As UK deaths from Covid approach 100,000, we must never forget the political failures which led us here, argues Alex Snowdon

Almost three weeks into the lockdown, we can begin to gauge its impact. We are also now seeing real acceleration of the vaccine rollout, allowing us to forecast how it might affect the weeks and months ahead. So where are we?

We currently have the paradox of terribly high death and hospitalisation rates while infection rates are falling. This is due to the different time frames at work: hospital numbers and death figures lag behind infection rates by 3 or 4 weeks.

The latest reports are of over 38,000 people in hospital with coronavirus. We should pause to consider how appalling this is and avoid becoming too desensitised. There was a time when 20,000 – perhaps 25,000 at a real stretch – was cited as the capacity figure for the NHS. We have been above that level for weeks. The numbers are now 78% higher than at the peak of the first wave.

The notion of the NHS being overstretched has therefore moved from hypothesis to reality. Capacity has been stretched further by a combination of cancelling non-Covid operations and treatment and staff working overtime. The social crisis in our hospitals that was always a worst-case hypothesis has come to pass.

100,000 deaths

The death figures have reached new peaks – much higher than in the worst of the first wave – in the last two weeks. We know from the infection rates and hospital admissions numbers that for the next two weeks they will continue to be dizzyingly high.

The official tally for deaths is now 95,981 and will pass 100,000 in a few days. The real figures are certainly higher, made clear by Office for National Statistics records. In a couple of weeks, we should see the numbers begin to fall.

That is because lockdown is clearly having an impact. The infection numbers have been falling over the last two weeks, as lockdown’s reduction of social contact makes itself felt. However, the virus had been allowed to spread so far and so fast that this is starting from an exceptionally high level.

This is where the new strain fits in. The newer variant, B117, is estimated to be 70% more transmissible. Many experts, in both Sage and Independent Sage, have warned that a harsher lockdown is needed because of this new strain. Otherwise, we could face a very drawn-out lockdown indeed.

Dithering and delay

Yet the government has been dithering over bringing in stronger restrictions. It has instead focused on public health messaging exhorting people to follow the rules. It is often the case that public health campaigns reflect policy failures. That is unquestionably the case here.

It is an approach that encourages people to blame each other. However, the biggest factor in continuing transmission is almost certainly the fact that so many workplaces remain open. The government is unwilling to close non-essential workplaces.

Pupil numbers in schools are thought to be around five times higher than during the first lockdown. Nurseries, meanwhile, haven’t been closed at all: they were made exempt from the announcement about schools closing to most pupils. This wider opening of schools and early years settings is linked to higher numbers of parents going out to work than during the March-May lockdown.

The government was hopelessly late in introducing international travel restrictions. Even now, there are photos of busy airports appearing. This is especially dangerous because of the threat of newer variants of the virus being introduced into the country. There are reports of discussions inside government about tighter border measures, but we have waited too long for decisive action.

The general picture is one of horrifyingly high levels of hospital admissions and deaths due to coronavirus, while infection rates fall – but from an extremely high level and too slowly due to the weaknesses in the form of lockdown adopted. This reluctance to impose lockdown properly stems from fear of the impact on business, yet long-term economic wellbeing would be enhanced by making lockdown as effective as possible.

Enter the vaccine

In this context, there are hopes that the vaccination programme can provide a much-needed rescue. The good news is that numbers getting their first jab have increased sharply.

It is genuinely possible, though not yet certain, that the target of two million a week will soon be reached. The public coordination of the programme, through the NHS, means it is far more effective than the shambolic, fragmented and outsourced test-and-trace arrangements.

This is a long game though. It will be another few weeks before the 12 million people in the top priority groups have had their first dose. It takes two or three weeks for it to have full effect.

Then there is the matter of getting the second dose. World Health Organisation advice was to have a gap of 3-4 weeks between the first and second dose, yet this advice (now backed by the British Medical Association) is being ignored. That is extremely risky, with major concerns about how much protection the first dose provides. There are also still unknowns about the vaccines, like whether they will work against newer strains that are emerging elsewhere in the world.

In the long term, vaccination will hopefully provide a way out of this pandemic. But for the immediate future its impact will be limited and slow, while tens of thousands more people die.