What do you think the chances are of another national lockdown before the year is out? Are you glass half empty, glass half full, or do you question if there is really a glass at all? I think a lot of people are looking at the same Covid data right now and coming to wildly different conclusions. The pandemic has been characterised by these moments. The days and weeks pass until reality can no longer be ignored, at which point it is usually too late to prevent catastrophe, but in time to mitigate it.
For the glass is half-full folk the vaccine roll-out has been a solid success. The early decision to delay second doses and focus on getting as many people protected almost certainly saved lives in the last wave and this has put us in a good place for the next one, though the number of people with a single dose has left some temporal vulnerability. We have gradually opened up and peeking through the gloom, some of life has a thrilling feel of normal to it. You might be asking: is it not time to just walk the last few steps and open everything up?
At this point we have to stop and admit a few things. Firstly, though there has been a roadmap, and some clarity over the plans for loosening restrictions, the government has not done a good job of outlining the bigger picture and preparing people for anything except the most blindly optimistic path ahead. The prospect of a more transmissible or more deadly variant was not an unreasonable one to consider and we should really be explaining what that might mean. It is partly bad luck that we are near the front of the queue with the Delta variant, and partly a failure to learn from our mistakes, especially around border control and our poor system of support for tracing and isolation. None of this was unpredictable.
Back to the data. The Delta variant is causing a wave of cases not entirely dissimilar to previous waves. Why is this? Because it is significantly more transmissible, and because there are still plenty of unvaccinated and partially vaccinated people to infect. We would also expect some cases among fully vaccinated people, because none of the vaccines are 100 per cent effective.
Fortunately hospitalisations remain low, though they have more than doubled in the last two to three weeks. This is both a positive and negative. The low percentage of new cases being hospitalised is almost certainly the vaccine effect, but it is not zero (and we would never have expected it to be). Some people are looking at this and worrying, some are more sunny and wondering why we are delaying opening up when the vaccines are doing a great job, and some just refuse to see any problems at all. But most of the debate is focused on the next few weeks and nobody is talking about what comes after.
So here it is. We have been down the road of hoping for the best already, twice. It doesn’t work when it comes to pandemic preparedness. We seem likely to be heading towards another lockdown later this year – this is baked deep into our current approach. This is despite the vaccines working.
If we keep reacting sluggishly to new waves, they will almost certainly result in national lockdowns. We also need to be honest with people. Our failure to vaccinate on a global scale will leave the virus out in the world, circulating and mutating for some time.
To avoid months of lockdown, we may need to accept earlier, smaller, more localised but harsh measures. Border controls still need to be tightened, with more effective quarantine and probably continued no-fly rules for much of the world. The government should be straight with the public and make it clear that foreign travel is off the menu for 2021 and consider what the implications for supporting those industries on the edge of the precipice would be.
What we do at the borders is irrelevant, however, if we don’t deal with what is going on within them. We need to urgently revisit and revise the system of support available for people to self-isolate. The UK may have as low as 18 per cent adherence to self-isolation(though there are always problems when surveys rely on self-reporting and ONS data has more recently put that figure higher). This should be worrying all of us and especially policy makers.
We need to move towards being able to rapidly shut down outbreaks ahead of widespread problems, a situation that should be possible in a vaccinated population. We will be living with the spectre of Covid-19 for some time yet and it is now time to accept this and start planning more long-term. We are in a better place, and it will get better still, but it is not a smooth path and the sooner we get this message out there the more time people will have to come to terms with it.
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