries. In July and August, the Delta variant spread rapidly in countries as diverse as France, Indonesia and Iran. The Covax programme is half a billion doses below its distribution target to the Global South. Covax became necessary because vaccines were created not as a public good but through pharmaceutical companies selling disproportionate supplies to rich countries. Rich countries even obstructed proposals to help less wealthy nations develop vaccines. The British government, which recently committed to sending out 9 million surplus doses and 100 million over the next year, initially negotiated to give wealthier foreign clients a choice of vaccine through Covax.

Despite all these uncertainties and global surges in cases and deaths, vaccines have now become the main rationale for ‘opening up’ for the UK government, but the ‘we’ who must learn to live with the virus covers people with uneven probabilities of infection and unequal vulnerabilities to severe complicating diseases. COVID has a differential impact and roughly follows the social gradients in society itself. The poor, minorities, and people with particular health conditions, many of which stem from living and working in unsafe conditions, are more susceptible. Included in the universalised ‘we’ is the almost fifty per cent of children living in poverty under Britain’s ‘punitive, mean-spirited and often callous’ social welfare system, as described by a 2018 UN report.

Extreme poverty coincides with the proliferation of extreme wealth as elite businesses and professions profit from the pandemic. Some lawyers have been paying themselves almost £2 million a year with starting annual salaries at law firms at £100,000. Pandemic wealth also included billions obtained from government COVID-related contracts to individuals and companies known to the government through procedures that lacked transparency and involved conflicts of interest. Some of this wealth resides with individuals such as former Goldman Sachs financier Chancellor of the Exchequer Rishi Sunak. With his wife, Sunak has a £1.7bn shareholding in Infosys, a £900m-a-year joint venture with Amazon in India, and several other shareholdings and directorships including a Mayfair outfitter that supplies the tailcoats for pupils at Eton College. Javid has a net worth of £8 million acquired from his 18 years in banking and finance.

Yet, government rhetoric views people with such different life chances as sharing the same interests. It needs little imagination to see that ‘opening up’ is connected to profit-generating mass consumption that has made the prosperity of some in government possible. Individual ministers and Johnson personally are part of a wider political web of managed wealth according to a recent report in the Financial Times. This consists of corporate and individual donors, often linked via Eton and other elite institutions, in the ‘Advisory Board’ whose members pay £250,000 donations in exchange for secret monthly meetings with Johnson or Sunak, presumably to promote individual and corporate financial interests.

‘Learning to live with the virus’ obviously appeals to someone who believes that vaccine development is owing to greed and capitalism and not to Britain’s publically funded educational, research and health institutions. Conveniently side-stepped in the vaccine triumphalism is that Britain is the fourth highest country in per capita rates of COVID deaths, behind only Peru, Colombia and Brazil, and has the highest fatality rate per case of any Western nation. The deaths are also unevenly distributed. According to Office of National Statistics data, up to December 2020, people in ‘elementary occupations’ and care and leisure work, had particularly high rates, as did healthcare workers in England and Wales. NHS staff has been overworked to the point of exhaustion, and have not financially profited during the pandemic. On 22 July, NHS staff was ‘awarded’ a 3% pay rise, which is essentially a pay cut after inflation.

This is where ‘levelling up’ comes in. Although promising economic advancement for swathes of voters in a post-pandemic society, the slogan has been called out as ambiguous by some Conservative Party members and lacks substance according to the Parliamentary Covid Recovery Commission. Yet the ambiguity must be deliberate for a government comprised of extremely wealthy individuals that want to appeal to meritocracy in a country that, along with the US and Italy, has relatively low levels of intergenerational social mobility. In July, the Social Mobility Commission reported that ‘social mobility, already stagnant, could move backwards,’ with the poorest families being financially, educationally and medically worst affected by the pandemic. ‘Levelling up’ in such circumstances would be a Herculean task, needing huge reinvestment in the public and community services that Conservatives have belittled, dismantled and privatised over four decades. Indeed, the Johnson government’s relatively poor response to COVID-19 relative to comparable countries is related to long-term public sector cuts that have meant, among many other adversities, the halving of NHS hospital beds over the last 30 years.

So, what does ‘learning to live with the virus’ mean, not for some undifferentiated ‘we’, but England’s unequal and socially static population? The Johnson administration clearly believes that vaccines and rhetorical candy about ‘levelling up’ will legitimate social and economic arrangements from which they individually and the business interests they represent benefit. While vaccinations have undoubtedly reduced COVID hospitalizations and fatalities, the almost magical confidence in jabs in the absence of major social changes wilfully ignores what we know of other infectious diseases; most were not made less prevalent by magic bullets or greed, but public welfare and empathy. As the pioneering epidemiological research of Thomas McKeown showed, decreases in mortality and morbidity since the 19th century in Britain, especially from infectious diseases, could not be mainly attributed to medical education, scientific advances, medical technology, inoculations and doctors’ healing powers. They were more powerfully explained by social policies directed at alleviating poverty, building sanitation, better nutrition, the advent of a safe water supply, and raised standards of living.

While improvements in these areas alone are not going to eradicate COVID, ‘living with the virus’ through ever-changing populist policy will be as morbidly chaotic as this UK government itself.

About the Author: Colin Samson works in the Department of Sociology at the University of Essex.  He has long-standing research interests in the indigenous peoples and first nation communities of Canada and the impact that colonialism has had on these societies.