The Adam Smith Institute’s latest paper, written by Senior Fellow James Lawson and Head of Research Matthew Lesh, outlines how to protect human life while not re-entering lockdowns in the face of endemic Covid-19:
The rapid rollout of vaccines against Covid-19 is protecting the vast majority of vulnerable people and the wider adult population, significantly reducing the virus’s capacity to spread and kill, and accelerating the end of the pandemic.
Covid-19 is becoming endemic with substantial ongoing community spread. The virus is also mutating, producing variants. There is uncertainty about our capacity to respond to a rise in cases over the winter months.
We must learn to live with the virus while maintaining liberty. This can be enabled by boosting the UK’s vaccine campaign and developing greater societal resilience against Covid-19 and future pandemics.
The UK is enjoying a “vaccine dividend” which is disrupting the link between Covid-19 cases and deaths by as much as 90%, saving around 50,000 lives in the most recent wave of cases.
It is imperative to ensure restrictions are withdrawn and not reintroduced by building sufficient resilience.
The UK’s vaccine campaign was a success but could have gone even faster. There are lessons to be learnt in multiple areas including around “war-effort” style distribution, use of spare doses, pacing, dosing schedules, reward mechanisms, new supplies, mix-and-matching doses, vaccine centre ventilation and safety, and countering misinformation.
There are about 2.1 million vulnerable (“Phase I”) individuals who are entirely unvaccinated and 600,000 yet to have a second dose. There are 10.4 million adults who are entirely unvaccinated — which, if they catch the virus, could result in 39,600 deaths and 148,000 hospital admissions.
There are many receptive to vaccines yet unvaccinated and growing evidence that there may be waning efficacy over time.
The UK is falling behind other countries that have vaccinated more people, such as France, and begun providing booster shots, such as Israel.
There is also a lack of transparency about forthcoming vaccine supply and efforts to update or procure next-generation vaccinations.
Recommendations
If the Government wants to maximise the effectiveness of the vaccine campaign, protecting human life and increasing resilience, they should take the following steps:
1. Redouble efforts to vaccinate those in the “Phase 1” vulnerable group who are due a second dose and/or completely unvaccinated, including using mobile vaccination units and home visits — providing protection to those most likely to be hospitalised or die. This would make the most immediate contribution towards reducing hospitalisations and deaths, and building resilience.
2. Begin providing boosters, which are essential to maintain protection against waning antibody immunity, the Delta variant and future threats; prioritising the vulnerable but also offering a booster to the entire adult population.
3. Publish a detailed roadmap for Covid-19 vaccinations over the next five years, including an upcoming delivery schedule with plans for a backlog of boosters.
4. Update regulatory process to enable rapid approval of vaccine updates every time there is a new variant of concern, following the annual flu vaccine process.
5. Purchase a diverse range of new Covid-19 vaccines including updated Delta-variant specific vaccines and oral/nasal and “universal” vaccines.
6. Embrace “mix-and-match” doses, to enable greater supply flexibility and enhanced protection.
7. Offer vaccination to children aged over 12, with parental/guardian consent. This should be undertaken without coercion or implied restrictions, mirroring the rules of other vaccines offered to children and as a lower priority initiative than boosters for the vulnerable.
8. Counter misinformation to address vaccine hesitancy and enhance targeted marketing and distribution for those who are ready and willing to be vaccinated but have yet to make bookings.
9. Offer the flu vaccine across the entire population — not just to those aged over 50 and vulnerable — to build resilience against winter spikes in respiratory diseases, hospitalisations and deaths.
10. Permit pharmacies and private doctors to purchase, distribute and register vaccines from the international market, enabling more flexible boosters, greater vaccine choice and enhanced distribution capacity.
11. Support expanding human challenge trials to rapidly test updated and new vaccines.
If the Government wants to avoid ongoing restrictions, protect liberty and increase broader societal resilience, it should take the following steps:
12. Allow the ‘Coronavirus Act’ to automatically lapse and introduce new limited emergency mechanisms, including extensive parliamentary oversight, for future public health-related emergencies.
13. Reject ‘vaccine passports’, a form of state-sanctioned discrimination that would effectively coerce some people into undertaking a medical procedure without informed consent (but maintain venue-customer and employee-employer freedom of contract).
14. Establish an enhanced antibody testing capability, better informing individuals about their levels of protection and public health officials about overall societal resilience.
15. Simplify travel restrictions further to encourage global economic activity, with better collaboration with airlines, a further easing of restrictions for the vaccinated, and a simplification of the “test to release” scheme.
16. Encourage, using guidance, ventilation through continued al fresco retail, hospitality, and leisure activity, use of outdoor heaters and better ventilation in schools as they reopen.
17. Encourage, using guidance, for vulnerable people to use masks with respirators, such as N95, KN95, FFP3, and FFP2, rather than less protective cloth or surgical masks.
18. Proactively invest in new and emerging treatments to tackle Covid-19, such as monoclonal antibody therapy drugs (i.e. Ronapreve, Sotrovimab, AstraZeneca’s AZD7442), antiviral treatments (i.e. Pfizer’s PF-07321332/Ritonavir), and other emerging drugs (i.e. fluvoxamine).
If the Government wants to ensure medium to long term resilience against pandemics, it should take the following steps:
19. Review medical regulatory processes to accelerate the assessment, approval, supply and distribution of new vaccines.
20. Expand manufacturing and logistics capacity for rapid production of vaccine updates and new vaccines against future pandemics.
21. Invest in vaccine platforms and proactively assess viral threats on an ongoing basis, developing fast-moving responses.