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12 February 2021updated 21 Sep 2021 6:01am

How the UK could vaccinate every adult by mid-May and end lockdown

If vaccines continue to prevent hospitalisations and deaths there is no reason why significant restrictions should last. 

By Harry Lambert

From reading the news today, you might be forgiven for thinking the world has not discovered vaccines that protect against Covid-19, or that if any have been discovered, the UK is struggling to roll them out. Neither is true, and nor has any variant of the virus been shown to limit the ability of current vaccines to prevent hospitalisations and deaths. 

Yet today’s Times reports that “Social distancing rules in England could remain until autumn”. While the Daily Mail reported that on ITV’s Peston Professor John Edmunds, a leading member of government advisory group Sage, said that most curbs on daily life, “which may include the Rule of Six, are likely to be in force until the end of this year, while less restrictive curbs – like face mask wearing on public transport and indoors – could possibly be in place ‘forever'”.

These statements are remarkable because they seem to take no account of the UK’s vaccine programme: namely how quickly it is proceeding and how effective it is likely to be.

The speed of the vaccine roll-out, and its probable impact, continues to be under-publicised. This weekend the government is set to meet its target of vaccinating the most at-risk 15 million people in the UK by 15 February. This should – beginning from two to three weeks from today, reflecting the time the human body takes to mount an immune response – begin to reduce the UK-wide Covid death rate among the most vulnerable groups by 88 per cent, official estimates suggest. 

[see also: Europe’s vaccine crisis has revealed to the UK and Ireland the true nature of the European Union]

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In other words, the high infection fatality risk of the virus – the reason the world has been on hold for a year – is soon set to decline dramatically in the UK. If it does, it is unclear why we should treat Covid-19 as having the same severity it had in 2020, as today’s headlines suggest we might.

A new paper published yesterday in the Anaesthesia journal shows the impact that vaccinating the UK is likely to have over the next three months. Under this timeline, the fatality risk of Covid will collapse in March, as shown by the red line, with pressure on the NHS – defined by intensive care (ICU) admissions, the yellow line – easing more slowly, as the age of the typical ICU admission (61 years old) is significantly younger than the typical Covid fatality (who is aged 83).

 

This projection assumes that the vaccines currently available in the UK offer 100 per cent effectiveness against hospitalisations and deaths: an assumption that has not been disproven by any existing research, despite much fear over the threat of variants. 

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As the lead author of the paper – Dr Tim Cook, a consultant anaesthetist at Royal United Hospital in Bath and a former Macintosh Professor of Anaesthesia at the Royal College of Anaesthetists – writes: “It is uncertain whether vaccination will be as effective with the new variants of the virus as those prevalent during vaccine studies, but most predictions and emerging evidence is currently reassuring.”

This paper also assumes 100 per cent take-up of the vaccine when it is offered. That is probably too high, but not by much; current take-up rates in older populations are above 90 per cent.

Meanwhile, the UK’s vaccine programme is continuing apace. Last week (1-7 February) the country vaccinated three million people. Data so far this week shows that rate holding steady. If the UK’s weekly rate remains at three million, then around 20 million more people will be given a first dose of the vaccine by late April – even with second doses beginning to take effect from early March.

If the rate of vaccinations increases gradually in the coming weeks, as it had been prior to this week, and eventually rises to five million per week by late April, it is plausible that every adult in the UK could be vaccinated by mid-May.

 

If the rate does not rise above three million per week, the need to give second doses will put a limit on the UK’s roll-out by May. But that will be no great problem. It is the first nine priority groups that matter, not the entire UK population. And the government has accepted that all nine of those groups will be vaccinated by May, as is predicted by current rates of the roll-out.

The first nine groups include everyone over 50 and anyone else who is clinically vulnerable. By that point, as Cook’s paper shows, 98 per cent of the fatality risk from Covid should have been eradicated. Eighty eight per cent of the pressure on hospital admissions should also be cut.

It is hard, in other words, to see why restrictions of any significance would continue to be in place by mid-May, or certainly by the summer, if that is defined as starting on 1 June. This optimism assumes the UK’s borders will be adequately controlled and that the risk of vaccine-evading variants is effectively eliminated by doing so. 

But the key point to remember is that no variant has yet been shown to evade the vaccine on the metrics that matter: causing hospitalisations and deaths. The world did not shut down because of the threat of mild to moderate Covid disease.

It is unclear why the UK should remain locked in restrictions throughout the summer if Covid soon amounts to no more than that, as has been suggested by Andrew Pollard, the Oxford professor and head of the UK’s Joint Committee on Vaccine and Immunisation.

[see also: Why the threat of ten-year sentences for Covid rule-breaking is absurd]

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