After receiving my second vaccination in April, I contracted Covid a week ago. I’m now “living with the virus”, a phrase emblematic of the failure of UK public health. Just look at the relative death rates in China (population 1.4 billion), Vietnam (100 million), the United States (340 million) and the UK (68 million). When plotted on the same graph, you cannot see the death curves for those two Asian states because they are so low.
Anthony Costello is professor of global health and sustainable development at University College London www.theguardian.com
Britain’s leaders and their advisers told us last year that we could not suppress the virus. China and Vietnam did, within six weeks. They told us these countries would inevitably face a huge second wave. They haven’t; just smaller outbreaks, suppressed with good public health practice implemented by people on the ground.
As we know, exploding cases in March 2020 forced the UK into a 13-week full national lockdown, with huge damage to livelihoods, the economy and mental health. None of the east Asian states had national lockdowns, only local ones. In 2020, China’s GDP grew by 2% and Vietnam’s by 2.9%, according to the World Bank, compared with the UK’s 9.9% contraction.
Last summer the UK government set up a privatised, call centre-based test-and-trace system divorced from our underfunded local public health and primary care teams – quite unlike anything done in successful east Asian states. It couldn’t possibly work, and it didn’t. The Treasury refused to give any financial support to poorer people to isolate – in case, as the then health secretary, Matt Hancock, told a Commons select committee, they “gamed the system”. So poor families gamed the test-and-trace system instead, to keep working and feed their families. The virus simply spread, without public health control, and was only suppressed by two more prolonged national lockdowns.
The vaccines arrived with a huge wave of nationalistic fervour. We are world leaders, crowed the prime minister. The first to jab. Yes, our GP network stepped in magnificently to roll out the vaccines, but local authorities and public health remained deprived of any financial support. Meanwhile, test and trace staggered on, a fortune spent on private consultants, test companies and cronies. The £37bn spent was equivalent to a decade’s funding for the whole UK public health programme.
So the third lockdown now ends in a staggered and collapsing roadmap. In February the chief scientific adviser, Patrick Vallance, was alone among advisers saying that find, test, trace and isolate was crucial when case rates fell to low levels. On 19 May, we saw only 1,517 cases a day. Yet no changes were made to our ineffective test-and-trace system – it remained outsourced, with the lowest rate of financial compensation for isolation in any OECD country. So another wave began.
On Monday the prime minister told us we would have 50,000 cases a day by his so-called “freedom day” on 19 July. A day later the health secretary, Sajid Javid, said we could hit 100,000 a day this summer. But it was OK, he told us. We can “live with the virus” because we are all vaccinated.
Well, all except children, and the poorest and most hesitant groups. Actually, only half Britain’s population (34 million) is fully protected with vaccines. Yes, admissions and deaths will go up, but the government can’t say by how much. The possibility of the virus becoming vaccine-resistant was not mentioned. Vaccine protection appears much less effective at stopping infection than it does at preventing serious illness or death. Talk of long Covid is seemingly taboo among ministers, even though the latest government figures show more than 2 million people have lived with symptoms for at least 12 weeks. A new study has found measurable thinning of the brain cortex areas covering taste and smell in these patients.
And the government seems to think it fine for 8.8 million children up to age 16 to become infected – even though the US, Europe and Israel have vaccinated more than 7 million children because the benefits clearly outweigh the risks. Our vaccine committee is still thinking about it. Meanwhile, even in English school classrooms, masks are no longer required.
And what of the global vaccine shortage? At last month’s G7 meeting in Cornwall, President Joe Biden urged fellow leaders to share the patent with all countries so they can manufacture the vaccine themselves. The UK, Germany and Canada said no. Although 95% of funds to develop vaccines came from the public purse, it appears that the shareholders of big pharma companies must be protected. So a million people must die every month to sustain free markets.
New variants will emerge, but those same multinationals can make new vaccines – no doubt with new patents. No new G7 money was committed to the Covax global distribution scheme. And with Indian supplies blocked, Nepal, Bangladesh and the whole of Africa have virtually no vaccines.
Under the new libertarian public health system, “living with the virus” means we must not compromise people’s freedom to do what they like. If you prefer to cough and sneeze in a crowded commuter train, so be it: there’ll be no legal restriction on that. If porters, nurses, doctors, care workers, bus drivers or factory workers become infected, and if some of them die, so be it.
Seemingly no one is accountable. Politicians say they follow the science. Advisers say ministers must make the decisions. An explosion of cases is imminent, the burden on the NHS could be severe, and the threat of new variants that can break through the present vaccine protection is real, as I know. Rather than a merry-go-round of birthday honours and George Crosses, we need a plan to deal with the rampant third wave – one that will keep us safe.