The UK is past the worst of the Covid pandemic but should be braced for some â€œpossible bumps on the roadâ€, according to the scientist who helped shape Britainâ€™s lockdown strategy.
Prof Neil Ferguson, a leading epidemiologist at Imperial College London, said things were looking up as the country passed the peak of yet another wave of coronavirus infections.
â€œI am optimistic that the bulk of the pandemic, in terms of deaths and hospitalisations, is behind us. Though we should still be prepared for some possible bumps on the road,â€ he said, adding that any new variants â€“ which were highly likely to arise â€“ may have a less dramatic impact than Omicron.
â€œThe very high level of immunity in the UK population â€“ acquired via both vaccination and infection â€“ means that the risk of a new variant causing unmanageable levels of healthcare demand is much reduced,â€ he said.
â€œAn additional positive is that if any new variant arises from Omicron â€“ not a certainty â€“ there is a fair chance it will retain the reduced severity of that strain,â€ he added.
Ferguson said a key development was Covid vaccines, in particular those based on mRNA technology, while important lessons had also been learned, such as the need for data to make informed decisions. â€œCompared with now, 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.â€
Another lesson was the need to tailor the speed of policymaking to the speed of the virus.
â€œThat means in particular, you may have to make decisions before you have the full picture on severity,â€ he said.
With Omicron spreading rapidly in the UK late last year, ministers were faced with a stark message from scientific advisers: to avoid the potential worst case scenarios, measures needed to be brought in quickly.
But while the UK government introduced plan B in England, it resisted calls to go further, despite stronger measures in Scotland, Wales and Northern Ireland.
Ferguson said the political stance had evolved over time. â€œI think weâ€™re in a different place, in terms of how policymakers think about this two years in than we were back in February, March of 2020,â€ he said, adding that the change had led to more nuanced and difficult decisions.
On Wednesday, the prime minister announced that plan B measures in England would be lifted as cases were now falling. But Ferguson does not believe this will cause Omicron to come back in force.
â€œRestrictions are always a trade-off between infection control and economic cost,â€ he said. â€œHowever, given that case numbers are in decline in all regions and that hospitalisations are starting to drop, I donâ€™t think lifting restrictions poses a large risk of causing a major resurgence. Though obviously trends will need to continue to be monitored closely.â€
According to Ferguson, scientists rarely interact with politicians, with Sir Patrick Vallance and Sir Chris Whitty acting as mediators. But at times there were frustrations, such as in autumn 2020 when the Alpha variant took off.
â€œBecause then we were seeing case numbers go up. There was a lot of misinformation around frankly, at that point,â€ he said.
Covid was evolving to become 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 meant it was manageable. And, as experts have noted, endemic does not necessarily mean mild.
â€œ[Covid] is going to become an endemic disease, which unfortunately kills people every year,â€ said Ferguson. But, with careful management and building immunity, he hoped waves of infection would bring a lower toll of hospitalisations and deaths â€“ although it may be necessary to expand hospital bed capacity.
But politicians have short memories, he said, and he worries that we may stop preparing for the next pandemic once the immediate shock of coronavirus starts to fade from the national consciousness.
â€œIâ€™m sure for the next 10 years, pandemic preparedness will be a top priority for governments, for research funders around the world,â€ Ferguson said. â€œWhat I worry about is in 15 or 20 yearsâ€™ time, does that memory fade? Thatâ€™s the real risk.â€