Omicron is the predictable consequence of political failure. Until the international community gets serious about vaccine sharing, there will be ever nastier Covid mutations
Well, what did we expect? Consider how we got here: we decided not to make the vaccination of the world a true priority; handed the virus a huge playground in which it could mutate without constraint; and are now reaping the rewards.
The arrival on these shores of what looks like the nastiest variant to date may well be a shock; but it certainly should not be a surprise. This is the direct consequence of a political choice.
In his novel Mao II, Don DeLillo writes that the brand names of modern medications sound “like science-fiction gods”: Xanax, Zoloft, Lantus. In much the same way, the variants of Covid-19 call to mind planet-busting galactic villains: Delta, Zeta, and now, with particular menace, Omicron.
Which is appropriate, really. If you want to know how alarmed the global scientific community is by B.1.1.529, look at the unprecedented speed with which the World Health Organization declared it a “variant of concern” (VOC). Delta, which is still the dominant strain, was classified as a “variant of interest” (VOI) by the WHO on 4 April, but did not graduate to full VOC status until 11 May.
In sharp contrast, Omicron skipped the interim VOI classification entirely and was fast-tracked to the VOC column on Friday, only two days after monitoring began. Why so? The preliminary datasets, though comparatively small, are big enough to have filled genomic analysts with trepidation about the new variant’s transmissibility and potential for vaccine escape. Today, the WHO assessed the “overall global risk” as “very high”.
It was remarkable on Saturday to hear the normally boosterish Boris Johnson speak in the most guarded way about the likely capacity of existing jabs to withstand the onslaught of Omicron. There were, the prime minister said, “good reasons for believing they will provide at least some measure of protection” (my italics). These were the uncharacteristically cautious words of a politician who had clearly already received some pretty unnerving briefings from his most senior scientific advisers.
It is true that little is yet known with any certainty about Omicron – especially concerning its comparative lethality – and the UK government has given itself until 18 December to review the evidence as it accrues from around the world. But what has stopped scientists in their tracks is the sheer extent of its mutations: no fewer than 50, of which 32 have been detected on the key spike protein that enables the virus to latch on to human cells. Since Sars-COV-2 was first designated in February 2020, epidemiologists have been struck by its talent for mutation and adaptation – not something for which coronaviruses are normally noted.
For almost two years, they have watched with anxiety as it has morphed and shapeshifted. Yet as one senior figure engaged in the UK’s pandemic strategy told me yesterday: “I think we had hoped that Delta might prove to be the peak variant. What’s worrying about this little bastard is that it shows that the virus is just getting started when it comes to variation.”
The point, then, is not that Omicron is certain to be significantly more deadly than its predecessors, or dramatically to weaken the immunity granted by vaccines and boosters, or to fill the nation’s ICUs once more with Covid patients. What makes this variant – or “flavour”, as epidemiologists like to say – so frightening is how very different it is, how furiously evolved, how aggressively modified. It is the most pointed reminder to date that this pandemic is not yet finished with us.
On Friday, the fumes of panic were billowing out of the Whitehall engine. If, as the limited data suggests, Omicron is seriously transmissible, then the logic of the case – however horribly unpalatable – is to start planning for another national lockdown.
But every minister and official engaged in Covid management knows that, whatever the epidemiological projections signal on the basis of further genomic evidence, there is not the slightest chance of Johnson instructing us all to stay at home a fourth time. As Dominic Cummings has revealed, the PM was always strongly averse to lockdowns, and allegedly said in his study, after agreeing to the second, that he would rather see the “bodies pile high” than impose a third.
As it happens, he went on to do just that on 5 January – but vowed with militant certainty that this would be the very last such measure, and that the roadmap out of these restrictions would be “irreversible”. Add into the mix the fact that Johnson’s political position is considerably weaker now than it was at the start of 2021: Tory sleaze, energy prices, the cost of living squeeze and his own increasingly erratic behaviour have seen to that.
A year ago, he was opposed to lockdowns on principled grounds. Now – I am told – the PM fears that, even if he had a change of heart and decided that a fourth was indeed necessary, the public might not comply with his instructions. Indeed, after his brazen refusal to wear a mask at Hexham hospital on 8 November, in spite of explicit on-site guidance to do so, one wonders how seriously the population of England will take even the new rules on face covering.
With creditable speed, the government has imposed bans on travel from South Africa, Botswana, Lesotho, Eswatini, Zimbabwe, Namibia, Angola, Mozambique, Malawi and Zambia. Johnson has bad memories of the vilification to which he was subject for waiting until 23 April to put India on the red list – a fortnight later than neighbouring Pakistan and Bangladesh, during which time, it is assumed, many people infected with Delta were able to enter the country unimpeded.
The booster programme has been accelerated, quarantine rules for all travellers from overseas have been tightened and, from tomorrow, masks will once again be mandatory on public transport and in shops. Again, all of this is sensible, as far as it goes.
But ministers’ refusal to heed the guidance of their own Scientific Advisory Group for Emergencies (SAGE) on working from home – that employees should do so if possible – or to introduce vaccine passports, shows that they are gambling on Omicron being less of a threat than many of their own scientific advisers fear. This is a strategic response dictated by political calculation, not clinical analysis.
Let us hope that Johnson has bet wisely and that Omicron proves to be less of a threat than many perceive it to be. But that will be very far from the end of the matter. As G7 health ministers meet today to consider their collaborative response to the new variant, they would do well to focus on the absolute fundamentals of the case.
How have we got here? Because the international community has failed abjectly to do what it said it would do, which is to strain every sinew to vaccinate the world. Listen again to James Harding’s Slow Newscast on the pathetic outcome of the G7 summit in Carbis Bay in June. “Vaccinating the world by the end of next year would be the single greatest feat in medical history,” Johnson declared. “I’m calling on my fellow G7 leaders to join us to end this terrible pandemic and pledge we will never allow the devastation wreaked by coronavirus to happen again.”
Sounds great, doesn’t it? Yet – in practice – the summit pledged only 870 million doses; and, disgracefully, included in that total all the promises already made by the seven nations since February.
Since then, this platitudinous performance has become an almost monthly ritual. Heads of government gather in person, or connect on Zoom. They recognise the overwhelming moral case for vaccine sharing, and the parallel argument from self-interest (an unvaccinated world is a petri dish for variants). They agree to do something about it – and then settle, at most, for the bare minimum.
At Tortoise, we have been proud to lead a coalition under the banner of #TheArmsRace, calling for an urgent plan of international action on vaccine equity. The level of commitment from individuals such as Gordon Brown, the WHO ambassador for global health financing, institutions such as Duke University, organisations like the Covid Collaborative and businesses such as Unilever and Brunswick has been inspiring. But the response from governments has been depressingly insipid: on Covid, as in so many respects, we are witnessing a near-total collapse of traditional multilateralism.
Worse, there are vaccines available, today, right now, that could be sent to parts of the world where they are needed, but instead are being hoarded by richer countries: at least 500 million unused doses in the G7 nations that will pass their expiry date soon if they are not airlifted to the places where they are desperately needed.
The gap between rhetoric and reality is breathtaking. On Friday, President Biden declared that “the news about this new variant should make clearer than ever why this pandemic will not end until we have global vaccinations.” True: but why, in that case, has the US only delivered 25 per cent of the doses that it promised?
On Saturday, Johnson went even further, insisting that vaccine sharing “is something I think the UK can be incredibly proud of, and we have done a huge amount to vaccinate the world….The UK has been leading in that.” Really? How then does the PM explain that this country has supplied only 11 per cent of the vaccines it has pledged?
Even more slippery was Johnson’s claim that “when you look at the arrival and spread of Omicron, sadly it’s been in countries where the problem has not been supply of vaccine – it’s been really to do with hesitancy and lack of take-up.”
It is true to say that doubts about the jab and complex logistics have played a part in the low levels of vaccination in sub-Saharan Africa and other developing nations (problems which the new Global Covid Corps public-private partnership pioneered by US Secretary of State Antony Blinken will try to address). But to suggest, as Johnson did, that supply is not the principal problem in the achievement of vaccine equality is a straightforward lie.
As things stand, all low-income countries are set to miss the WHO’s target of 40 per cent vaccine coverage by the end of the year. According to the same organisation, only 7.5 per cent of people in such countries have received even one dose (compared to 64 per cent in high-income parts of the world). For the PM to claim that these appallingly low figures reflect failures within the world’s poorer countries was geo-political victim-blaming of the shoddiest sort; and demeaned the office he holds.
But, then again, how would he know? After all, Johnson could not even be bothered to attend Biden’s presidential summit on Covid on 22 September. His instincts on the management of the virus are bound by national borders; domestic political calculation; and the visible shrinkage of his own imaginative horizons.
Apart from a few rhetorical flourishes and unjustified boasts, he has shown next to no interest in the all-important question of vaccine sharing. Indeed, he is more comfortable talking about Peppa Pig World than the reality of a planet still racked by a vicious disease and by millions of avoidable deaths.
Naturally, most people want to know whether Omicron is going to ruin Christmas. But Covid is the ultimate Grinch. It is utterly indifferent to our longing for a normal festive season, as it is to our exhaustion, boredom and yearning for normality. It ploughs on, transforming itself relentlessly so it can continue its grim, criss-crossing journey around the planet.
The bitter irony is that there is so much more that could be done, quite straightforwardly, to thwart the pathogen’s march. If the international community were to stop talking about vaccine sharing, and to make good on its promises, Covid’s freedom to mutate would be radically diminished. Hundreds of thousands of deaths could be prevented, and the duration of the pandemic significantly curtailed.
The most infuriating aspect of the Omicron scare is that it was wholly predictable. Will it be the shock to the system that is so badly needed? Will it jolt heads of government around the world to collaborate, lead, and display the determined statesmanship that has been so terribly lacking? Perhaps so. Let us just say, as 2021 draws to a close, that such an excellent outcome would be a triumph of hope over experience.
Photograph by Phill Magakoe/AFP