Liz Stanley

The viral character of how some media stories circulate – with a current story picked up by other media sources and multiply repeated with minimal changes or  by transferring it into local examples – is well known. Thus Llandudno goats coming down from the hills to roam the town streets fetches up with a media story in Brazil and sheep in one of its cities. And similarly with key terms and ideas which circulate and recirculate: for example, there has been a flood of reporting that lockdown is restriction and a liberties infringement and the suffering it engenders (all that sitting on sofas eating snacks and watching TV) is treated as on a parallel with being bombed in the Blitz. And at a point when hospital deaths might be declining though still high but those in care homes certainly aren’t, comes many journalists over the last few days reporting, promoting, encouraging, anticipating, the lifting of lockdown and the need for exit strategies.

Little else is being reported – it‘s coronavirus coronavirus coronavirus – and trying to find new angles on this to fettle up for today‘s reports. Into the mixture comes ‘the experts’, and hunt the tame expert by journalists who seize upon a statistician here, an epidemiologist there, a frontline doctor there, a cancer specialist here, a chief medical officer there. The obsession in the first 10 days of May has been with lifting the lockdown, the exit strategy, the five rules for lift up and other buzz terms currently in circulation. From the start and even before the term pandemic was used, there have been ideas about more rigorous distancing rules for groups of people characterised as particularly vulnerable. In the present rush in the world of media journalists to lift lockdown, these have been joined a few days ago by another such buzz term, ‘segmented shielding’. 

While well meant, initially at least, ideas about vulnerability and shielding have important negative consequences for independence, autonomy and agency, for personhood. On the one hand there are GP practices in the UK that have issued letters asking ‘vulnerable’ people – those over 70, and those with disabilities in specialist care homes – to sign forms agreeing to not being resuscitated, while on the other hand there is ‘extend the lockdown’ for some groups being advanced. Interestingly, the idea of ‘herd immunity’ heard much at an earlier point lies at back of the ‘segmented shielding’ idea just reported in the news media. 

On 7 May, a number of news reports appeared in the UK concerned with this idea of segmented shielding. “The Coronavirus: Is it time to free the healthy from restrictions?” item on the BBC news app by a ‘Health correspondent’, for example, gave it prominence by reporting on a piece of epidemiological modelling with quoted comments from its lead researcher. It also repeated such phrases as ‘experts have found..‘ and ‘researchers have shown’, various of which appear in a press release from the research team (which can be accessed here).

The BBC news item is structured using quotations from a number of designated experts stitched together with an ‘it is so’ kind of narrative commentary. Younger people are said to be less at risk than they think, and those who died or had severe coronavirus most likely had unrealised underlying health factors – “…we have “lost sight” of the fact the virus causes a mild to moderate illness for many, says Dr Amitava Banerjee, of University College London”. It continues, it is also important to take full account of other costs, emotively including domestic violence, mental health problems and restricted access to other healthcare, leading to the implicit weighing of these against the cost of further deaths, which from the commentary and linked graphs are largely those of the elderly and vulnerable. 

Segmented shielding enters frame here via comment about an Edinburgh-London research project, to the effect that restrictions could be lifted if the most vulnerable are shielded. This is backed by a quotation from the team leader that for most people coronavirus carries no more risk than a “nasty flu”. Researchers from Stanford University are then brought into play, in calculating the UK risks for those under 65 as equivalent to driving 185 miles a day, “with deaths in non-vulnerable groups being “remarkably uncommon”.” 

The BBC news report seems remarkably okay with the idea of dividing the population and imposing strict restrictions on everyone designated as vulnerable. It also accepts without question calculations as to the proposed minimal impact of coronavirus on the rest of the population, seeing its members as largely herd immune or only minimally affected. However, there is more to the idea of segmented shielding than appears in the news report, found in the research press release and associated full report (which can be accessed from the press release referenced above).

The Edinburgh-London press release writes of its own work in terms of expertise and in a third-person voice – “experts suggest, researchers say, academics from the Universities of Edinburgh and London, researchers say, the team proposes, the team says, the team stresses”. It is in fact recipient-designed as a press release produced with journalist-use in mind. The result is that its claims can be inserted into ‘news reports’ as though the reporter is designating the people concerned as experts, rather than this being a self-designation. The press release contains a link to the research paper reporting the piece of mathematical modelling carried out. The typescript report writes that:

“Key risk factors for vulnerability to COVID-19 are defined by the World Health Organisation (WHO) as those over 60 years old and those with underlying medical conditions (such as cardiovascular disease, hypertension, diabetes, chronic respiratory disease, and cancer)…

We enumerated these categories using published data… For our baseline scenario we designated 20% of the total population as vulnerable. We assumed a 1:1 ratio of shielders to vulnerable. The remaining 60% of the population are not in either category and we refer to this as the 20-20-60 model…”

Problems with this are clear. The calculation of risk factors for those deemed not vulnerable have to be accepted as 100% precise, assumptions about how coronavirus infections spread have to be watertight, certainty in identifying vulnerability has to be absolute, and the one-to-one ratio of ‘shielders to vulnerable’ has to be fully accurate. The untenable character of calculations of risk, assumptions about infection spreading, and identification of underlying health factors, are sufficiently obvious as not to require elaboration here. The shielder/vulnerable ratio is also dubious, for those with the most serious health issues require significantly more assistance than from one person. But even supposing all these were not disputed claims but factual certainties, how to achieve an impermeable separation between the herd 60%, the shielder 20%, and the vulnerable 20%?

“…Measures including self-isolation of cases, quarantining of affected households, contact tracing and voluntary physical distancing will be necessary to achieve this. In all our scenarios the vulnerable segment is subject to increased protection indefinitely…

…In addition, S&S could be greatly strengthened by infrastructure and technological support for effective biosecurity, both at institutional (e.g. care homes, hospitals) and household levels in order to keep transmission rates low between and within shielders and vulnerable populations. For maximum effectiveness biosecurity requires training, high standards of hygiene, effective personal protective equipment and screening of everyone in contact with the vulnerable population…”

Segmented shielding, S&S, is being envisaged as an indefinite system involving biometrically-based surveillance of the vulnerable and shielder populations, coupled with frequent, indeed daily, medical tests to ensure compliance. The result would be a brave new world indeed, of a permanently sequestered 20% vulnerable population, a permanently routinely tested 20% shielder population, and an unrestricted 60% supposedly immune or resistant population. So much for notions of independence and autonomy, and instead a state of high surveillance, ongoing biometric and medical interventions, and indefinite sequestration for a huge proportion of the population. Agency for the vulnerable 20% would go to the wall for an indefinite period; and the shielder 20% would be under indefinite multiple surveillance and have minimal agency themselves.

In the meantime, polls suggest that the majority of the UK population are not clamouring of the lift of lockdown, are not demanding for restrictions to be lifted on a privileged supposedly largely immune group. So where have these ideas come from? Is it a case of hunt the other experts, and hunt the other journalists in search of an easy story they can sex up? The buzz terms circulating provide a route into exploring this. For instance, a PS to this discussion is that on 11 May in commentary on a speech by the UK prime minister Boris Johnson, claims about most of the population being immune or only minimally affected were repeated and associated with the Edinburgh and London research as well as the same Stanford and Cambridge comments. The strong indications are that once in circulation there is a high chance of such buzz terms and ideas being recirculated and recirculated.

The alternative to the ‘brave new world’ of the herd and the vulnerable and its appalling prospect is not to do nothing, but to look for non-discriminatory ways forward that do not have the implied eugenicist basis of this. Eugenicism has already raised its ugly head in the rash of GP practices issuing letters and forms about non-resuscitation; segmented shielding and biometric interventions are another variant. And the alternatives? Vaccines and related treatments along the lines of managing HIV/AIDS, and mass changes in expected behaviour in which everyone observes a social bubble approach, are among them.