I hear people saying over and over again in interviews their greatest fear is that when restrictions are eased we’ll get another spike of infections and a further lockdown. So how do we dodge them?
We’re pinning our hopes on our exemplary vaccination rollout and it is undoubtedly bringing hospital admissions and deaths down. But on its own, vaccination isn’t enough, for us or any other country facing the same dilemma.
Lockdown is a blunt tool. We require more sophisticated tools to prevent them happening again.
On this subject I turn to Christina Pagel at University College London’s Clinical Operational Research Unit. She is always impressive with her lucid analyses of our problems and her crystal-clear exit strategies, as outlined in the BMJ.
She’s reassuringly unafraid to tackle bad news and tells us vaccines will certainly help us get out of lockdown, but alone they won’t suffice.
As she says, we don’t yet know to what extent vaccines prevent transmission of the virus, but even if they could we can’t vaccinate our way to zero cases.
We could do worse than learn from role models. By the middle of March, Vietnam had reported only 35 deaths in total, out of a population of 98million. Thailand had reported 89 (70 million population), South Korea, 1,688 deaths (51 million population), and New Zealand 26 deaths (five million population).
People in these countries have been out of lockdown for months. Following their lead, the way out is for the UK to pursue a national suppression strategy – zero tolerance for any community transmission – which Pagel says would protect ourselves from homegrown vaccine-resistant variants.
She proposes four steps to get us to a new normal. First, we need to continue to vaccinate the entire adult population as quickly as possible to prevent long Covid, severe illness, hospitalisations, and deaths. With luck this could also abbreviate transmission.
Second, we need to have strong restrictions in place until we have driven cases down much lower.
Third, we need to rebuild local contact tracing to drive cases down as restrictions are eased. New future outbreaks must be spotted quickly and stamped out, with financial support to isolate for those who test positive and their contacts.
Fourth, we need strong border control with negative tests before and after travel and 14-day managed isolation on entry for everyone, including returning citizens.
No one is safe until we’re all safe so we can’t realistically exit the pandemic unless all countries do. Without global suppression, a vaccine-resistant strain is likely to emerge and Covid will spread again. So it’s imperative we work internationally to ensure rapid vaccination worldwide.