It is one of the conundrums of the current phase of the Covid pandemic: the UK has among the highest number of infections across the world and a death toll that continues to steadily climb, yet the national mood seems sanguine. So is this down to British stoicism, a Keep Calm and Carry on mentality?
Not according to experts. They talk of many factors being at play – and warn it may not last.
“We’re in a phase where we still have large numbers of people dying from this disease,” said Linda Bauld, professor of public health at the University of Edinburgh. “But it has gone into the background. We’ve become used to something that has not gone away. I think there’s been a desensitisation to the mortality.”
On Thursday, the UK reported more than 45,000 new coronavirus cases – the most since mid-July – and more than 800 deaths were reported in the past seven days. Hospitalisations are rising, with one-fifth of ICU beds occupied by Covid patients, and the latest figures showed an estimated 200,000 pupils absent from school.
The UK is faring far worse than its European neighbours, with a rate of deaths per million people nearly triple those seen in France, Germany and Italy.
However, the figures are still better than some predictions; Sage scientists said October could see 7,000 hospitalisations a day
In any case, it is not all about the statistics.
“When the Covid announcements were made, they’d say ‘Very sadly, three people have died’, then it was ‘Very sadly 70 have died’,” said Prof Robert West, a behavioural scientist at University College London.
“Now they don’t say ‘Very sadly’. One thing we know about humans is our emotions are stirred by images, they’re not stirred by numbers.”
Bauld believes current attitudes have been shaped by the “Freedom Day narrative” – the social contract made between the government and the public that if people came forward for vaccines, life would return to normal. “A lot of people have bought into that,” she said.
This includes some scientists. “There’s some who are of the view that Covid is becoming endemic, it was always going to become endemic and we just need to get on with it,” said Bauld.
“Then we’ve got another group of scientists saying ‘Look around the world at other countries that won’t tolerate such high rates of infection, and what about long Covid?’”
Growing division in the community means that scientists are no longer providing a coherent argument – and to some extent the government can pick and choose which views it amplifies.
Is there something particular to the British psyche – a stiff upper lip, an internalising of angst – that makes the country appear relatively unshaken by the ongoing toll of the pandemic?
“There definitely isn’t,” said West. “The British are much more safety conscious than most other countries when you look at driving, health and safety at work, the way we approach public health.
“This is something that is conditioned by the norms we see around us. When our leaders talk about Covid in the past tense, it gets through to people.”
A steady state
As a disease shifts from an initial pandemic phase to an endemic illness, the data curves outlining its spread become less precipitous. And psychologists say this steady stream of daily deaths – although the UK is now on an upwards trajectory – tends to feel less alarming than the rises we witnessed in the first year of the pandemic.
“We’re built to react to change. We don’t react to steady state,” said West. “Something will have to change in people’s psyche to make people feel like we need to do more about it.”
This may have been reflected in the health secretary’s apparent lack of concern when asked on Thursday about the continuing high rates of infection. “Overall things feel quite stable at this point. The numbers are a bit up, a bit down over the last few weeks,” Sajid Javid told Times Radio.
According to West, accepting steady state is a question of framing. “There are steady states that appear troubling for humans,” he said. “By virtue of the fact that’s it going to go on and on … the public may start saying: ‘We can’t keep having 1,000 deaths a week.’”
A possible trigger for such a reappraisal may be the continued strain on the NHS. Hospitals may not be “overwhelmed”but figures released this week showed that 5.7 million people were on waiting lists at the end of August, the highest figure since records began in 2007.
“We’re not back to normal, it’s as simple as that,” said Prof Tim Cook, a consultant in anaesthesia and intensive care medicine. With about 20% of ICU beds and 10% of hospital beds occupied by Covid patients, there is no prospect of an imminent return to business as usual.
“That proportion will continue to slowly occupy hospital beds for many weeks or months to come,” Cook said. “I don’t see an end to this level of occupancy for quite some time.
However, there is disagreement even among health professionals about what an acceptable “steady state” would be for Covid.
“Some still support a zero Covid model, with an aim of having no cases, while others are accepting of the current situation, in which we have about 40,000 cases,” said Andrew Goddard, president of the Royal College of Physicians.
“We have all accepted – doctors included – 10,000 deaths from flu each year so this tells us much about what we might accept with regard to Covid, although the impact on the most deprived parts of society and on certain ethnic minorities may reduce tolerance for such levels.”
The new normal?
It is not yet clear where the UK public sits on this continuum and some push back at the notion that there is an acceptance of the current situation.
“The idea that everyone is accepting the new normal is very dangerous,” said Prof Stephen Reicher, a psychologist at the University of St Andrews. “Then you reinforce a sense of fatalism.”
Reicher points to a wealth of evidence in psychology showing that our behaviour can be shaped to a greater extent by what we think others think than by our own beliefs. “If your attitude is at odds with a perceived social norm, you’re less likely to act on it,” he said.
According to Reicher, the government has been “systematically normalising” the UK’s current rate of infections.
“They’ve been acting like this is inevitable, seeming relaxed about infections going up,” he said. “People often want a generic psychological explanation, but we mustn’t ignore the political and ideological context in which this is happening. We’re looking at a phenomenon of normalisation.”
A powerful way of normalising a situation is to explain it through a natural phenomenon, for instance putting the ongoing spread of Covid down to the virulent properties of the Delta variant.
The media also plays a role in setting a perception of what is “normal”, according to Reicher. “[Research shows] that the media changes virtually nobody’s mind,” he said. “But it changes people’s belief about what others think.”
The most recent surveys show that the public retain cautious attitudes on Covid safety. However, there is a widening gap between attitudes and behaviours.
To some, the lack of public reaction to the ongoing death rate is bewildering. “It feels very surreal that we are just accepting the current infection rates. No one is making a fuss about it, but well over 100 people are dying every day due to Covid,” said Kit Yates, a senior lecturer in mathematics at the University of Bath.
Yates points out that, while vaccination has changed the outcome of high Covid rates, having so much virus in circulation is not without consequence.
“The current death rate is equivalent to over 40,000 people a year dying of Covid. This is not normal,” he said.
“The government has abandoned all pretence at public health measures to control Covid. It’s a national scandal, but one which seems to have largely slipped from view.”