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The idea of controlling this virus is a myth – all governments are doing is lowering our quality of life

As every doctor knows, good medicine is about more than saving lives. It’s also – obviously – about the quality of the lives being saved - getty
As every doctor knows, good medicine is about more than saving lives. It’s also – obviously – about the quality of the lives being saved - getty

How should governments control travel this winter? Should we be allowed to go on holiday, or even to see our families? Should mandatory Covid testing be introduced at borders? Or should we be doing something else entirely?

As every doctor knows, good medicine is about more than “saving lives”. It’s also – obviously – about the quality of the lives being “saved”. In the strange case of coronavirus, it’s about the quality of everyone’s lives – including the vast majority of people at very low risk from the virus – due to the intrusiveness of the rules by which governments believes they are “controlling” the virus. Since travel is a vital part of many people’s quality of life, this really matters.

You wouldn’t know that our government understands the point about quality of life by their approach to coronavirus over the last few months. Initially there was a focus death numbers, without ever giving a context by which they could be understood. Then, when the deaths became very low indeed (despite coronavirus being a notifiable disease) they switched to case numbers, apparently solely because those are bigger.

Yet there is now an obvious disconnection between case numbers and the key figure of admissions to hospital. The latest figures (week ending September 18) show 139 deaths where coronavirus was mentioned on the death certificate, just 1.5% of the 9,523 total deaths for that week, and much lower than the 14% of deaths where “influenza and pneumonia” was mentioned. Deaths in hospitals were actually 365 lower than the five-year average for deaths at this time of year, which is itself lower than the 10-, 15-, 20-, and 25-year averages (ONS statistics go back 27 years), and therefore flatters the seriousness of the pandemic.

So the numbers do not support the idea that travelling this winter carries a different risk from travelling in many winters of the last 25 years. Also, despite massive testing, and mobile units rushing around the country to test at “cluster” locations (which therefore tend to become self-fulfilling prophecies), case numbers seem to levelling off. Yes, 7,143 were announced on Tuesday, but that followed three consecutive falls for the first time since August 17: 6,874, 6,042, 5,693 and 4,044 daily new cases from September 25 to September 28.

So that’s good. But would testing at borders at least allow everyone to travel with confidence? Coronavirus cases need testing because they cannot be dependably diagnosed clinically – the symptoms overlap with those of many other pathogens. Unfortunately testing is not a straightforward thing.

All pathology tests are normally carefully developed and validated before being rolled out for mass use. Even then there are always false positives (test is positive, but pathogen not present) and false negatives (the opposite).

For coronavirus this careful, peer-reviewed development and validation process has not happened. Tests have been rushed through to meet the perceived need, but there are many problems bubbling away. For example, false positives are probably 1 to 10% of results, meaning 2,500 to 25,000 incorrect results when you’re doing 250,000 tests a day. The PCR method being used is also critically sensitive, meaning that false positives/negatives can be cranked up or down by exactly how you do the test. Furthermore, many “positive” tests seem to be “weak positives”, with viral loads 100 times lower than cases with serious illness, and are usually asymptomatic, with little risk of infectivity.

So instituting such tests at borders, for an illness whose significance has been exaggerated, would simply be a recipe for chaos and unfairness. Many would be wrongly prevented from travelling, while others with the disease would go ahead. And even the meaning of genuinely positive tests remains unclear.

Instituting tests at borders, for an illness whose significance has been exaggerated, would simply be a recipe for chaos and unfairness - getty
Instituting tests at borders, for an illness whose significance has been exaggerated, would simply be a recipe for chaos and unfairness - getty

In fact, why should travelling between countries be regulated at all? We can now see that the viral curves around the world are pretty much the same, despite wide differences in how governments believe they “control” the virus.

So the idea of “controlling” this virus is largely a myth and the risks of travel remain what they always have been. Bold leadership requires making difficult decisions. In this case the right direction is clear. Governments should not double down on misconceived restrictions and regulations that lower quality of life, but change little else. Making our own risk assessments should be the responsibility of people who want to travel, as it always has been. Freedom of travel within and across borders should be restored.