We are nearing our one year anniversary of the first lockdown in the UK. Hooray. You will be forgiven for not rushing out onto the street to celebrate, largely because that would be illegal, but also because the solemn milestone of 100,000 deaths reached in recent weeks leaves us little room for cheer.
Since the pandemic began, the whole country, or rather the whole world, has endured the pain, confusion and solitude brought on by lockdowns, isolation and the persistent climbing of the death toll. The phrase: ‘we are living through a moment in history’ is one often heard and one quite true; 2020 will force changes in the ways we operate as a society and as individuals. However, as the Prime Minister said in his press conference announcing the latest lockdown, we are ‘entering the last phase of the struggle’.
In that same speech, Johnson outlined the change that has allowed this final phase to begin – vaccinations. ‘By the middle of February’, he said, ‘if things go well and with a fair wind in our sails, we can expect to have offered the first vaccine dose to everyone in the four top priority groups’. It is the ‘biggest vaccination program in our history’, one that will ensure that in the coming weeks all over 70s, all social and health care workers, all care home residents and staff, and all clinically vulnerable citizens will develop an immunity to Covid-19. It is an enormous task. But it is one we are on course for, and one that will bring about the beginning of the end, the beginning of our return to normality in whatever form it may take.
For the rest of this article, I would like to look forward to that transition away from restrictions, thinking about the pace at which they will be relaxed and just how quickly we can expect a return to some form of normality. To be clear, this will not be ‘anti-lockdown’. Those of the cynical opinion that all measures thus far have been harmful need to stand aside from their own individual concerns and acknowledge the fear that those more at risk than themselves feel when they see the death toll rising. This pandemic has pressed us up against our own mortality. No government could ever policy death, no matter the impact on the economy. We have the unfortunate first-world disposition of expecting nothing to go wrong if problems are handled (more or less) correctly. This is a pandemic and will of course bring negatives.
However, as Johnson stated, ‘not only is the end in sight, but we know exactly how we will get there’. From the point that the most at-risk groups are vaccinated there will be a ‘time lag of two to three weeks from getting a jab to receiving immunity and a further time lag until the pressure on the NHS is lifted’. That places us towards the end of March, and it is from there that Johnson says we will begin ‘cautiously to move down the tiers’.
It is this point that I would like to question. This was a speech peppered with conditions and balanced on the word ‘if’. Recently, advisor Professor Susan Hopkins told Andrew Marr, ‘I hope that this summer will be similar to last summer. I hope that we’ll get down to those sorts of case numbers.’ I believe we can be more definite than this. But to do so, we need to stop focussing on ‘case numbers’ and concentrate solely on the death rate.
In a WHO report on mortality rates, the organisation stated that ‘efforts should be made to calculate risk-group-specific estimates of fatality risk in order to better describe the true patterns of fatality occurring in a population’. This is because the effects of Covid-19 vary widely with certain variables, the most telling being underlying health conditions and age. An Imperial College London report stated that in high-income countries, the fatality ratio (the percentage of people who die from contracting Covid-19) is 1.15%. This falls to 0.23% in low-income countries with much younger populations, despite their lack of access to medical technologies. They found the fatality ratio to be greater than 5% for individuals over 80 and only 0.1% for those under 40. To quote directly from the report, ‘the researchers find… the risk of death doubling approximately every eight years of age’.
This casts a different light on the statistics we have all been bombarded with over the past months. According to the Office for National Statistics, for the week ending 23rd January ‘the percentage of positive tests was highest in young adults (school Year 12 to age 24 years) at 2.01% and lowest in adults aged 70 years and over at 0.86%’. Yet the numbers of hospital admissions and deaths were dominated by those aged 70 and older. Those who, come the end of March, will have immunity to the virus. Hopefully it becomes clearer that measures such as case numbers and the much lauded ‘R-rate’ aren’t as useful as first thought. Or, more accurately, won’t be as useful post the vaccination roll-out.
For Professor Susan Hopkins to judge restriction relaxation to be on the condition of ‘case numbers’ and for Johnson to state that we must ‘cautiously…move down the tiers’ after the initial wave of vaccines, they must consider the symptoms of the virus significant enough to justify the closure of the economy and the stripping of all social activities. I would gladly sacrifice my sense of smell for a meal out and an opportunity to work again.
It is difficult to avoid sounding callous when talking on the subject of mortality but it’s a conversation that needs to be had, and a point that needs to be made in the coming weeks, as the country prepares to transition back to a much needed normality.