BORIS JOHNSON promised for a long time that Britain’s emergence from the closure would be “cautious but irreversible”. With the announcement of the last easing of restrictions on April 5, the prime minister is looking forward to a bar trip where he will ‘carefully but irreversibly’ lift a pint of beer on his lips. It was the kind of informality that irritates critics and cheers fans on.
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There are a growing number of the latter, with more people praising the performance of Mr. Johnson approved as at any stage since the early stages of the pandemic. Nearly half of the British received a vaccine, and jabs were dished out according to a schedule that many considered absurdly ambitious. As a result of this and the strict closure, business collapsed from almost 900 per 1 million people in January to less than 50 (see graph).
Britain is therefore grappling with something that will soon confront a large part of the West: how to manage the transition to a world in which covid-19 is less deadly. The government has decided on a dual approach: restrictions must be lifted slowly (this will only disappear in England on 21 June) and a series of measures will be introduced to reduce the transfer, some on a scale agreed by few other countries. .
Of the interventions, vaccine passports have attracted the most attention – and are the furthest from the launch. The government is experimenting on opportunities that a club night and the FA Cup final. Although its use is excluded in pubs and restaurants when they reopen, which will not take place earlier than May 17, it is not excluded that it will be introduced in such places later this year.
There are technical issues to overcome, including how to incorporate negative test results and to merge different databases. There are also political issues. Labor and the Liberal Democrats opposed, as well as some conservatives who are upset about the slow pace of return to normalcy, who like to quote Mr Johnson’s jeremiads ID maps from his time as a journalist.
Polls show strong public support. And the mere possibility of their introduction serves a purpose. According to Ipsos-MORI, a voting star, only one in 20 people will now turn down a vaccine, compared to one in seven in December. The main reason for this change is the expectation that vaccination will be necessary for travel or other recreational activities.
Britons may be enthusiastic about vaccines, but they are less eager to help a tracking system that, in the words of an insider, is ‘nice as a … sieve’. Nearly a quarter of those who test positive are not reached by trackers or refuse to give their details. People reached pass on average four contacts, compared to the 15-20 expected at the beginning. There are also concerns about how many people with symptoms are isolating themselves, with Rishi Sunak, the chancellor, stubbornly resisting efforts to increase sick pay.
But more careful treatment is given to worrying variants. Thanks to Britain’s enormous genetic sequencing ability, mid-March was almost half positive PCR results are examined. The government has used ‘improved contact detection’ for cases of the South African variant, against which the Oxford-AstraZeneca vaccine appears to offer less protection. This involves the door-to-door testing and careful examination of the transmission chain (ie what is simply called ‘contact tracing’ in China or South Korea).
Fall cases also offer other opportunities. Of England’s 343 local authorities, which tend to find more cases, 59 are involved in a “Local-0” pilot who is responsible for detecting all matters in the area. When host rooms reopen, all visitors should clock in the national contact tracking app, rather than just one member in each group, which should provide their markers with many more contact details.
But the biggest change, and where Britain stands out most internationally, is its testing capability. It does about 1 million tests a day, about the same number as America, which has five times the population. Numbers will soon increase. 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 pick up the virus than PCR children, but offers a quick turnaround.
The offer twice a week was previously available to medics and families with children at school. According to a scientist advising the government, tests in hospitals in early March picked up about 30,000 cases among staff who would otherwise go to work.
Research published by the Department of Health and Social Care (DHSC) suggests that the false-positive rate of the Innova lateral flow test, one type used, is 0.03%. It may seem small, but if the virus is rare and millions of tests are used, it means that many positive results are untrue. Critics worry that many people will get a nasty shock and be forced to isolate themselves unnecessarily. To mitigate this, the government last month changed its policy and reaffirmed everyone who tested positive PCR test.
The other concern is that lateral flow tests record fewer actual cases, thus providing misplaced assurance to some who are negative. But although they are less likely to take on those with low viral loads than PCR tests, they pick up the most infectious people. A preview by researchers at the University of Oxford, the DHSC and Public Health England suggest that lateral flow tests will record 83-89.5% of cases now leading to detected transfer events.
How effective the experiment will be depends on a large number of variables, not the least. The tests will be available for free in pharmacies, as many advocates in America have asked. The impact of Britain’s rapid vaccination has been thoroughly studied around the world. The entry into a new era of the pandemic will also be. ■
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This article appears in the UK section of the print edition under the heading “Opening shots”