Now that we have significant new variants of coronavirus here in the UK and most worryingly in South Africa, it is even more obvious: we can’t eradicate this virus, we have to live with it; it will be with us probably for some years; it may change like the flu, so requiring constant adjustment in our means of combating it; and continuing our current course would mean severe lockdown until vaccination.
Therefore, the present vaccination plan must be altered and radically accelerated.
As it is now, much of the country will not be vaccinated until spring or summer. The economic and health damage, physical and mental, caused by such a timetable will be colossal.
This is the most difficult challenge ever faced by government. There may also be information the prime minister and his key advisers have, which I don’t. But the following should be deeply interrogated by our decision-makers.
The Medicines and Healthcare products Regulatory Agency should clear the Oxford-AstraZeneca vaccine within days, to add to the Pfizer one. We have several million doses available and with perhaps another 15 million available in January. It is a two-dose vaccine, but even the first dose will provide substantial immunity, with full effectiveness coming with a second dose two to three months later – longer than originally thought.
We should consider using all the available doses in January as first doses, that is, not keeping back half for second doses. Then, as more production is rolled out, we will have enough for the second dose. Thirty million Johnson and Johnson vaccines – which is a one-dose vaccine – should also be with us by end of January. We should aim to use them all in February.
We should continue to prioritise frontline health staff and the most vulnerable, but let this not hold up vaccinating others. The aim should be to vaccinate as many people as possible in the coming months. The logic behind age is naturally heightened risk of mortality. But if it is the spread we’re anxious about, then it makes sense to consider vaccinating those doing the spreading, in particular certain occupations or age groups such as students.
Revisit the logistics plan to see if we can’t radically increase the volume of vaccination. If the vaccines are available, is it really impossible – given the gravity of our plight – to cover a majority of the population by the end of February?
Sort out the mass testing problem! I know it is argued that the rapid antigen tests are insufficiently accurate. My own sense – based on the research from my institute – is that yes, the PCR tests are the gold standard; but antigen tests have a crucial role. In Liverpool – which remains in tier 2 – the government has conducted a mass testing experiment where 25 per cent of all positive cases have been found in asymptomatic carriers through lateral flow rapid tests.
On a national scale this could identify and curtail significant spread. There is a risk of a false negative with rapid tests; but at present all untested asymptomatic Covid cases are essentially false negatives. A 30-year-old asymptomatic Covid sufferer, unaware of their condition, could have a high viral load and be helping the virus mutate.
Drive up production of the life-saving therapeutic drugs and give every patient the opportunity to enrol in drug trials.
Data: we need the best data system available in the world and we need it now. Please do not believe our existing systems are adequate. They’re not. Because of mutations, because we will learn immensely more in 2021 than we ever learnt in 2020. We must capture every test taken, every vaccine administered and every drug received in one single record.
Prepare for a form of health passport now. I know all the objections, but it will happen. It’s the only way the world will function and for lockdowns to no longer be the sole course of action.
This is nothing to do with politics. I just want the government to succeed in getting on top of this virus. But we cannot afford to get this vaccination plan wrong.
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