Boris Johnson in intensive care as coronavirus rages through the land

With British Prime Minister Boris Johnson moved to intensive care on Monday evening, the health crisis affecting the nation due to the rapid spread of coronavirus seems to be snowballing into a political crisis too.

The 55-year-old Prime Minister, who tested positive for COVID-19 on March 27, was moved to the St Thomas Hospital in Central London on Sunday as he continued to have persistent fever.

Downing Street officials said the admission was a “precautionary step” as the coronavirus symptoms continued for the past 10 days.

Boris Johnson himself tweeted on Monday morning that he was “ in good spirits” and “ keeping in touch with my team, as we work together to fight this virus and keep everyone safe”. However, by early evening, it was officially announced that doctors had moved him to intensive care as his condition worsened. The move was again described as a precaution in case he needed ventilation to get through a critical phase of the illness.

Boris was not the only high profile personality to catch the virus – his Health Secretary Matt Hancock and the heir to the British throne, Prince Charles – also earlier tested positive to the virus but came out of it largely unscathed.

Following the announcement, the Foreign Secretary, Dominic Raab, who had already been announced at the start of the COVID outbreak in the country as a “ designated” survivor in case needed, has now been asked to deputise for the Prime Minister, where needed. Already, Dominic Raab presided over the cabinet meeting on Monday morning in the absence of Johnson.

Constitution silent on succession

The UK’s unwritten Constitution does not have a formal Constitutional role of a deputy or caretaker Prime Minister automatically taking over the office of the Prime Minister in case of illness or death. The role is also not a permanent one either and is at the discretion of the Prime Ministers; in the recent past, Nick Clegg was the Deputy Prime Minister in the 2010-2015 Conservative-Liberal Democrat coalition government and before that  during the Tony Blair era, John Prescott was the Deputy Prime Minister.

The current scenario is thus new. While the expectation is that Boris Johnson will soon make a recovery to lead the government in the fight against coronavirus, in the meantime, it has fallen on his first Secretary of State, Dominic Raab to lead the government in this time of crisis.

Boris Johnson’s illness has prompted a flurry of “get well soon” messages from a wide range of politicians, both in the UK and abroad. In the UK, the newly elected Leader of the Labour party, Sir Keir Starmer, Scotland’s First Minister Nicola Sturgeon, French President Emmanuel Macron, Germany’s Angela Merkel, Trump’s daughter Ivanka Trump were among those who sent messages of support to the ailing Prime Minister. (Trump earlier sent a message before it was known Boris Johnson was moved to critical care).

NHS under pressure as confirmed cases surge

Boris Johnson’s deteriorating condition could not have come at a more inopportune time in the nation’s struggles with the virus.

The coronavirus casualty figures crossed 5,000 today, with nearly 400 more deaths being reported in the past 24 hours. The number of confirmed cases also crossed 51,000 – making the UK the country with the fifth highest number of cases in Western Europe (after  Spain, Italy, Germany and France).

With the virus already in the community transmission stage and the ‘peak’ of the pandemic expected in two weeks, the fatalities are likely to rise, especially among the vulnerable 70+ age group.

Unsurprisingly, there is enormous pressure on National Health Service (NHS), the unique state-funded health service that is revered in the UK as something close to religion.

The NHS which has been severely underfunded for the past decade and has been blighted by cuts and savings targets, is still a strong institution but the pandemic would have threatened and subsumed the NHS if the virus were allowed to go unmitigated.

Boris Johnson’s government was initially toying with the idea of not paralysing the economy with such harsh measures as closing down businesses but allow the virus to infect the population so that “a herd immunity” developed. This became controversial but a scientific modelling by the academics of London Imperial College which projected an unacceptable number of 5,10,000 deaths if the virus was allowed to rampage through the population unmitigated, put paid to the government thinking and forced it to change tack  and announce the lockdown.

Lockdown costs — social and economic

The country has been in a semi-lockdown for the past two weeks, with government allowing people to move out of their homes only under limited circumstances – a rare instance of government intervening so drastically in people’s social lives in a country where people cherish personal freedom and liberty.

Moves that would have been considered unthinkable – closing down of that socially ancient institution of pubs – have been announced to disrupt the transmission of the virus.

Libraries have been closed, sports events cancelled, restaurants closed, most non-essential shops and businesses shut down, gyms (including open gyms in parks) and other leisure activities stopped – it has been a massive knock down of a long-lived way of life in this country.

The Britons, known for their “mustn’t grumble” attitude, so far seem to have taken the measures with a sense of resignation — somewhat with a grudging acceptance that the “ therapeutic authoritarianism” as a columnist in the Conservative leaning Telegraph called it, was perhaps necessary for a larger good.

But no one knows how long the British acceptance of the restrictions would last. The British public are allowed to go out of their homes only under four circumstances – to buy essentials like food, as infrequently as possible, to have one form of exercise once a day, alone or with family members, to go to the hospital or to visit a family member in hospital  and to go to work (if working from home is not possible).

The economic cost of the lockdown has been tremendous, with nearly one million people now registering for universal credit (a form of income support) after loss of jobs, reflecting the economic emergency caused by the pandemic. The government has already announced that it would bear upto 80 percent of the wage bill for small and medium sized businesses to continue to pay their work force.

Though the government initially announced the lockdown for three weeks, an early lifting of restrictions is unlikely. Health Secretary Matt Hancock  said the government would stop people leaving their homes for exercise, if it found too many people flouting social distancing rules.

Hancock’s threat came over the weekend, when the sunny weather prompted a crowd of sunbathers rush to a park in Lambeth in south London, forcing the local council to close the park on Sunday.

(The government has already announced building emergency field hospitals in London, Birmingham, Manchester,Bristol and Harrogate in England and one each in Glasgow in Scotland, Belfast in Northern Ireland, Cardiff in Wales) to tackle the need for additional beds for coronavirus patients. The London hospital, with a capacity for 4,000 beds, has been declared open a few days ago in the ExCel Centre in East London).

All these raise  the inevitable question about the exit strategy for this lockdown. There have been a lot of scientific discussion and debate about when to ease the lockdown but the government has not so far officially indicated its position. The current thinking seems to be first to hold the curve down, bring down the number of fatalities and infections, initiate aggressive testing and contact tracing and when the virus is under control, ease the lockdown. All this would take weeks, if not months, depending on how the virus spreads. It is going to be an agonising wait for the British people and the political uncertainties at the top, arising out of Boris Johnson’s illness is an unwelcome complication.

(The writer is a senior journalist based in London)