Sun 5 December 2021

Byline Times’ Chief Medical Officer, Dr John Ashton, considers the continuing challenges ahead in the Coronavirus pandemic – despite the development of a vaccine

As we enter the second year of the COVID-19 pandemic, we are faced with a bleak mid-winter.

With the numbers of new Coronavirus cases escalating daily, hospitals and intensive care units are at breaking point. Staff absences are running at more than 20% from COVID-19 through self-isolation from the virus and stress-related conditions. Seriously ill patients are being shipped around the country. But, following the Prime Minister’s lax approach on gatherings during Christmas in parts of the country, the worst is sadly still to come.

The death toll stands at more than 1,000 people each day and the grim total is heading towards 100,000 people before the end of January. So much for the Government’s Chief Scientific Advisor Sir Patrick Vallance’s optimistic target of less than 20,000 deaths that he espoused in March, along with his naive embrace of ‘herd immunity’.

A Tradition of Anti-Vaxxers

But it is not all doom and gloom and we must celebrate the remarkable achievement of clinicians and scientists around the world collaborating to produce effective vaccines less than a year after the Coronavirus made its unwelcome appearance.

Coming exactly 100 years after virology came into existence during the period of the influenza pandemic of 1918-19, this is surely the moment when the new discipline has come of age and can be added to the time-tested methods of practical, shoe-leather public health in rooting out and preventing death from nature’s most devious allies.   

Yet, there is many a slip between cup and lip as can be seen from the story of the eradication of smallpox. It took the best part of 200 years from when Edward Jenner first demonstrated the effectiveness of cowpox inoculation against its most dangerous viral relative in 1796, to when the World Health Organisation was able to declare the demise of the virus in 1980. In the interim, efforts at mass vaccination ran into the sands of highly organised opposition.

Although smallpox vaccination was made compulsory for all newborn infants in Britain in 1853, branches of the Anti-Vaccination League soon brought it to a halt. From its centre in Leicester, the league organised a highly successful campaign against vaccination culminating in a large-scale demonstration in 1885, which led to a Royal Commission and the abolition of compulsory vaccination.

The basis of objections to vaccination were to be found in religious superstition and fear of needles, together with arguments about personal liberty and an anti-science movement – which seems to have gathered even more momentum today at a time when science has given us greater insights into the natural world than ever before.

It remains to be seen whether the 80% of the population willing to welcome COVID-19 vaccines with open arms will have their public health rights compromised by a fanatical minority.

But it is not only the anti-vaxxers that should arouse our concerns. We must also be aware of the disastrous failures of the Government to take decisive and effective action at each point in the pandemic.

Government Incompetence

Whether it be testing, tracing and support for isolation, personal protective equipment, or leading from the front and implementing effective interventions in a timely way, the Government has been found wanting.

We are about to see whether the defining characteristic of the handling of the emergency in over-promising and under-delivering is about to be repeated with the roll-out of the vaccination programme.

After a nationalistic rush to be the first out of the blocks with a vaccine in December – and implying by sleight of hand that a German-developed vaccine was somehow ‘British’ – the programme has struggled to get into its stride with some 300,000 vaccinations being given out each week.           

We are now being asked to believe that, within a week, this will become 300,000 vaccines daily, that all care home residents will have been vaccinated by the end of January, and that the 13.5 million most vulnerable citizens will be protected by mid-February.

These ambitious targets are all too reminiscent of Boris Johnson’s wild promises at other points of the pandemic, as well as Health and Social Care Secretary Matt Hancock’s confabulation of the difference between capacity and delivery with regards to the ‘Test and Trace’ operation last year.

Meanwhile, the alibis for failure are already being lined up – vaccine manufacturers unable to deliver on the changing production promises, and GPs who say they are being let down by the supply side of the equation.

Setting aside that GPs had previously claimed that they could deliver the vaccination programme without recourse to reinforcements whilst simultaneously being under the cosh for all the extra work thrown up by COVID-19, they were also being promised £10 a shot for delivering vaccinations in contrast to the £11 an hour for the army of vaccinators who were supposed to do the actual work. It has now emerged that the recruitment of the army is also faltering.

Initially, the NHS advertised that non-clinical workers as well as retired doctors and nurses could sign up to be vaccinators to staff an extensive network of vaccination centres around the country. It has subsequently transpired that a Government that could reconvene at the drop of a hat to “get Brexit done” could not pull off the same trick to authorise the training of non-clinical professionals.

What finally seems to have caught the Prime Minister’s fleeting attention has been letters to the broadsheet newspapers from retired clinicians drawing attention to the bureaucratic process that even the most experienced clinician must navigate in order to join the army of jabbers. These include hours of arcane online training, only some of it relevant in a national emergency but including fire safety, guidance on heavy lifting and preventing terrorism, followed up by the need to search out educational verification in the form of 50-year-old ‘O’ Level certificates.

It is said that history repeats itself, first as tragedy and then as farce. As it stands, it is a toss-up between the Government and the anti-vaxxers when it comes to who will attract the most historical opprobrium.

Dr John Ashton is a former director of public health and the author of ‘Blinded By Corona


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