The World Health Organisation defines public health security as: "the activities required to minimize the danger and impact of acute public health events that endanger the collective health of populations living across geographical regions and international boundaries," adding that "all countries have a responsibility to keep their people safe". Two leading European countries, whose populations are suffering from outbreaks of COVID-19, are faring very differently in terms of meeting the WHOs definition of adequate health security.
Figures from Johns Hopkins University published on April 9th show that of approximately 1.5 million COVID-19 cases worldwide, over half are in Europe. To date, according to the figures, there have been 88,554 deaths from the virus and 330,163 recoveries.
The figures show that in the United Kingdom, there have been 60,733 recorded cases with 7,097 deaths. Germany has recorded 113,296 cases and 2,349 deaths.
Data from Johns Hopkins published on 8th April showed that Italy has the highest case-fatality ratio in the world, with 12.7%. The UK is second with 11.6%, while Germany's ratio is 2.1%.
While there are likely to be multiple inaccuracies in the COVID-19 data at this early stage, but the statistics provided comparing these two countries with comparably sized economies, contrast so starkly that they may have political repercussions. The UK government, which has been led by the Conservative party since 2010, may soon be called to provide answers to parliament about why a country at a similar developmental level to the UK, Germany, appears to have far higher levels of health security.
The opposition Labour party recently elected a new leader, Sir Keir Starmer, and they will be able to point to their own manifesto, which pledged far higher spending on public health than that pursued by the government over a decade. Critics of the Conservatives' handling of the pandemic will also be able to point to figures from the UK's Office of National Statistics comparing public health spending in different countries. ONS statistics for 2017 show that the UK government spent £2,989 per person on healthcare. That same year, Germany spent £4,432 per person. Furthermore, Organisation for Economic Co-operation and Development data published in 2019 on numbers of hospital beds also revealed a sizeable gap between the two countries. The UK has 2.5 beds per thousand inhabitants, while Germany has 8.0 beds per thousand inhabitants. In November 2019, there were 127,000 hospital beds in the UK. This is the lowest number in the history of the National Health Service and the lowest of any European country. At its founding in 1945, the NHS had 400,000 beds to cater for a population that was tens of millions lower than it is today.
During the onset of the pandemic, Germany was quicker to roll out mass testing, while the UK rejected WHO advice in this regard. Critics of the response of prime minister Boris Johnson might also recall the initial government move towards 'herd immunity' which was quickly scrapped, but which added to the sense of indecision in London.
Also potentially damaging to the UK government could be the publication of the suppressed report on the UK's 2016 pandemic drill, codenamed Exercise Cygnus, which tested the country’s readiness for a health crisis on the scale of COVID-19. It is understood that the country's chief medical officer Professor Dame Sally Davies asked the government to act accordingly when the report concluded that the country would find itself ill-equipped for a pandemic, but they ignored the request. The report also specifically warned about the lack of ventilators in the country, something that has become an acute crisis during the COVID-19 outbreak.
Ministers, and Johnson himself, may have to answer as to why actions were not taken following the pandemic drill and why the Department of Health buried the report. Health security could be a key political issue in the UK for the foreseeable future.
