The government’s roadmap to end England’s third lockdown is a recipe for future disaster. A third wave and fourth lockdown in the UK will be the responsibility of the British government’s negligent loosening of restrictions and not due to the third wave from Europe ‘washing up on our shores’. Despite Prime Minister Boris Johnson’s repeated declarations that his roadmap represented a cautious approach to lifting the existing restrictions, and that further steps would be guided ‘by data and not by dates’, it is a desperate gamble to reopen the economy and its success is dependent on the hope that the country can vaccinate and test its way out of the pandemic. The result, even on the most optimistic scenarios, will be tens of thousands more deaths in the months to come, and hundreds of thousands of people of all ages suffering the little-acknowledged debilitating effects of Long Covid. Caution has been thrown to the wind as all students returned to school on 8 March with little to no mitigations, a move endorsed by Labour leader Sir Keir Starmer.
The roadmap says nothing about keeping the reproduction number R below 1.0 to prevent an exponential rise in coronavirus infections. It admits that vaccination and asymptomatic mass testing are the government’s twin strategies for managing the pandemic. There is no plan whatsoever to reduce community transmission to zero: Johnson claimed ‘There is therefore no credible route to a zero-Covid Britain or indeed a zero-Covid world.’ The examples of at least 30 countries such as Cuba, New Zealand, Australia and China, show that a strategy of virus suppression is not only viable but essential to minimising the effects of the virus on humanity as a whole. Yet with the explicit support of the Labour Party, the ruling class is once again putting private profit before public health. The consequences of a third wave will be disastrous for working class people. Another increase in transmission will provide ideal conditions for the emergence of deadly immunity-dodging ‘escape variants’ of the virus which will affect unvaccinated people, as well as vaccinated people in whom the vaccine is ineffective.
Unlocking and testing
The phased unlocking began on 8 March when all schools reopened for face-to-face teaching. The rule of six came in on 29 March. Pubs and shops will reopen ‘no earlier than’ 12 April, and hospitality venues from 17 May. All legally enforceable social contact restrictions will end ‘no earlier than’ 21 June 2021, as nightclubs reopen. Although there will be five weeks between each phase to enable analysis of infection data, Johnson claimed that: ‘we cannot escape the fact that lifting lockdown will result in more cases, more hospitalisations and, sadly, more deaths. And this will happen whenever lockdown is lifted, whether that is now or in six or nine months.’
Johnson set out ‘four tests’ that would have to be met before moving to the next phase, notably the ‘successful deployment’ and effectiveness of vaccines in reducing hospitalisations and deaths from Covid-19; the prevention of ‘unsustainable pressure’ on the NHS, and the emergence of any new variants of concern. It is claimed that this unlocking will be ‘driven by the data not the dates’, so why are there dates in the roadmap in the first place? There will be constant pressure from the business class represented by the Covid Recovery Group (CRG) of Tory MPs to rush through these phases with no pauses, for economic reasons. This is implicitly admitted by the claim that this roadmap is an ‘irreversible road to freedom’.
The government plans to use rapid asymptomatic testing using US firm Innova’s lateral flow devices (LFD) to control further spread in schools and workplaces. Whilst use of the more accurate PCR test (0.005% false positives) has been reduced from 400,000 a day in January 2021 to ~200,000 daily, the cheaper LFD tests have been increased massively to over 1.2 million tests daily. From 19 March, secondary school pupils will be voluntarily tested twice weekly. At a false positive rate of 0.1% and with infection prevalence of 0.05% in the community, these tests will mean thousands of pupils, their bubbles and parents having to wrongly self-isolate for 10 days each week. The muddled government strategy means that LFD positive results at home or the workplace can be overridden by a negative confirmatory PCR test, but LFD positive results in school cannot and government advises the student not to bother getting a PCR. The guarantee of thousands of false positives each week if millions are tested, mean that with no financial support many parents will withdraw consent and workers will avoid these rapid tests, and the opportunity to find at least some asymptomatic carriers will be lost. The sensitivity of the LFD is estimated at 40-50%, so half of all infected people will be missed as they test negative. However, these ‘false negatives’ can be mitigated by repeat testing. Testing alone cannot be the strategy, and schools must be made safe as many scientists have advised.
SAGE advice
The government’s Scientific Advisory Group for Emergencies (SAGE) presented a report on 7 February 2021 summarising modelling studies that show the consequences of possible scenarios for easing restrictions in England. All four scenarios, modelled on different speeds of easing, led to a ‘substantial resurgence in hospital admissions and deaths’ and the report concludes ‘it would be inadvisable to tie changes in policy to dates instead of data.’ SAGE advised ‘a careful evaluation of data before any further unlocking was allowed. Several weeks between steps are required to determine if that change has significantly increased transmission.’ The models assume four million doses of vaccine administered per week from 22 March, an 85% coverage with two doses of all over 50s (and 95% of over 80s), and high public adherence to social distancing and mask wearing from the end of lockdown, as well as a functioning test and trace system. Even the most optimistic scenario predicts a third wave in September 2021 to January 2022 resulting in at least 30,000 deaths. If all restrictions were lifted by 21 April as the CRG demands, 62,000-107,000 people in England would die. The scenario that most closely resembled the government’s roadmap estimated that 32,200-54,800 people would die between February and the end of June 2021. All these deaths are preventable. The government has shown it is prepared to sacrifice these lives for the economy and has chosen to ‘live with the virus’.
SAGE also advised that reopening schools would lead to a 10-50% increase in the R number, and studies, including one from the London School of Hygiene and Tropical Medicine, show that opening all schools without additional mitigation measures such as full mask-wearing, social distancing, and ventilation/air filters, raises the R number from the current 0.8 to 1.0-1.5; and opening primary or secondary schools alone increases R to 0.9-1.2. These studies didn’t consider the more transmissible B117 ‘Kent variant’ now dominant in the UK. SAGE advised on 4 February 2021 that ‘relaxation of measures over six or nine months results in much smaller subsequent epidemic waves than relaxing measures over three months…[which could] lead to hospital occupancy higher than the January peak.’ This has been ignored, as has Independent SAGE’s A sustainable suppression strategy report of 19 February 2021.
Test and Trace
Where a local authority run test and trace system was set up in Ceredigion, West Wales, before a single positive case was identified, in March 2020, better results have been consistently obtained, with positivity rates currently 0.15% and cases at 4.1 per 100,000 people, the lowest in Wales, and one of the lowest in the UK. By contrast, the £37bn Serco Test and Trace system run by private corporations continues to fail to reach all contacts or return all test results within 24 hours. Contacts of those who test positive are still not being tested, but advised to self-isolate contrary to WHO and CDC advice, and the ‘service’ is still restricted to just three symptoms. The 10 March 2021 Public Accounts Committee report Covid-19: Test, track, and trace showed that ‘Despite the unimaginable resources thrown at this project, NHS Test and Trace cannot point to a measurable difference to the progress of the pandemic’ and has failed to avoid either of the two lockdowns since it was set up in May 2020. Around 2,500 Accenture, Deloitte and McKinsey consultants are on an average daily rate of £1,000, with some paid £6,624 a day.
Vaccination – an inadequate strategy
Johnson’s roadmap depends completely on the rapid rollout of vaccination and extremely high rates of take-up among all sections of the population. But vaccines are never 100% effective; they do not provide perfect protection against transmission, infection or illness. Vaccine efficacy shown in clinical trials is always higher than vaccine effectiveness in real-world use, and not everyone is, or can be, or wants to be vaccinated. Hence even if all adults in the UK (79% of the population) were vaccinated with an 84% effective vaccine, only 66% of the population would be protected against severe disease.
Further, the UK, US and EU prioritisation of their economies have allowed the emergence of new highly virulent variants of coronavirus, leading to new surges in infections. In Britain since the emergence in September 2020 of the more transmissible, more deadly and more severe illness-producing B117 variant, it has mutated further. There are ten variants, home-grown and imported, now circulating in the UK, a few carrying the E484K mutation which enables the virus to escape immunity. A variant in France, the ‘Brittany variant’, has emerged that can bypass the standard PCR test and so can’t be tracked by testing. Allowing vaccinated vulnerable and unvaccinated ‘mixer’ populations to socially mix during periods of high virus transmission puts the highest pressure on the virus to produce an escape mutant – a very high-risk strategy. Vaccination rates in the UK, as well as the risk of catching Covid-19, are also stratified according to race and levels of deprivation, meaning that already entrenched inequalities will make Covid-19 a disease of the poor and ethnic minorities.
Hidden from sight: Long Covid
Criminally, the government’s plans fail to acknowledge the risks of spreading the numbers of people who experience the little-understood syndrome of Long Covid. Covid-19 isn’t just a respiratory disease as first thought, but a multi-system syndrome which can take the form of neurological, blood, respiratory, or cardiovascular disorders. According to an Office for National Statistics report in December 2020, 10% of people of every age, including children, who had tested positive were still reporting symptoms such as fatigue, headaches, cough, muscle pain, loss of taste/smell 12 weeks after infection. They included people who had suffered minimal or no symptoms initially; a later study published in February 2021 estimated that the number of people experiencing symptoms which continued after five weeks in December 2020 was 301,000. An estimated 8-9 million infected people in the UK means 900,000 possible Long Covid sufferers. The long-term impact of this syndrome on patient health is unknown at this point. It has equal prevalence across all age ranges: returning children to school on 8 March without adequate preventative measures such as mandatory masking, or proper classroom ventilation, could result in hundreds of thousands of Long Covid cases among young people.
It is completely wrong to keep comparing Covid-19 to the flu as Chris Whitty, Boris Johnson and the CRG keep doing. Clinical epidemiologist Deepti Gurdasani describes a situation where ‘there is media bias around discussing an elimination strategy – which is considered “unrealistic” or not possible in the UK – where the rhetoric from government and its advisers has been “acceptable deaths” or “living with it”’, and has stressed the dangers of large numbers of Long Covid cases as a consequence of the government’s approach to reopening schools. However, Johnson is desperate to restore profitable production given the state of the British economy, and Labour will not oppose him. For socialists and the working class, there is no alternative to virus elimination. We demand a Zero Covid maximum suppression strategy now.
Charles Chinweizu
FIGHT RACISM! FIGHT IMPERIALISM! 281 April/May 2021
