Great Britain, the covid-19 laboratory | The Economist

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Great Britain, the covid-19 laboratory | The Economist



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BORIS JOHNSON has long promised that Britain’s exit from lockdown would be “cautious but irreversible.” Announcing the latest easing of restrictions on April 5, the Prime Minister was eagerly awaiting a trip to a pub where he would “cautiously but irreversibly” wear a pint of beer to his lips. It’s the kind of informality that annoys critics and applauds supporters.

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The latter are growing in number, with more people endorsing Mr Johnson’s performance than at any time since the early stages of the pandemic. Almost half of Britons have received a vaccine and injections have been distributed on a schedule that many consider absurdly ambitious. As a result of this and a tight lockdown, cases have dropped from nearly 900 people per 1 million people in January to less than 50 (see graph).

So Britain is grappling with something that will soon confront much of the West: how to manage the transition to a world in which covid-19 is less deadly. The government has taken a two-fold approach: slowly lifting the restrictions (they won’t go away in England until June 21 at the earliest) and introducing a series of measures to reduce transmission, some on a scale comparable to few other countries. .

Among the interventions, vaccine passports have garnered the most attention – and are furthest from their introduction. The government is experimenting with events that include a club night and the FA Final cut. While he ruled out their use in pubs and restaurants when they reopen, which won’t happen until May 17, he hasn’t ruled out their introduction in such places later in the year.

There are technical issues to overcome, including how to incorporate negative test results and how to assemble various databases. There are also political issues. Labor and Liberal Democrats have voiced their opposition, as have some Tories upset by the slow return to normalcy, who like to cite Mr Johnson’s whining against username maps of his time as a journalist.

Polls show strong public support. And the mere possibility of their introduction serves a purpose. According to Ipsos-MORI, according to a pollster, only one in 20 people would now refuse to be vaccinated, against one in seven in December. The main reason for this change is the expectation that vaccination will be necessary for travel or other leisure activities.

The British may be enthusiastic about vaccines, but they are less eager to help a tracing system which, in the words of one insider, “leaks more than a … sieve”. Almost a quarter of people who test positive are not reached by the tracers or refuse to give their contact details. On average, people with the disease transmit four contacts, compared to 15-20 initially expected. There are also concerns about the number of people with symptoms isolating themselves, with Chancellor Rishi Sunak stubbornly resisting attempts to increase sickness benefits.

But more rigorous treatment is now given to disturbing variants. Thanks to Britain’s enormous genetic sequencing capacity, by mid-March, nearly half of PCR the results were under review. The government has rolled out what it calls “improved contact tracing” for cases of the South African variant, against which the Oxford-AstraZeneca vaccine appears to offer less protection. This involves door-to-door testing and careful examination of the chain of transmission (ie what is simply called “contact tracing” in China or South Korea).

The cases that fall also offer other opportunities. Of the 343 local authorities in England, which tend to be more successful in finding cases, 59 are involved in a ‘Local-0’ pilot project, taking responsibility for tracing all cases in the region. When drop-ins reopen, all visitors will need to register using the nationwide contact tracing app, rather than just one member in each group, which should provide their trackers with much more contact information. .

But the biggest change, and where Britain stands out most internationally, is its testing capacity. It performs about 1 million tests a day, roughly the same number as America, which has five times the population. The numbers will soon increase again. On April 5, the government announced that everyone in England would have access to lateral flow tests twice a week, which are less likely to detect the virus than PCR but offer a quick turnaround time.

The fortnightly offer was previously available to doctors and families with children in school. According to a scientist informing the government, in early March tests in hospitals had detected around 30,000 cases among staff who would otherwise have gone to work.

Research published by the Ministry of Health and Social Affairs (DHSC) suggests that the false positive rate of the Innova lateral flow test, one type used, is 0.03%. It may sound small, but when the virus is rare and millions of tests are used, it means that many positive results are false. Critics fear that many people will experience a bad shock and be forced into unnecessary self-isolation. To mitigate this, last month the government changed its policy by offering anyone who tests positive PCR test.

The other concern is that lateral flow tests pick up fewer genuine cases, thus providing misplaced assurance to some who test negative. But while they are less likely to pick up those with a low viral load than PCR tests, they capture most infectious people. A pre-print by researchers at the University of Oxford, the DHSC and Public Health England suggests that lateral flow testing would catch 83-89.5% of cases that now lead to detected transmission events.

The effectiveness of the experiment will depend on a large number of variables, including their adoption. The tests will be available at drugstores and by free delivery, as many advocates have called for in America. The impact of the rapid deployment of vaccines in Britain has been closely studied around the world. Its entry into a new era of the pandemic will also be.

Dig deeper

All of our pandemic and vaccine related stories can be found on our coronavirus hub. You can also listen to The Jab, our new podcast on the race between injections and infections, and find trackers showing the global vaccine rollout, excess deaths by country, and the spread of the virus in Europe and America.

This article appeared in the Great Britain section of the print edition under the headline “Opening shots”

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