Thursday, September 21, 2023

Lancet editor: UK “firmly refused to follow science” | News on the coronavirus pandemic

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England was plunged into its third national lockdown due to the coronavirus pandemic a week ago, with the whole of the UK now under strict social distancing checks as it struggles to contain a variant of COVID-19, which is spreading faster.

The United Kingdom recorded 59,940 confirmed cases and 563 deaths on Sunday, bringing the overall toll to more than 81,000.

London Mayor Sadiq Khan has declared a “major incident” in London, the epicenter of the outbreak in the UK, with hospitals in the capital struggling to cope with the number of patients.

Richard Horton, editor-in-chief of The Lancet, one of the world’s oldest and most prestigious medical journals, talks to Al Jazeera about the crisis.

More than three million confirmed cases of COVID-19 have been recorded in the UK since the outbreak of the pandemic [Simon Dawson/Reuters]

Al Jazeera: Why is the UK fighting to contain the coronavirus pandemic?

Richard Horton: The main reason the UK has struggled is because it failed to learn the lessons from the first wave of the pandemic in 2020 and steadfastly refused to follow the science, despite claims it did. would do.

The lessons learned from science have been that when there is an increase in infections, you must immediately tackle transmission to reduce the prevalence of infection in the community. But at every step, the government delayed and delayed and delayed the lockdown, with the result that the virus got out of hand.

The result is an increase in hospitalizations and deaths. It would have been completely avoidable if the government had acted more decisively, and sooner.

I think the prime minister [Boris Johnson] appeased a small group of MPs, who are fiercely libertarian and anti-lockdown – a group of MPs who just don’t understand the impact this pandemic has on people’s lives. And this is the same appeasement strategy that is being used to deal with Brexit that it is now using to deal with this pandemic. It is entirely political.

Al Jazeera: What should the government have done differently?

Horton: If we start with last year, the evidence presented by SAGE [the government’s Scientific Advisory Group for Emergencies] to ministers, about the overwhelming threat of the pandemic was in early March, and yet it took until March 23 for a lockdown to be announced.

This two to three week period allowed the pandemic to spiral out of control, resulting in tens of thousands of unnecessary deaths.

We are now in exactly the same position, when it was clear in December, before even understanding the new variants, that we were threatened with a resurgence of the pandemic. SAGE and Independent SAGE both recommended urgent and decisive government action. The government refused to act; in fact, they were planning to ease restrictions on Christmas.

And then just before the holidays we have this new variant, but it still took until the first week of January for the government to announce a lockdown. Again, we have wasted at least three weeks when we should have had a much more active policy of suppressing community transmission of the virus. Once again, we’ve wasted time. And as a result, we’re going into January, with the National Health Service (NHS) under real threat of overload.

Al Jazeera: Are the government’s future plans reasonable?

Horton: It’s ridiculous what Johnson is saying about ending the lockout in mid-February. If you look at what’s going to happen over the next three months or so over time, you can determine it based on what happened in the spring of last year. We expect that if this lockdown is implemented effectively and the public supports it, there will be a spike in the number of deaths towards the end of January this year, likely around January 22, and then there will have a gradual decline. It wasn’t until July 4 of last year that pubs, restaurants, hairdressers, etc. are open and households are allowed to mix. So it was from March 23 to July 4.

If you apply the same period from January 6 when [the most recent] the lockdown has been put in place, that brings us to April 14th. So I predict, despite the fact that we are trying to immunize millions of people, that it will get us past Easter before we can lift the lockdown restrictions. And the situation is worse today than it was last spring because it is winter and we have a more transmissible virus. So this discussion of fine, “We’re coming to February 15th, and we’ll be able to facilitate the lockdown.” This is absolute nonsense.

We should manage public expectations better than we do. Because if, once again, you have too many promises and you fail to keep the commitments, that’s what erodes public trust and public trust. And the lesson we learn from the Dominic Cummings episode is that as soon as you shake public trust, people don’t take government advice. Unnecessary damage is measured by the number of people who have died needlessly, and in COVID along the very large number of people who have had the infection and have residual health problems. And this proportion could reach 30, 40, 50% of people infected with COVID.

Al Jazeera: Would you say the UK government let ethnic minorities down during the pandemic?

Horton: I think it’s important to recognize that this pandemic is a synthesis of epidemics. It’s a virus combined with a chronically unhealthy population, and it feeds on inequalities. And so the people who are at the bottom of the social gradient, those who live in poor housing, do not make a lot of money, depend on the social protection system, they are particularly exposed to this virus. This includes black, Asian ethnic minority communities. Because the government is failing to prioritize inequalities in its social policy and still fail to prioritize inequalities, as far as I know, this leaves millions of people vulnerable to further waves of the pandemic.

The point on the inequality is that in order to fight the pandemic, it’s not just about the virus, it’s about the state of your society. And if your society is fundamentally unequal, then you leave the most marginalized, the most excluded, the most at risk of harming their health, and that is still the situation today, the government has no strategy to address inequalities, which is the most important social determinant of the outcome of infection.

But the legacy also extends to children. Children have missed school so much that they are now at least six months behind what they should be in terms of schooling. And now we are in a situation where they will fall further behind – the digital divide across the country means that inequalities are compounded by the pandemic among children. It is a real existential crisis for a new generation.

Al Jazeera: How concerned should we be about the new variant?

Horton: I think we should be very concerned about the mutations in UK, the B117 variant, which is surprisingly different from the original version of the virus. And this is a cause for concern with the vaccine because several of the mutations occur in that part of the virus which is extremely important for protective immunity. The South African variant is potentially even more worrying. And so I think the government was right to try to protect our borders more aggressively. So yes, I am very concerned that the virus is mutating, and mutating in ways that threaten the effectiveness of a vaccine and our ability to keep the pandemic under control.

There is no doubt that the UK among Western countries is leading the way in terms of vaccine implementation. And I think it’s a good start to have already vaccinated well over a million people, at the start of the year, is a massive achievement by the NHS, and we have to see that continue. I have a concern, and this again relates to the management of expectations. The government has set a target of February 15 to vaccinate more than 14 million people in the main groups identified by JCVI [Joint Committee on Vaccination and Immunisation]. That means we’re going to need to vaccinate over 350,000 people every day, two and a half million people every week to reach that number by mid-February.

This is a huge huge demand. This will stress the system at a time when already winter pressures on the NHS are enormous. We have to be very careful not to over-promise and under-deliver. I would rather we had a steady increase in the immunization schedule, rather than rushing it, and stumbling and not meeting public expectations. And remember that even when we get to February 15, even though we were able to immunize 14 million people by then, these are not the only categories on the JCVI list. There are still 16 million more people, people over the age of 50, who need to be vaccinated. Thus, the total number that JCVI identifies is over 30 million people. It has never been done in any country on this scale or at this speed. We should not underestimate the logistical challenges we face here.

Al Jazeera: How would you characterize the anti-vaccine movement in the UK and what can be done about it?

Horton: I do not see the anti-vaccination movement in the UK making any significant progress. It’s a very small group. And that doesn’t seem to have much of an influence on the general population. I think the anti-vaccination movement is much more powerful in countries like the US, France and elsewhere, but in the UK it’s really a fringe group. And I don’t see it playing a significant role in obstructing vaccine deployment.


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