Every Loser Wins

Once a war to win, the management of the COVID-19 pandemic is shifting into a new way of life. The new rhetoric is key so we don’t throw our toys out of the pram as we face our ‘failure’. Instead, this may just allow us to learn from mistakes and be better prepared for the future.

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I am a spectacularly bad loser

Weirdly “winning” tends not to offer me a tremendous amount of joy – but losing is something I take preposterously personally. So great is this affliction that I actively avoid anything that could be construed as a competition, lest I revert back to the Monopoly board flipping child that lurks constantly beneath the surface, just waiting for the opportunity to protest that everyone else is cheating, and storm out of the room.

Thus, when the ongoing struggle to contain COVID-19 started to be coached in military terms, I became increasingly uneasy. Wars after all, are things that can be won or lost.

The era of the ‘COVID war’ – a call to fight and a political stand

Of course, I can understand the rhetoric. It’s incredibly hard to talk about the subject without reverting to words like “fight”, “battle” or “war”. When dealing with a somewhat abstract emotionless disease that threatens to harm those we love, it’s so much easier to cast it in the role of an invading force. In the past we’ve used similar language as a metaphor for treating other health problems – most notably cancer – in the hope of motivating us, and putting us on alert for that unseen enemy.

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It’s politically useful too – “war” in particular is a shortcut to evoking patriotic fervour and jingoism. Certainly, politicians seem to enjoy reaching for it. Matt Hancock in particular employs the metaphor again, and again, and again. What better way to get a nation into the mindset required to surrender its freedoms, than to evoke the Spirit of the Blitz? War metaphors have another, darker, political function as well. Once you accept you are at war, you have acknowledged there will be casualties. War might get the emotions stirring, but it also brings with it the unspoken promise of death. “Of course there’s a high mortality rate”, runs the subliminal message, “we’re at war after all. What did you expect?”

Which is, of course, one of the problems with such language.

The wounded of the war rhetoric

There is evidence to suggest that battle metaphors are actively unhelpful when talking about cancer – they emphasise the idea of difficulty, encourage fatalism, or conversely make those who “lose” feel guilty for not “fighting”. One can’t help but wonder whether such metaphors are equally unhelpful when discussing COVID. Does talking of war really engage us in battle – or lead us to surrender to a force that feels too overwhelming to contemplate? Why wash your hands, or wear a mask, when the enemy has us surrounded?

Which brings us back to the question of losing.

If we’re to look at COVID-19 in the context of war, or a simple binary contest to be won, then the difficult reality is that by nearly any metric, it appears we’ve lost. To lessen the pain, let’s break it down via the reassuring medium of Star Wars titles:

The Phantom Menace

There was a point in the last year when we were hopeful, confident even at first, that we might somehow keep the virus out of the country entirely or suppress its spread. Then as those defences quickly crumbled, we turned to the belief that we could eradicate it ­– that herd immunity (either acquired from vaccine or reckless rampant infection) would render it nothing more than a distant memory, to be filed in a drawer in a lab somewhere next to the smallpox.

A New Hope

The vaccine programme was the new hope – the vaccine centres hastily cobbled together in mere weeks by GPs the awkward metaphorical equivalent of fishing boats off the coast of Dunkirk. All we had to do was somehow vaccinate everyone in the country, and we’d be saved.

The Empire Strikes Back

Except, of course, the virus did what we always knew it would. It changed. First there were mutations seen in the mink population in Denmark, leading to a mass cull, and surreal news reports of Zombie Mink rising from their graves. Pretty soon we were discussing mutations from Kent, South Africa and Bristol, with changes stoking fears that the virus was developing resistance faster than we could vaccinate. Meanwhile there were suggestions that treatment with convalescent plasma actively drove up mutation.

It seems likely that vaccination will continue to greatly reduce individual morbidity and mortality (please, if you’re offered a jab, have one), but that despite this the virus itself is here to stay. Matt Hancock has dropped the references to war, and has graduated instead to a position of appeasement – stating that he hoped that COVID would become a disease “we can live with, like flu”. That’s roughly equivalent to a shift from “we will fight them on the beaches” to “we’ll invite them in for a nice cup of tea, and hope they don’t break anything”. If nothing else, Mr Hancock appears to be worryingly unaware that plenty of people are sadly unable to “live with” flu every year.

The Force Awakens

So – if the ongoing labours to control COVID-19 are a war, then it doesn’t look good. The invading force has well and truly established itself on our soil, and our Government is describing a situation in which we manage to live alongside one another as a position to be “hoped for”. We have, put simply, lost. Let’s throw the chess pieces across the table, kick over our chairs, and go to our bedrooms to sulk…

Except, of course, it’s not a war

There is no winning, or losing, there is simply How It Is. Which is a situation both nowhere near as good as we would have liked, nor as terrible as it might have been, or might yet become. We have a new virus to sit alongside the many we already endure – a recurring event in the history of mankind, and merely novel in our brief lifetimes.

To be fair, Matt Hancock’s statement might have been badly phrased, but I don’t think it was wrong. It does seem likely that COVID will become an established part of our lives, and sometimes our deaths. As such perhaps it was an attempt to move the rhetoric back to a more rational position, either because common sense had won the day, or more likely because admitting to losing a “war” is not a position any Government tends to embrace.

Growing up and learning from our mistakes

Certainly if we have “lost” against COVID, then we have a lot to learn – and despite the tragic deaths of 2.4 million people and counting, it’s perfectly possible that when the next pandemic hits (and it will) it could be considerably more deadly yet. That then, is the greatest danger of all this talk of war, and of winning and losing. That it encourages us to avoid the hard reality of our “failure”. We cannot afford to act like petulant children. We need to look calmly and critically at all that we have done, at every mistake we have made, and learn how to ensure we don’t make them again.

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Chris Preece

GP Partner

I've worked as a GP Partner in North Yorkshire since 2004, and still relish the peculiar challenge of never quite knowing what the next person through the door is going to present with. I sat on the Governing Body of my local CCG until April 2015, and despite thinking I had escaped that world for good, I'm now the Clinical Director of a Primary Care Network. When not being consumed by all things medical, I occupy myself by writing, gaming, and indulging the whims of my children. I have previously written and performed in a number of pantomimes, occupied the fourth plinth in Trafalgar Square and won the 2016 “Caterpillar Story for Children Prize”. Tragically, my patients no longer tell me I look too young to be a doctor.
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