The government’s reliance on its triumphant vaccine rollout as a trump card for difficult questions, regardless of topic, is wearing thin—not least because it is no longer such a strong card anyway. Despite speedy initial progress, the proportion of the British population who have received at least one shot is no longer significantly greater than that of many other countries. The current figure of 68 per cent in the UK is comparable with Canada and Chile, while the US and most European countries have proportions of between 50-60 per cent; by May, continental Europe had mostly recovered from its disastrously slow start. So while Boris Johnson claimed at the press briefing on 5th July that “What we have achieved with the vaccine rollout has put us in a very strong position with comparison to many other countries,” that is no longer really the case.
On actual Covid infections it’s another story—and not at all a happy one. Although Spain, Poland and Russia are currently hard-hit, the UK has become Europe’s Covid hotspot, with typically several hundred people per 100,000 carrying the virus—many tens or even a hundred times higher than much of the rest of the continent. In other words, not only does the UK no longer seem so obviously to be winning the vaccine race (for which of course there is in truth no winner at all) but it is doing very poorly at containing the virus.
Infections are now rising exponentially in the UK, and if the matter were being determined on those figures alone then we would surely be facing another lockdown, rather than a lifting of all restrictions on 19th July as the government intends. Thankfully, however, the protection afforded by the vaccines is keeping hospitalisations and deaths low. With so many older people fully vaccinated, infections are currently greatest among young people who are at much lower risk of serious illness.
That doesn’t mean this third wave is not a concern. For one thing, the vaccines don’t offer complete protection. Even some people with double doses are catching the virus and getting badly sick from it; a few are dying, and more will do so. Several thousands more deaths are forecasted over the summer, while hospitalisations could reach two thousand a day. What’s more, the shadow of long Covid is looming ever larger: hundreds of thousands are now suffering from it, experiencing symptoms including exhaustion and “brain fog” many months after being infected. One recent study suggests that more than two million people in the UK might have, or have had, some form of long Covid. And even young people can get very ill: small fractions of very large numbers are still big in absolute terms.
But there is an even graver cause for worry. As Steve Paterson, co-director of the Centre for Genomic Research at the University of Liverpool, has put it, “Letting a virus rip through a partially vaccinated population is exactly the experiment I’d do to evolve a virus able to evade immunity.” The high rate of infection is partly due to the reduced efficacy of the vaccines against new variants of the virus, especially the delta form first seen in India, as well as their faster spread. Already the greater vaccine-resistance of these variants seems to be because of their ability to actively suppress our immune system—a strategy that can’t obviously be countered by a straightforward retooling of the vaccines.
Although vaccination seems largely able to protect against severe illness even in jabbed people who get infected nonetheless, high levels of infection create a big pool within which new variants can emerge by random mutation of the viral genome. And widespread vaccination creates a strong selective pressure for a vaccine-evading form. The nightmare scenario is that eventually a fast-spreading form of the virus might emerge against which the vaccines don’t confer significant protection at all.
That’s one reason why many scientists are deeply troubled not only by the lifting of the restrictions of 19th July but by the government’s apparent willingness—some say its desire—to let Covid spread freely among unvaccinated schoolchildren in a kind of age-limited version of its original herd-immunity plan. Infections are currently highest among children and people under 24, who are mostly unvaccinated. Very few children—albeit some—will experience significant illness. But they will maintain a large viral population: a cooking pot for new variants. Whether or not children should be vaccinated is still being debated by the UK’s Joint Committee on Vaccination and Immunisation, which must balance the tiny risk of side effects in young people against the comparably small danger of serious Covid—and also, one hopes, the continuing hazard for the rest of society posed by widespread infection of the young.
How did we get here, when the vaccine rollout seemed to be going so well? It’s no secret that the government’s tardiness in implementing travel restrictions, especially from India, in April probably allowed the delta variant to gain a strong foothold in the country. That decision was never explained by ministers, just defended with untruths. Had delta not been allowed to gain such a foothold, says Christina Pagel, professor of operational research at University College London, we could have got away with relaxing the restrictions while most of the population had still received only one jab.
But it’s not just about delta. The government’s monotonous parading of its vaccine performance in fact betrays a misguided belief that vaccination alone will be the way out of the pandemic. Pagel says it has failed to introduce other measures to slow spreading, such as making sure Test and Trace is working well (with adequate support for people who need to isolate), communicating the different symptoms of the delta variant (which can present more like a cold) and not investing in better ventilation in workplaces and schools.
In the face of all this, the government’s determination to relax all restrictions looks like a foolhardy gamble. However, even those who oppose that move must acknowledge that there is some justification for relaxation. The country is exhausted by the current measures, and many businesses are close to collapse, especially in the hospitality industries. Besides, as Dominic Wilkinson, Professor of Medical Ethics at the University of Oxford, has said, in making this decision politicians are not only permitted but obliged to admit other considerations besides the scientific. “Some have claimed that the government is not ‘following the science’ in planning to relax the rules,” Wilkinson said. “However, science cannot tell us when to unlock. That depends on what we choose to prioritise. Like all major policy decisions during this pandemic, decisions about relaxing restrictions are not purely scientific. These are ethical questions."
Yet that doesn’t justify doing away with all measures, regardless of how minimally disruptive they are, in a symbolic demonstration of a commitment to “freedom.” Making mask-wearing a matter of “personal responsibility” for example, is breathtakingly disingenuous, if it is not motivated by simple ignorance. Efforts of public health workers throughout the pandemic to explain that masks are worn to stop the wearer infecting other people, rather than being infected, are now being ignored and undermined. As health psychologist Robert West of UCL put it, “It's like having a government that thinks road safety should be completely up to 'individual responsibility': no traffic lights, no highway code, no law about driving on the left, no crash barriers…” Stephen Reicher, a behavioural scientist at the University of St Andrews who, like West, advises the government’s Scientific Advisory Group of Emergencies (Sage), says “it is frightening to have a 'Health' Secretary [Sajid Javid] who wants to make all protections a matter of personal choice when the key message of the pandemic is "this isn't an 'I' thing, it's a 'we' thing.” The chief medical officer Chris Whitty commendably said that one situation in which he would always wear a mask is when anyone else let him know they felt uncomfortable with his not doing so. But with mask-wearing already so politicised, making it optional will inevitably allow—and indeed goad—some to refuse in such a circumstance, creating a recipe for more social conflict. As Peter English, former chair of the British Medical Association’s Public Health Medicine Committee, has said, “Allowing people to make their own choices [about masks] is, effectively, handing control of the safety of [public] spaces over to the least informed, least caring, and indeed the most callous members of society.” He calls it “a gross failure of leadership.”
Mask-wearing is, after all, a measure that costs virtually nothing in effort or money, and would serve to remind people that things are not back to normal, whatever the government might say. But perhaps that’s the problem.
The same is true for the planned abolition of the bubble system at schools, imperfect though it is, and the removal of the requirement for children to self-isolate if they might have mixed with an infected pupil. And as Pagel says, there has still been rather little done on one of the most effective and simple measures for lowering transmission in schools: improving ventilation, which Sage says could be having much more impact in reducing transmission than it currently is.
Johnson and Javid seem resigned to the current rapid growth in infections as a necessary price to pay for “freedom” and economic opening up. But a new paper from Sage argues that “there remain many advantages in maintaining both low prevalence and R<1” (meaning that infections are not growing). It then becomes easier to suppress local outbreaks and to conduct Test and Trace effectively, and it reduces the chance of new variants, the incidence of long Covid, and the continued disproportionate impact on lower-income and deprived groups. And if dangerous new variants do necessitate another lockdown, starting from a position of high incidence means that “restrictive measures would be required for much longer.” In other words, the government might yet again be literally making a false economy, failing to learn the lesson that caution on health will benefit economy in the long run.
A mature leadership would, if opting for the risky strategy of opening up, develop a careful package of measures to navigate through the bad situation we are in. It should explain honestly and carefully to the public that a full relaxation of restrictions at this point does not come with a scientific stamp of approval and that this is a gamble, not an act of largesse and liberation. Instead, Javid has implied that the much lower rates of hospitalisation and death, thanks to the vaccines, constitute a “health case” for opening up—turning a “less bad” into a “good.”
It’s disturbing too how Conservative ministers and MPs, and their supporters in the press, are framing the government’s position as “reclaiming our freedom.” As scholars of both Orwell and Maoism are well aware, keeping the populace in line by telling them they are struggling against an imaginary oppressor or foe is a well-known authoritarian tactic. Some have already identified that foe compromising our freedoms as the scientists themselves, especially Whitty and the chief scientific adviser Patrick Vallance—dubbed Doctors Doom and Gloom by the rightwing press and MPs. The consequences of that imputation were horribly evident in the recent recurring harassment of Whitty.
One might assert that the real enemy of the freedom-loving British people is the coronavirus itself. But giving the pathogen this oppressive autonomy is not dissimilar to making the Northern Ireland Protocol a kind of spontaneously generated threat to our “freedom” to exchange goods without border checkpoints across the Irish Sea. Here, as in that case, any constraint on our “freedom” has actually come from the actions of the government itself: from restrictions partly made necessary, or prolonged, by procrastination and incompetence.
While vaccines never could be the sole solution to this crisis, the UK did once seem well situated to make them a key part of it. That advantage has been squandered, and now we will have to pray that a new variant doesn’t send us back to square one. You might imagine that ministers would have seen enough of their false and premature reassurances evaporate to avoid creating yet more hostages to fortune. Sadly, however, there is still no sign of any thinking beyond the performative gestures of the moment.
