Coronavirus 14: Boosted Waves or Merely a Ripple?

Is it over?

  • YES

    Votes: 9 17.3%
  • NO

    Votes: 14 26.9%
  • It will never be over

    Votes: 13 25.0%
  • I'm over it

    Votes: 14 26.9%
  • I'm more worried about Monkey Pox

    Votes: 2 3.8%

  • Total voters
    52
Biden will end the vaccination requirement for foreign entry in to the US on May 11.
 
Well, here we go.

Covid-19 is no longer a global health emergency, says WHO

Declaration a major step towards end of pandemic that has killed more than 6.9m people

Spoiler :
The Covid-19 pandemic, which has sickened or killed almost 800 million people over three years, no longer constitutes a global health emergency, the head of the World Health Organization has said.
The WHO first gave Covid its highest level of alert on 30 January 2020, and its panel has continued to apply the label at meetings held every three months.

While the WHO director general, Tedros Adhanom Ghebreyesus, announced on Friday the UN health agency was downgrading Covid’s alert status, he also delivered a stark warning about its persistent threat. The disease still killed someone every three minutes, he said.
“Yesterday, the emergency committee met for the 15th time and recommended to me that I declare an end to the public health emergency of international concern,” said Tedros. “I’ve accepted that advice.”
He added: “It’s therefore with great hope that I declare Covid-19 over as a global health emergency. However, that does not mean Covid-19 is over as a global health threat. Last week, Covid-19 claimed a life every three minutes – and that’s just the deaths we know about.”
The global health emergency status helped focus international attention on the Covid threat, as well as bolstering collaboration on vaccines and treatments. Lifting it is a sign of the progress the world has made in these areas, but Covid-19 is here to stay, health officials believe, even if it no longer represents an emergency.
The WHO does not declare the beginning or end of pandemics, although it did start using the term for Covid in March 2020. Tedros said the decision to downgrade the alert status did not mean the danger was over, cautioning that the emergency status could be reinstated if the situation changed.
“The worst thing any country could do now is to use this news as a reason to let down its guard, to dismantle the systems it has built, or to send the message to its people that Covid-19 is nothing to worry about,” he said.
Covid has officially claimed more than 6.9 million lives, and affected the health of more than 765 million others, according to the WHO. It said the true figures were likely to be much higher. Covid deaths globally have plunged by 95% since January, but the disease still killed 16,000 people worldwide last month alone.
Despite the lingering danger, the pandemic has faded from mind in many if not most countries. This week, Tedros said testing and tracing efforts had “declined significantly around the world, making it more difficult to track known variants and detect new ones”.
He has also warned of the ongoing impact of long Covid, which provokes a long line of often severe and debilitating symptoms that can drag on for months or years. The condition is estimated to affect one in 10 people who contract Covid, suggesting hundreds of millions of people could need longer-term care, he has said.
Long Covid was devastating lives and livelihoods and wreaking havoc on health systems and economies, Tedros told the Guardian last year as he urged countries to launch immediate and sustained efforts to tackle the “very serious” crisis.
“While the pandemic has changed dramatically due to the introduction of many lifesaving tools, and there is light at the end of the tunnel, the impact of long Covid for all countries is very serious and needs immediate and sustained action equivalent to its scale,” he said.
He added: “Early in the pandemic, it was important for overwhelmed health systems to focus all of their life saving efforts on Covid-19 patients presenting with acute infection. However, it is critical for governments to invest long-term in their health system and workers and make a plan now for dealing with long Covid.”
 
Post-Lockdown, Chinese Shrug Off Looming Covid Wave
BY BRIAN SPEGELE

BEIJING—Roughly this time last year, Beijing was a Covid-19 fortress teetering on the edge of a lockdown. As daily case counts crept up to around 100 in this mega-capital of more than 20 million people, residents cleared out grocery stores, lined up for near-daily testing and postponed travel out of the city due to the risk that they wouldn’t be allowed back in. Today, Beijing and the rest of China are gearing up for a new Covid-19 wave that a top Chinese medical expert says could infect 65 million people a week by late June. Office workers are already calling in sick, many of them catching the virus for the second time in six months.

And yet the mood this time is decidedly blasé. Restaurants, train stations, concert venues and soccer stadiums are teeming. Tourists clutching umbrellas in Tiananmen Square seem more worried about sunburn than Covid-19. One of the few outward signs of the latest wave is that more people are wearing masks on the streets—but even then mask-wearing is optional and many are left to dangle around the chin.

The contrast points to the dramatic changes in China’s approach to the virus that have completely altered daily life in the country. As the government now races to rewrite some of the history of its handling of Covid-19, many Chinese are eager to move on.
For three years after Covid-19 first emerged in the central Chinese city of Wuhan, China adopted a zero-tolerance approach to the virus. The strategy boiled down to confronting Covid-19 with brute force, cutting off chains of transmission by isolating people who might have come into contact with the virus. It used heavy-handed lockdowns to control people’s movements and tracked them with intense digital surveillance.

Today, the government says defeating Covid-19 is impossible. “It won’t be gone once and for all,” Zhong Nanshan, a top Chinese epidemiologist and government adviser during the pandemic, said at a conference this week. Partly responsible for the latest wave is the XBB.1.5 sub-variant, Zhong said. This strain of the Omicron variant has also been found widely in the U.S., transmitting more easily than other subvariants. Zhong said modeling showed Covid case counts in China would reach around 40 million infections a week by the end of May before peaking around 65 million cases a week by late June, adding that most people infected for a second time would have mild symptoms.

A huge wave of Covid-19 cases swept over China beginning late last year after the government started relinquishing controls. An estimated 1.1 billion to 1.2 billion people—as much as 85% of China’s population— are believed to have been infected with Covid thus far, Zhong said. Public anger and frustration with the country’s zero-tolerance Covid-19 controls culminated in November with street protests in Beijing, Shanghai and other cities. Many Chinese say they are happy the government finally relinquished control, despite the huge wave of sickness and death that swept over the country late last year and early this year.


A Covid-19 test was administered ahead of the China-Central Asia Summit in Xi’an last week. MARK R CRISTINO/ EPA/ SHUTTERSTOCK

China hasn’t reported any deaths from the latest outbreak, although the country’s reporting of Covid statistics has been widely debated. China’s official data recently put the death tally for the whole pandemic at around 84,000, while some experts have estimated as many as 1.5 million people have died.

As of late last year, China said that more than 90% of its population was fully vaccinated, although it remains relatively easy in China to find people who haven’t gotten vaccinated.
 
Study after study concludes that the spike protein is the most harmful part of the virus in terms of long-term negative health effects. Now several for neurological effects.

But still those who committed personally to promoting vaccines that induce the production of this very same spike protein make a point of pretending that the obvious question should not be talked about!

Of note, this work cannot be misconstrued to relate to Covid vaccines, a theoretical issue that would need to be separately explored.

Misconctrued? The question is very much immediately raised. It is the same protein! Calling it "theoretical" does not make what happened any less real.
And those that pretended there was no possible problem to worry about were most of the "scientific community". Which means that we have this avenue of scientific inquiry still forbidden in public talk, or even openly discussed among peers. Now they oh-so-very discreetly start talk of "exploring" it, years after the harm was hastily imposed on people as "the solution" with "scientific assurances" that it was all right...

Covid didn't just discredit government and politicians. It discredited medics, public health institutions, and researchers.
 
Study after study concludes that the spike protein is the most harmful part of the virus in terms of long-term negative health effects. Now several for neurological effects.

But still those who committed personally to promoting vaccines that induce the production of this very same spike protein make a point of pretending that the obvious question should not be talked about!



Misconctrued? The question is very much immediately raised. It is the same protein! Calling it "theoretical" does not make what happened any less real.
And those that pretended there was no possible problem to worry about were most of the "scientific community". Which means that we have this avenue of scientific inquiry still forbidden in public talk, or even openly discussed among peers. Now they oh-so-very discreetly start talk of "exploring" it, years after the harm was hastily imposed on people as "the solution" with "scientific assurances" that it was all right...

Covid didn't just discredit government and politicians. It discredited medics, public health institutions, and researchers.
It is interesting, but it does sound like these effects would be strongly does dependant. You have a whole lot more spike protein around if you get infected compared to if you get vaccinated.

Our results revealed the accumulation of the spike protein in the skull marrow, brain meninges, and brain parenchyma. The injection of the spike protein alone caused cell death in the brain, highlighting a direct effect on brain tissue. Furthermore, we observed the presence of spike protein in the skull of deceased long after their COVID-19 infection, suggesting that the spike’s persistence may contribute to long-term neurological symptoms. The spike protein was associated with neutrophil-related pathways and dysregulation of the proteins involved in the PI3K-AKT as well as complement and coagulation pathway. Overall, our findings suggest that SARS-CoV-2 spike protein trafficking from CNS borders into the brain parenchyma and identified differentially regulated pathways may present insights into mechanisms underlying immediate and long-term consequences of SARS-CoV-2 and present diagnostic and therapeutic opportunities.​
 
Inno skipped over the bit where they note that the vaccines show a significant protective effect against long Covid. Presumably because it's not really reconcilable with the narrative that the Spike protein from the vaccines replicates the symptoms seen from actual Covid infection, which is what these studies investigate.

To underscore, all of the participants of this study were unvaccinated, which takes out the potential confounder impact of Covid vaccines. There are ample studies to tell us that vaccination helps protect against Long Covid, such as the prospective one published this week, which also confirmed the risk of reinfection for subsequent Long Covid.

Note also that the authors of this work expressly do not agree with the narrative Inno is trying to attach to it.

Misconctrued? The question is very much immediately raised. It is the same protein!

Technical correction time! No, it's not the same protein. Both Pfizer and Moderna introduced modifications to the wild type sequence to stabilize it in the prefusion conformation. Without these modifications, it is more dynamic, and shifts into the postfusion conformation. This goes by the (somewhat grandiose) name of spike protein technology. For a more detailed explanation of these different conformations, and why they matter, this is quite a good paper. The short answer is that it would in fact be very surprising if the spike protein expressed from the vaccine were to show the same biological behaviour as the viral wild type.

This is far from the first time you've tried to claim to know better than the experts who wrote the study, and presented an interpretation that they expressly (and preemptively) reject.

And those that pretended there was no possible problem to worry about were most of the "scientific community". Which means that we have this avenue of scientific inquiry still forbidden in public talk, or even openly discussed among peers. Now they oh-so-very discreetly start talk of "exploring" it, years after the harm was hastily imposed on people as "the solution" with "scientific assurances" that it was all right...

This kind of stuff does get tiresome. You've made demonstrably false claims about what is and is not allowed to be discussed, researched and published in the scientific community before. Most glaringly your endless insistence that Ivermectin was a suppressed and banned subject. That merely investigating would be more than our careers were worth! You persisted in this even in the face of study after study being published showing that yeah - the research was being done (and Ivermectin kept not doing anything in controlled trials). It's been one of the most over-researched and discussed topics I've ever seen, with zombie projects still rumbling along in places. You cannot even claim that this was refusal to publish results in favour of Ivermectin, because a few of these did get published - and then had to be retracted when they turned out to be fraudulent.

Studies critical of the vaccines are entirely publishable, in mainstream high impact journals. They're even a bit easier to get by the journal editors, thanks to being that bit "spicier" and better for the metrics. Such studies though do tend to rely on the idea that Omicron and post-Omicron variants are extremely low risk for younger age groups who are otherwise healthy (and therefore even very rare vaccine side effects have a questionable risk/reward ratio). This stance is incompatible with concerns about neurological effects from the virus discussed above, and also your long held attitude to both the severity of Covid, and the level of measures justified in (futile) attempts to eradicate it.
 
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China’s rolling COVID waves could hit every six months — infecting millions

The latest surge in COVID-19 cases in China is not surprising to researchers, who say that China will see an infection cycle every six months now that all COVID-19 restrictions have been removed and highly infectious variants are dominant. But they caution that rolling waves of infection carry the risk of new variants emerging.

“Unfortunately, a new reality with this virus [is that] we will have repeated infections,” says Ali Mokdad, an epidemiologist at the Institute for Health Metrics and Evaluation at the University of Washington in Seattle. “The fear is that this virus will produce a new variant that can compete with the current ones and is more severe.”

The current surge is caused mainly by a highly infectious subvariant of Omicron called XBB.1.5, first identified in India last August. According to Nanshan Zhong, a prominent respiratory physician in China, as many as 65 million people could become infected per week by the end this month.

This is the first major reinfection wave that China has seen since the central government dropped all its COVID-19 control measures in December, prompting a widespread Omicron outbreak.

China has vaccinated more than 90% of its population, and the outbreak in December infected at least 85% of its people, says Zhong. But immunity is waning, and XBB can evade protection from vaccines and prior infections. Mokdad says that, although XBB has not caused a major rise in hospitalizations and deaths, the sheer number of infections could put pressure on China’s health-care system.

Last December, more than 200 million people in China contracted COVID-19 in 20 days. This time, the wave is spanning several months, owing to the differences in people’s immune backgrounds, such as antibody levels, says Cao. “The peak of COVID-19 waves will generally become flatter and more stretched out after each cycle, which is a pattern we see in countries like the US. People are still getting infected in the US, just not all at once,” he adds. A flatter wave would also lessen the burden on health-care systems, Cao says.

Because China no longer publishes its COVID-19 case count, it is unclear how many people are becoming infected in the latest wave; however, the Beijing health authority says the number of COVID-19 cases reported in the capital city quadrupled between late March and mid-April. Cao says it’s hard to make estimates without accurate data. But on the basis of his past research, he estimates that at least 30% of the population could become reinfected in this wave, amounting to more than 400 million people.
 
First global survey reveals who is doing ‘gain of function’ research on pathogens and why

As US policymakers spar over how to regulate research involving potentially harmful pathogens, a report finds that it will be difficult to do so without compromising studies that are necessary for creating vaccines and life-saving therapies.

Researchers at Georgetown University’s Center for Security and Emerging Technology in Washington DC scanned the scientific literature using an artificial-intelligence tool to assess where and how often ‘gain of function’ (GOF) studies are conducted. These studies, in which scientists bestow new abilities on pathogens by, for instance, inserting a fluorescent gene or making them more transmissible, are common in microbiology research, the team found, but only a small fraction of the research involves agents dangerous enough to require the strictest biosafety precautions in laboratories. The researchers also found that about one-quarter of studies involving GOF or loss of function (LOF) — in which pathogens are weakened or lose capabilities — are related to vaccine development or testing.

“I was so relieved to see a data-driven approach” to assessing GOF research, says Felicia Goodrum, a virologist at the University of Arizona in Tucson. It helps to support the argument that GOF studies are paramount in molecular virology and are necessary to study the impact of genetic mutations that pathogens acquire in nature through evolution, she says.

Surveying the landscape

The bitter debate over the origin of the COVID-19 pandemic has intensified calls to clarify and tighten oversight of this research. Many virologists say that the SARS-CoV-2 coronavirus probably spread to humans through contact with infected animals, but some argue that it could have escaped from a laboratory in which researchers might have been conducting GOF work.

This has led to intense politicization over precisely what constitutes GOF research and how it should be regulated, says Anna Puglisi, a biotechnologist and policy specialist at Georgetown, who co-authored the report. That’s why she and her colleagues produced their report: “There’s so much discussion and hype about gain-of-function research, but what does it really look like?” she asks. Getting an answer to that question is “the only way you can start to understand what the true risk for both not regulating it and over-regulating is”, she adds.

Puglisi and her colleagues first identified about 159,000 original English-language research papers involving pathogens that were published between 2000 and mid-2022. They then developed a machine-learning model that looked for key terms that would identify papers containing GOF and LOF work. (The authors searched for both types of paper because microbiologists use similar experimental techniques in each case, so future regulations might affect both areas of research, they say.)

The model found about 7,000 studies that fitted the bill. The researchers then randomly chose 1,000 of those and manually sorted through them to ensure that they were, in fact, GOF or LOF studies. This left them with 488 publications.

When the authors drilled down into these, they found that about one-quarter of the studies involved only GOF work, and about three-quarters involved less controversial LOF work, either alone or in combination with GOF.

The team also explored which pathogens are studied most often, and how dangerous they are to humans. More than 60% of the research that was analysed involved viruses, and more than half of these belonged to the viral families that cause flu, herpes, dengue and COVID-19 (see ‘Family matters’). Most of the pathogens studied were of moderate risk to humans. Only 1% of the studies focused on a tier of pathogens that require the highest biosafety-containment-level precautions (BSL-4); among these are the Ebola virus and smallpox (see ‘Research by risk’).

One drawback of the report, says Kevin McConway, an emeritus statistician at the Open University in Milton Keynes, UK, is that the 1,000 publications randomly reviewed by the Georgetown team might not be representative of all LOF and GOF studies. The machine-learning model might have missed studies that differ in some systematic way from those reviewed by the researchers, and that could skew the analysis, he says. Caroline Schuerger, a biotechnology and policy specialist at Georgetown who co-authored the report, responds that the findings are just the “tip of the iceberg”, and that the team’s aim was to provide the “first broad, large-scale analysis” of the research landscape.

A struggle over guidelines

The report finds that the lion’s share of GOF and LOF research is conducted by researchers in the United States (see ‘Geographic hotspots’). This is where some of the most intense scrutiny of the work is taking place. There has been a years-long effort by US policymakers to revise the guidelines for funding and overseeing a small subset of GOF research, which aims to enhance the transmissibility or virulence of pathogens that could cause a pandemic. In January, a panel of US experts recommended broadening the criteria that funders and institutions use to determine whether proposed studies should receive extra scrutiny by health officials.

But some lawmakers are calling for even stronger action; legislators in Florida banned all GOF research on potential pandemic pathogens in May, and similar legislation is pending in Wisconsin and Texas. At least one bill introduced in the US House of Representatives seeks to ban the National Institutes of Health, the largest public funder of biomedical research in the world, from financially supporting any GOF research, regardless of its potential threat to human health.

Such blanket regulations are too blunt an instrument, Puglisi and her co-authors say. “One-size-fits-all policies aimed at mitigating dangers from one approach could limit other, less-risky research, and overly broad regulations could ultimately limit the scientific community’s ability to prepare for future disease outbreaks,” their report concludes.

Although the report makes this argument nicely, says Gigi Gronvall, a biosecurity specialist at Johns Hopkins University in Baltimore, Maryland, it’s unlikely that it will change many minds. The report doesn’t “get to the heart of what makes people so upset about these issues”, she says — adding that, for many, “it’s about whether we should go against nature [by manipulating pathogens] to try to determine whether something is likely to become a pandemic threat.”






Report Writeup
 
This looks interesting, but both the paper and the writeup are paywalled :(

How accurately a person recalls the COVID-19 pandemic is affected by motivational factors, including how they feel about their vaccination status. The recollections of vaccinated and unvaccinated people are skewed in opposite directions, leading to different retrospective narratives about the pandemic. This distorted recall influences how individuals evaluate past political action, and will complicate preparation for future crises.

How people recall the SARS-CoV-2 pandemic is likely to prove crucial in future societal debates on pandemic preparedness and appropriate political action. Beyond simple forgetting, previous research suggests that recall may be distorted by strong motivations and anchoring perceptions on the current situation. Here, using 4 studies across 11 countries (total n = 10,776), we show that recall of perceived risk, trust in institutions and protective behaviours depended strongly on current evaluations. Although both vaccinated and unvaccinated individuals were affected by this bias, people who identified strongly with their vaccination status—whether vaccinated or unvaccinated—tended to exhibit greater and, notably, opposite distortions of recall. Biased recall was not reduced by providing information about common recall errors or small monetary incentives for accurate recall, but was partially reduced by high incentives. Thus, it seems that motivation and identity influence the direction in which the recall of the past is distorted. Biased recall was further related to the evaluation of past political action and future behavioural intent, including adhering to regulations during a future pandemic or punishing politicians and scientists. Together, the findings indicate that historical narratives about the COVID-19 pandemic are motivationally biased, sustain societal polarization and affect preparation for future pandemics. Consequently, future measures must look beyond immediate public-health implications to the longer-term consequences for societal cohesion and trust.
 
This looks interesting, but both the paper and the writeup are paywalled :(

How accurately a person recalls the COVID-19 pandemic is affected by motivational factors

I beg to disagree with the opening sentence of that paper.

(a) Recall is likely to be more effected by whether people were properly knocked out for a couple of weeks OR only knew they had it because of a positive test OR never caught it.

(b) Or whether a near and dear one died or not.

(c) I dare say that losing or not losing a job because of Covid may also impact people's recall.

I.e. personal experience of the pandemic rather than motivation or political views.

Unless the analysis can take these factors into account; I'd be sceptical of any conclusions.

I dare say one's opinion of how Donald's or Boris' government dealt with it may influence
one's thinking on future pandemics, but I don't think that subtle variations in recall are key to that.

The following sentence is interesting:

Although both vaccinated and unvaccinated individuals were affected by this bias, people who identified strongly with their
vaccination status—whether vaccinated or unvaccinated—tended to exhibit greater and, notably, opposite distortions of recall.

One selectively better remembers the facts that justified one's decison, to be vaccinated or not to be vaccinated, to vote D or R etc.

Thought that was common knowledge.
 
I beg to disagree with the opening sentence of that paper.

(a) Recall is likely to be more effected by whether people were properly knocked out for a couple of weeks OR only knew they had it because of a positive test OR never caught it.

(b) Or whether a near and dear one died or not.

(c) I dare say that losing or not losing a job because of Covid may also impact people's recall.
In my post the first paragraph is the writeup, and is description of the findings of the paper, the abstract of which is the second paragraph. This is the preprint of the paper, I have not read it in detail but my understanding is that is not conjecture but the actual results of the study. This seems to be showing the results:


Spoiler Biased recall of pandemic perceptions and behaviours in Study 1 :
Note: Each panel shows the results of a linear regression predicting individual recall of past perceptions based on actual past ratings (x-axis) in 2020/2021 and present ratings (y-axis) in late 2022, as well as interactions with vaccination status (colours) and vaccination status identification (VSI; dashed/dotted lines) of n = 1,644 participants (if not indicated otherwise) for (A) infection probability, (B) infection severity, (C) affective risk, (D) trust in government (n = 1,600), (E) trust in science (n = 1,489), (F) mask wearing (n = 1,600), (G) exaggeration perception and (H) life satisfaction (n = 1,539). Each line indicates the recall at a fixed value (scale midpoint, e.g. line represents recall = 3 for mask wearing as it was measured on a 5-point scale and recall = 4 for all other variables as these were measured on a 7-point scale) as predicted by past and present ratings. Direction and strength of bias are indicated by the line’s position relative to the midpoint of the scale; the angle indicates the extent to which recall is influenced by past and present perceptions (the more tilted towards horizontality, the more influenced by present ratings; the more tilted towards verticality, the more influenced by past ratings). Example: The lines in 1A represent the predicted recall of infection probability = 4 given different past and present ratings. For instance, the dots mark the recall of infection probability = 4 given the actual past rating of 4 for highly identified vaccinated and unvaccinated people. The respective lines are tilted below (vaccinated) and above (unvaccinated) the midpoint. This indicates that people’s recall of the probability of infection is influenced by their present rating of the probability, and that this influence goes in different directions for the vaccinated (higher recalled infection probability than actually perceived in the past) and unvaccinated (lower recalled infection probability than actually perceived in the past). As indicated by the dashed lines being closer to the midpoint, the influence of the present rating relative to the past rating is weaker for weakly identified people. See Study 1 Analyses in the Methods for more information on the regression models; regression tables are provided in Extended Data Tables 1–8.
 
and that this influence goes in different directions for the vaccinated (higher recalled infection probability than actually perceived in the past) and unvaccinated (lower recalled infection probability than actually perceived in the past).

Yes, those who thought they would likely get it got vaccinated; those who thought they were less likely to get infected didn't get vaccinated.

And how does the study deal with those who got infected before there were vaccinations available and therefore decided not to bother to get vaccinated ?

Not sure I can make sense of many of the diagrams, although H Life Satisfaction makes perfect sense to me; and does indeed reflect motivation.
Those who were miserable were understandardly less worried about dying from Covid and therefore bother to get vaccinated while those who
were happy were more inclined to want to live on and therefore get vaccinated.

Well that is enough anodyne comments from old me. I will wait to see what MrCynical says.
 
Offline: “Laughing at the Italians”

A former minister for health in England wrote to me that “The COVID-19 inquiry will make us the laughing stock in the eyes of the world.” But it is worse than that. The level of criminal incompetence exposed by recent witnesses to the UK COVID-19 Inquiry, chaired by Baroness Heather Hallett, has proven that many, if not most, of over 230 000 deaths were preventable. Amid the claims of extreme misogyny, profanity, and chaos that litter the evidence is a story of complete government breakdown.

WHO declared a Public Health Emergency of International Concern on Jan 30, 2020. The UK Government was confident it could ride out the storm coming from China. Martin Reynolds, who was at the time Prime Minister Boris Johnson's Principal Private Secretary, believed “the system [was] gripping the challenge”. Lee Cain, who was Downing Street's Director of Communications, thought the outbreak was simply a matter for the Department of Health and Social Care. Chris Whitty, the Chief Medical Officer (CMO), briefed Johnson about the risk of a pandemic on Feb 4, 2020. Johnson expressed concern about over-reacting. The discussion focused on repatriating UK nationals from China, according to Imran Shafi, then Private Secretary to the Prime Minister for Public Services. Government committees were waking up to the threat. COBR (Cabinet Office Briefing Rooms), a group responsible for managing national crises, concluded that the UK's public health system lacked capacity for dealing with a pandemic. But the extent of the danger did not penetrate to the centre of government. The CMO reassured Downing Street that there was no sustained transmission outside Wuhan. Then something very strange took place. Johnson took a 2-week holiday. From Feb 14 to Feb 24, he absented himself from Cabinet and COBR meetings, and received little or no further information about the growing risk of COVID-19. Yet it was clear by mid-February that there was sustained coronavirus transmission in the UK. Matt Hancock, then Secretary of State for Health and Social Care, reassured colleagues that a plan was in place. By the time Johnson returned from his vacation, clusters of infection were being reported in Italy's Lombardy region. The “macho culture” of No 10 translated into politicians and their advisers “laughing at the Italians”, according to Helen MacNamara, who was Deputy Cabinet Secretary. They remained supremely confident that the UK would be world-beating at conquering COVID-19. A meeting of the Civil Contingencies Secretariat on Feb 28 concluded that a global pandemic was now likely (Shafi). Still Johnson and his closest advisers failed to engage.

Johnson chaired his first COBR meeting on March 2. A COVID-19 Action Plan appeared the next day but, according to Cain, it was nothing more than a “thin overview”. By the time Italy locked down on March 9, Reynolds readily agreed that the UK was “playing catch up”. But there was still no plan, no strategic direction, and no leadership. Instead, a debate raged about mitigation versus suppression. The evening of March 13 was the moment Downing Street realised that the NHS would be overwhelmed if it continued to pursue a policy of mitigation (herd immunity). Only now did the principals have NHS data showing that hospitalisations were rising faster than models predicted. Dominic Cummings, Johnson's main adviser, drew out the threat on a whiteboard that became the instrument for persuading politicians that lockdown was the only option. Treating coronavirus like influenza had been a monumental mistake—“something had gone horrifyingly wrong” (Cummings). “We were heading for a total disaster” (MacNamara). Yet Johnson still remained sceptical. In a meeting on March 19 between Johnson and Rishi Sunak, his Chancellor, Johnson said, “We’re killing the patient to tackle the tumour…Why are we destroying the economy for people who will die soon anyway” (Shafi). The UK Government finally locked the nation down on March 23. Officials who have given evidence looked wearily astonished as they described the country's biggest national crisis since World War 2. After Johnson's landslide election victory in December, 2019, they had expected to serve a two-term government. But as the pandemic spread, they admitted that “we weren’t ready for the crisis” (Reynolds). It was a “historic catastrophe” based on “disastrous groupthink” (Cummings). The lies, deceptions, and callous conceit that characterised the UK's initial response to COVID-19 must surely bring some kind of reckoning.
 
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