At a press conference earlier this month, a few days before the U.K. government announced that the country had passed eighty thousand coronavirus deaths, the Prime Minister, Boris Johnson, briefed the public on the progress of the vaccine drive. He was flanked by the Chief Executive of N.H.S. England, Sir Simon Stevens, and, in full army fatigues, Brigadier Phil Prosser, a military commander enlisted to help with the rollout. Everyone looked a little pale. Prosser, speaking in a clipped, efficient monotone, described the vaccination effort as a logistical operation “unparalleled in its scale and complexity.” In thirty days, he said, “we have delivered 1.26 million doses of vaccine, hundreds of millions of consumable items, and established seven hundred and sixty-nine sites.” (On Monday, the government announced a further wave of vaccinations, bringing the total number vaccinated to just over four million.) “That’s the equivalent,” Prosser added, “to setting up a major supermarket chain in less than a month.”
Johnson has laid out plans to vaccinate four groups, including care-home workers and residents, frontline N.H.S. staff, the clinically vulnerable, and everyone over the age of seventy—fifteen million people altogether—by February 15th. These groups make up eighty-eight per cent of COVID-19 deaths, and immunity for the most at risk could be reached by early March. But March feels a long way off. Last week, government officials toured broadcast studios (virtually) to hammer home the message that the virus is out of control. This past Monday, England’s chief medical officer, Chris Whitty, told the BBC that “the next few weeks are going to be the worst weeks of this pandemic,” in terms of hospital admissions. In England alone, he said, thirty thousand people are hospitalized with the virus, compared with eighteen thousand during the April peak. In London, where a new, more contagious variant has spread quickly, one in thirty people are infected. The British press is full of stories about ambulances waiting hours to offload patients into wards already stretched to capacity. Johnson called it “a perilous moment.”
As the numbers keep ticking up, there’s a new chill in the air: Who’s breaking the rules? In Derbyshire, two women carrying coffee cups five miles from their respective homes were classed as picnickers and issued two-hundred-pound fines. (They were later rescinded.) Recently, Johnson was spotted on a bike ride seven miles from Downing Street, prompting heated debate about the meaning of the world “local.” (Kit Malthouse, a conservative M.P., described the bike ride as a “sort of Scotch-egg moment.” He was referring to an earlier phase of restrictions when some pubs, banned from serving alcohol without a “substantial meal,” added Scotch eggs to the menu.) The public has been advised to follow the spirit of the rules, and not look for ways to “flex” them. You should not use your daily exercise allotment to socialize. You should not fill a thermos with booze and wander the city for hours. You should not even, ideally, sit on a park bench for too long, unless you are very tired. In short, and when in doubt, you should not.
“There have been mistakes made all the way along,” Dr. Kit Yates, a senior lecturer in mathematical biology at the University of Bath and author of “The Math of Life and Death,” told me recently. Yates is a member of Independent SAGE, an unofficial advisory group of scientists who have been critical of the government’s response. (The official scientific advisory group to the government is called, simply, SAGE.) “A huge number of deaths have been caused by the government not acting soon enough, at almost every stage,” he added. We were speaking the day after the U.K. had reported what was then its highest daily death toll of the pandemic: one thousand five hundred and sixty-four. Yates expected the number of daily deaths to climb for around two weeks. “Things are going to get really bad. We might be seeing plus two thousand deaths reported on some days,” he said.
Much of that number can be traced back to the government’s slow response to the emergence of a new variant of the virus, known as B.1.1.7, which has ripped through Britain in recent weeks. First detected in the south of England in late September, scientists estimate that B.1.1.7. is between thirty and fifty per cent more transmissible than previous forms of COVID-19. Its rise has been startling. On December 14th, the health secretary, Matt Hancock, alerted Parliament to the existence of the strain. Days later, Sir Patrick Vallance, the chief scientific adviser, warned that it was “becoming the dominant variant,” “beating all the others.” On December 22nd, SAGE scientists called for an increase in restrictions to slow the new variant’s spread. Still, in many parts of the country, families were allowed to gather for Christmas. A national lockdown didn’t come into effect until January 4th, by which point hospitals in England were seeing forty per cent more COVID-19 cases than during the April peak. In a pandemic, every day counts.
There is no evidence that the U.K. variant is more deadly, or that it will be resistant to a vaccine. Still, Martin McKee, a professor of European public health at the London School of Hygiene and Tropical Medicine, called B.1.1.7 “very, very worrying.” “What seems to be happening with it is people infected with it are having a higher viral load,” he told me. The new variant may cause more of the virus to lodge in the upper respiratory tract, making transmission through conversation or, heaven forbid, a cough, more probable. There’s also some evidence that B.1.1.7 can get into cells more easily, through a mutation in the spike protein. All of these factors push the transmission rate, or the “R number,” beyond the point at which the U.K.’s current restrictions are effective in bringing down the numbers, McKee, who is also a member of Independent SAGE, said. “That’s the really alarming thing.”
On Monday, new rules requiring travellers entering the U.K. to show proof of a negative test came into effect. “Travel corridors,” which allowed some quarantine-free travel, have been banned. Britain is hunkering down. More frightening than anything coming in, though, is what has already left. On Friday, the Centers for Disease Control and Prevention said that B.1.1.7 had been detected in twelve U.S. states, and was on track to become the dominant variant in the U.S. by March. When we spoke, Yates told me that a variant that is fifty per cent more transmissible is much worse than one which is fifty per cent more deadly. Many more cases will result in more deaths in the short term. “I would do everything you can to stop getting this variant in the U.S,” he said. “And we are responsible as well. We should be mandating that people have a test seventy-two hours before they leave the U.K. to make sure they are negative,” he said. “It’s partly our responsibility to not export this new variant to other countries. But I worry that it may already be too late for that.”
