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Yesterday I joined the 13 million already vaccinated in the UK. Within just over a fortnight weeks this should give me around 65% immunity; my second dose within 12 weeks should raise this immunity to above 95%. The relief this offers is akin to picking up the ‘Get out of Jail Free’ card in Monopoly. Sitting within vulnerability group five (65-70 age group) I wasn’t expecting my first jab until the end of Feb, so well done NHS for rollout ahead of schedule.  This is a remarkable achievement so well done to all those in the development and distribution chain, praise & gratitude well merited.

Compared to other countries the UK vaccine programme does appear to be ‘world beating’. I think this is more Kate Bingham than Boris Johnson. See her Repubblica interview earlier this month:

However, after 100,000 deaths and several poor policy decisions over the past year, the UK could have avoided heavy dependence on a mass vaccine programme. Closing the borders a year late looks not only like stable door shutting but also tokenism. A vital step to protecting the public when the virus is outside the country is a futile gesture once the virus is widespread within in. As we are finding out with new variants cropping up where analysis is done, the virus doesn’t respect borders.

It was Donald Trump who stated the obvious truism ‘the more you test the more you’ll find’, so it is no surprise that new variants are found where the genetic sequencing tests are located.  Having rushed out to Bristol and Liverpool with testing for new variants, is it any wonder that they have been detected? On a global scale we are chasing the virus and learning more as we test more. There is another truism which affects policy: ‘absence of evidence is not necessarily evidence of absence’.  Just because we haven’t detected a new variant, it doesn’t mean it is not rife within the community.

Looking back to initial virus response last year, it is worth remembering that a viral epidemic was on the national risk register, contingency measures had been known for over four years. It was not that coronavirus was a Black Swan, an unseen risk; moreover it was a Grey Rhino, a known risk that was ignored or downgraded.  Why was it ignored? Probably the cost of contingency measures was considered too high, not a priority. With hindsight this risk assessment was woefully wrong, was it based on operational costs or strategic planning? Does blame lie with the NHS or the Treasury?

In 2012, under the Health & Social Care Act, the NHS was restructured to make it more cost conscious and independent of government. After nine years of experimentation it now looks as if the UK government has decided the NHS needs closer control in order to avoid being caught out by future demand for public health provision.  The inadequate virus testing and supplies of protective equipment are seen by the current government as being attributed directly to an absence of close government control. I wonder what Beveridge or Bevan would make of Boris?