Richard Dobbs | The Spectator columnists & writers

If we want herd immunity, we need mass testing

At the start of the pandemic, we talked a lot about herd (or community) immunity. But talking about the journey to herd immunity became toxic as it was variously linked to high infection rates, sacrificing the elderly, and the NHS becoming overwhelmed. The debate on herd immunity was restarted last week by Professor Karl Friston, of University College London, who told the Daily Telegraph that the 73.4 per cent vaccinated reached on Monday meant that 'based upon contact rates at the beginning of the pandemic and estimated transmission risk, this is nearly at the herd immunity threshold.' This is an outlying view: other academics questioned this analysis. Matt Hancock said that the government will continue to watch the real-world data.

How should we tackle vaccine hesitancy?

As Britain celebrates its vaccination success, we’re in danger of missing something important. A great many people have been offered the vaccine, but have turned it down — and we hear very little about them. No. 10 briefings trumpet the numbers vaccinated in the past 24 hours but are silent on the numbers who have refused. This matters, because if vaccine passports are on their way, granting access to pubs and so on, the unvaccinated will be excluded. More importantly, the unvaccinated will be vulnerable to the virus as we unlock. We need to know more about them. Dig deep enough and rough figures are there. Let’s look at the over-seventies in England. According to data from Oxford University’s OpenSAFELY analytics platform, just 4 per cent of white people in this group are unvaccinated: a hugely impressive number, beating expectations.

The need for speed: can we outpace Covid?

The Spanish flu pandemic a century ago resulted in around 50 million deaths worldwide. Its second wave was over ten times more deadly than its first. History is repeating, with the global death toll from Covid-19 this second winter already three times that of the first. In the UK, the number of deaths in this second wave is close to double the number we suffered in the first wave. The death toll in the first wave, while tragic, is somewhat understandable. A deadly pandemic came out of the blue, and we had to work out the best way of responding. But we cannot use this excuse to explain the higher death toll in our second wave, as we have had months to prepare this time. Of course, part of the reason for the higher death toll is that our second wave is over a full winter, unlike the first waves that started in March in the UK for both Covid-19 and the Spanish flu a century ago.

A race against time: can the vaccine outpace the virus?

The next three months may well prove to be the hardest of the whole pandemic. The new variants of Covid-19 appear to be the wrong type of game-changer. After our national lockdown in March, infection levels started falling because of extreme measures — including closing schools, places of worship and non-essential retail. But the infectiousness of the ‘Kent strain’ suggests that as it becomes prevalent, a new lockdown might be unable to contain it. When ministers first locked down, they did so in the expectation of taming the virus. This time, it’s more in hope. Boris Johnson didn’t show us any graphs when he announced the latest lockdown. He didn’t need to; the situation is clear. In England, in-patient numbers with Covid are 40 per cent higher than they were in the last peak.

The Edition

A race against time: can the vaccine outpace the virus?

34 min listen

The Edition

A race against time: can the vaccine outpace the virus?

34 min listen

Could ten million Covid tests a day get Britain back to normal?

In all the excitement about the Pfizer and BioNTech vaccine, it was easy to miss news of the other great hope for getting our lives back to some form of normal. Vaccines are not expected to have much impact for most of us this winter and it will be several years before they suppress Covid-19 globally. For now, a mass testing programme — not any jab — is probably the best chance of putting Covid back in its box. It has been piloted this week in Liverpool and it might be coming to us all in the near future. No one’s exactly sure yet how it will work, but you could start by imagining a world in which every other morning we all self-administer a rapid saliva test at home, with the results available within ten minutes.

The fundamental flaws of NHS Test and Trace

The NHS Test, Trace and Isolate programme — which was meant to be one of our main weapons in the fight against a second Covid-19 peak — has not had a good few weeks. First, when schools went back last month, an inevitable rush for tests was not met with sufficient supply. It then emerged that 16,000 people who had tested positive had failed to be transferred to the tracing system. Not a great start. Then, the government’s Scientific Advisory Group for Emergencies (Sage), for long an advocate, quietly disowned the programme, saying it is having marginal impact. Are these just teething problems as the programme gets scaled up? I’m afraid that even if there are no more glitches or shortages of tests, three fundamental strategic flaws mean it will not suppress a second wave of Covid-19.

The Edition

Xi’s world: how Covid has accelerated China’s rise

32 min listen

The Edition

Xi’s world: how Covid has accelerated China’s rise

32 min listen

Boris’s Dunkirk moment

It’s hard to deny that Boris Johnson’s government has so far had a ‘bad war’ against the pandemic. Our death toll is high compared with other countries and our economy is in worse shape. We face rising cases, increased hospital admissions and more restrictions. It’s all so bleak; yet that is why now is precisely the moment for Boris to imitate his great hero, Winston Churchill. In the coming months, Britain can play as pivotal a role in a global victory against the virus as we did in the second world war. The war analogies only go so far, of course. We are fighting a virus, not an evil ideology. But there are similarities. Like the second world war, Covid has caused UK government debt to exceed GDP. Moreover, just as the air force, navy, and army — backed by British science and technology — delivered victory in the 1940s, we are now ready to unleash the three attack branches of treatment, mass-testing and vaccines to defeat the virus.

Here’s how the Covid nightmare could be over by Christmas

Matt Hancock has announced his ‘Moonshot’ project of achieving population-wide mass testing for Covid-19. He should be congratulated for this shift in strategy. The previous strategy of 'Test, Trace and Isolate' relied on people with the virus feeling ill and so taking a test. Those who tested positive would then be called by one of the NHS tracers to ask for their recent close contacts, who the tracer would in turn contact and ask to self-isolate. While this approach has worked in the past with illnesses such as Middle East Respiratory Syndrome in countries such as South Korea, it is unlikely to work in the UK for Covid-19. The main reason for this is that up to 80 per cent of people with Covid-19 are asymptomatic, compared with around 15 per cent for Middle East Respiratory Syndrome, and so are unlikely to feel ill enough to need to be tested in the first place.

The case for mass testing

This morning, Matt Hancock claimed on the Today programme that the government is now working as fast as it can on developing a mass testing programme, which is ‘incredibly important’ if we want to ease coronavirus restrictions. The health secretary is right to finally focus on mass testing. So far, the UK’s performance has been relatively poor in fighting the pandemic, and we are currently expected to come out among the worst in the two-by-two matrix comparing Covid-19 performance on deaths and forecast economic impact: While some of this is structural – we have an economy that is more exposed to the service sectors than others and our population is more overweight, more diabetic, travels more on congested mass transport and lives more in multigenerational housing – we, citizens, businesses and the Government, have not played Covid-19 well to date.

Matt Hancock needs a ‘big, hairy, audacious goal’ for test and trace

Stanford Business School professors, Jim Collins and Jerry Porras in their book Built to Last: Successful Habits of Visionary Companies, introduced the idea of the ‘big hairy audacious goal’, or BHAG. A BHAG (pronounced ‘bee hag’) is a bold, clear and compelling target for an organisation to strive for, with the appropriate resourcing. A great example was President Kennedy’s speech to Congress in which he said ‘this nation should commit itself to achieving the goal, before this decade is out, of landing a man on the moon and returning him safely to earth’. This audacious goal committed and motivated NASA and its suppliers to deliver a massive step up in performance. Matt Hancock showed the power of a BHAG with his target of 100,000 Covid tests a day for England by the end of April.

Is our test-and-trace system ready to stop a second spike?

We are going to hear a lot about Test, Trace and Isolate (TTI) in coming weeks, as we approach autumn and fears of a second wave of Covid-19 grow. Now we have moved away from national lockdown but do not yet have a vaccine, the test-and-trace system is our main bulwark against a resurgence of the disease. But how good a defence is it? A study published in the Lancet Child and Adolescent Health this week suggests there is a huge amount at stake. Academics attempted to model what would happen in various scenarios over the coming winter, assuming schools return either full-time or on a part-time rota basis — and came to the stark conclusion that, depending on how well the tracing scheme operates, we could end up with no second wave at all, or with a second wave that would be more than twice as large as the first outbreak in the UK.