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18 May 2021updated 22 Jul 2021 4:46am

The spread of the Indian variant has revealed the government’s unlocking dilemma

No one expects Covid-19 to be entirely eradicated, the question is how many deaths ministers are prepared to risk.

By Ailbhe Rea

The Indian coronavirus variant has cast plans to ease restrictions in the UK into some doubt, amid multiple reports this morning that the government is drawing up contingency plans to either implement local lockdowns or delay the full unlocking on 21 June. 

The B.1.617.2 variant, which is expected to become the dominant strain of coronavirus in the UK within days, is more transmissible than the previously dominant Kent variant, but we do not yet know by how much. Early indications are that vaccines are effective against it, but again, we don’t have a full picture of that effectiveness, as Matt Hancock said at the despatch box yesterday.

These unknowns make things difficult for the government. The prevailing mood among Conservative MPs, as among many members of the public, is simply that once the vulnerable are vaccinated, there is no case against opening up. The medical consensus, meanwhile, is that we are inevitably heading for a third wave of cases in the summer if things unlock fully, but its potential severity when the most vulnerable have already been vaccinated is much less clear.

Even before the Indian variant was causing increased concern, the BMJ warned of the possibility of a spike in hospitalisations and deaths as the virus spread much more rapidly among an only partially vaccinated population. The warning was made on the basis of multiple reasons, not so much to do with vulnerable people declining the vaccine as immunisation failures among those who had had the vaccine and a small proportion of the large number of young unvaccinated people who catch the virus falling seriously ill.

The government’s priority, as ever, is to avoid a situation where so many coronavirus patients are in hospital at once that the NHS is unable to deliver other crucial healthcare. Without exact information about the transmissibility of the Indian variant and the effectiveness of vaccines against it, it is drawing up contingency plans to protect against the health service being overwhelmed, which would be a risk if the Indian variant’s transmissibility was sufficiently high. 

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While that remains unlikely, but not impossible, the current discussion reveals the uncomfortable decisions the government faces as we attempt to find a permanent path out of the pandemic. No one expects the risk from coronavirus to be entirely eradicated before we go back to normal. But that means the government has to answer a more delicate question about how much risk it does want the population to bear, and how many hospitalisations – and, indeed, deaths – it is willing to accommodate before everyone has been vaccinated.

[see also: Does the Indian variant mean the UK will suffer a dangerous third wave of Covid-19?]

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