Throughout the pandemic, the UK government has made a name for itself in repeatedly defying the prevailing logic of the time, at a cost of thousands of lost lives: delayed lockdowns; the care home scandal; failed testing and tracing; open, porous borders – these policies have been rooted in negligence or good old-fashioned British hubris, the sense that our way is the only way.
Not every decision has culminated in disaster and death. Quite the opposite. In the eyes of many, Britain’s vaccine success has papered over the gaping cracks of the past 18 months. By investing in the Oxford vaccine, building a comprehensive portfolio of jabs and adjusting the guidance on the dosing intervals, the UK demonstrated its ability to act pro-actively – rather than reactively – and take its first steps forward against Covid-19.
Now, the UK once again finds itself walking down a path that few others have yet dared to explore. In lifting all restrictions, reopening society and expecting the British public to “live with the virus”, as health secretary Sajid Javid proclaimed last week, the government is once again rolling the dice.
It is not so much the act of ‘unlocking’ which is being contested among the scientific community. It has been an inevitability from day one that we will, at some point, emerge from this half-life existence. Pandemics cannot rage forever. There is a beginning and an end. But it is the timing of the UK’s great national release which has set alarm bells ringing for many.
Cases are rising exponentially. Some 171,000 new infections were reported in the UK last week. The seven-day rolling average is now higher than it was back in autumn last year, when the so-called “circuit-breaker” was reluctantly enforced by Boris Johnson. That hospitalisations have not risen in tow is testament to the power of our vaccines. Research suggests that these life-saving tools have so far prevented an estimated 7.2 million infections and 27,000 deaths in England alone.
Yes, the vaccine wall has been built up high, but it is by no means complete. Only two doses offers high levels of protection against the Delta variant – yet nearly 40 per cent of the adult population are still waiting for a second jab, putting them at greater risk of hospitalisation or long Covid once restrictions are lifted on 19 July.
Of course, the elderly and clinically vulnerable – those most susceptible of being submitted to hospital – have been fully immunised. But “whilst the link between infections and severe disease has indeed been weakened by vaccinating the older members of the population, it most certainly has not been broken, and a strong link to morbidity remains,” says Dr Stephen Griffin, a virologist at the University of Leeds.
Raising the wall even higher before the great unlocking would therefore only serve to strengthen the UK’s hand, not weaken it, and better prepare the four nations to “live with the virus”. Greater immunity across the population would cut transmission, reverse rising infection rates, shrink the viral pool in which Sars-CoV-2 can mutate and take the heat out of the health system, which is now facing a daunting backlog of patients.
Indeed, those unvaccinated or partially protected individuals who are hospitalised with Covid – even at a low level – will have a big impact on capacity, as nurses and doctors attempt to refocus their attention on the millions of patients requiring treatment and care. The NHS lacked the bed space long before the pandemic, and new infection rules, which mean some beds have had to be removed to keep patients apart, has further exacerbated this issue. The Royal College of Emergency Medicine estimates the NHS could be short of 16,000 beds.
Allowing the virus to freely rip through communities will also widen the prevalence of long Covid, placing even further pressure on the NHS. Research suggests an estimated two million people have suffered from the condition at some point during the pandemic – a figure that will only rise with time. What demands will this place on our health services? What treatment will be required for the ‘long haulers’? How much more capacity will need to be built into the system? These are all questions that will need to be answered if we are to live with the virus and prepare the NHS for the months (and years) ahead.
But it’s not those questions which are the greatest cause for concern as we press ahead in unlocking, it is the evolutionary uncertainty of the virus. The more Covid spreads, the more opportunity there is for new mutations to emerge which, in theory, could render the vaccines ineffective.
“Ongoing replication that does not lead to hospitalisations and deaths, still allows the virus to mutate and generate new variants in the community – even without the international importation of new variants,” says Dr Julian Tang, a clinical virologist at the University of Leicester.
The chief scientist behind the UK’s booster trial went even further, recently telling The Independent that it is “fairly unthinkable” to suggest that we won’t be facing a new variant by the winter. What form and shape this variant takes is anyone’s guess.
But it’s safe to assume that it won’t help our situation in those winter months, especially at a time when flu and other respiratory illnesses are making their comeback.
In spite of the continuing threat posed by Covid, the government has decided it’s time the public has a greater say in how we live our lives. We are to be given the choice to wear masks or not, to keep our distance and avoid crowded spaces, to return to the office or work from home. It’s unreasonable to criticise Downing Street for this. These restrictions cannot persist forever. But in passing the baton of responsibility to the public, can this government confidently say it’s done everything in its power to make this a safe and secure exchange?