In the absence of vaccines, Covid-19 would force us to make the difficult choice between trying to live with the virus or trying to eliminate it. For an uncomfortably large number of people, living with it would mean dying with it. We could try to shield the vulnerable while a measure of herd immunity was built up, but shielding is harder than it sounds and there are a lot of vulnerable people out there. Non-pharmaceutical interventions, up to and including lockdowns, could be used to spread the epidemic over a longer period of time to avoid overwhelming the health service, but the policy would still involve around one in 150 people dying.
Eradication is no simple matter either. It requires an intense, lengthy period of lockdown followed by the near-total closure of national borders. The borders would have to be closed until the rest of the world eradicates the virus, possibly forever. When the virus inevitably creeps back in, as it recently has in Australia and New Zealand, you have to lock down again. And again. Until the rest of the world does you a favour.
Before the wonders of modern science produced vaccines for this wretched disease, these were the only long-term options available to us. When it looked like lockdowns were achieving nothing but delaying the inevitable, I leaned towards the “herd immunity” option. But that debate is so last year and I am happy to be out of it.
The vaccines changed everything. We can inoculate the vulnerable, reopen society, control our borders, monitor the virus abroad, and get back to normal. It is disappointing that the Prime Minister’s overly cautious roadmap out of lockdown, announced on Monday 22 February, does not seem to reflect the power of this miraculous medical game-changer. His sluggish timetable is at odds with the reality that, within six weeks, everyone who has more than a remote chance of dying from Covid-19 will have been offered a vaccine. This once-in-a-century health crisis is thankfully nearly over.
Even if the vaccines do not give 100 per cent protection against death – and much evidence suggests they do – they provide more than enough to “protect the NHS”, and therefore to protect us from further lockdowns. At worst, we might need an annual vaccination programme. But there is every prospect of Covid-19 joining the list of endemic diseases that you wouldn’t want to catch but don’t require nine million people on furlough and the biggest recession in 300 years to wipe out entirely.
Winston Churchill once said that a fanatic is someone who won’t change their mind and won’t change the subject. Now that we have multiple vaccines, anyone who still thinks the answer is to let the virus spread until we get herd immunity is deluded. On the other side, anyone who still thinks the answer is to lock down society until the virus is eradicated is equally absurd. Both sets of people are clinging to a masterplan that has been rendered obsolete.
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There is a belief among some people that the first lockdown could have achieved total suppression of the virus if it had only been kept in place a little longer. This is delusional. Lockdowns do not have a universal definition, but mine is the period between pubs being closed and pubs being open (along with the rest of the hospitality industry and it no longer being illegal to meet friends and family indoors). By this measure, the first lockdown in England lasted three and a half agonising months. Throughout this period, the case rate fell, but with diminishing returns. We never really got below 500 positive tests a day (and you can double that number because half the infections were not reported). The lowest number of total infections in England estimated by the Office for National Statistics was 14,000 on 9 July.
We tried a lengthy lockdown, and we never came close to defeating the virus. Case numbers were roughly halving every four weeks. It takes a long time to get from a thousand to zero at that rate. A massive, Wuhan-style effort could have sped it up but there are a lot of people who cannot work from home and a lot more who are prepared to break the rules when they last for too long. We don’t have the geographical advantages of New Zealand or the ruthlessness of the Chinese Communist Party. We can’t even stop people entering the country on dinghies.
Perhaps in June 2020, Boris Johnson could have persuaded a weary public to accept another few months of lockdown, along with even tougher restrictions. I somehow doubt it, but it doesn’t matter. We are not in that situation now.
Those who advocate zero-Covid today have an even tougher task than Johnson would have had in that scenario. They need to persuade people who have been kept away from their friends and family for most of the last year that they must now endure three or four months of the most brutal and unforgiving lockdown yet to protect them from a disease which almost everybody over the age of 60 will soon be vaccinated against. Having been told that vaccines are the path to freedom, the public would rightly see this as a bait and switch.
Lockdowns are a desperate last resort for countries facing a tsunami of hospitalisations and deaths. They create enormous economic, social and psychological costs. They are not something to be used until we eradicate risk altogether. Now that we have effective vaccines available, the zero-Covid cure would be worse than the disease.