The lockdown approach to combating Covid-19 has been undeniably effective. The surge in cases was stopped, the NHS was not overwhelmed, and many deaths were prevented. At the Francis Crick Institute, we could see the dramatic effect on cases, as we’ve been testing for Sars-CoV-2 to support our local hospitals. When we ran our first samples, at the peak of the first wave, nearly half were positive. Now we see perhaps one or two positive samples in a thousand.
But it’s not quite a fair comparison. Our earliest samples were from symptomatic self-isolating healthcare workers and we immediately realised that many other colleagues with no symptoms, or milder symptoms, would not be self-isolating. That meant they might be transmitting the virus. After a very regrettable delay, we persuaded our colleagues that it would be of critical importance to test asymptomatic healthcare workers too. One of many blunders in the first phase of the UK’s response was to allow substantial transmission within hospitals and care homes.
I don’t wish to dwell on past mistakes. When Boris Johnson recovered sufficiently to address the nation on 10 May, he outlined a new approach: suppressing this virus, keeping R below 1. The following day, flanked by Chris Whitty and Patrick Vallance, he emphasised this message again. I was delighted. Finally, we were pursuing the correct strategy, the one adopted early on by Hong Kong, Taiwan, South Korea, New Zealand – the strategy that Sage advice had hitherto failed to identify. An acquaintance responded somewhat sardonically to my jubilation that this was exactly right with, “Yes, in the sense that ‘score more goals than the other team’ is exactly the right strategy for winning at football.” He’s not a scientist, but a freelance singer; you can imagine how the lockdown has affected his income.
We now have the right mindset, but the challenge confronting Britain is greater than that faced by the countries that locked down early. To extend my friend’s analogy, we’ve been on the pitch with 11 playmakers nonchalantly passing the ball around, but with nobody who can either shoot or tackle. Testing, tracing and isolation is of course right, but mildly symptomatic people must be encouraged to request a test immediately. We have to turn those tests around more quickly, and we must be able to persuade their asymptomatic contacts to self-isolate. The app that could help with identification of contacts must have the broad support and trust of the public, as well as be technically beyond reproach.
Until last night’s announcement by Grant Shapps, mandating masks on public transport from 15 June, we have been given only lukewarm encouragement for their use; yet just about every successful country has had mask-wearing at the heart of its success. There is good reason to believe that mask-wearing will only have a substantial effect when most people wear one. We must enact the new policies with greater efficiency if we are to succeed.
If you want to, you can extend the analogy further: as with any fan, you might complain about the owners, or want a different manager. But this isn’t a game. Recent data from both Public Health England and the Office for National Statistics shows that less than 10% of the UK population is now immune to this virus. Reliable antibody tests at scale from multiple sources indicate approximately the same figure. We must discard any foolish optimism about “immunological dark matter” that will mysteriously prevent infection, or any other clutching at straws. The great majority of us are still susceptible to this virus, and if we allow it to transmit easily between us we will see a second wave – possibly during the winter, where it may be even more deadly.
Fundamentally, it is not just the government that has to get this right – it is all of us. If we want to preserve our economy and our NHS, we must behave with personal integrity and responsibility. There will be mistakes, and no doubt there will still be hypocrisy and incompetence. These are human characteristics from which no government will ever be entirely free. What matters now is that suppressing the virus is the correct approach – and that we have the means to carry it out. Matt Hancock has been upbraided by the chief government statistician for misrepresenting the number of tests, but however you count it, the capacity of 200,000 tests per day is a vast improvement on the situation in March. Credit where credit is due: it’s involved a huge effort from volunteer scientists at all the public health labs, hospital and academic labs and the Lighthouse labs. We can push this capacity even higher. If we can now target our testing effectively, we can loosen the lockdown and revive our economy.
If we get the next phase of our response – testing, tracing and isolation – wrong, our two remaining options are semi-permanent lockdown, or hundreds of thousands of deaths in an uncontrolled epidemic. Both possibilities will come with enormous economic damage, as well as a terrible cost in lives. The absolute worst thing we can do is give up hope. I wouldn’t despair too much about pictures of crowds. The virus transmits less well outdoors. But we should be keeping 2 metres apart, and it’s irresponsible not to – for any reason, even for highly justified protests. We cannot afford to mess this up.
I shall be supporting the government over testing and tracing, and helping to do all I can to make it as efficient as possible. I shall download the app when it becomes available, and I shall use it. I expect every government minister, and every government adviser to do the same. This would reassure me greatly that the app was safe to use. I have high confidence that recent events will have reminded key government advisers of the importance of privacy, and of the importance of leading by example.
New data on several vaccine candidates seems promising. If any prove successful, they will be deployed in record time. If we give up, we will see even more lives lost needlessly. If we keep up our collective effort, we can control this virus and prevent an overwhelming second wave.
• Dr Rupert Beale heads the cell biology of infection laboratory at the Francis Crick Institute in London
