- UK pandemic politics point to the downside risks that might be associated with a quick vaccine roll-out.
- The UK has been faster, more efficient, and the vaccine has been accepted by a larger share of the population than in almost any other developed country apart from Israel.
- This success, however, has further increased the political pressure on the government to reopen the country, creating new risks as the caseload explodes and the delta variant spreads.
88% of the adult population has had one dose of the vaccine, and 68% are fully vaccinated. The link between cases, hospitalizations, and deaths has been seriously weakened as a result. On 19 July, the government reopened England. Together with a three-week delay in closing the borders to India – at least partly motivated by the government's interest in a trade deal – this benefited the early and rapid spread of the delta variant, now accounting for 90% of all UK cases.
The full unlocking of 19 July was risky from a public health standpoint and difficult to delay from a political perspective. There is now significant growth – albeit more slowly than previously from a very low base – in hospitalizations and deaths. Deaths are already averaging at 50 per day. This might increase to 100 per day or more during August, with perhaps 10,000 or more Covid patients in hospital, many of whom are younger and not yet vaccinated fully. These will be key factors to watch, not just from a narrower perspective of pandemic management but also with a view to medium-term political support for the government's commitment to reopening.
In unlocking the country, Johnson responded to pressures from the Covid Research Group of Conservative MPs and some right-of-center media. The government hopes that relaxing restrictions during the summer will be better than trying to do so in the autumn and winter when schools are back, people are indoors, and the seasonal flu strains the NHS as it does every year. However, it is far from clear whether the public will continue to support this course in the scenario predicted by Health Secretary Sajid Javid, who has just gone down with Covid despite being double jabbed. Javid stated that new cases might reach 100,000 per day.
Among the risks is the longer-term medical threat of serious illness among the young and unvaccinated, including long Covid affecting many previously healthy people, and the danger of new variants emerging that may be more resistant to vaccines. In more immediate and perhaps politically more impactful terms, businesses and public service providers are already suffering serious disruption as many workers are sent into self-isolation amid rising case numbers. The risk is that the UK ends up falling behind its neighbors economically towards Q4 after having outperformed Europe with its vaccine roll-out.
The roll-out of the vaccine to all adults will help, but even then, no vaccine is 100% effective, not everyone will have had it, and most under 18s may remain unvaccinated. There is the possibility that UK cases will eventually start to stop rising or to fall as the virus hits a wall in terms of vaccines and antibodies from the unvaccinated who have recently had Covid. But nobody knows if and when this may happen or at what cost in terms of long Covid. The rest of Europe and the world will be watching closely as the UK tries to handle these risks of its own vaccination success.
The government's position is further complicated by its simultaneous attempts to redefine Conservative politics, leading to erratic messaging and a strategy that oscillates between a traditional focus on personal freedoms and a new concern for protecting more vulnerable groups. After the reopening, and in response to the rising caseload, the government has started to row back, encouraging people to continue to wear masks in crowded indoor spaces and is threatening to introduce vaccine passports for nightclubs and other major crowded indoor events. At the same time, it will allow the fully vaccinated to avoid isolation from the end of August if they have been in contact with someone with Covid and replace isolation with regular testing.
Back to restrictions?
Looking ahead, there is widespread fear in government, among its scientific advisers and on the Tory backbenches as well as among the public at large (who are more cautious than the government) that a further set of restrictions will have to be introduced in the autumn. These may even have to last until spring 2022 to help the NHS cope over the winter, particularly if seasonal flu shoots back up again after a year when nobody caught it due to the lockdowns. Israel and the Netherlands tried a full unlocking, and both have already had to re- introduce some restrictions.
Politically, re-imposing any restrictions would be difficult for Johnson as he and much of the Conservative Party wanted the unlocking to be irreversible. While the UK economy has made a strong start to the year, the return of some restrictions may reduce the speed and scale of the recovery. Johnson and the government's popularity is already beginning to fall after the major vaccine bounce they received in spring. Next might be a challenging winter with high new cases, employees isolating, and difficult decisions on how to pay for health, social care, and education catch-up through either painful savings or new taxes.