The UK is under lockdown again. According to YouGov (4340 adults surveyed on 5th January) 85% of citizens approve. There may also be Tiers, of the four former sorts, and a possible fifth for very serious cases, but these have probably been superseded, and should be considered old news. Now it is just lockdown, and the Tiers have been shed. There are exceptions, some special circumstances, but the general invocation is: DON’T MINGLE WITH OTHERS. Essential shopping is allowed, and essential going to the doctor, and essential exercise, but not the other stuff of life, unless absolutely essential. Doctors can still be trained at medical schools, which is comforting.
On a strategic front, the good news is that we are now better prepared for the next pandemic, which is due in about 4 year’s time. That prediction from South Korea is based on the observation that we are continuing to increase in population size, pushing against the remaining wild spaces, and that some people at those margins like eating the flesh of wild animals. We can be pretty certain that the next epidemic will come from China, where millions still live in close contact with animals (pigs and ducks, mostly) and have broad appetites; and also from the Congo, where bushmeat is prized. Viruses long circulating among bats, for example, will jump to other species, at a rate which broadly correlates with the spread of human settlements into the remaining wildness. That is the conventional story.
The unconventional one is that for years some virology labs have got trigger happy, or grant income happy, and have been doing wild “gain of function” experiments (artificially boosting the infectiousness of viruses so that they can jump to humans) which have doubtful utility and pose considerable dangers. Bats were just hanging in caves 900 miles from Wuhan, and if they had tried for some reason to fly there, they would have infected animals and perhaps people on the way. That did not happen. The virus that actually spread across the world was, the official Chinese authorities say, collected from those caves back in 2011 or so, and then safely kept in a test tube in Wuhan. Yes, it was taken out of storage and used in bench experiments in that lab, which may have included “passing” it through other hosts so that it learned how to infect them. That detail has not been disclosed.
American labs were front runners in this technique, which was supposedly done to create future hazards and then try to deal with them. Prevention, it was argued. The US funded this research at home, with very occasional fatal errors when things escaped from the lab, and the same swashbuckling researchers trained up and sent money to the Bat Lady of Wuhan. I would rank the “lab leak” view as a Plausible Hypothesis. It is possible that this pandemic is the result of the Chinese not properly containing a virus which was trained up to be more infectious. A year has gone by, and as of today, the team who are trying to investigate the year-old scene of the incident, or scene of the accident, have not yet gained access. The Chinese authorities, with straight face and great politeness, explain that the delays are being created by their wish to have everything absolutely ready for the inspectors. A preliminary view is that we did not get the full story from China, to our great and continuing cost, and are unlikely to get it for a long time.
Meanwhile, back in Blighty, we are watching and living in the sequel of a low-grade horror movie. All the frightening indicators are up: cases are up, even when controlled for extra testing, positive test results are up, particularly for the new variant, and in recent days, so are deaths. As a rule of thumb, deaths are 5000 per million infected. That is low, from one point of view, but 5000 times higher than the likely side effects of vaccinating one million people. Even the most prudent of gamblers is likely to consider vaccination to be a good bet. Projected uptake in the UK is expected to be 70%, and possibly 80%. Care home workers, who are prime vectors for passing the virus on to the most vulnerable are said to be less keen, with 40% doubting they would take it, but that was a brief survey of 300 workers, so may not be accurate.
Now the story is “why are we waiting?” General practitioners cannot answer that question, but sincerely request that their patients shut up and stop asking them when they will be vaccinated, because the doctors don’t know. For some days the government blamed the pharma companies for hesitant supplies. The companies replied they were delivering as promised. Then it turned out that volunteer vaccinators, even with impeccable medical and nursing credentials, were facing bureaucratic hurdles such as diversity training which were putting them off. That was denied by official sources. Then it was alleged that the vaccines were being subjected to an additional inspection regime, imposing at least another 4 or 5 days of watchful waiting. Normal practice, and prudent, but many of these organisations were working 5 days a week, while the death rate was over 1000 a day. The virus works weekends. Few bureaucrats do. The testing of stock inspection was in addition to the first phase, in which only hospitals gave the vaccine, in case of bad reactions. That is now over, and ordinary clinics can do it, but some have not been receiving any supplies.
Meanwhile Israel was stealing the headlines by using its four nationwide health service organisations to compete with each other to vaccinate as many citizens as possible. (If you don’t like the one you are in you can sign up with another). Drive through and walk through clinics were working with military efficiency. The old socialist basis of health care winning kudos at last. Other countries are still trying to cut deals with Pfizer, and making slow progress.
In the spirit of capitalism new entries in the market, like Johnson and Johnson, are offering (once approved in a few week’s time) to do an effective job with one jab. If so, then their Janssen vaccine will be a clear winner. The price is also good, which impacts take up in poorer countries, where most people live. A purely capitalist approach would be to pay good money to vaccinate one’s self. A socialist approach is to subsidise the vaccination of most people so as to live in a safe herd. Both approaches have their benefits. An ideal approach would be to target all health workers, potential super-spreaders, and then the most vulnerable.
The latest advice to family doctors is that they should prioritize vaccination above all other activities, since this will provide the greatest benefit to the health of the nation. All we need to do is to join the dots, and get the products to the vaccinators so that they can get them into the arms of the public. The Prime Minister has promised that this will happen at the rate of 2 million per week “within weeks” such that 14 million will have been vaccinated by mid-February. Only 31% think it likely that this will be achieved.
Who will be the modern day Boccaccio?