Last modified on Wed 6 Jan 2021 20.10 GMT
Everything now hinges on a vaccine: how many more Britons die, whether the NHS finally breaks, how long the UK stays locked down. All depends on how fast the country can get vaccinated against this plague. Yet we’re in this position in large part because of government failure. When the prime minister imposes lockdowns late and with a sulky grumble; when we haven’t fixed our £22bn test-and-trace system (which, by the way, now bankrolls more outside consultants and contractors than the Treasury has actual civil servants); and when the Dominics and Stanleys are allowed to carry on as if rules are for the little people. If Boris Johnson blunts every political instrument he can lay his pale and meaty hands on, pretty soon a syringe is the only resort.
Vaccines were always going to be how the world limped out of this pandemic; but as Taiwan and New Zealand show, even without inoculation it is possible to drive the number of Covid cases significantly down. Compare their record with the UK – which is on course to hit 100,000 Covid-related deaths before January is out, and where a staggering one in 30 Londoners is today infected. The lecterns from which Johnson and his top advisers gave their press conference this week read “Stay Home. Protect the NHS. Save Lives” – exactly as they did at the start of all this last March, as if to confirm how little progress they have made in almost a year.
For all the anger and anguish caused by this week’s lockdown, modelling suggests it is simply too late to make much difference. Analysis from the London School of Hygiene & Tropical Medicine shows that shoving all of England into tier 4 and shutting its schools will barely dent the total number of Covid deaths. The only major impact will be immunising 2 million people a week.
That’s the kind of goal this prime minister loves to punt at, before missing by miles. This serum could be a similar story. Last summer the health secretary, Matt Hancock, boasted to parliament that “we have already secured 100 million doses of the Oxford vaccine”. This became “30 million doses available by September”, which was swiftly halved to “aiming to deliver up to 15 million doses … in 2020”.
Those millions were nowhere to be seen on Monday morning, as Johnson posed for the cameras at a London hospital delivering the first doses of the Oxford vaccine. His government had only 530,000 shots ready to go, with another 450,000 due this week. Compare that with the Serum Institute of India, which already has 50 million doses ready to ship, and plans soon to make double that each month. Meanwhile in the UK, Chris Whitty and his fellow chief medical officers jointly warn: “Vaccine shortage is a reality that cannot be wished away.”
So: another Boris balls-up? It is more troubling than that, and reveals more about the state of this country. In many respects, the UK goes into this mass inoculation as well-prepared as possible. Standing ready to deliver the doses are not only NHS staff but, remarkably, a volunteer army of retired medics. The regulator moved speedily to approve both the Pfizer/BioNTech and the Oxford/AstraZeneca vaccines. And Britain is blessed with world-class scientists, which is why we have a homegrown shot.
But if the UK’s future depends on a vaccine, where are its vaccine factories? It is a fundamental question, yet one that only scientists appear to be asking. And their answer is utterly damning.
Listen to John Bell, regius professor of medicine at Oxford and key figure in its partnership with AstraZeneca to develop a British vaccine. This weekend he told the Times: “The government has been completely disinterested in building onshore capacity for any of the life-sciences products … And it turns out that manufacturing is a strategic asset for health security when stuff gets tough.” Like now.
The UK lurched into this pandemic with only one injectable-vaccine factory of any size, a situation described by the head of the London School of Hygiene & Tropical Medicine, Peter Piot, as “a national security risk”.
What does he mean? The Serum Institute of India was ordered on Sunday to surrender all of its Oxford/AstraZeneca shots to the Indian government. Its contracts to make 1bn shots for the rest of the world could go hang. This is vaccine nationalism, and there is no guarantee that the UK, currently relying on other countries for its vaccine supply, will not be caught on the wrong end. As Piot says: “It will be your own people first.”
His nightmare scenario has long been known about. For years, the threat of a pandemic has topped the government’s risk register. For almost as long, Whitehall has commissioned papers bemoaning the UK’s lack of vaccine and medicine manufacturing. Yet pharmaceutical companies, which often draw heavily on subsidy from the British taxpayer, have continued to run down their manufacturing in the UK and to stick their factories wherever they get tax breaks: Ireland, Belgium, Singapore.
In 2018, the government invested public money in a Vaccines Manufacturing and Innovation Centre. It is due to open by the end of this year, just after the entire country has already been injected. Had it been running now, the UK would almost certainly be a lot further along in the mass vaccination programme. As it is, Whitehall and the private sector have had to cobble together a domestic supply chain by repurposing other factories.
Amid all this, ministers have carried on slapping their own backs over “the extraordinary bioscience sector”, as Johnson called it in his first speech as prime minister, without looking too closely at what it does and where.
When Hancock hails the Oxford vaccine as “a great British success story”, who but the stony-hearted would deny him a celebration? Yet the UK pharmaceuticals industry is neither great nor especially British. It is really two giant companies – AstraZeneca and GlaxoSmithKline – sitting atop a flotilla of biotech research firms. And more than half of its world-leading research happens in just three cities: Oxford, Cambridge and London. As Prof Richard Jones of Manchester University says: “[The industry’s] priorities are not set by the needs of the UK healthcare system, or the burdens of ill health faced by the UK’s population.” Instead its main focus is producing expensive drugs to be paid for by private US healthcare providers.
Each stage of this pandemic has revealed another British pathology. We were late to lock down because of an inept political class chronically unserious in the face of a serious threat. We handed over our vital test-and-trace system to a bunch of pirates in pinstripes because we think the private sector is magic and ignore the public realm’s expertise. And now we rely for our vaccine programme on an industry that has run down its manufacturing in this country. Such are the UK’s underlying conditions, ignored or accepted for so long, and they are being preyed upon by this killer virus.