Macron and others played politics with AstraZeneca. The consequences for many EU citizens are fatal.

24 Feb

In January this year, many will remember Emmanuel Macron telling reporters, in no uncertain terms, what he thought about the vaccine developed by AstraZeneca and Oxford University.

Today we think that it is quasi-ineffective for people over 65”, he said, hours before the European Medicines Agency recommended it for adults of all ages. “[T]he early results we have are not encouraging for 60 to 65-year-old people concerning AstraZeneca”, the French president warned, as well as criticising Britain’s strategy of delaying the second dose of the vaccine to get the first one out quickly – in another act of incredible diplomacy.

Days earlier a German newspaper incorrectly claimed the AstraZeneca jab is only eight per cent effective in the over-65s. While the figure was quickly dismissed, several countries haven’t exactly inspired confidence in AstraZeneca’s efficacy. Germany advised that it should not be given to people aged 65 or above, citing “insufficient data”, and France, Switzerland, Denmark, Sweden and Norway have also recommended it only for younger people.

Ursula von der Leyen, the European Commission Chief, even went so far as to accuse the UK of compromising on “safety and efficacy” safeguards in delivering its vaccines. And Clément Beaune, France’s Europe Minister, warned “the British are in an extremely difficult health situation. They are taking many risks in this vaccination campaign.” You don’t have to be a Brexiteer to get the idea: British vaccines = bad. Even John Bell, a medical professor at Oxford University, accused Macron trying to reduce demand for vaccines to cover up the EU’s huge issues with procurement, culminating in its dangerous attempt to control vaccine exports across the Irish border.

So one wonders what the mood is in Brussels now that research has revealed just what a success the much-attacked AstraZeneca vaccine has been. A study in Scotland, where 1.14 million people were vaccinated between December 8 and February 15, showed that both the AstraZeneca and Pfizer vaccines led to a “very substantial” drop in serious illness across all adult age groups.

Critically, researchers found that by the fourth week after receiving an initial dose of each vaccine, the risk of hospitalisation from Covid-19 reduced by up to 85 per cent (Pfizer) and 94 per cent (AstraZeneca), in a result that will please people who’ve had it – but raise serious questions about the language and policies of EU leaders.

Their actions have fuelled vaccine hesitancy. In Germany, for instance, people have failed to turn up to appointments for the AstraZeneca vaccine. As of Friday, only 150,000 out of 1.5 million doses of the vaccine had been used – leaving the country with less than six per cent of its population immunised (compared to 26 per cent for Britain).

There are also reports of hospital workers in France and Belgium demanding that they be given the Pfizer jab instead of AstraZeneca (one nurse in a Flemish hospital even told a publication she would go on strike if offered the latter). Politicians have failed to convey the bigger picture; that everyone is lucky to be offered one vaccine with high efficacy rates (50 per cent protection would have been a good outcome), let alone that several have been developed.

As Ryan Bourne and Jethro Elsden have already written for ConservativeHome, the EU’s difficulties in procuring vaccines is dangerous enough in itself – Bourne estimates the UK has saved around nine thousand lives by choosing its own vaccination programme, and Elsden says the country has gained approximately £100 billion from doing this.

The fact that some EU leaders have added to this chaos by planting doubts about AstraZeneca’s vaccine makes the situation even more alarming. The vulnerable are less protected, and – on a global scale – if we do not get transmission of the virus down, it can mutate and mean that the current vaccines do not work.

Some leaders realise the seriousness of the problem. Michael Müller, the mayor of Berlin, has warned that people could be sent to the back of the queue for vaccines if they refuse an AstraZeneca job. “I won’t allow tens of thousands of doses to lie around on our shelves while millions of people across the country are waiting to be immunised”, were his words, and Angela Merkel’s spokesman has pleaded with Germans to take the “safe and highly effective” jab.

It’s a start, but terrible that so much damage has already been done. Some might remember that in November 2020, MPs here debated whether social media companies should be doing more to remove anti-vaccine disinformation. Never could they have imagined it would be Macron spreading some of the most troublesome ideas.

Andrew RT Davies: Wales. Here’s how we can extinguish the dangerous flame of separatism.

24 Feb

Andrew RT Davies is the leader of the Welsh Conservatives and Assembly Member for South Wales Central.

One of the many unfortunate, if unintended, consequences of the Blair devo-revolution has been to undermine the Union’s sense of “permanence” – both from an ideological and an institutional perspective.

Designed to see off the nationalist threat, devolution has merely shifted the political narrative into an endless cycle of debates around further powers, with little correlation emerging between the performance of devolved governments and the level of support for independence.

It’s scarcely been more fashionable among constitutional experts (and BBC journalists) to view separatism as inevitable, but I certainly don’t share the view that it’s a foregone conclusion. Far from it.

The patriotic fightback has started and, as the leader of the Welsh Conservatives, these are some of the steps I want to see us take to extinguish the dangerous flame of separatism.

Put ‘Project Fear’ on ice and champion the pride of Britain

As Unionists we can often be guilty of basing arguments in process or economics. All very valid, and all incredibly important, but we need to own the emotive, patriotic argument – remembering and learning the valuable lessons from the victorious Brexit campaign many of us were part of.

We need to put “Project Fear” on ice and champion the pride of Britain.

I’m a proud Welshman. Proud of a Wales that consistently punches above its weight on the sporting and cultural scene, and has been to the fore on the pandemic frontline in delivering the Oxford-AstraZeneca vaccine through Wrexham-based firm, Wockhardt.

But I’m also a proud Brit. Incredibly proud of our world-leading armed forces, our pharmaceutical industry, our rule of law and our enviable creative industries.

It’s the very best of our country and a symbol of the greatest union the world has ever seen – socially, culturally and economically. Why would we want to undermine and banish that great unity for division and separation?

But we shouldn’t rest on our laurels and the British state can do more. Why don’t our great institutions such as the Imperial War Museum, National Gallery, British Library project themselves into Wales? That footprint can and should be easily corrected. Let’s do it.

And yes, where appropriate let’s champion the economic benefits too. In Wales, we’ve benefited enormously through the various support schemes delivered during the pandemic by the Government, which have saved hundreds of thousands of Welsh jobs during the recent crisis, and are now saving thousands of lives with Britain’s hugely successful vaccination programme.

I’m a proud Welshman and proud Brit and make no apology for it, and that’s the turf I want to see us fight on. Let’s dictate the terms of engagement, and redouble our efforts to make the positive and patriotic case for Wales, Britain and the Union.

Minister of the Union and inter-governmental relations

There’s no greater champion of the UK than the Prime Minister, and he’s taken the duty head-on with responsibility as Minister for the Union, working alongside the three excellent secretaries of state.

One of the PM’s greatest strengths is on the campaign trail and while it was brilliant to welcome him to Wales last week, it’s a shame current restrictions prevent him from engaging more widely with the public on his agenda to level up all parts of the UK, which will be the cornerstone of securing the Union’s long-term future.

It’s been well briefed in the press that Lord Dunlop’s (as yet unpublished) report recommends the creation of a new cabinet position for the Union, and suggests that it should be elevated in line with the other great offices of state to help keep the UK intact.

Whether this is necessary is a call for the PM, and the PM alone, but one area I have long felt needs attention is inter-governmental relations within the UK.

It’s my personal view the Joint Ministerial Committee requires urgent reform/reprioritisation to improve collaboration and decision-making, particularly with Brexit and the significance of UK-wide frameworks.

The devolved leaders are mischievous at the best of times and their aims are not always aligned to ours, particularly Holyrood’s EU-flag-waver-in-chief.

But an overhaul is required to shower them with attention and keep them in check, particularly when they pretend they have responsibility for areas they do not.

Unleash the opportunities of Brexit

While it may seem counter-intuitive, particularly given the strength of feeling in Scotland on the issue, Brexit provides us with an opportunity to reaffirm the benefits of our Union, and to shift the focus onto a positive discussion around the country itself.

The UK’s new found agility has allowed us to save lives thanks to a dynamic procurement strategy and rapid rollout of Coronavirus vaccinations, in comparison to the European Union’s overly bureaucratic and beleaguered jabs programme. Team GB at its best!

But there are other tangible benefits to Brexit, with the automatic repatriation of a vast array of new powers to these shores, including the devolved nations.

We need to ensure the new Shared Prosperity Fund (SPF) delivers for our poorest communities – levelling up our country – and reaching people who were for so long ignored.

This is an exciting opportunity for the Conservative government to transform all four corners of our country, and a game-changing regeneration scheme would be a powerful cocktail to the politics of division, separation and hate.

Devolution should never have been about power-fanatics in Cardiff Bay, Holyrood or Stormont – it’s about local communities

The biggest failure of Welsh devolution has been the hoarding of power in Cardiff Bay with people in north Wales feeling as disconnected with the Senedd as they ever did with the EU.

Devolution was meant to bring power and decision-making closer to communities, and it’s not too late to ensure that’s the case, albeit the UK government will have to be the driving force.

It’s important UK government spending is effectively targeted and given the PM’s ambition for large-scale projects, I’d like to see the designation of “Union Highways” that would unblock Wales’s arterial routes on the M4, A40 and A55 and boost important cross-border growth.

Where devolved government fails, let’s help local authorities and the communities they serve.

No more referendums, no new constitutional chaos, but a sole focus on recovery

People in all corners of the country want to see politicians across the UK working in partnership to focus on defeating Coronavirus and the other challenges we face.

And whatever happens post-May, the UK government should stay strong. The Scottish referendum of 2014 was a once-in-a-generation vote, one which the separatists lost. End of.

The energy and resources of governments at Westminster, Cardiff Bay, Holyrood or Stormont should be focused on our post-pandemic recovery. Anything else would be unforgivable.

And as we emerge from this crisis, Conservative energies must be focused on improving everyday lives and rebuilding our economy, which will be the best antidote to the constitutional fanatics.

So let’s back Wales, back Britain and get on with the patriotic job of building back our country better than ever.

Ryan Bourne: How many lives will we save by choosing our own vaccination programme, not the EU’s? Let’s start at nine thousand.

3 Feb

Ryan Bourne is Chair in Public Understanding of Economics at the Cato Institute.

Delay is extremely costly in this pandemic. When the post-mortems are written, lethargy will rank high on the list of consequential policy mistakes. With a rapidly spreading virus, procedural bureaucracy or a failure to grease the wheels for vaccine rollouts will be found to have cost tens of thousands of lives in each advanced country, alongside incalculable damage to livelihoods.

As I explain in my forthcoming book, Economics In One Virus, governments have certainly spent big on testing, tracing, and vaccines. But the sums are piddling in comparison to the amount allocated for economic relief.

The latter is demanded by voters, but it would have been wiser to put more funds into paying over-the-odds to encourage vaccine manufacturing scale-up, to overcome bottlenecks, and to facilitate around-the-clock rollout as soon as vaccines were ready. This would have handsomely paid for itself in a more rapid economic normalisation, not to mention the lives saved. As economist Alex Tabarrok has written, this was the easiest cost-benefit analysis in the world for policymakers. When the inquiries begin, governments will lament their relative stinginess on spending where it mattered most.

As of writing this on Monday, the UK’s vaccine rollout performance is improving still, of course, with nearly 600,000 jabs registered Saturday and England’s figures for Sunday up 45 per cent on the week. It might seem a bizarre time then to lament that we didn’t go quicker still. Yet two months after the first vaccine was approved, still only around 14 per cent of the public have received at least one dose. While the manufacturers and the NHS are (understandably and heroically) pulling every lever given where we are, we will surely regret in future not having had an Israeli-style mobilisation in place.

That’s not to say the UK’s performance has not been *relatively* impressive. The dexterity of the MHRA in understanding the trade-offs associated with the approvals process puts the US to shame, as that country stalls on approving AstraZeneca’s vaccine despite tens of thousands of Americans dying per week. The UK government’s willingness to stump up more cash has exposed the false economy of the EU’s haggling over pennies in contracts too.

For the costs of delay are exacerbated by the way this virus and the vaccines operate. An infection might take three to four weeks before it manifests as a death. Vaccines themselves take a couple of weeks before they are high efficacy. So now we see the consequence of the relative lack of acquired protection for many elderly people in mid-January. It is only in the next three to five weeks that we should start seeing the big vaccine-induced falls in mortality, if indeed vaccines really do have near the 100 percent touted effectiveness in preventing deaths.

The Covid-19 Actuaries Group (CAG) believes that if the Government delivers on its eminently achievable target of vaccinating all over-70s, care home staff, frontline health and social care workers, and the clinically vulnerable, by mid-February, daily Covid-19 deaths will fall by two-thirds by the end of the month. By the tail end of March, deaths should be down 86 percent against a world without vaccines. So one can understand the angst inside the EU—their tardiness in getting vulnerable populations vaccinated will cost lives that will be all the more observable if British trends go as expected.

How many extra deaths have we avoided through our speedier rollout? Calculating the exact magnitude is extraordinarily difficult. Lockdowns and tier restrictions perversely lower the immediate “lives saved from vaccines,” because without them more people would have been exposed. Working out how many lives the UK will save compared to the EU in the coming months is also muddied by not knowing the eventual speed of each country’s vaccination program or the underlying prevalence of the disease for the nations.

But comparing the UK to France, Germany, Italy and Spain (the EU-4) gives us an idea of magnitudes. These countries have only vaccinated between two and four percent of their populations respectively, and are currently vaccinating at a rate of 0.11 to 0.12 percent of their populations per day.

The UK has vaccinated 14 percent of its population, and is currently vaccinating over 0.55 percent of its population per day. If extrapolated forwards, the UK would vaccinate its four priority groups once by mid-February. The EU-4 would achieve the same proportion of population dose numbers by mid-to-late July. Indeed, even if the EU-4 were suddenly able to up their daily vaccinations to UK rates from now, they would not hit the same number of doses as a proportion of the population as the UK’s February target until early March—three weeks behind.

My calculations based on the Covid-19 Actuaries Group report suggests that, if the vaccine is 100 percent effective in eliminating death, the UK has already seen around 1,300 fewer deaths as a result of vaccines. Given the lags discussed between infections and deaths, as well as the time it takes for vaccine efficacy, this is almost certainly close to 1,300 more lives saved than would have been saved had we been as tardy as the EU.

Projecting forwards to how many lives are being saved from the recent and current vaccinations is more difficult. We have to try to model what cases and deaths would have looked like absent a vaccine. We would also need to know how fast the EU vaccination program will become, something that I profess no knowledge of.

But, for illustrative purposes, let’s assume that, absent a vaccine, deaths would otherwise have fallen through February and March as a pure reflection of how they rose in December and January. Under this scenario, the UK has already locked in 9,000 fewer deaths through mid-April than if it had moved at the EU-4’s vaccination pace to date (saving 20,000 lives overall). And that’s assuming the EU-4 countries wake up tomorrow and suddenly match the UK’s speed.

Realistically, of course, some of the EU-4 are not planning to widely vaccinate for a month or two, while they are sticking to the regimen of two doses sooner that will leave fewer people on the Continent protected in the near-term. So, it’s very safe to say the UK will have saved tens of thousands of additional lives relative to going at the EU-4’s pace over the coming months, with the gap especially dramatic if the EU does not up its game in the very near future or if, as a result of vaccinations, the UK then relaxes its lockdown restrictions. The costs of delay in public health and economic terms are clearly enormous.

David Gauke: The UK, the EU, vaccines – and future relations. Here, jingoistic politicians. There, Trumpian ones. Bodes badly.

29 Jan

David Gauke is a former Justice Secretary, and was an independent candidate in South-West Hertfordshire at the recent general election.

Will the new, post-Brexit relationship between the UK and the EU run smoothly? Will the Trade and Cooperation Agreement (TCA) provide a foundation on which a closer relationship is constructed (albeit still much more distant than the one we had), or will it provide the means by which the UK diverges from the EU?

The first few weeks after the transition period have confirmed many of the predicted difficulties of a hard Brexit. Businesses have struggled with red tape and trade with the EU is much reduced.

Whatever the Prime Minister claimed, the TCA does not address non-tariff barriers in the same way as the Single Market, and the erection of trade barriers will have a long-term economic impact. Northern Ireland is adjusting to a border in the Irish Sea, and it must finally be occurring even to the DUP that campaigning for Brexit and against a deal that kept Northern Ireland and Great Britain closely aligned has not served the Union well.

Given the obvious problems of Brexit and that, by the time the transition period ended polls showed that a clear majority of the public thought the country had made a mistake in 2016 in voting to leave, one might expect that, over time, we would begin to move to a more collaborative relationship. The likelihood, however, is that we will go the other way.

There are a number of political reasons for this. Perhaps most importantly of all, the political imperative for the Conservative Party is to maintain the support of those Leave-voting Red Wallers who delivered the Prime Minister his majority.

This week saw the Conservative Group for Europe relaunched as the Conservative European Forum. The CEF’s Chairman, David Lidington, delivered a characteristically thoughtful, well-informed and pragmatic speech setting the case for building a constructive relationship with the EU.

I hope the Government follows his advice, but I fear it won’t. If the Government’s approach to the EU is thoughtful, pragmatic and constructive, this is not going to get the patriotic juices of Workington Man flowing. There needs to be rows, conflicts and Brussels-bashing from Boris Johnson whilst portraying Labour as the party of ‘rejoiners’. ‘Keep Brexit Done’ will be something we could hear a lot in 2024.

To nullify this risk, there is every sign that Keir Starmer will want the next general election to be about almost anything other than the EU. The most straightforward way for Labour to win more seats is to win back the Brexit-voting Red Wall.

The absence of much opposition from Labour to a hard Brexit position might create an opportunity for the Liberal Democrats to articulate a pro-European one that will cut through to the public. But betting on a Lib Dem revival has not proved to be a profitable pursuit in recent years. In any event, pro-European votes have tended to be split amongst many parties and heavily concentrated in safe seats whilst Brexit votes are most efficiently distributed and, as long as Nigel Farage can be kept at bay, will vote Conservative.

The upshot of all this is that even, if the public continues to become more pro-European in the way that it has in the last five years (largely because of demography), the chances of an explicitly pro-European Government being elected in 2024 remain slim.

Nor should we discount the possibility that UK opinion becomes more hostile towards the EU in future. Even the day-to-day negotiations with the EU which we are now condemned to – endlessly having to make judgements as to how we balance ‘sovereignty’ with access to our most important market – can have a deleterious impact on how the EU is seen.

A bigger trading partner willing to leverage its strong negotiating position to protect its interests can be an unlovely sight, as the Swiss discovered after narrowly rejecting EU membership in 1992, since when support for joining the EU has fallen sharply.

Within weeks of the transition period coming to an end, we have faced more than the day-to-day challenges. The row between the European Commission and AstraZeneca is turning into a crisis that could have very serious implications for UK/EU relations.

Even before the recent difficulties with the AZ supplies, plenty of Brexit supporters were claiming that the UK’s success in rolling out the vaccine is a vindication of our departure from the EU. The reality is that at the relevant time, we were still required to comply with EU rules and everything we did on vaccines we could have done as EU members. Nonetheless, it is true to say that in these particular circumstances, going it alone has served us well. It is not surprising some are describing this as a benefit of Brexit.

The case, however, needs to be made that what worked in the very specific circumstances of finding vaccines in a pandemic applies elsewhere. It is not obvious that there is a read across from our approach to vaccines to other challenges we will face, not least because we are not yet capable of cloning Kate Bingham.

Not every decision that this country has taken during the pandemic has been quite so world-beating, and there is also a risk that we learn the wrong lessons from the vaccine issue and, in the pursuit of self-sufficiency in a whole host of areas, become increasingly protectionist.

But the immediate danger of protectionism comes from the EU in its export controls on vaccines. Understandably, EU citizens are concerned about the slow rollout of the vaccine and the response of the European Commission has been to panic, lash out and distract.

The news that AstraZeneca is unable to deliver the number of doses hoped for has resulted in demands that it diverts the product committed to the UK. Notwithstanding the statements made by EU Commissioners, the publication of the agreement between the EU and AZ reveals that the contractual basis of such demands is, at the very least, questionable.

So its next step is to control exports to the UK. Yesterday, this even involved triggering Article 16 of the Northern Ireland Protocol enabling the EU to block exports from the Republic of Ireland to Northern Ireland.  This is supposed to be a “last resort” mechanism, but its use was premature, provocative and sets a precedent that will be cited by those unwilling to accept the consequences of the Protocol.  The Commission has now seen sense and backed off.

There is an argument that, if the EU is throwing its weight around in order to prioritise the interests of the citizens of member states, this suggests that it is a good idea to be a member state. However, it is an unattractive argument that is, at best, ‘right but repulsive’.

Medicine supplies rely on internationalism and interdependence, and vaccine nationalism will mean that we all end up as losers. The UK’s response to the strident language coming out of the EU has been strikingly mature and measured. On this issue, at least, it has wisely sought to de-escalate tensions.

Let us hope that this is what happens, that the behaviour of the EU is performative and that the practical implications of yesterday’s announcement are limited. But it might not be.

The fundamentals of the UK’s need for a constructive relationship with the EU have not changed. It was not in our national interest to leave the EU; it is in our interests to create a new, special relationship. Such an outcome is not inevitable but the Trumpian behaviour of the EU in recent days makes that task all the harder.

Vaccines. The United Kingdom v a “rules-based organisation”.

28 Jan

One challenge for Brexiteers trying to sell their project to sceptics is overcoming the widespread psychological tendency towards loss aversion. This is a pattern of behaviour which, when applied to economics, is defined by Wikipedia as “the tendency to prefer avoiding losses to acquiring equivalent gains”.

Simply put, and perhaps not unreasonably, people tend to react more strongly to the prospect of missing out on something they already have, which is real and tangible, than on gaining something new, which is not.

This raises obvious difficulties when it comes to selling Brexit. Even if you are convinced that leaving the European Union will make Britain better off in the long-run, those gains lie in the future (and are in any event subject to our making the right policy decisions to reach them, which isn’t a given). Meanwhile the downsides, in the form of port delays, trade disruption, and so on are felt at once.

Not all of these will endure – some will simply be the reality of de-alignment, others ‘teething issues’ – but they still make the costs of Brexit more apparent than the benefits to those not predisposed to support the idea.

Which is why the extraordinary story of the UK’s vaccine rollout is so significant. Not only because by providing a happy ending to the Covid-19 saga it might yet, as Tom McTague argues, salvage public perception of Boris Johnson’s handling of the pandemic despite our passing the grim milestone of 100,000 casualties. It’s also an unusual example of an immediate, tangible benefit to Britain being outside the bloc.

As this interview with Pascal Soriot, the CEO of AstraZeneca, makes clear, that benefit was simply that London was able to conclude a deal months before Brussels could. This gave the company more time to work the kinks out of its supply chain, and meant that by the time the EU finally got to the table all AstraZeneca could offer was a “best efforts” contract that reflected the difficulty of scaling production up in the time available. As he puts it:

“We’ve had also teething issues like this in the UK supply chain. But the UK contract was signed three months before the European vaccine deal. So with the UK we have  had an extra three months to fix all the glitches we experienced. As for Europe, we are three months behind in fixing those glitches.”

In response, the EU is trying to claim that its contract with AstraZeneca doesn’t contain a clause to the effect that other customers have higher priority, although unless there’s a clause to the effect that the EU itself has priority it isn’t obvious that matters, and even whilst ‘upping the ante’ Brussels does seem to admit the implications of the ‘best efforts’ formulation.

Either way, it’s pretty desperate stuff that doesn’t exactly smack of ‘modern, rules-based organisation’ behaviour and has the potential to deeply poison UK-EU relations if it looks like the latter is trying to make off with our vaccine supplies (especially if they break international law, perhaps in a “specific and limited way”, to do so).

Some will doubtless point out that there was nothing technically stopping the UK pursuing an independent vaccine policy. But the fate of the ‘Inclusive Vaccine Alliance’, which saw France, Germany, Italy, and the Netherlands team up to secure vaccines before being browbeaten into giving way to the European Commission, strongly suggests that we wouldn’t have. Especially when the UK was home to the European Medicines Agency and had a general track record of gold-plating, rather than subverting, the EU order.

Neil O’Brien: The virus and the lockdown. Let’s keep calm and carry on – for there’s reason to believe that a vaccine is coming soon.

2 Nov

Neil O’Brien is MP for Harborough.

Sarah Thomas is a lunatic. And amazing. About a year ago, she became the first person to swim the Channel four times in a row without stopping. It took 54 hours.

Between booking her slot, and getting in the water, she survived cancer. Setting off, she was immediately stung in the face by a jellyfish. On her fourth crossing, strong tides pushed her off course, turning 83 miles of swimming into 134, forcing her to sprint-swim to break free from the current.

She’s inspiring. And swimming the channel isn’t a bad metaphor for our fight against coronavirus. Metaphorically, we’re somewhere in the middle, when you can’t see Britain, but can’t quite see France either.

The national restrictions announced by the Prime Minister on Saturday underlined that we will still be slogging through this for a while yet. Polls suggest the public strongly back his decision: given the alarming data, it is definitely the right one.

Yet everyone’s tired of the restrictions and not seeing loved ones and friends, and the good things we look forward to once this is over remain a way off.

As we go through this marathon ordeal, what can we learn from Sarah Thomas?

First, most top athletes are taught to visualise success.

Regarding Coronavirus, the finishing line is becoming more visible, with progress on vaccines looking good. The New York Times runs a Vaccine Checker which lets you follow progress.

Eleven different vaccines are in final-stage “Phase 3” clinical trials, with half a dozen or so now seeing limited use outside trials.

There were always reasons to be optimistic about a vaccine: when the whole world wants something really badly, it’s likely to get produced. Producing a vaccine for coronavirus isn’t like inventing the atom bomb or putting a man on the moon, which required oodles of new technologies. A Covid-19 vaccine is a sideways-step from existing technologies. Several categories of vaccines look like they will be ready to roll in the coming months:

  • The Oxford / AstraZeneca vaccine is basically a weakened version of a common cold type virus, modified to carry a protein which Covid-19 also shows, so that your body can learn to seek and destroy it without exposure to the real thing. Trials found it produces a good immune response including among older people, and doesn’t have side effects. The UK, US and EU have signed for hundreds of millions of doses.
  • Other vaccines based on a similar approach in final stage tests include China’s CanSino vaccine, Russia’s Gamaleya Research Institute and Johnson & Johnson in the US.
  • Another promising approach is based on the use of messenger RNA: a blueprint for making proteins. The Pfizer / Biontech vaccine works like this and may well be the first to go into non-trial use in the US. There was some speculation last week that we could start using it here in the UK before Christmas, which seems a bit soon, but it isn’t far off. Another similar vaccine from the Gamaleya Research Institute is also final stage trials.
  • Finally, there’s a bunch of traditional vaccines based on inactivated versions of Covid-19 (like the Hepatitis B vaccine, which has been around since the 1960s). China’s Sinopharm and Sinovac both offer vaccines like this – the Sinovac one is already being used outside clinical trials and you can buy it in some cities for $60. The Indian Council of Medical Research is also in final stage trials of an equivalent.

So the shore’s not so far away.

The other lesson from Sarah Thomas is about listening to the right people. She says she nearly quit halfway, but her team egged her on.

Contrast that with the British commentariat, large parts of which are dishing out terrible advice. If they’d been in Sarah Thomas’s support boat they’d have been telling her to give up, harping on about how cold it was. They’ve been hopeless throughout.

First, they dismissed the problem. Richard Littlejohn wrote in the Daily Mail on March 2nd/

“My default position on all these health scares is weary scepticism. We’ve been here before. Sars, Mers, Ebola, Bird Flu, Swine Flu… All passed in Britain, at least without the catastrophic death toll the so-called ‘experts’ confidently predicted”.

Wrong.

Then they declared the problem over. In the Daily Telegraph, Allison Pearson wrote in May that that, by June: “a scientist friend assures me the coronavirus will have petered out.” Sunetra Gupta, one of the authors of the Great Barrington Declaration, (and who the media fawns over), predicted in May that “the epidemic has largely come and is on its way out in this country”, which she said was “due to the build-up of immunity”.

Wrong.

The commentariat want to shout down wiser voices. In September, Sir Patrick Vallance faced a torrent of abuse for saying that there might be 200 deaths a day from Covid-19 by mid November. “Project fear,” thundered one Telegraph columnist. Piers Morgan blasted the Government’s “scaremongering.”

Wrong.

In fact we hit that grim milestone sooner, in late October, and hit 326 by the last day of October. We need to start listening to the right coaches – not hopeless people who get it wrong time and again, but face zero accountability.

Finally, top athletes learn from the best. In terms of Coronavirus, the best performers are Japan, Korea and New Zealand. France has had 19,800 cases per million people. The UK 14,800. Japan has had just 795, and Korea just 512 and New Zealand 325.

New Zealand is rural, but Japan and Korea are heavily urban. How did they do it?

Partly it’s about near-universal mask use. As the Lancet notes: “In Hong Kong, Japan, and South Korea, the habit of mask wearing by people with respiratory conditions was already widespread before the pandemic”. Part of it is that all these countries also have tough virus border controls.

There are other factors. Japan locked down Tokyo at a very early stage. South Korea’s super-duper test and trace system uses records of credit card transactions, mobile phone and global positioning system data, to fill in gaps in what coronavirus patients can remember in interviews.

The most important lesson from Asia is that success breeds success. A low rate of cases makes it easier for test and trace staff to isolate and shut down chains of infection, and contain local outbreaks. Too many cases and such approaches are overwhelmed.

To use an analogy, it took us a long time to work out how to conquer inflation. The key discovery was that the only way to have stable inflation is to have very low inflation.

The same’s true of coronavirus. Either you are beating coronavirus, or it is beating you. It doesn’t want to go in a straight line or rise gently, but to streak exponentially upward. Korea, Japan and New Zealand have got it pinned to the floor, so can get on with their lives. Instead of surrendering, as let-it-rippers in the commentariat advocate, they’ve decided to win.

Unlike Sarah Thomas we don’t have to swim for 54 hours. But we’re all enduring hardships. To get to the other side of this we need to keep thinking straight. It’s easy to be seduced by the idea that there’s some easy way out. There isn’t.

When she was far out to sea, her team called to her: “Just keep swimming.” At first, I thought that sounded really dumb. But when you are out in the middle of the Channel, it’s not such bad advice.

Robert Sutton: The Coronavirus. We must stop pinning our hopes on a vaccine – and learn to live with it

14 Sep

Rob Sutton is an incoming junior doctor in Wales and a former Parliamentary staffer. He is a recent graduate of the University of Oxford Medical School.

The phase three trial for one of the leading contenders for a Covid-19 vaccine has been paused. The collaboration between Oxford University and AstraZeneca has been put on hold after a patient became unwell.

The official line from the Government and developers has been that this is perfectly normal procedure – such setbacks are common in clinical trials, and we should not worry prematurely. Matt Hancock has described it as “not necessarily a setback,” while an AstraZeneca statement said it “is a routine action…In large trials, illnesses will happen by chance.”

This is true, and we do not have any reason to believe the incident is a significant issue for the trial. But it highlights a disturbing vulnerability in the Government’s current strategy.

That a pause has prompted so much speculation shows how heavily we have become invested in the idea that a vaccine will be the solution to the current pandemic.

The development of a number of promising candidates has been used to justify the economic and social disruption which has been imposed to counter the virus’ spread. That we will be promptly able to eradicate Covid-19 once we have a working vaccine is assumed by many, including those in Government steering the response, to be a given. Boris Johnson has said he expects a “significant return to normality” by Christmas.

While never explicitly stating it, this Government’s entire coronavirus response has been based on this assumption that the Coronavirus is a short-term problem to which a vaccine is the solution. Hancock reiterated only a few days ago that “the best way out of this coronavirus pandemic remains a vaccine.”

If it were to be condensed into one of the three-line stanzas which attempt to communicate to the public the ever-changing guidance, it might be: “Lock everything down; get everyone vaccinated; beat the coronavirus.”

But what happens if we are not able to achieve that second step?

The technical, social and political challenges in producing an effective vaccine over such a short timeframe are myriad. Even if the Oxford vaccine does prove to be safe and effective and enters mass production by early next year (which is a big if), getting the public to accept it widely will be a challenge at a time when faith in the Government’s handling of the response is low.

A programme to vaccinate the majority of citizens across the UK will be extraordinarily difficult. Achieving sufficiently high coverage to prevent further spread and to protect vulnerable individuals requires a high level of compliance. If too low a fraction of the population is vaccinated, it will have little effect in preventing further spread. But many younger citizens will not be interested, as the threat to them is so minimal. Others will be concerned about the possible side effects of a vaccine which has been rushed through production at breakneck speed.

Yet for vaccination to be successful in protecting vulnerable populations, these groups must be included. And with many on the Conservative backbenches already uncomfortable with the Government’s growing encroachment on civil liberties, it seems unlikely there will be sufficient political capital available to force citizens to comply.

Even if we manage to produce a safe and effective vaccine and achieve mass inoculation, return to life as normal will not be as simple as flicking a switch back on again. Disruption to industries and supply chains will take time to subside, and in some cases the damage will be permanent.

The Government should spend less time thinking about life after Covid-19 and more time planning how to safely life and work alongside it. The coronavirus is unlikely to be gone by Christmas, and in the meantime, we must consider if the self-inflicted damage caused by this government’s response could begin to outweigh the threat of the virus itself.