Like the ancient mariner, the virus refuses to leave us alone. Resurging in Blackburn, Spain, and America, it is still going to be around here when the winter comes. As we head indoors, it will be back for a dreaded second wave, disguised among a host of colds and flus. Yet I am now optimistic that the nightmare will end this year or at least by the spring. Here are five reasons.
First, vaccine trials were promising. Having proved safe and capable of raising both a T-cell response and an antibody response, Oxford University’s vaccine, developed in collaboration with Astrazeneca, is now more likely to succeed than to fail, so long as its side effects are manageable in the elderly. And behind it comes a stream of other vaccines, some of which will surely work.
The second reason for hope is that, as Oxford University’s epidemiologist Sunetra Gupta has argued, herd immunity may be achieved more easily than we first thought. Indeed, from the way that infections have continued to dwindle despite lessening social distancing it seems probable that herd immunity has already been achieved in London at least. Half the population could be immune already because of recent exposure to coronavirus colds, while children seem to resist catching Covid-19, let alone passing it on. As the chief medical officer Chris Whitty has conceded, the epidemic was already in retreat before lockdown began. That is because the virus depends heavily on a few superspreaders, and pre-lockdown measures we were taking in March are remarkably effective: no handshakes, frequent hand washing, no large gatherings and so on.
So the third reason for optimism is that as long as we continue with these measures then this virus will struggle to keep spreading in the community. The one place where the virus did spread with horrible ease was in care homes and hospitals. Why was this? T-cell senescence is an issue, so old people’s immune systems are just not as good at coping with this kind of infection, and there were dreadful policy mistakes made, like stopping testing people, clearing patients out of hospitals to care homes without tests, and assuming no asymptomatic transmission. Healthcare and care home staff were not properly protected and were allowed to go from site to site. Many were infected and became carriers.
The fourth cause for cheer is therefore that now we know about asymptomatic transmission, we have more protective equipment and we have a better, if still imperfect, capacity to test, track and isolate cases, it is likely that the hospital-acquired epidemic of the spring will not be repeated.
My fifth excuse for being hopeful is that we now know better how to treat people who get seriously ill. Ventilation is not necessarily the answer, blood clotting is a real threat, making patients lie face down is helpful, dexamethasone can save lives and some antiviral drugs are showing promise.
These are reasons that even if a lot of people catch the virus this winter, fewer will die. Colds and flu viruses usually peak in mid winter when we are indoors. Viruses survive longer in colder and drier conditions, and centrally heated air dries out our protective mucus membranes. Covid-19 will certainly be hoping to peak then. But Australia offers a glimmer of reassurance. It’s winter there now, and this is proving to be the country’s weakest flu season on record. From January to the end of June, 21,000 Australians were diagnosed with flu. Last year more than 132,000 people were diagnosed in the same period. Social distancing is presumably the main reason. If that is repeated here, then not only will Covid have fewer flus and colds to hide behind, but it too will struggle to mount a seasonal peak. And fewer people will die from flu.
If we can beat this virus, then we can beat most respiratory ones. The ridiculous way in which we tolerate cold-spreaders, mocking them for taking a day off and praising them for trudging into work while feeling miserable, has to stop. It should be socially unacceptable to go to a party with a cold, let alone kiss the host on the cheek when you get there. Our children’s permanently runny noses need not be inevitable.
Ten years from now, I predict that we will not only have defeated Covid-19, but made colds rarer too.
Our bigger challenge this winter will be to tackle the backlog of treating cancer and other medical problems delayed by Covid. And to unleash economic growth to help those who lost their jobs.
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