How is living with the virus going for you? In the UK, 1.2m people in the second half of March were literally living with the Covid virus—many from their sickbeds, and some from hospital. At the start of April, infection levels in England are now the highest ever: around 1 in 13 people. Tragically, between 150 and 200 people a day have been unable to keep living with the virus at all. The Omicron variant has stormed across the country, just as it stormed through Norway and Denmark at the start of the year. It is wreaking havoc in Hong Kong and has put parts of China, including Shanghai, into lockdown.
Odd, then, to hear former health secretary Matt Hancock say that “we had to get to a place where we could deal with Covid like we do with flu. That’s exactly where we are now. The pandemic is over.” It seems no one has told the virus.
Hancock—who was forced to resign from his post after being caught breaking lockdown rules in an extramarital clinch with a work colleague—has set out his position in an article in the Daily Mail. If it is any indication of the current orientation of the British government, then it is deeply troubling: an unserious mixture of denial, rewriting of history, and infantilisation.
Not only is the pandemic over, says Hancock, but the country has emerged from it pretty well, all things considered. “Thanks to the vaccine, and the prime minister’s leadership—removing all remaining restrictions before any other major country in the world—we finally have our freedoms back.”
“There’s no prospect of a lockdown,” he reassures us, because “we’ve done all we can.”
This narrative implies that the only alternatives are lockdown or “freedom.” It’s an infantile view that appears to be guided more by political expediency than by a concern for public health, and plays into an emerging tendency to regard any mitigation measures either as a de facto lockdown or a Trojan horse for reintroducing it. Some press commentary implied that the dropping of all Covid protections in the UK in late February—brought forward by a month in a move that many regarded as a ploy to distract from the “Partygate” scandal—was itself the “end of lockdown,” even though the UK had by then not been in lockdown for almost a year. “Lockdown” has, in this view, come to be associated with any measures to prevent transmission: the hallmark of a state determined to suppress personal liberty because of dubious, fearmongering models by scientists.
Has the government come to believe its own convenient fantasies?
In reality, there are no serious suggestions that the current Omicron wave requires a lockdown, and nor should there be. The spread of the virus, now mostly of the newer BA.2 variant, which has perhaps as much as 30 per cent greater transmissibility, might instead be slowed by the kind of low-cost, minimally inconveniencing measures that were in place before 24th February: mandatory mask-wearing in public places where infection is likely (such as on public transport) and mandatory self-isolation for those who test positive, with appropriate support for loss of earnings. But even testing itself is no longer available for many people. The distribution of free lateral flow tests, and the provision of free PCR testing, has now been discontinued even for symptomatic people—although to all intents and purposes LFTs have not been available for weeks anyway (as anyone who tried to order them recently will have discovered).
What’s more, other monitoring programmes are being stopped. Funding for the React study, which surveys 150,000 people every month to assess levels of Covid infection across England, and for the Zoe study that tracks individuals’ reports of Covid symptoms via a phone app, is being cut. “It’s ironic that after so much boasting about being ‘world-beating’ on vaccination and test and trace”, wrote mathematician Kit Yates in the British Medical Journal, “the government is axing one area of the UK’s Covid response that genuinely is world-leading— our surveillance capabilities.” The withdrawal of funding for these projects, Yates says, “is consistent with the government’s ongoing quest to convince us that things are ‘back to normal’ by removing the ability to properly track what’s happening with Covid.”
“This is about as far from ‘following the science’ as you can get,” virologist Stephen Griffin has said. “Losing these programmes will almost certainly end up costing more in terms of disruption than saved.”
And there is little coordination of the remaining scientific efforts to track and assess the pandemic, as Sage has been stood down. None of these steps makes any sense from a public-health perspective. But they are all politically useful because the prime minister, beleaguered by the incessant stream of gaffes and now facing fallout from the police inquiry into the Downing St lockdown parties, is reliant on the support of the libertarians in his party. Declaring the pandemic over, in defiance of all the facts, is a political gambit. It might not even save any money, given the economic costs of severe disruption to the workforce through illness; it is certainly impacting on schools, which have been facing renewed teacher shortages because of Covid absences.
But has the government come to believe its own convenient fantasies? The indifference, even denial, ministers are displaying is staggering in the face of such dramatic statistics. When, in response to a request in the House of Commons that free tests be retained, the health minister Maggie Throup asserted that they are no longer needed because “we have moved on and broken the chain of transmission with the vaccination programme,” it is genuinely difficult to fathom what she thinks when she looks (as we must at least hope she does) at the recent charts of soaring infections. It is all too evident that vaccination is a highly porous barrier to Omicron—but the political respite granted by the early rollout of vaccines has, in the eyes of some ministers, given it a quasi-magical status as an invocation that will dispel all devils.
In any case, we still don’t know whether vaccines confer any protection against long Covid for those who catch the virus. That the vaccines have severely weakened the link between infection and death is what enables us now even to contemplate an eventual end to the pandemic. But to make this the sole determinant of policy, and to ignore the long-term health toll of Covid-inflicted disability, would be a grave error.
For Hancock, meanwhile, it is now time for unseemly crowing about those countries “who at first were lauded for their ‘zero Covid’ response” by keeping “high levels of restrictions throughout” the pandemic. Now, he says, they “have a significant problem… Countries like China now find they are unable to live with Covid like the flu as we are. They don’t have the levels of immunity.”
Hancock’s implication is that a zero-Covid approach failed to create a high level of immunity in the population through natural infection—an echo of the “herd immunity” idea that has never really gone away. But that is dangerous nonsense.
By mid-March, the death rate in Hong Kong was more than twice as high per capita than that in the UK during the terrible second wave, whereas the severity of preventative measures had until recently kept Hong Kong’s death toll to below 200 people in total. The key reason for this was a disastrous mishandling of Hong Kong’s vaccination programme, not levels of infection-acquired immunity. Instead of taking the sensible approach of focusing first on vaccinating the at-risk elderly, Hong Kong has delivered jabs across the board. So while 85 per cent of its population has had at least one dose, by February only 50 per cent of those aged 70-79 had had a double dose, and only just over 20 per cent of those aged 80+. Why the uptake was so low isn’t clear, but it is possible that the previously almost non-existent infection rates removed any sense of urgency. There seems also to have been a tendency for the Hong Kong media to play up scare stories about vaccine side-effects.
In other words, the problem was not a zero-Covid policy per se, but the absence of a good exit strategy. In New Zealand, by contrast—which famously kept itself Covid-free for most of the pandemic with stringent measures—Omicron is also running rampant, but the excellent vaccination coverage (more than 90 per cent fully vaccinated for all ages above 12) has kept new deaths since March to just 150 or so. (This contrast, incidentally, could hardly provide a stronger indication of how lethal anti-vaccine rhetoric can be.)
The early start for the UK’s vaccination programme was indeed impressive, although tarnished by Johnson’s repeated false claim that Brexit somehow enabled it. But it made little difference in the long run: the UK’s current vaccination coverage is now nothing special, mid-table among European countries.
Besides, even in Hong Kong the cumulative per capita death toll is still a tiny fraction of that of the UK—and if, as suspected, the Omicron peak is sharp and swift, it will stay that way. The zero-Covid strategy could then still be argued to have paid off—all the more so when accompanied by a good vaccination programme, as in New Zealand.
Tolerating high rates of infection simply because the vaccines can keep deaths low is in any event a risky strategy. As the emergence of the highly transmissible BA.2 shows, the virus still has scope to do worse—and the greater the prevalence of the virus in a population, the greater the risk of other new variants. There is absolutely no reason why SARS-CoV-2 could not produce a variant even more able to evade immunity and cause serious illness. We might get lucky and avoid that, but the best way to do so is to keep infections low. There is no law of nature that dictates a progressive weakening of the virus’s ability to do harm.
Instead of attacking the scientific basis for lockdowns, we should ask why we were so poorly equipped to handle them
Hancock’s misrepresentation is just one intimation of efforts to rewrite the history of the pandemic before the public inquiry finally begins collecting evidence, which seems unlikely to happen this year. Despite what Hancock claims, the fact that deaths per capita in the UK have been comparable with those in France and Germany is not particularly laudable. It simply shows that, as global health expert Devi Sridhar points out in her new book Preventable, many well-resourced and wealthy western nations fared far worse than one might have expected. Sridhar’s judgement is that “no one could have anticipated that the US and UK, consistently ranked by pandemic preparedness indices as the top two countries for capacity and readiness, would suffer as badly as they did.”
And while Hancock admits that “there were mistakes,” he suggests these were other people’s. For example, he says that he was misinformed about asymptomatic transmission. “In early 2020, we were told over and over again that Covid could only be transmitted by people when they did have symptoms,” he said. “I remember phoning the WHO when there was one report out of China saying there might be asymptomatic transmission, but their response was: ‘no we think that was a mistranslation.’” But in fact, a report of asymptomatic transmission in China was publishedin the Lancet on 24th January 2020, and could have been incorporated into the policy response from that point on.
We must expect to see more of this back-covering and whitewashing as the inquiry moves closer. Such behaviour will, I fear, be accompanied by an anti-scientific backlash that is perhaps already here. In a speech in late January, Conservative MP Bob Seely alleged of the lockdowns that “Thanks to some questionable modelling—poorly presented and often misrepresented—it is true to say that never before has so much harm been done to so many by so few, based on so little potentially flawed data. It is a national scandal.”
“Modelling and forecasts were the ammunition that drove lockdown and created a climate of manipulated fear which was despicable and unforgivable,” Seely said, blaming “hysterical forecasts” from the pandemic modelling group at Imperial College, led by Neil Ferguson, in particular. The Spectator has spearheaded attacks on the Imperial team, sometimes selectively misrepresenting what the modelling actually forecast. The right-wing American Institute for Economic Research, which supported the anti-lockdown Great Barrington Declaration (and has flirted with climate-change denialism), has made the ludicrous allegation that “the epidemiology modeling of Neil Ferguson and Imperial College played a preeminent role in shutting down most of the world” and “may well constitute one of the greatest scientific failures in modern human history.”
It's undoubtedly true that the UK lockdowns caused a great deal of harm—economically, educationally, socially and psychologically. That is precisely why most scientists regard them as a policy of last resort, and indeed an admission of the failure of other containment measures. But the consequences of lockdowns have varied widelyacross the globe, because they depend on the robustness of the society in which they happen. “Other countries were far more resilient in terms of social care, health and support structures,” says Griffin. “Deprivation maps onto Covid impact in the same way it does other measures of health inequity, foodbank use [and] poverty.” The answer is not to attack the scientific basis for lockdowns—there is plenty of evidence that they saved lives—but to ask why we were so poorly equipped to handle them.
Although the pandemic is most certainly not over, we’re surely now at a point where it is appropriate—and indeed essential—to stand back and take stock. But such evaluation is itself filled with hazard, not least for the scientists who tried (with varying degrees of success) to steer policy. They cannot afford to leave it to others to write the history—nor, indeed, to recuse themselves from ongoing strategic decisions. They must wish as fervently as the rest of us to see the back of this virus, but sadly their job is far from done.
