ABSTRACT
rhurley@bmj.com Follow Richard on Twitter @rich_hurley The NHS has administered a covid-19 vaccine to more than 18 million people, a quarter of the UK population, since December—an extraordinary logistical achievement.1 But vaccinating everybody here will not protect us from longer term harm, say infectious disease experts, including the government’s SAGE adviser and Wellcome Trust director, Jeremy Farrar, in The BMJ Interview this week,2 also available in podcast (bmj.com/archive/podcasts). What he terms “enlightened self-interest” echoes recent calls by the World Health Organization and World Trade Organization.34 The longer that SARS-CoV-2 is in circulation anywhere, the greater the chance that variants with resistance to existing treatments and vaccines will emerge and spread.5 Vaccine nationalism will cost $3.4 trillion a year, says the US non-profit RAND Corporation,6 and global economic crashes reverberate at home. The UK government, facing sustained criticism for policies that led to 130 000 covid-19 deaths, is keen to keep the spotlight on the success of its domestic vaccination programme, a critical step to its “road map” out of lockdown.8 Indeed it has just announced that all adults will be offered a first dose by 31 July, bringing the target forward a month, but this is not necessarily good for global equity or the best strategy to control the pandemic domestically.9 Perhaps it was coincidence that this news coincided with the High Court ruling that England’s health secretary had acted unlawfully in not publishing the details of contracts worth billions of pounds awarded without competition during the pandemic?
ABSTRACT
A covid-19 pandemic is highly likely, warns our editorialist, the epidemiologist John Watkins (doi:10.1136/bmj.m810), and we need to plan now how to reconfigure care services to cope with the looming escalation in demand. “We should plan on the assumption that most of the population may contract the virus with few or no long term effects,” he writes, “while harnessing vital secondary healthcare resources to treat the small percentage of people who become seriously ill.”As at Tuesday 3 March the UK had confirmed 51 cases of infection (doi: …