Delaying and preventing infection as much as possible through this pandemic was a worthwhile strategy. In early 2020, there were few treatments, limited testing and no vaccines. The costs of those lockdowns were big, but the effort to buy time paid off. In that time, science has transformed Covid from a deadly virus to a much less serious, nasty disease – one that is manageable at home, for the vast majority of those vaccinated. It has, largely, defanged it.
But even as we have had success treating and preventing serious infections, Sars-CoV-2 has become increasingly transmissible. ONS survey data indicates that one in 15 are positive in England, with similar numbers for the other three nations. While the good news is that the Omicron variant is resulting in less severe disease and a smaller fraction of hospitalisations, so many people are infected and isolating that critical services are struggling with staffing. This is what is driving governments to rethink isolation policies, and ask whether they are becoming more disruptive than the virus itself.
In England the prime minister announced today that restrictions including masking requirements will be removed from next week, and self-isolation requirements will be reviewed in March. I think this is largely reasonable – all governments face the question of how to approach this new landscape.
For policymakers, it’s a bit like landing an aeroplane on an icy landing strip. The fuel of public patience is running low; and wear and tear, in the form of economic and social damage, has built up over two years in a holding pattern. The need to land is obvious, and we have the tools to do so, but it’s still a tricky feat in current conditions.
There are now clearly three camps of scientists voicing opinions on what is happening and what to do in the coming weeks. This can be confusing for the public.
The first group still seem to see the virus as the same deadly one of March 2020, despite the massive scientific progress in managing it, and they suggest extremely cautious measures. The second say they’ve been right all along in that mass infection is unavoidable; this is the “let it rip” group. They ignore the dramatic difference that mass vaccinations and treatments have made – avoiding serious illness from Covid-19 now is wholly different from 2020.
The third group – where I sit – have evolved their position as the data and tools, namely vaccines and therapeutics, have also evolved to transform Covid-19 into something more akin to other infectious diseases that we control and manage. My analysis has consistently responded to the latest evidence.
First, we now have safe and effective vaccines that protect the vast majority of people from hospitalisation and death. Recent data from the UK Health Security Agency shows that unvaccinated people are between three and eight times more likely to be hospitalised with Covid-19. Early in the Omicron wave, New Yorkers who were not vaccinated were more than eight times more likely to be hospitalised than New Yorkers who were fully vaccinated. If everyone who was offered a vaccine and booster would take it, the pandemic would be effectively over in richer countries.
And while our current vaccines don’t stop us getting infected, major investment is being made in next-generation vaccines that offer sterilizing immunity, meaning they stop infection completely in those getting two doses.
