The scientist who helped shape Britain's lockdown strategy said that the UK is past the worst of the Covid epidemic but should be prepared for some bumps on the road.
As the country passed the peak of another wave of coronaviruses, things were looking up, said Prof Neil Ferguson, a leading epidemiologist at Imperial College London.
I am optimistic that the majority of the pandemic is behind us, in terms of deaths and hospitalisations. He said that any new variants that are highly likely to occur may have a less dramatic impact than Omicron, although we should still be prepared for some bumps on the road.
He said that the risk of a new variant causing unmanageable levels of healthcare demand is reduced because of the very high level of immunity in the UK population acquired via both vaccination and infection.
He added that if a new variant arises from Omicron not a certainty, there is a fair chance it will retain the reduced severity of that strain.
Ferguson said Covid vaccines, specifically those based on mRNA technology, were a key development, while important lessons had been learned, such as the need for data to make informed decisions. In March 2020 we were basically blundering around in the dark in terms of our real knowledge of how much infection was in the country. Another lesson was the need to tailor the speed of policymaking to the speed of the virus.
He said that you may have to make decisions before you have the full picture of severity.
Ministers were faced with a stark message from science advisers: to avoid the potential worst case scenarios, measures needed to be brought in quickly, with Omicron spreading rapidly in the UK last year.
The UK government introduced plan B in England, but it refused to go further despite stronger measures in Scotland, Wales and Northern Ireland.
Ferguson said the political stance had evolved over time. He said that the change had led to more nuanced and difficult decisions because we are in a different place in terms of how policymakers think about this two years in comparison to what they were back in February, March of 2020.
On Wednesday, the prime minister announced that plan B measures in England would be lifted because cases were now falling. Ferguson does not believe that this will cause Omicron to come back in force.
He said that restrictions are always a trade-off between infection control and economic cost. I don't think lifting restrictions pose a big risk of causing a major resurgence, given that case numbers are in decline in all regions and that hospitalisations are starting to drop. Trends will need to be monitored closely. Ferguson said that scientists rarely interact with politicians, with Sir Patrick Vallance and Sir Chris Whitty acting as mediators. There were frustrations, such as in autumn 2020 when the Alpha variant took off.
Case numbers went up because we were seeing them go up. He said there was a lot of misinformation around at that point.
Covid was evolving to be more transmissible and was not yet in a classic endemic disease scenario in the UK, he said. Flu mutated each year, and could cause seasonal epidemics, but the immunity we have acquired over our lifetimes made it manageable. As experts have noted, endemic does not necessarily mean mild.
Ferguson said that Covid is going to become an endemic disease that kills people every year. With careful management and building immunity, he hoped that waves of infection would bring a lower toll of hospitalisations and deaths, although it may be necessary to expand hospital bed capacity.
But politicians have short memories, and he worries that we might stop preparing for the next epidemic when the immediate shock of coronaviruses starts to fade from the national consciousness.
For the next 10 years, pandemic preparedness will be a priority for governments, research funders and research funders around the world, Ferguson said. What do I worry about in 15 or 20 years time?