Controlling the spread of disease

The global coronavirus pandemic highlighted the need for controlling the spread of disease, but there is disagreement on how best to do this

The World Health Organisation officially reported global deaths in the Coronavirus disease (COVID-19) Pandemic as 5 million by early November 2021, although estimated figures are more than twice that number.   This resulted in a severe economic shock worldwide.  It is too early to analyse this subject conclusively at the time of writing, but it is already clear that it raises several important questions.  Ideally, governments aim to minimise early deaths and economic harm until the pandemic burns itself out, but their political ideology affects their decision-making.

The Johns Hopkins Coronavirus Resource Center reports numbers of deaths in relation to population size, which show a wide variation between countries.  Brazil, the United States and the United Kingdom – which were governed by authoritarian populist leaders in 2020 – had very high cumulative death rates in November 2021 for example.  As described earlier (, authoritarian populist leaders want to appear strong; all three leaders initially tried to underplay the seriousness of the disease, likening it to flu.

Governments have constrained people’s individual liberty, to control the spread of the virus.  It is unclear, though, to what extent applying the force of the law has been more effective than persuasion.  Sweden had a lower death rate than Britain, even though it relied less on compulsion.

Compulsory lockdowns, shutting businesses and preventing people from working, have been very costly in economic terms and in affecting the quality of people’s lives – especially for younger people whose education and careers have been put on hold.  Pandemic decision-making, as described earlier on this website, is complicated by trying to remain popular.  Politicians want to be seen to respond to the immediately visible deaths, which receive a lot of publicity in the short term, but less attention is paid to the long-term reduction in people’s quality of lives and their early deaths: which might be the effects of stress, deprivation, or the delayed treatment of other diseases.

Lockdowns reduce the number of deaths in the short term, but they cannot be left in place indefinitely.  A BBC report, Most rules set to end in England, says PM, described the political balancing act of releasing lockdown in July 2021: “Unlocking was always going to drive up infections. And the problem with trying to delay that is the risk of a surge in cases at a much worse time.”

Older people are more likely to die from COVID-19 than those who are younger.  Experts disagree about the best way of controlling the spread of disease: whether it is possible to protect the old whilst letting the young have more freedom, for example.

Politicians have claimed to be guided by science, although in practice they must make a judgement about whether people will comply with any regulations that are introduced.  Vaccination has been very successful in reducing the number of deaths, but questions have been raised as to whether it can be or should be compulsory.

There is a conflict between a desire for personal liberty and the moral duty to get vaccinated and wear a mask in crowded places to reduce the risk of infecting others.

This issue has become politicised, especially in America – where Republicans reacted angrily against a Democrat government which introduced compulsory vaccination for some occupations to reduce the risk of unvaccinated workers infecting the public.  The Economist reported that America’s pandemic is now an outlier in the rich world (which had a plentiful supply of vaccines) in September 2021:

“….Adjusting for population, the death rate is now about eight times higher in America than in the rest of the rich world.

“A slowdown in vaccinations in the country is largely to blame.

“….YouGov’s poll indicates that, among those who voted for Donald Trump in 2020, 31% say they will not get vaccinated, 71% strongly disapprove of President Joe Biden’s vaccine mandate and nearly 40% never wear a face mask.”

The idea of vaccine passports has also proved to be politically divisive, as illustrated by a Reuters report: Thousands protest against COVID-19 health pass in France.

Rich countries have obtained more vaccines, and made more progress in vaccinating their populations, than poor countries.  This raises moral questions, and it creates practical problems.  It is unsurprising that politicians have prioritised their own countries, but the unchecked spread of the virus elsewhere can allow new variants to emerge which might be harder to control.

The role of the World Health Organisation (WHO) in controlling the spread of disease has been contentious.  It has provided expert advice to every country in the world, and it has helped to distribute vaccines to poor countries through the COVAX scheme, but it relies on voluntary contributions from governments; it has been accused of bending to political pressure from China for example.

As described in the Economist article, How the world learns to live with covid-19, “in the end, all pandemics burn out. Eventually, sufficient numbers of people develop immunity so viruses can no longer find new hosts at the rate they need to sustain their growth.”  People gain immunity either through infection or vaccination – and the latter is much safer.

The ‘new normal’ for living with COVID-19 will be when it is endemic: always present, always killing some vulnerable people who might otherwise have died from a different malady, but not requiring harsh restrictions on most people’s behaviour.  Governments need to avoid letting health services be swamped, though, so some caution will continue to be necessary.

Risk reduction is a series of options, including some mandatory mask-wearing, encouraging working from home, allowing vaccine mandates, and using health passes at crowded venues.  Politicians, guided by expert advice, must choose which measures to impose at any moment – but the experts don’t always agree, as illustrated by two contrasting articles that were published within 3 days of each other in October 2021:

A Guardian article, UK faces ‘another lockdown Christmas if we don’t act soon’, reported on calls for action to be taken swiftly to avoid much tougher COVID restrictions later.

The BBC report, Covid: Are cases about to plummet without Plan B?, notes that some experts were predicting a fall in infection rates for other reasons – without the need for the restrictive measures referred to as ‘Plan B’.

Future pandemics should be combated by immediately restricting international travel and advising the population to avoid risky behaviour until a vaccine can be developed.  Political leaders should act swiftly and decisively, leading by example.  As noted earlier (6.3.4), a leader’s attitude and personality make a huge difference to the effectiveness of a government’s response.


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This page is intended to form part of Edition 4 of the Patterns of Power series of books.  An archived copy of it is held at https://www.patternsofpower.org/edition04/6755.htm.