'Cry freedom' after the vulnerable are vaccinated? Not so fast, Matt Hancock
As several NHS trusts warned staff this month that they faced imminent collapse, the health secretary, Matt Hancock, gave a sunny interview to the Spectator. Looking to the vaccine as a “light at the end of the tunnel”, he outlined his desire to loosen restrictions the moment that enough vulnerable people had been vaccinated. The plan, he said, was to “cry freedom”, and open things up before the majority of the population had received the vaccine.
It was an extraordinary comment. The government has now twice allowed the pandemic to rage nearly out of control by ignoring warnings from experts to lock down until the last possible minute. We are still suffering from those failures months later: measured in deaths, the current wave hasn’t even peaked yet. Government action, as its own scientists have said, has always come “too little, too late”. Now, despite there being a clear end in sight, they want to try their luck with “too much, too early”.
This, predictably enough, is totally out of step with scientific advice, which calls for a slow and cautious release of restrictions as vaccination coverage builds up. The hope is that once a certain level is reached, community spread will all but cease – the vaunted state of “herd immunity”, currently estimated to kick in once 60-72% of a population has protection. But until that point, we have to remain exceptionally careful.
As Prof Adam Finn, an expert on vaccination at the University of Bristol, explains, everyone is “pretty optimistic that the vaccination programme will stabilise the situation, but not that it will solve it in the short term”. Vaccinating vulnerable people is vital, but it doesn’t stop the virus from spreading in the population at large. The toll would be lower in the vaccinated groups, says Finn, but there would still be waves of infection with “large numbers of hospitalisations and deaths”.
There are many reasons for this. Vaccine coverage won’t be perfect, and vaccines don’t offer 100% protection. And while deaths have largely occurred in older and vulnerable groups, 43% of the tens of thousands of ICU admissions since September have been people below the age of 60, and nearly 20% of admissions have been under 50. Young people aren’t immune.
And beyond the predictable and terrible human cost, we’ve already seen how large, uncontrolled outbreaks of the virus act like a petri dish, incubating variants like the B117 strain that was first identified in Kent. This variant is bad enough, but scientists are also warning that others capable of reinfecting people or rendering vaccines less effective could arise with similar speed.
Dr Jasmina Panovska-Griffiths, a senior mathematical modeller at UCL and Oxford, says that, in any case, it’s too early to say what level of vaccination would allow us to ease lockdown measures. “We don’t yet know the effect it will have on the R rate, on cases, hospitalisations,” she says. As vaccination creeps up and we know exactly how many are vaccinated in each group, scientists will be able to input this into their models to untangle its actual effects on the epidemic, and plot out scenarios for lifting restrictions that the government can evaluate. But we’re not there yet.
One reason it’s particularly worrying to see Hancock champing at the bit is that despite the world-topping rates of infection and death, and despite stalling on lockdown, the government at least bought us enough vaccines – and they arrived earlier than anyone thought possible. We are getting a scientific bailout of historic proportions. To squander that would be unconscionable.
The problem is, he’s not alone. Witness the transport secretary Grant Shapps on Julia Hartley-Brewer’s TalkRadio show saying he will “join her on the barricades to get our freedoms back” as soon as people aged over 70 are vaccinated. Or the former cabinet minister Andrea Leadsom on the BBC saying she wants to challenge the chief medical officer, Chris Whitty, on his predictions for how long restrictions should stay in place. I want to end lockdown as soon as possible too, and government advisers shouldn’t go unchallenged. But these are members of a political party that has proved itself wrong over and over again, asking to place one final big bet with other people’s lives.
It’s easy to chalk this up to a kind of blithe incompetence. But it’s more than that. The consistent heel-dragging is the result of viewing the crisis, and the wider world, through a particular ideological lens: a self-professed libertarianism that espouses a narrow conception of personal freedom, and is suspicious of action for the collective good. Under this rubric, the freedom to do what you want unimpeded must be the default. What many experience as a result, however, is not greater choice, but the obligation to work an unsafe job during a global pandemic or face eviction and poverty. Freedom to go out and shop trumps freedom from illness and death.
We may hope that “cry freedom” may be more rhetoric than reality – but it is alarming nonetheless. It sounds like more of the stuff that got us into this mess, a bias against intervention of any kind, a failure to see that the ideological accoutrements of Tory party conference are not what you bring to a national fight against a force of nature like the virus.
The prime minister has so far indicated that restrictions will end not with a “big bang, but a gradual unravelling” – an approach the foreign minister,
Dominic Raab, repeated nearly verbatim in an interview with Andrew Marr at the weekend, and the vaccines minister, Nadhim Zahawi, reiterated on Monday. Perhaps, for the time being, caution is winning out. But the pressure to ease up quickly – from business, from the party’s lockdown sceptics, from the Treasury – will become tremendous once the vulnerable have been protected. And Boris Johnson is ideologically susceptible to the arguments of the cry freedom crowd. A senior Tory told the Times in March that the prime minister “really doesn’t want to shut stuff down”, and that he worried more than most about the economic costs of suppression measures. In September he projected this on to the wider population, suggesting Britons were too “freedom-loving” to follow strict lockdown rules.
As exhausting as it sounds, we’re probably heading for the same fight we just went through over lockdowns, but in reverse. There will be a powerful faction calling to open everything up as soon as some small proportion of people are vaccinated – to revive the economy a few weeks early in the middle of a global depression. Since the outset of the pandemic there have been those who have wanted to let the virus rampage through the young and middle-aged as if it had no consequences. That argument was always bad, but it had more bite when we faced a series of endless, interminable lockdowns. The vaccine finally gives us all an endpoint. We should commit to getting there together safely, leaving no one behind.
Stephen Buranyi is a writer specialising in science and the environment