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Views And Reviews Acute Perspective

David Oliver: Soundbites won’t solve a pandemic

BMJ 2021; 374 doi: (Published 01 September 2021) Cite this as: BMJ 2021;374:n2121

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  1. David Oliver, consultant in geriatrics and acute general medicine
  1. Berkshire
  1. davidoliver372{at}
    Follow David on Twitter @mancunianmedic

The former BBC director general Mark Thompson, in his 2016 book Enough Said, explored the rise of simplistic, populist rhetoric in politics and public discourse at the expense of complexity, nuance, and professional expertise.1

We’ve often experienced this soundbite culture in trite and simplistic statements about our response to the covid crisis. Slogans and quick fixes may sound attractive. They’re more digestible than the nuanced, messy, multifaceted reality of a pandemic virus with variables that can’t always be controlled or predicted. But a soundbite isn’t a logistical, risk assessed plan—something that the hard realities behind “Get Brexit done” have illustrated.2 Just saying something doesn’t make it so.

In England’s covid response, the politicians have proved fond of three point sloganeering: “Hands, face, space”; “Stay alert, save lives, protect the NHS”; and, after “freedom day” on 19 July, “Keep life moving.”3 At least the first of these contained some health protection suggestions for the public to follow, whereas the second and third are merely ambiguous and opaque.

The government has also been obsessed with quoting big numbers or targets to achieve these aims—“100 000 tests a day”;4 “761 million pieces of personal protective equipment”5—as if these were ends in themselves, when what matters more is whether people who need the tests or equipment can access them in a timely fashion and whether they’re effective at reducing transmission. At least the government’s boasts about the success of the vaccination rollout related to a key solution in exiting the pandemic.6

Beyond our ministers and government communications teams, however, are some more simplistic soundbites. For example, from some quarters we’ve heard, “Stop telling us to protect the NHS. It should be there to protect us.”7 That may sound compelling, but the NHS has only limited beds, staff, and resources, with no ability to expand capacity at pace. It’s a universal public service for the many. Without the sometimes restrictive public health protection measures to reduce pandemic load, the service could have become so overwhelmed that many other people and their families would have died avoidable deaths. The Equality and Human Rights Commission highlighted this balance between individual freedoms, the collective good, and risks to rights and wellbeing from any road taken.8

In a similar vein, we hear that the NHS has favoured covid patients at the expense of people with other conditions,9 as if completely avoidable decisions were made to sacrifice non-acute care. To be clear: if intensive care facilities have doubled in size and are relying on anaesthetists, staff, and equipment from operating theatres; if one in three acute beds is taken up by someone with covid; and if vulnerable people would be at risk by coming to that same building—there isn’t an easy choice.1011 The soundbite doesn’t come with any workable solutions.

“Why didn’t they just use the Nightingale hospitals for covid patients?” is another one. But how, without the staffing and resources needed to run them?12

Another favourite is, “We’ll have to learn to live with covid,”13 often followed by comparisons with seasonal flu.14 Short of “zero covid”15 approaches (another buzz phrase in want of a sustainable action plan), what does that actually mean? It seems to be used by people opposed to behavioural restrictions or protective measures. But maybe “living with the virus” means continuing with some physical distancing, some indoor mask wearing, some testing, and, of course, vaccination.16 What are the concrete policy implications?

As the UK’s response to the pandemic has shown, I wouldn’t rely on people who coin or repeatedly quote soundbites to run anything beyond an advertising or election campaign—let alone a response to a global pandemic.