Politics: a pivotal moment

By Richard North - June 1, 2021

News of the moment from the BBC is that the World Health Organisation is to rename the UK (Kent) and other coronavirus variants with Greek letters. The UK variant is now to be called “Alpha”, the South African variant is “Beta”, and the Indian variant becomes “Delta”.

On the face of it, the reason for the change has been made to simplify discussions, as it is so hard remembering complicated names like “Kent variant” and “Indian variant”. But the real reason, it seems, is to help remove some stigma from the names, particularly after the Indian government criticised the naming of variant B.1.617.2 – first detected in the country last October – as the “Indian variant”.

One does wonder, though, whether the Indian government is being a tad over-sensitive. There is a long-established convention of naming microorganism types (and diseases) after their locations of discovery. For instance, amongst the 3,500 serotypes of Salmonella, we have such delights as Salmonella Newport, Salmonella derby, Salmonella Arizona and even Salmonella heidelberg. There has never been any “stigma” associated with this.

However, regardless of the Indian government’s sensitivities, the Guardian obviously hadn’t got the memo last night, offering two reports on its website referring to the “Indian variant”. I guess the Indians will have to put up with being famous for a new variant of coronavirus.

One of the Guardian’s reports firms up on the warning aired in my piece yesterday, about the effects of a third wave. “If India variant starts a third wave”, we are told, “England’s Covid rules may have to stay”. And, with that, the view is that hopes of restrictions ending on 21 June are dwindling as this highly transmissible variant spreads.

New data, it appears, suggest that the “variant of concern first detected in India” has continued to spread across England, with samples containing the variant now found from Cornwall to Canterbury, Bury to Bromley.

According to Sage, there is now a “realistic possibility” that the variant could be up to 50 percent more transmissible than the Kent variant that previously predominated. And, on that basis, University of Warwick modellers suggest that there could be a third wave of Covid-19 with a peak of 10,000 hospitalisations per day – assuming no changes are made to the roadmap.

There is some comfort here in the knowledge that modelling of case rates for Covid-19 in the UK has been consistently wrong, with modellers tending to exaggerate outcomes – cases and deaths. Nevertheless, there is enough concern for the second of the Guardian’s pieces to headline: “Scientists call on UK to speed up second Covid jabs as India variant spreads”.

The British Medical Association has called on Johnson to honour his pledge to lift measures based on “data, not dates”, saying that the government should hold off giving the green light to progressing to stage four of the roadmap “until the latest data can be scientifically considered”.

BMA council chair, Chaand Nagpaul, thinks “We are at a pivotal moment”, and warns that what he calls a “premature” ending of all legal restrictions may result in a surge of infections that “would undermine our health service” and undo all the progress made suppressing Covid-19. “We cannot afford to repeat past mistakes”, he says.

Politically, Labour seems to be getting its second wind on this, accusing the government of being “distracted” by the turbulence resulting from Cummings’s testimony last week.

Shadow health secretary, Jon Ashworth, claims that the single biggest threat to the 21 June reopening is “ministerial incompetence” – which is probably not that far from the truth. Members of the cabinet, he says, are engulfed “by internal rows and blame shifting at just the moment we need a laser-like focus on this variant”.

Once again, ministers are on the back foot, as the new data are difficult to read. Cases are going up but, for the moment, we’re not seeing a corresponding rise in hospital admissions and the figures for deaths are holding steady. Both are trailing indicators, though, and the situation could change very rapidly.

That left duty apologist, Defra secretary George Eustice, to explain to BBC viewers that the government is as yet unable to say whether there will be any changes to the roadmap scheduling. The key date is 14 June, when the situation will be assessed and a decision made.

Predictably, the hospitality sector is increasingly concerned. Kate Nicholls, chief executive of UK Hospitality, says that not being able to fully reopen in June would be “devastating” for venues. Many, she said, were operating at 60 percent capacity (because of social distancing) and “haemorrhaging cash”. A delay would “push them closer to the cliff edge of business failure”.

Everything, therefore, seems to rest on keeping up the momentum of the vaccine programme. There are calls for the gap between the first and second doses to be reduced to eight weeks for all adults, in addition to cutting the period for priority cohorts which included health workers and the elderly.

Efforts to get the first dose to other adults has also been intensified, especially in areas where the incidence of the India variant is high. Here, though, there is an issue which has been raised by the BBC. With an estimated million-plus “undocumented” workers in the UK, it reports, this cohort presents an “invisible public health risk”.

By “undocumented”, of course, the BBC means illegal immigrants. These will not be registered with the NHS or social services and will be missed by the current vaccination programme.

It was instructive, therefore, when a “no questions asked” vaccine bus was despatched to London’s Chinatown recently, it was mobbed by so many people that the police had to be called to control the crowd.

At least, given the opportunity, the Chinese community turned out to be vaccinated. By contrast, in Indian variant hotspots, a degree of vaccine “hesitancy” amongst ethnic communities has been experienced, potentially creating the conditions for uncontrolled reservoirs which seed the wider community.

Add to this, assertions (paywall) that the success so far of the UK’s vaccination programme is giving Britons a “false sense of security”, and one has to concede that a substantial increase in Covid incidence is a possibility.

But whether even a delay in the final lifting of restrictions is politically feasible remains to be seen. The chances are that enforcement will become progressively more difficult, as public cooperation is lost. Johnson may find himself having to choose between what his scientific advisors tell him is desirable, and what is actually possible in enforcement terms.

He will also have to consider the growing toll of ill-health occasioned by the cessation of most of the routine procedures undertaken by the NHS. Interrupting the burgeoning catch-up programme to deal with a relatively modest uptick in Covid-related morbidity could do more harm than good – and that is without factoring in the economic damage.

Such are the variables than even a competent, trusted prime minister would be hard-put to choose the right path and make his decisions stick. Johnson could thus find that, whatever he does, he will be condemned – with plenty of people willing to join in.

To that extent, the next couple of weeks could prove to be make or break, for Johnson’s political fortunes and for the nation as a whole. We are indeed at a pivotal moment.