British response to Covid warns other countries

There are downsides to most Covid-19 precautions. Keeping children home from school can make them fall behind. Working from home can hamper creativity. Staying away from friends and relatives can take a toll on mental health. Wearing masks can stifle speech, obscure smiles, and fog up glasses.

For all of these reasons, the ideal Covid policy for any company balances the benefits and costs of precautions. He recognizes that excessive caution can do more harm than good. From now on, regular readers will recognize the search for Covid balance as a theme of this newsletter. Today we want to focus on one place that seems to err on the side of too little caution: Britain.

Over the past year, Britain’s response to Covid has included some major victories. The country rushed to vaccinate people (as we explained) and was also ready to reimpose behavioral restrictions last winter. These measures have contributed to a sharp drop in the number of cases.

In response, Britain reopened over the summer, allowing people to live largely without restrictions. Schools and workplaces are back to normal, without masks. The restaurants are reserved. Finding a taxi on a Saturday night in central London is still a challenge.

“It feels like we can finally breathe,” Devi Sridhar, head of the Global Public Health Program at the University of Edinburgh, wrote in August. “We can start to try to recover what we have lost.”

The problem is, Britain now seems to have lost its sense of balance, like Sridhar also suggested. Cases have increased this fall, more than in the rest of Europe, the United States or many other countries. Yet Prime Minister Boris Johnson’s government continues to oppose measures that could reduce cases.

We want to focus on Britain in part because it can offer lessons to the United States and other countries. The Delta variant arrived in Britain earlier than in many other places, making it a leading indicator. Cases in Britain rose for about two months from May and then started to decline. But the decline did not last:

Over the past week in the United States, cases have also stopped falling. The reasons are not clear, as is often the case with Covid, and the recent increase is tiny. But it’s a reminder that the pandemic will likely continue to have its ups and downs.

Experts say Britain appears to be making three main mistakes that are making the pandemic worse.

1. Not enough vaccines

Despite being ahead of most European countries when it comes to vaccinating adults, Britain has waited to approve vaccines for adolescents. He only recommended vaccinating 12-15 year olds in September, weeks after many students had returned to school, as our colleague Josh Holder noted. Today, only 21% of young people aged 12 to 15 in England are vaccinated, compared to 80% of adults.

The United States faces a related challenge. About 57% of Americans ages 12 to 15 have been vaccinated, and children ages 5 to 11 are about to become eligible. A significant number of parents remain suspicious, in part because Covid is rarely severe in children. But childhood immunizations – in addition to the individual benefits – is likely to hold back cases for everyone.

The biggest problem in the United States is a lower vaccination rate than most other high-income countries.

2. Decreasing immunity

The rate at which vaccines lose their effectiveness remains a subject of intense debate. Most experts believe that vaccines are still great at preventing serious illness, even months after injection. But most of the evidence suggests that vaccines lose some of their ability to prevent at least mild infections. This is especially true for the AstraZeneca vaccine, which has been widely used in England.

Britain’s initial speed to vaccinate people lowered the number of cases earlier this year. Yet it also meant that declining immunity became a problem sooner than in countries that were slower to give injections. Britain is now offering reminders for people 50 and over, as well as health workers and medically vulnerable people.

Over the next few months, declining immunity could become a growing problem in the United States, especially for the most vulnerable. All Americans 65 and over are eligible for the booster shots, as well as anyone who has received the Johnson & Johnson vaccine and others people.

3. Live and let live

Behavioral restrictions – like wearing a mask – aren’t as effective as their supporters sometimes suggest. Britain offers a case study: Scotland, where masks are often mandatory, has a similar level of Covid spread to England, where masks are less common, like John Burn-Murdoch of Financial Times wrote. If masks determined the spread of Covid, Scotland’s rate would be lower than England’s.

But there is a difference between a precaution having a modest effect and no effect. Masks help, according to a wide variety of evidence, although their impact is sometimes outweighed by other factors. Britain appears to be suffering from a lack of almost all restrictions, including mask warrants. One of the biggest problems, Burn-Murdoch notes, is the number of crowded indoor gatherings across Britain, including Scotland.

When cases decrease, it often makes sense to let people live more freely. When cases multiply, the reverse is true. Britain is ignoring this lesson – and the pleas of many experts.

The bottom line

The recent UK policy on Covid has claimed lives and overwhelmed hospitals. “When a health care system fails, increasing numbers of people suffer and die needlessly,” Dr. Kenneth Baillie wrote on Twitter. “This is happening now all over the UK”

Still, it’s worth putting Britain’s problems in perspective. The country’s high vaccination rate means that only a tiny fraction of recent cases have led to serious illness, and the death rate this fall was only a fraction of what it was last winter. “This virus is going to be with us for years, if not the rest of our lives,” Willem van Schaik, a microbiologist at the University of Birmingham in England, told us. “We definitely left the worst behind us.

Despite the Covid outbreak in Britain, the United States – where the overall vaccination rate is lower – arguably remains in worse shape, with a significantly higher per capita death rate. Why? Immunization rates always matter more than anything else.

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