Where next on COVID?

At the onset of January 2021 things were very grim, but there was a growing chorus of hope on the horizon. Sure, we were in the midst of our worst viral wave yet, and heading into a national lockdown, but we had vaccines, we had a plan to get the jabs in people’s arms, and it looked very likely we would be able to achieve a semblance of normality by the middle of the year; albeit perhaps a temporary or flexible one. The idea of COVID vaccines being the ultimate saviour of humankind has always been cautioned on by the experts, who have consistently said an effective vaccine is merely one part of a multi-pronged approach, which has never seemed more accurate than right now.

Viruses mutate. We didn’t give this much thought during the initial onset of COVID-19, but as we learnt more about the thing our great scientific minds went more in depth about the risks and the hopes for the future. The hopes were vaccines fostering some form of herd immunity, and society gradually adapting to COVID over the next few years how we’re now used to dealing with the flu, or measles, the risks were mutations of the virus, or immunity failing to manifest long term in people who have either been vaccinated, or even had the virus itself.

The Kent variant of COVID has shown itself to be manageable. 30% more deadly and more contagious, sure, but absolutely susceptible to vaccination and plausibly can be brought under control. The risk now, as we discovered in more detail towards the end of last week, and heard much about heading into this week, is the South African variant. The Oxford-AstraZeneca vaccine, the one made in Britain and the one we have huge supplies of, isn’t able to stop transmission or mild disease from that strain (it may still combat severe disease thankfully, hopefully saving the lives of those who’ve had it).

This news was undeniably a huge blow in the fight against the virus; by no means a massive, or a terminal blow, but a setback for all the timetables we fancied likely in this battle, and a massive cold shower on any hubris about total normality by the summer (always a really questionable proposition when you talked to epidemiologists, but now even less likely).

What we’ve seen is that as these strains spread, they mutate more. The lucky star when it comes to the South African variant is that as of right now it doesn’t have a transmission advantage over the Kent variant, meaning over the next few months (no one knows about indefinitely) it is highly unlikely it’ll rapidly grow or become the dominant British strain, as it has for South Africa. This buys science time, and we now need to factor in the idea of a booster shot some September/October/November in order to get on top of this strain before it topples our response to the virus by bypassing our defences heading into the winter.

I cannot emphasise this next part enough: if you are offered the Oxford-AstraZeneca vaccine, please, please, please take it. Don’t even hesitate, take it. All the vaccines are safe, all the vaccines offer you protection. DO NOT wait for an updated vaccine. Right now, the vaccine you are offered is your best bet, this can never be zero sum, this will help you, and if you need a booster down the line then fine, we worry about that then. Get what you are offered, wherever you are in the world, all the approved vaccines around the world are safe and verified by the experts, and all of them will protect you to varying degrees from the virus that’s upended our lives. The single best thing you can do right now is get the jab, and as someone who isn’t an expert on these areas of science, writing a piece about these things, it’s absolutely crucial I tell you that.

The longer term strategy and the hopes of our government are once again in free for all. The idea of a March budget marking the beginning of a post-COVID era, the govt winding down its support and its response throughout the year, and normality resuming heading into 2022 , is now over. It was always overly optimistic, but now we’re back to the question of how we manage and mitigate this if it keeps mutating and spreading; letting it rip through our populations is still the most scientifically illiterate and stupid idea anyone has conceived of throughout this, and that hasn’t changed.

This can foster a reset in the UK’s virus response, it’s either that, or another year of U-turns and free for all. We need to suppress the virus to the point it isn’t widespread amongst the population, by staying locked down, even hardening it, pumping far more into the safety net, maybe even a UBI trial to mitigate poverty and hardship throughout this, all until the virus is more suppressed, cases are lower, than at any point since the pandemic began. Hit where we hit last summer, and keep pushing; remember, it’ll be harder because it’s now more transmissible.

Following this, we must reopen on a national level slowly and gradually, emphasising caution and prioritising schools. We must only reopen once we have a publicly run Test, Trace, Isolate system in place capable of tracking and containing every case in the country, and incentivising these individuals to self isolate with financial support. We must have cases so low we can mitigate and contain any outbreaks, with closed borders for all but crucial supply chains etc, and be able to sequence every single case we find, in order to keep track of, and adapt to, variants.
Yes, the Johnson govt must find its mojo and “moonshot” level ambition, by embracing a strategy of Zero Covid, if they really want the economy and society fully open anytime soon.

This can only be for a limited time, but it’s the best way to enjoy some limited freedom, all while putting a sock in the viruses ambitions, by preventing it from mutating as much by limiting its transmission to a bare minimum, with a New Zealand level goal of zero cases for as long as possible. We can do this, we can build the systems and do it, but only with some ambition and creative thinking on the part of the state. The hope long term must to be have a degree of normality everywhere, with mitigatory measures where needed, and a vaccination programme annually, where the ideal eventuality would be that the virus one day becomes as normal, and non-threatening as the flu; something we can deal with as part of a package of public health measures.
I must emphasise: please listen to the experts, wherever you are. Trust the science, and listen to the experts; that is entirely separate from discussion of policy as is featured here; policy is debatable, facts and science are not.

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Toby Lipatti-Mesme

Toby Lipatti-Mesme

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Insightful and innovative UK journalism and commentary, from Toby Lipatti-Mesme.