Cry freedom. Britain is finally heading for the sunlit uplands. OK, so we might be on track for one of the coldest Mays for a few hundred years since records began, but I confidently predict that is not going to dampen the spirits of the multitudes who are now one small step closer to the freedoms this country has been enjoying since the Glorious Revolution (and prior to March 2020, of course).
But wait – what is this? A frisson of tension is in the air. Despite the (expected) seasonal abatement of respiratory disease, with excess mortality in the UK running comfortably below average, apparently a new Indian variant is running rampant in Bolton. This claim seems not to be supported by the government’s own data. Nevertheless – according to HM Government ‘ministers’ – a full reopening on the first day of summer is ‘at risk’ due to ‘vaccine refusers’. This is an extraordinary leap, especially given the absolute numbers involved: Bolton NHS Foundation Trust reported a grand total of 12 patients with Covid-19 have been admitted to hospital since the beginning of May.
And to add fuel to the fire, note the tone: ‘vaccine refuseniks’ are being ‘targeted’. Given the specific historical references to Soviet repression of minorities, and noting the exhortations of a notorious cavalcade that took to cruising the north London streets at the weekend, one might naively have expected more nuanced language. But perhaps this is too much to expect from a government that seems to be drinking deep from the populist well.
This is a very sinister development, and raises the bar regarding the use of menacing language to achieve ends unknown. After all, everyone who is at risk has been offered a vaccine; levels of natural immunity are very high. There is a high degree of confidence that the vaccines protect against the Indian variant, and as reported in Nature, we can and should expect very high post-infectious T-cell immunity in those who have recovered from Covid-19. In fact, as argued in the BMJ in an article published last week, “once most adults are vaccinated, circulation of SARS-CoV-2 may in fact be desirable, as it is likely to lead to primary infection early in life when disease is mild, followed by booster re-exposures throughout adulthood as transmission-blocking immunity wanes but disease-blocking immunity remains high”. Along these lines, it will not have escaped people’s notice that many places in the northern hemisphere have been operating without restrictions now for many months, helping to boost natural immunity in the younger population.
We should note, of course, that we do not live in a risk-free world – an asteroid could obliterate us at any moment. But that should just encourage us to live out the days we do have. The chances of a few cases of the Indian variant in Bolton triggering an epidemic are infinitesimally small, especially at this time of year – viruses that cause respiratory disease are currently themselves in lockdown, waiting for autumnal cold and humidity. This is especially true given the progress of said variant in India itself, with a sharp downturn in new cases despite negligible progress on the vaccination front.
Against this background, the pressure being brought to bear seems out of place. The concept of asymmetric risk has been discussed at length. The ‘My Body, My Choice’ crowd seem curiously quiet: an individual’s decision to proceed with an injection should be a matter of informed consent, not something decreed by top-down diktat and laced with veiled threats. Resorting to such foul means risks huge damage to the credibility of vaccines, one of the most miraculous cornerstones of medical advancement since Louis Pasteur’s discoveries in the 19th century. If it is possible to achieve 90 per cent plus take-up of a vaccine that protects from measles (a horrific childhood disease) by ‘winning the argument’, then we should be doing the same here. In the words of our Chief Medical Officer, Covid-19 now faces a ‘wall of vaccinated people’.
In the fight to encourage people to accept the prick of a needle, it is not acceptable to threaten the use of blunt instruments for those that will not (or indeed cannot). The use of threatening language to unjustifiably scapegoat these groups is vile, unethical and likely to be hugely counter-productive. The government should not be a playground bully; it must try to win the argument.
Dr Alex Starling is an advisor to and non-executive director of various early-stage technology companies. Follow him on Twitter: @alexstarling77