The UK Stopped All Pandemic Control. Let's See What Happens Now

Some countries in Europe (the United Kingdom and Denmark are spearheading the movement) have decided to embark on an experiment, based on hope more than science, that will probably define how the rest of the world faces the next phase of the pandemic. It is therefore important that we all pay attention.

The basic idea is to pretend that SARS-CoV-2 doesn't exist. Or, to be more precise, that it behaves like many other respiratory viruses that are part of our yearly routines and, therefore, need no special attention. It is assumed that there are going to be collateral victims; that's why it is now being compared to the flu, a seasonal disease that has a substantial death toll worldwide but doesn't alter our daily routines. Is it really the time to carry on and forget COVID-19?

Let's take a look at some figures (all data obtained here). Since declaring "freedom day" last July, the first British attempt at returning to some sort of normalcy, the average rate of new daily cases in the UK has only briefly fallen below 500 per 1 million persons. To give some context, this is higher than any value registered since the beginning of the pandemic, except the peak of the January 2021 wave.

This shows that tests and vaccines — basically the only control tools used in the UK until the Omicron wave — are not enough to control infection. Currently, the values are over 600 per 1 million persons and are steadily declining, but it's early to know if the trend is going to continue long enough to reach the low levels seen when the pandemic was tightly controlled (20-30 cases per 1 million persons).

It could be argued that we don't need to aim for that point anymore; immunization (be it natural or through jabs) has radically changed the outlook of the disease, with death rates plummeting compared with what was seen in the first waves. It all comes down to what cost we are willing to accept to go back to normal. If we look at the death rate in the UK, it hit rock bottom last June (0.09 per 1 million persons daily), but after freedom day, it started to climb back up again, becoming more than 100 times higher on average. It has never been below 1 since then (and has often been twice as much).

Other European countries, in the meantime, managed to keep low figures by being a bit more careful (Germany, for instance, kept it well under 1 until Omicron arrived). We must wonder how many deaths could have been avoided if freedom day had never happened. This is if we only consider deaths, but the case could be widened to long COVID (still a disease we know very little about), as-yet unknown long-term complications, and all of the nondeadly suffering that comes with the most serious cases (which, although rarely, also affects children, lest we forget).

Given this precedent, is it a good idea to, again, not make every effort to keep infection rates as low as possible? We could consider that the situation is different from the one we had at the end of last year, since Omicron seems to be less deadly. It may be less aggressive than Delta, the previous variant, but not necessarily milder than the ones before, which killed plenty. It would be a mistake to assume that this is now a "benign" virus.

A good vaccination rate would be most important to reduce the number of deaths; this seems to be the main reason that explains why the current wave has fewer victims that the previous ones. In the UK, 72% have received two jabs (vs 64% in the United States), which is still a long way to go until anything resembling herd immunity.

Also, Omicron needs a booster because it partially escapes immunity, and only 55% of Brits have received a booster at the moment (vs only 28% in the US, which is more worrying). There's a big chunk of the population that may not be properly protected, and still the plan is to press on and see what happens. And we have to hope that we don't get worse variants, which is still a very real possibility (as they say here, "Viruses don't inevitably evolve toward being less virulent; evolution simply selects those that excel at multiplying"). It all seems a bit risky, particularly if you decide to stop tests, masks, and isolations.

We will get to a point where we will be able to live without paying attention to COVID-19, but I don't think we are there yet. We may need higher immunization rates and better case monitoring before we can declare "mission accomplished." But let's watch closely what happens in the UK from now on. The least we can say is that the experiment is dangerous. We'll soon see if it works.

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About Dr Salvador Macip

Salvador Macip, MD, PhD is a doctor, researcher and writer. He obtained his MD/PhD at the University of Barcelona (Spain) in 1998, then moved to do oncological research at the Mount Sinai Hospital (New York). Since 2008, he has led the Mechanisms of Ageing and Cancer Lab at the University of Leicester (UK). Macip has published over 30 books, including Where Science and Ethics Meet (2016) and Modern Epidemics (2021). Connect with him on Twitter: @DrMacip

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