Why we will avoid another winter lockdown

It feels eerily familiar: end-oflockdown excitement, meeting friends in the sunshine and even the possibility of a holiday abroad. The numbers are almost identical, too. Last year, as this May, new Covid cases drifted well below 2,000 a day. Then as now, summer – and freedom – was unleashed at last.

But we know how 2020 ended. A brutal spike and an equally brutal lockdown. Educations were trashed. Christmas was cancelled. So if we do, as many suspect we will, get a new winter take-off of what appears an ever-more seasonal virus, will we face the same misery again?

Vaccine threats

Last year, cases began to pick up again towards the end of August, and by the end of September were over 10,000 a day again.

This time around, the Government hopes, vaccines will halt that rise. All adults will have had their first jab by the end of July. But there’s a wrinkle to the success of the rapid rollout – as the virus potentially surges back in autumn the most vulnerable people, including the elderly, will have had the longest gap since their first injections.

“We might see some immunity waning, particularly among older people,” says Sarah Lewis, professor of molecular epidemiology, University of Bristol. No wonder that this week Nadhim Zahawi, the vaccines minister, announced autumn boosters, most likely for everyone over 50.

The second big threat is not waning antibodies, but new variants of the virus itself, which have previously shown they can be deadlier or spread faster, and partly elude the protection conferred by some current vaccines.

The impact of such mutations can be seen in the statistics for last November, when the post-summer surge in cases was abating, only for a huge third wave to crash over Britain as we retreated indoors for winter.

The “Kent variant” forced us into a new lockdown.

As with waning antibodies, there is an official response to the variant threat, too – the Government this week announcing almost £30million to build labs at Porton Down specifically to monitor vaccines efficiency against worrisome mutations of the virus.

Nightmare scenario

For those battling the pandemic, the fear is that these two factors – waning immunity and variants – combine to produce the nightmare scenario which now appears to be playing out in the Seychelles. There, more than 60 per cent of the population has been fully vaccinated, only for the archipelago to experience a huge spike in cases – from 15 per day a month ago to up to 145, in a population of just 100,000.

At the beginning of this week it had 1,480 cases per million people, compared with a mere 30 or so in Britain. Per capita it is worse off than India. As Prof Christina Pagel, director of the Clinical Operational Research Unit at UCL, noted: “Fair to say that high vaccination rates alone are not necessarily enough to stop a surge in cases.” The islands, which thought they had consigned Covid-19 to the past, are now back in lockdown.

All is not lost

What is happening in the Seychelles does not deny, but actually confirms, the promise of vaccines. The country relied heavily on China’s Sinopharm vaccine, rated little more than 50 per cent effective at preventing infection.

And just as such protection rate figures would imply, half as many jabbed people as non-jabbed have been infected in the new Seychelles outbreak. Significantly, however, the Chinese vaccine, like all vaccines, is highly effective – more than 80 per cent – at preventing serious illness.

So outbreaks like the Seychelles can be seen in one of two ways. For many they show that this mercurial virus will inevitably overcome vaccine defences.

Prof Tim Spector, at King’s College London and the man behind the Zoe symptom tracking app, acknowledges that “a lot of my colleagues – more than 50 per cent – are in this camp. They are pessimists. They see the march of these variants and worry about them.”

But there is an alternative view, which is to celebrate the fact that in 2021, because of vaccines, the link between cases and serious illness (and death) is being broken. That, some experts say, is the true difference between this year and last – and has profound consequences for policy.

Last year, we went all out to stop cases because cases correlated strongly with hospital admissions and deaths. Not today.

“It’s now highly unlikely that we’re going to have zero protection as if we’ve never met the virus before when everyone in the country has either had Covid or a vaccine,” says Prof Spector. “It would really have to be a totally new virus to do that.”

Time, he adds, is also on our side. “Generally, viruses tend to get less deadly. We hope it’s going to mutate into a very mild form that is like a common cold, and all our children will get used to and become immune to it.”

A fresh mindset

“We need a new mindset,” says Prof Lewis – one that accounts for the fact that while Covid is not being eradicated, and outbreaks will occur, time, exposure and vaccines are helping to ensure it becomes a far less deadly disease. “The key thing to watch is the number of hospitalisations and deaths rather than the number of people catching Covid,” she says.

New measures

So when, from this autumn, the spikes do occur, what should the Government do? “Hold your nerve,” says Prof Spector. Because of this year’s lower hospital admission rates with Covid, he says the chances of the NHS being overwhelmed are “extremely unlikely”. Instead, he adds, testing should be localised where there are outbreaks, and hospitals and care homes properly protected. Recent intensive hunts of variants in London, he says, offer encouraging signs that “after £30billion of our money, [test and trace] might be getting their act together.”

From improved financial support for those who need to quarantine, to sourcing outbreaks as well as stemming them, “lockdown is not the only option to control this”, says Prof Lewis. Not least because the moment of official hesitation is likely to come when schools go back in September.

Education will once again be on the line, and other diseases will return. “We’ve been so focused on this because it’s novel,” says Prof Lewis, who is also a school governor, “but we have to move away from that. We might have a bad flu season. We just can’t have children go through what they did before.”

“As we’ve seen,” adds Spector, “the Swedish approach has done as well as our approach. Life has got to carry on”.

‘After £30bn of our money, [test and trace] might be getting their act together’