How the UK Succeeded with Vaccines
The history of the Covid-19 pandemic has yet to be written, and perhaps no definitive history of it will ever be written, not only because history has no definitive end, but because the writing of history has no end.
The question of the virus’s origin is likely to remain as vexed and contested as the origin of the First World War; but almost every other question about it is likely to remain equally vexed and contested. Were the responses in the western world at the time reasonable or justified (not quite the same thing)? Could they have been better—or worse? Did they reveal something alarming, or reassuring, about the soul of modern man? What were the epidemic’s long-term effects, good, bad, indifferent, or avoidable? These are difficult questions, especially as we cannot yet say that the pandemic is completely behind us.
The difficulties of interpretation are likely to remain formidable. The statistics will be sifted and re-sifted, subject to ever-changing qualification and reinterpretation, in the attempt to find answers. There is a tendency that will have to be resisted to look at official statistics and assume that they must represent reality. The number of possibly relevant variables is almost infinitely large, rendering comparison, the main way in which conclusions will be drawn, difficult and hazardous. Since the manner in which death rates from the disease are ascertained and calculated may vary between countries, even the crudest comparisons may be hazardous.
The one undoubted human triumph of the pandemic so far is the development of vaccines in record time. The three main vaccines seem to be both safe and effective—unless, as believed by some, there is a giant conspiracy to deceive the people of the world. Overall death rates possibly related to the vaccine are very low, so low that they cannot show up on trials even of quite large size. The evidence is well-nigh conclusive that, if they are not a hundred per cent effective, they reduce the incidence of fatal and even serious infection with great efficacy.
Of course, no vaccine can protect individuals or induce herd immunity if it is not administered, in the latter case to a sufficiently large proportion of the population.
The British vaccination programme has been one of the most successful in the world, even though in other respects the country’s response to the pandemic has been slow, hesitant, contradictory, and draconian by turns, without any unmistakable sign of success in any of its phases. Britain’s death rates attributable, or at least attributed, to the disease are similar to those of other comparable countries—Spain, Italy, Belgium, the United States—and within the margin of error of others such as France. Yet other countries—Germany, Austria, the Netherlands—have had lower rates. What all this variation means, and whether it is attributable to policy differences, is uncertain. Moreover, as Sherlock Holmes would have put it, the game is still afoot. During the height (so far) of the pandemic, countries that seemed to be doing well by comparison with others suddenly rose (or fell) catastrophically in the “standings,” so that millions followed the rankings with the intense concentration that is often displayed by sports fans.
As statistics go, those relating to vaccination are more trustworthy, and they show that Britain was initially far ahead of its European neighbours in the race to vaccinate the population, though—as was to be expected—the continent is catching up. This success has been trumpeted as a vindication of Brexit, but not quite honestly. Even if it had remained within the European Union, Britain could have opted out of the European-wide vaccine procurement scheme, which slowed the process, and still achieved what it did.
The first good decision the British government took was to bypass its own civil service in appointing a very successful venture capitalist with a background in biochemistry and pharmaceuticals, Kate Bingham, as the head of its vaccine procurement and vaccination strategy agency. She took on this role without pay, and her success has reinforced my belief that management at the highest level of public administration ought to be amateur rather than professional: amateur in the sense of being unpaid and undertaken from a sense of public duty, not in the sense that it should be amateurish, as so much professional management is. Those who act temporarily at this level without pay have no vested interest in complicating matters or in institutional empire-building, and insofar as they have a personal interest, it is in the glory of successful accomplishment.
Being used to informed risk-taking, that is to say risk-taking without foolhardiness, Bingham early procured large numbers of doses of vaccines, much quicker than did the cumbersome European procurement programme. The British government also invested heavily, through Oxford University, in research which led to the development of a cheap and effective vaccine. By contrast, the European Union’s bureaucracy placed an extremely foolish bet (which Bingham did not) on the drug Remdesivir, €1 billion worth of it. Remdesivir turned out to be of marginal use at best.
Another British advantage came from what, in many other circumstances, is a disadvantage, namely the centralised system of the National Health Service. Practically every person in the country is registered with a family doctor; it was a simple matter, therefore, or at least a conceptually simple matter, for every person in any given age group or group at special risk to be invited to a vaccination centre, either at doctors’ offices or at specially-converted institutions (I was vaccinated at a racecourse, having been telephoned by my doctor’s office—I was in France at the time—to make an appointment). There was never any question of jumping the queue or of granting special privileges for supposedly special people. The acceptance of the government’s priorities as far as groups to be vaccinated was concerned was total. The website to make appointments was brilliantly simple and gave everyone an ample choice of time and location to be vaccinated.
A third advantage was the relatively low level of vaccine scepticism in Britain by comparison with, say, Germany or France, where initially half the population said that it would not take the vaccine. The figure in Britain was never anything like this, and I predicted (for once correctly) that resistance in France would decline when push came to shove and once the advantages of vaccination became almost indisputable. The resistance on all kinds of grounds—that we do not know the long-term effects of the vaccines, that they were not totally effective, that they were an instrument in world domination by shadowy conspirators—slowed or delayed the vaccination programme, but only for so long. 82 per cent of those aged 75 to 79 in France have now been vaccinated.
A fourth possible advantage for Britain (strictly in the speed of its vaccination programme) was the undeclared but real state of war existing between Britain and the European Union, which led EU leaders to denigrate the British vaccine, to the temporary disadvantage of its own population, and the relative advantage of the British. This is a fascinating story in itself.
It is too early for the British to declare victory, as the vainglorious and boastful Boris Johnson is so apt to do, because vaccination is a means to an end and not an end in itself. Moreover, any British advantage will not be long-lasting. But the programme was a rare success.