Spike: the virus versus the people could well have been subtitled, “The politicians versus the scientists.” The government is fudging its response to Covid again. Last year it refused to follow the science and impose a circuit breaker in September. Now it is offering Plan B, if the virus takes off again. IF! More likely, when. And if Plan B doesn’t work we have Plan C. The intention is obvious. Stumble on and hope the vaccines save us. If not, can we put off the inevitable until after Christmas? Despite claims to follow the science they hide behind the science to mask their failure. We know what happened last year. Welcome to virus Groundhog Day!

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So once more we see the spectacle of the politicians versus the scientists, a constant theme in Spike.

After ministers shunned the idea of imposing restrictions, such as the circuit breaker, in September, transmission rose in the UK. The measures advised by SAGE to lower transmission were not implemented and the virus was able to take off.

Jeremy Farrer with Anjana Ahuja: Spike. Profile Books 2021. Page 197

And we all know what happened next. Farrar spells it out in this memo to colleagues on 14 February 2021

Worth just noting – UK has seen ~50% of all deaths [so far] in the last 7 weeks and >35% of all hospital admissions. Sobering. A reminder of what happens if you lose control of an epidemic, if you make the wrong decisions or poor decisions coincide with events beyond your control – new variants!

Jeremy Farrer with Anjana Ahuja: Spike. Profile Books 2021. Page 197

About the Author

I finished reading Spike on the day that the government announced their “plans” for managing the COVID pandemic this winter. The lead author, Jeremy Farrar is well qualified to give us the inside story. As Director of the Wellcome Trust since 2013 and a member of SAGE, he enjoys a direct line to Ten Downing Street. He has also served on the front line against epidemics including bird flu and Ebola.

From 1996 to 2013, Farrar was Director of the Oxford University Clinical Research Unit in Ho Chi Minh City where, in 2004, he helped to alert the world to the re-emergence of the deadly bird flu, H5N1, in humans. Last year he was one of the first to alert the world to the threat from Covid-19. He helped to release the Covid-19 genome sequence on 11 January 2020 against the wishes of the Chinese government.

The Inside Story

Spike reads like a thriller in places. We learn how Farrar, Eddie Holmes from Sydney University and the courageous hero of the piece, Professor Yong-Zhen Zhang of Fudan University worked to outwit the Chinese authorities and place Zhang’s work on sequencing the virus in the public domain. This forced the Chinese government to act. The following day they published their sequence, confirming Zhang’s work. Now scientists around the world had the tool they needed to work on vaccines and treatments.

Two days later Professor Sarah Gilbert and her team at Oxford University had used the genetic sequence to design a vaccine. By the end of January her colleague, Dr Catherine Green was ready to start making the first batch of vaccine. The story of the Oxford Zeneca vaccine is not central to Spike. Read it instead in their book Vaxxers.

Spike concentrates more on the efforts to determine public policy in Britain and worldwide. It names some of the heroes and villains and the difficulties that SAGE encountered in persuading the government to enact proper measures. Those difficulties have not gone away.

The politicians versus the scientists

It is a shame that politicians and the media were not so quick off the mark. They cannot say they had not been warned. On 23 January 2020 Farrar spoke at a press conference at the World Economic Forum in Davos, alongside Richard Hatchett of CEPI, the Coalition for Epidemic Preparedness Innovations, and Stéphane Bancel, CEO of Moderna who, like the Oxford University team, had already started work on a vaccine. Wuhan had just locked down. Farrar told the audience that we were six weeks into the outbreak and it could be spread by human transmission. Hatchett, who had been a White House adviser during the swine flu pandemic in 2009, said that without vaccines or treatments measures like lockdowns were the only defence. He announced that CEPI would be funding vaccine development.

A missed opportunity

Bancel returned to America, where he began lobbying government agencies. Farrar did the same in the UK. The Lancet published research papers from Wuhan demonstrating human to human transition and cases started to appear outside of China. For governments this was a missed opportunity. But for the whole of the month of February the government did nothing. Farrar cites examples of politicians versus the scientists. These were four meetings of SAGE, which urged the government to act before the reluctant imposition of the first lockdown and were ignored. When Johnson said in a televised address to the nation on 10 May 2020 that, “We did not fully understand its effects,” he was lying.

As Richard Horton said:

On 26 January I tweeted, “It’s now imperative to recall the WHO’s IHR Emergency Committee to review the evidence for and against declaring a Public Health Emergency of International Concern. The needle is moving towards the affirmative.” On 30 January the director-general of WHO did indeed declare a PHEIC. The facts were utterly opposite to the message from 10 Downing Street. There was an international scientific consensus. The government had simply chosen to ignore it.

Richard Horton; The Covid-19 Catastrophe. Polity Press 2020. Pages 94-95

Herd Immunity

This is a striking example of the politicians versus the scientists. Herd Immunity was never discussed or recommended by SAGE. It is always a possible outcome of disease. But the cost would be intolerable. Farrar suggests that it would require 40 million infections and 400,000 deaths in the UK. And there is no guarantee it would work. It is less than two years since Covid-19 became a threat. Since then four variants have evolved that are adapted to evade the antibodies in previously infected people. But the level of scientific ignorance inside government led them to confuse possibility with probability and to make this untested hypothesis a policy for a few short weeks at the start of the pandemic.

And Richard Horton, Editor in Chief of the Lancet, was clear in his book, The Covid-19 Catastrophe that, 

In the UK, for example, ministers have claimed they did not pursue a policy of herd immunity early in the pandemic. The statements from ministers and science advisors clearly prove the opposite.

Richard Horton; The Covid-19 Catastrophe. Polity Press 2020. Page 95

Chaos at the heart of government

Farrar is scathing in his opinions of many politicians and government officials. He blames Matt Hancock for the PPE shortages and the testing fiascos. Gove went AWOL for much of the crisis. Dido Harding was a disaster. But, this description of Johnson sums it all up.

If tests are being carried out in the wrong place in the wrong way on the wrong people, they can do more harm than good. At that Downing Street meeting with companies selling rapid tests, I saw the same lack of strategic thinking in Boris Johnson. He sat in the middle of the room waving his arms around as he put in offers to buy millions of unproven rapid tests., brushing off the concerns of people in the room who felt, rightly, that test kits needed proper quality control.

Jeremy Farrer with Anjana Ahuja: Spike. Profile Books 2021. Pages 223-224

Are vaccines a Get Out Of Jail Free card?

You might want to see the government in jail over the corruption and incompetence that have killed so many people. But the success of the vaccine programme is being touted as a “get out of jail free” card for the nation.

Mass vaccination programmes across the world would be a precursor to unlocking economies and  resuming normality.

Jeremy Farrer with Anjana Ahuja: Spike. Profile Books 2021. Page 192

“Across the world.” Britain has bought 367 million doses. Other wealthy countries have done the same. We have a stockpile. Poor countries have need. We cannot protect ourselves unless we protect the world.

Variants or mutations could evade the vaccines just as they have done with herd immunity. The first one appeared in South Africa, closely followed by a similar one in Kent at the end of November 2020, just as the vaccination programme began.  Both were more transmissible than the original virus. Since then two new variants have caused concern, one was first discovered in Brazil and another, the Delta variant is now the dominant variant in the UK. 

Sharon Peacock, professor of Microbiology at Cambridge University and founder of COG-UK, the Covid-19 Genomics UK Consortium warns us:

Our ability to fight the variants will be in direct proportion to how far we can reduce infections in this country and around the world, because that’s the key lever that we have in getting mutation rates down. It’s about how quickly the vaccine can be rolled out and whether we can persuade people to continue behaviours like social distancing and hand washing. And it will also depend on what we do about borders.

Jeremy Farrer with Anjana Ahuja: Spike. Profile Books 2021. Pages 202-203

Zero Covid? Eradication versus Elimination

We hear a lot about “learning to live with the virus.” We don’t lockdown for influenza. We vaccinate the vulnerable and carry on. This kind of talk is encouraged by politicians versus the scientists. But COVID is not Flu. Covid-19 is properly named SARS-CoV-2. The original SARS-CoV-1 made people very ill very quickly and many died. Covid-19 is different. It is very infectious. While most people do not get very ill they are still infectious. What if a variant emerges that is highly contagious and highly lethal? Farrar thinks we have missed the boat on eradication. But a policy of living with high levels of infection invites mutations to happen that can escape the vaccines. We need to invest in public health measures like infection control to eliminate the virus from as many areas as possible. That way, we can use tried and trusted methods of infection control to isolate and control fresh outbreaks.

The politicians versus the public

The public have responded heroically to government restrictions when given clear and timely leadership and guidance. But mixed messages lead to a mixed response. Three times now they encouraged us to think that the battle against Covid is over. Just as foodbank use has become normal, so the daily death tolls and infection figures are accepted. The media is complicit. They tell you that 100,000 people were vaccinated yesterday. Set that against 1000 in hospital and 50 deaths. This makes it easy to persuade yourself that the crisis has ended.

So you go on holiday, go to the pub, go to that concert or football match. Who will follow advice to wear a mask or stick to social distancing when the one-way system in the supermarket has gone? When the cases rise again and the restrictions are imposed, they will blame us for not following the advice; not the government for fudging and failing the nation again.

What next?

Spike, like Horton’s book, The Covid-19 Catastrophe is an indictment of government failure to take the proper measures to protect its citizens. It is also a warning that when the next disease emerges – and there will be a next time – it may be even more devastating. We must rebuild public health infrastructure, not just at home but abroad. New diseases often emerge in poor countries. Unlike refugees, they do not arrive in small boats. They arrive anonymously at international airports.

At one point Farrar praises capitalists as people who “can and mostly do make the world a better place”! He has given us an honest account of the pandemic to date. He identifies what worked and what needs to be done in the future. This is the value of an insider’s account. Because he is an insider he finds it hard to step outside and identify the systemic barriers to change. Those barriers have been built in defence of capitalism. Instead of politicians versus the scientists, it would help if we had more scientists willing to speak out against the politicians. We will give them a chapter in Creating Socialism: the people versus the system. That is the book we are still writing.

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