Covid may be losing the vaccine battle. But, as the virus evolves fast to form new variants, the war is most definitely not over
[Clip: Dido Harding at the science select committee]
That‚Äôs Baroness Dido Harding, head of the Government Test and Trace strategy, addressing the Commons Science and Technology Committee on 3 February.
And yes: she did say what you thought she said. That ‚Äúnone of us‚ÄĚ ‚Äď meaning, presumably, nobody in the political and public health world ‚Äď could have been reasonably expected to predict that a new variant of Covid-19 would emerge to cause trouble.
We‚Äôll return to Dido Harding‚Äôs astonishing statement which certainly stunned the MPs on the committee ‚Äď as one of them told me, ‚ÄúI wish I‚Äôd had a piece of toast in my hand to drop‚ÄĚ.
But first to explain why it matters so much. I‚Äôm Matt d‚ÄôAncona and, as part of a Tortoise series of audio stories on the government‚Äôs pandemic strategy, I‚Äôve been looking at the variants of the original virus first found in Wuhan; how they have shaped our experience of Covid and the restrictions that have come with it; and ‚Äď most importantly ‚Äď what their role will be in the future.
What has not been fully appreciated, as we‚Äôll see, is the extent to which ‚Äď in private at least ‚Äď fear of variants has driven Boris Johnson‚Äôs most recent pandemic strategy as much as optimism about the deployment of vaccines.¬†
As one Cabinet minister put it to me: ‚ÄúWe‚Äôre in a weird space right now. Vaccine euphoria punctuated by attacks of variant terror‚ÄĚ.
Why do variants deserve our attention? Because they are inevitable ‚Äď the fast-moving work of evolution, in real-time. And because, the form that they take can be, quite literally, a matter of life and death.
Here‚Äôs Boris Johnson making that point very clear in Downing Street on Monday 22 February, as he launches his surprisingly cautious plan for exit from lockdown:
[Clip: Boris Johnson‚Äôs press conference on variants on 22 February]
On the trail of these tiny mutants, I‚Äôve spoken to more than twenty ministers, MPs, government scientific advisers, sources in pharmaceutical manufacturing, and university experts working round the clock to predict what Covid will do next.
It‚Äôs a battle between ingenuity and evolution. Between big brains and microscopic particles. And ‚Äď as so often in the pandemic story ‚Äď it‚Äôs a tale of the fuzzy space where scientific data meets political decision-making, and mistakes can easily be made.
[Clip: News clips ‚Äď montage of variants chatter]¬†
Covid is the defining global emergency of our era and many of its most vivid dramas have involved political personalities in angry disagreement and the errors that have been nurtured by these tensions ‚Äď over when to impose this lockdown, or sign off that contract, or change yet another failed testing app.
But the most important protagonists in this story are pathogens. The South African, Brazilian and Kentish variants of the original virus. Each, like the suspects in a murder mystery, has a very different character.
And each is almost unimaginably tiny. The budding Sherlock Holmes who goes in search of the next villain needs more than two pipes to crack the case. He needs an electron microscope.
Every virus particle ‚Äď or virion ‚Äď is 50 to 200 nanometres in diameter.¬†
To give you an idea of what that means, one nanometre is a hundred-millionth of a metre. Looking at it another way ‚Äď to the question, ‚Äúhow many viruses can you fit on the head of a pin?‚ÄĚ The answer is: about 500 million.
Yet each one of those particles can differ. As virologists like to say, they come in an infinite number of ‚Äúflavours‚ÄĚ. And the overwhelming majority of these flavours won‚Äôt make the slightest difference to the danger coronavirus represents to us.¬†
But ‚Äď and it is a big but ‚Äď some do: and if the mutation is lethal, climbing over the barriers set by existing vaccines, one such variant is more than enough.
Dido Harding‚Äôs remark was so surprising because it‚Äôs a 101-course question in public health studies that viruses mutate all the time. If one thing was absolutely, completely predictable about Covid-19, it is that this would happen.
Many scientists believe that the second wave of the Spanish Flu of 1918 was deadlier because of mutation.
HIV, furthemore, is divided into two main strains, each of which is subdivided into alphabetised subgroups.
Regular winter flu is constantly mutating, which is why the global health community gathers every January or February to share genomic data and agree on a new, re-engineered vaccine that can be administered around the world later in the year.
In the case of coronavirus, the mutations matter only if they make big changes to the so-called ‚Äúspike protein‚ÄĚ which the virus uses to enter human cells.¬†
Again, this might not sound like much. But imagine a building that has an automatic water-sprinkler system triggered by fire ‚Äď and malware that disables the system.¬†
The computer code causes malfunction that burns the building to the ground. This, in effect, is what a nasty variant could do to escape vaccine protection. So far, this hasn‚Äôt happened. But it might.
This is why, for example, the scientists at Oxford University that cracked the vaccine code in January 2020 ‚Äď the breakthrough that was to enable the AstraZeneca jab ‚Äď have been tracking mutations ever since.
Professor Katrina Lythgoe of Oxford‚Äôs Big Data Institute explains in this Royal Society primer:
[Clip: Professor Katrina Lythgoe talking about mutations]
But the word ‚Äúvariant‚ÄĚ was not one you heard ministers or public health experts utter very often for most of 2020. As one senior adviser to the government told me: ‚ÄúIt wasn‚Äôt so much ignorance as political bandwidth. Most of us just didn‚Äôt get round to thinking about anything except putting out fires. Test and trace was a disaster. And then the second wave really hit us in September. We didn‚Äôt start discussing variants properly until November‚ÄĚ.
[Clip: Boris Johnson discussing the possibility of a second lockdown on 18 September 2020]
That was the prime minister on 18 September. What he didn‚Äôt yet know was that the virus was already twisting and turning and plotting against his best-laid plans.
Two days later, on 20 September, a variant was detected in a chronically-ill Covid patient in Kent.
What was anecdotally apparent ‚Äď and later to be confirmed by hard data ‚Äď was that this brand new coronavirus was more transmissible than the common-or-garden Wuhan variety.
But Boris Johnson knew nothing of this on 31 October when he announced the second national lockdown ‚Äď a four-week closure to try and take some of the pressure off the NHS, pressure that was becoming dangerously heavy again.
[Clip: Boris Johnson announces lockdown 2.0]
Meanwhile, in mid-October the variant had been officially isolated as B.1.1.7, by ¬†the Covid-19 Genomics UK Consortium (Cog-UK) which detected the full genetic code in two samples that had been collected in Kent and London.
How had the mutation occurred? An early hypothesis ‚Äď and one that has yet to be confirmed ‚Äď is that the treatment of chronically ill patients with convalescent plasma ‚Äď the blood of people who had recovered from Covid-19 ‚Äď had extended the time in which these particular patients were fighting the virus, thus giving it space to shapeshift and morph.
It‚Äôs a paradox of treatment therapies that, much as they may help the patient to recover, they also give the virus time to evolve and try out new genetic armaments.
But ‚Äď and this is the crucial bone of contention in the story ‚Äď the government‚Äôs Scientific Advisory Group for Emergencies (or SAGE) did not alert ministers to the new variant until 11 December.¬†
Collectively, the system had acted sluggishly. It was quite clear by mid-November that things were going badly wrong in Kent and the south-east. On 23 November, Roger Truelove, leader of Swale Borough Council in north Kent, had this to say:
[Clip: Roger Truelove blames spread of variants on lockdown not being observed]¬†
On that very day, data had been released showing that ‚ÄúJust two regions, London and the South East, are seeing a rise in new cases in the majority of areas, with steep drops in hotspots in the north.‚ÄĚ South East England had the highest rate in the country with rates of infection increasing in 34 of the 67 local authority areas.
Matt Hancock was well aware of the problem. As he told the Commons on 26 November:
[Clip: Matt Hancock discusses the tier system in the House of Commons]¬†
What is so striking is that, even in late November, the problem was still being attributed to patchy compliance of lockdown regulations and that there was still so little attention being paid to the possible impact of a variant virus that had been isolated more than two months before.
Indeed, it was not until 8 December that the Kentish mutation was finally declared a ‚Äúvariant under investigation‚ÄĚ by the UK and then, ten days laters, reclassified as a ‚Äúvariant of concern‚ÄĚ.¬†¬†
[Clip: Matt Hancock announces new variant in the House of Commons on 14 December]
By this stage, Hancock and his boss, the prime minister, were finally persuaded that the Kentish variant was the culprit ‚Äď and with good reason.¬†
By 19 December, it was clear that the new ‚Äúflavour‚ÄĚ of Covid was much more easily transmitted ‚Äď a bleak reality that drove Boris Johnson to impose Tier 4 restrictions on 18 million people across London and Eastern and South East England.
[Clip: Boris Johnson says variant may be up to 70 per cent more transmissible]
The two-week curfew led to the cancellation of millions of Christmas Day family gatherings. And any hope that the Tier 4 restrictions would get the virus under control was quickly dashed.
On 4 January, the prime minister announced the third lockdown ‚Äď with great reluctance, but in the face of overwhelming evidence from Chris Whitty, the Chief Medical Officer, and Sir Patrick Vallance, the government‚Äôs Chief Scientific Adviser, that there was what they called ‚Äúa material risk‚ÄĚ of the health service being overwhelmed by the numbers of Covid admissions.
[Clip: Boris Johnson announces third lockdown]
By now, a nagging voice in the back of ministers‚Äô minds was growing ever more insistent.¬†
As one put to to me: ‚ÄúWhy the fuck didn‚Äôt SAGE tell us sooner? If the scientists knew the details of the Kent variant in October, why did they wait till December to, you know, let us know?‚ÄĚ
In private, the scientists reply that this sentiment shows how much the politicians still have to learn about public health policy.¬†
According to one SAGE expert: ‚ÄúLook, we have the best genomics capacity in the world. We‚Äôre constantly mapping new variants, more than any other nation, half of all the Covid sequencing in the world. We didn‚Äôt have enough data in October to say with any confidence that this particular variant was the cause of the spike in cases.‚ÄĚ
The same source added: ‚ÄúThe better question people might like to ask is ‚Äď why weren‚Äôt ministers interested in variants until so late in the year and why didn‚Äôt they actively seek our advice on the subject?‚ÄĚ
In which context, let‚Äôs return to that extraordinary statement by Dido Harding to the Science and Technology Committee on 3 February ‚Äď that nobody could have predicted the Kentish variant.
Later in the same hearing, the committee‚Äôs Conservative chair, Greg Clark, invited her to revisit this remark:
[Clip: exchange between Greg Clark and Dido Harding about her comment on mutations]
In other words, Dido Harding ‚Äď who is a successful businesswoman, but was in this case speaking on behalf of the embattled science and public health community ‚Äď was saying to the incredulous MPs: get off our back. This stuff isn‚Äôt as easy as you political time-servers reckon.
As so often in the pandemic story human foible and failure to communicate is as important as outright failure. And there is exasperation on both sides.¬†
The politicians accuse the scientists of giving them the wrong kind of advice, or the right kind of advice too late. The scientists throw up their hands in despair at the short-termism of the politicians and their inability to walk and chew gum at the same time.
But the deeper criticism levelled in private by some of the scientists is even more damning. It is this: that Boris Johnson and his team were not only uninterested in variants of the virus until the problem was jammed in front of their faces.
They had also managed to create a dream context for mutation.
As we‚Äôve seen, viruses always evolve. They are subject to what‚Äôs called ‚Äúselective pressure‚ÄĚ: if we try to shut them down, they‚Äôll look for evolutionary escape hatches, changing and altering in response to any new circumstance or context.¬†
But there are contexts that they especially love ‚Äď they can have great fun in the body of an infected individual patient, morphing and transforming in the course of one wretchedly long stay in hospital.
What they really relish, though ‚Äď the coronavirus playground, if you like ‚Äď is a context of high case rates. The more people that are infected, even without symptoms, the greater scope the pathogen has to do a biological dance and try on new genetic costumes.¬†
So the most damning charge against the Government is that the ferocious emergence of the Kentish variant was the consequence of bad decisions taken earlier in the year.
As one SAGE member says: ‚ÄėIf we had locked down a week or ten days earlier the first time in March, it would have made all the difference. We might have had a chance ‚Äď at least a chance ‚Äď of nipping the whole thing in the bud. But, instead, Boris dithered until 23 March.
In exactly the same way, the disaster of test and trace over the summer meant that the virus spread faster and further than it needed to. And the more it spread, the more it adapted.
To this, ministers and their advisers respond angrily. As one senior source puts it: ‚ÄúThe fact is that we can‚Äôt even be sure that what we call the Kentish variant was born in Kent. The whole point of these mutations is that they can happen anywhere and that they are horribly mobile. It was tracked down in Kent. But who knows where it started?‚ÄĚ
What is not in doubt is the muscular power and increasingly global reach of the Kentish variant, fairly named or not. By 6 November, it had reached California. By 23 November, Florida. On 21 December, more than 40 countries halted flights from the UK.
In practice, the Kentish variant is the mirror-image of the UK vaccine roll-out, which has been justly hailed around the world as a British success story.¬†
The mutation is a force for ill in the pandemic that we really don‚Äôt want to be wrapped in the Union Flag ‚Äď but most certainly is in news bulletins around the world.
[Clips: News clips from the US as Kentish variant spreads across the US in December]¬†
When ministers boasted about the ‚Äúworld-leading‚ÄĚ nature of the British management of the pandemic ‚Äď as they did for much of 2020 ‚Äď this probably wasn‚Äôt what they had had in mind.
Still, even before Christmas, the UK variant wasn‚Äôt the only new villain in town.
On 23 December, British scientists announced that another variant ‚Äď first detected in South Africa in October ‚Äď had now been isolated in two patients in England.
[Clip: News bulletin on arrival in the UK of South African variant]
Labelled B.1.525, the South African variant had been traced in 147 people in the UK by 5 February, at least 11 of whom had not set foot in South Africa.¬†
[Clip: News bulletin on the spread of the South African variant in the UK]
The new flavour of coronavirus was spreading, in other words, albeit more slowly than its Kentish cousin.
What worried ministers and scientists alike was that the South African variant showed limited signs of cutting through the protection offered by the vaccine.¬†
The Kentish variant was more transmissible, yes, but the early data suggested that it didn‚Äôt put those who had received the jab in any greater danger. But the South African variant ‚Äď well, that was a different story.
Nicknamed ‚ÄúRio‚ÄĚ in the Cabinet Office ‚Äď with occasional bad-taste bursts of the Duran Duran song of the same name ‚Äď this mutation was starting to work on ways of getting through the vaccine firewall.
Here‚Äôs Professor Sarah Gilbert, head of the Oxford University team that created the AstraZeneca vaccine, on the BBC‚Äôs Andrew Marr Show on 7 February explaining the problem:
[Clip: Professor Sarah Gilbert on the Andrew Marr Show on 7 February]¬†
So it‚Äôs very important to emphasise that the South African variant has not put anyone who has received the jab in mortal danger, or even at risk of serious illness.¬†
But ‚Äď at a time of justified celebration about the vaccine roll-out in the UK ‚Äď its emergence was a reminder that this was a war potentially without end.¬†
Here‚Äôs Patrick Vallance at a Downing Street press conference on 22 January, emphasising the vigilance required by the rise of the variants.
[Clip: Patrick Vallance on the variants potential resistance to vaccines]¬†
The virus would not just give up, in other words. On the contrary, the logic of evolution would send it seething into battle against the vaccine that was so successfully thwarting its work.
The same is true of the so-called Brazilian variant ‚Äď or¬†¬†P.1 as it‚Äôs known in the lab.¬†This version was not, in fact, spotted in Brazil at all, but by Japan‚Äôs National Institute of Infectious Diseases on 2 January in four travellers from Brazil‚Äôs Amazonas state.
The discovery rang alarm bells for one obvious reason: with almost 250,000 deaths to date, Brazil is second only to the US in Covid fatalities. So its epidemiological data is of concern to the whole world.
What worries ministers and scientists in the UK ‚Äď and everywhere else ‚Äď is what happened in the rainforest city of Manaus ‚Äď the capital of the state of Amazonas.¬†
In the first wave of the virus, up to three-quarters of the city‚Äôs population were infected, a terrible toll that ought to have had the consolation of offering high levels of immunity.¬†
The surviving population (or enough of them) would have generated antibodies to protect them from a further surge. But that is precisely what happened, to the dismay of the city‚Äôs inhabitants.¬†
By mid-January Manaus was running low on basic medical supplies and private citizens were taking to the road, in conditions of extreme heat and rainfall, to get oxygen and other essentials for their families. Bodies were reportedly being buried in mass graves as Covid returned for a second savage bite.
[Clip: News clips on the Manaus crisis]¬†
The Brazilian variant shares with the South African version a genetic mutation called E484K (or ‚ÄúEeek!‚ÄĚ as it is nicknamed) that seems to cut through existing immunity ‚Äď though not predictably so. Again, there is no evidence that it will endanger those who have received the vaccine.
On 21 February, Matt Hancock told Sky‚Äôs Sophy Ridge that the incidence of the two main variants was falling in the UK.
[Clip: Matt Hancock on Sky on 21 February]¬†
So how have these mutations been contained so far? By two principal means: first, border control and quarantine
On 16 February, the Government announced details of its plan to ban travel from 33 ‚Äúred-list‚ÄĚ countries ‚Äď except for UK and Irish nationals who would have to quarantine for 10 days in a government-approved hotel
[Clip: Boris Johnson announcing travel ban from red-list countries in the House of Commons on 16 February]¬†
Labour‚Äôs Jon Ashworth, the Shadow Health Secretary, urged the prime minister to go further and to consider even tighter border controls:
[Clip: Jon Ashworth in the House of Commons on 16 February]¬†
The problem is that no modern nation, dependent upon the supply chains of the global economy and the movement of individuals across the border, can long sustain such restrictions.¬†
The Department for Transport has already been tasked with setting up a successor body to the Global Travel Taskforce established in October, to co-ordinate the phased resumption of relatively normal border control.¬†
But as one senior virologist put it to me: ‚ÄúTravel is pretty much all or nothing. Once anything like regular human traffic resumes you can work on the basis that any significant variant will get here sooner or later.‚ÄĚ
So the second weapon against variant outbreaks is more important for the long term ‚Äď so-called ‚Äúsurge testing‚ÄĚ. Here‚Äôs Steve McManus, the director of trace operations at Test and Trace, explaining to the Science and Technology select committee on 3 February how the system works:
[Clip: Steve McManus on surge testing]¬†
This sounds good, but it would be a stretch to say that there is full confidence within the government or the scientific community that the hitherto-shambolic test and trace system is up to the task.¬†
As one who has been involved with the pandemic strategy for the full 11 months says: ‚ÄúWe want it to work, it has to work. But we‚Äôre also conscious that the success of vaccine roll-out doesn‚Äôt mean that everything else will suddenly be a success, too. And testing and diagnostics have been by far the weakest point in the whole system all the way through.‚ÄĚ
Such anxieties are significant because they lead us back, as always in the story of the pandemic, to the mind of the prime minister; his stop-go approach to Covid restrictions; his own brush with mortality last April; his consciousness that his place in history is as likely to be defined by the how posterity judges his handling of Covid as by the success or failure of Brexit.
Talking to those who know him best, I was struck by how important the threat of variants has become to the PM‚Äôs thinking. If he and his colleagues were late to this particular party, they are not leaving any time soon.
Take the initially controversial instruction to healthcare professionals on 30 December to extend the time between the two vaccine doses from two to three weeks to 12 weeks ‚Äď an idea that had first been proposed by Tony Blair and then embraced by the prime minister.
Here‚Äôs Professor Jonathan Van Tam, the Deputy Chief Officer, defending the change on LBC radio on 13 January.
[Clip: Jonathan Van Tam on limited supply and need to maximise access to the vaccine]¬†
In public, the government and its advisers emphasised the unpredictability of supply chains, and the need to get at least one jab into as many arms as quickly as humanly possible. But vaccine supply was not the only issue.
As one Number Ten source puts it: ‚ÄúBy the end of the year, Boris was really aware of the menace of the variants. He‚Äôd got the message that high case rates would lead to more of them, and who knows what might happen if one of them was truly vicious. A big part of the changed dosage plan was to reduce the risk of mutations by hopefully bringing down infection numbers.‚ÄĚ
Even more interesting is the pointed caution that characterised the prime minister‚Äôs lockdown exit plan on 22 February and differentiated it sharply from previous promises of swift emancipation.
[Clip: Montage of Boris Johnson‚Äôs cautious language in the House of Commons and Downing Street on 22 February]¬†
This less reckless approach to unlocking the country was intrinsically sensible. Johnson wants this to be the last lockdown and has been steered towards a less buccaneering approach in general by a new cohort of advisers.
But the change was also, to a considerable extent, the consequence of a specific concern that has not been hitherto reported.
According to one source close to the PM: ‚ÄúWhat happened was this. The scientists told Boris that the next month looked like a variant minefield. That the genomic evidence made them very wary about February and March and what surprises the virus might have in store. Of course, they could well be wrong. But the warning definitely got under his skin.‚ÄĚ
This meant that even the reopening of schools on 8 March was at risk ‚Äď a risk, in the end, that Boris Johnson decided he had to take. But the tests and conditions written into the whole lockdown plan are no accident.¬†
Apprehension about new and existing variants is present everywhere in the strategy. There are tripwires and emergency brakes everywhere to enable the PM to slow down or halt the unlocking process.
And if you‚Äôre wondering why you won‚Äôt be able to go to your local for a pint before 17 May at the earliest, look towards Kent, South Africa and Brazil. Fear of the mutants looms large in the PM‚Äôs mind ‚Äď and with good reason.
On the plus side, the vaccine companies are already gearing up to re-engineer their jabs as the virus mutates.
[Clip: Domitzer and Gilbert at Science and Technology Committee on 24 February]
At present, there may be no requirement for a new vaccine this year. If the need arises, the reengineered jabs will require three to four months of clinical trials ‚Äď and crucially, a sufficient level of coronavirus in the community for such trials to be meaningful.¬†
This is the trickiest bit about such trials, a sting in the tail if you like. With any new treatment, double-blind tests mean that there is a group of patients that receive the new product and a control group that receive a placebo. And unless there is a measurable risk of them catching Covid ‚Äď which is to say, enough virus in circulation ‚Äď the test results don‚Äôt tell you very much.
That aside, the pharmaceutical industry is already capable of producing a second-generation booster by the autumn if the need arises ‚Äď assuming that the Medicines & Healthcare products Regulatory Agency gives the new product the green light and there are no manufacturing glitches.
But two huge questions linger. The first is what will happen when border controls are relaxed, as they must be if the UK economy is to stand a chance of recovering.¬†
‚ÄúIt‚Äôs one of the scariest variables,‚ÄĚ says one minister. ‚ÄúIf the last 11 months have taught us anything it‚Äôs that the names we give variants are pretty meaningless. They might come from South Africa or Brazil or wherever the next one is first detected. But in the end, sooner or later, they‚Äôll end up here. The idea of the UK as a Zero Covid nation is daft and, in any case, unobtainable. We have to assume that new variants will arrive on these shores during 2021.‚ÄĚ
Behind the scenes, AstraZeneca, which manufactures the Oxford jabs, is already working on so-called ‚Äúdedicated vaccines‚ÄĚ ‚Äď highly bespoke immunisations that can be specifically engineered to deal with a hotspot outbreak of a new mutation.¬†
For this reason, some of those advising the Government think that the PM was foolish to declare that this would be the last lockdown and think he will be forced to eat his words by the need for ‚Äď at the very least ‚Äď localised quarantines to contain surges of new mutations.¬†
In fact, the 68-page document setting out the detailed provisions of the plan says that the government will indeed take ‚Äúa highly precautionary approach, acting fast to address outbreaks.‚ÄĚ But the public will remember the PM‚Äôs repeated promise that the exit from closure would be ‚Äúirreversible‚ÄĚ.
As one senior Conservative figure puts it: ‚ÄúThis was a silly hostage to fortune by Boris. The truth is that there may well be a variant that escapes vaccine protection or diminishes it sufficiently that tight controls are needed again. They might not be national but they‚Äôll still be required. Now, even if the measures are entirely sensible, they‚Äôll look like a failure by the prime minister who promised that the path out of lockdown was irreversible.‚ÄĚ
The second overarching question is how to prevent developing countries from becoming a permanent greenhouse for new variants, some of which will be more dangerous and ‚Äď inevitably ‚Äď make their way around the planet.
The ethical case for assisting poorer nations with vaccination is, of course, compelling and underpins the Covid-19 Vaccines Global Access or Covax scheme. By the end of 2021, Covax aims to have administered two billion doses. Here‚Äôs Pope Francis in August weighing in to make this moral case:
[Clip: Pope Francis on CNN discussing the need for vaccines to be universally distributed]
But the achievement of this objective is not just an altruistic goal. Successful vaccine roll-outs in the developed nations will not stop the virus mutating elsewhere. High case-rates, remember, are what the virus loves best as it itches to mutate ‚Äď and it is not fussy about where on the surface of the planet it does so.
In principle, this is common ground. You will often hear it said by ministers, public health officials and their counterparts around the world that nobody is safe until everyone is safe.¬†
[Clip: Boris Johnson on healing the world]
So much for the statements of fine intent. The fact remains that 130 countries have still not received a single vaccine dose: 75 per cent of vaccines administered so far have been confined to 10 countries
At the Science and Technology select committee meeting last week, the Scottish Nationalist MP, Carol Monaghan, pressed Nadhim Zahawi, the vaccine deployment minister, on this very point.
[Clip: Carol Monaghan in discussion with Nadhim Zahawi at a Select Committee meeting on 24 February]
You can feel Zahawi squirming between two positions. On the one hand, the absolute priority of vaccinating UK citizens. On the other, the strategic pointlessness of doing so unless the rest of the world is vaccinated, too.
Add to this the fact that developing nations may end up with vaccines unused by richer countries that are quickly made redundant ‚Äď or at least less potent ‚Äď by variants. The wealthy nations use the reengineered jabs. The less affluent have to make do with the leftovers and hand-me-downs ‚Äď with the result that even more mutations may arise in their territories.
In the end, the distinction between domestic and foreign strategy against Covid is a false dichotomy. It‚Äôs one single campaign, fought on countless terrains, in a bewildering variety of ways.
Populist governments hate this. They hate uncertainty. They like simple answers to complex questions. They wanted to ‚ÄúGet Brexit Done‚ÄĚ ‚Äď and they did. Now they want to ‚ÄúGet Covid Done‚ÄĚ ‚Äď and see the vaccine as the means of doing so.
Except that one of the defining characteristics of a lethal virus ‚Äď perhaps the defining characteristic ‚Äď is uncertainty and unpredictability.¬†
Coronavirus has not yet mutated in such a way that it escapes vaccine protection and there is no intrinsic reason to think that is going to. But it might. That‚Äôs the point. And that‚Äôs why everybody involved in the campaign against Covid has to behave as if it is going to happen.
This is how Professor Wendy Barclay of Imperial College London put it to the same select committee meeting:
[Clip: Professor Wendy Barclay makes the point that ‚Äúthere will come a point‚ÄĚ when the efficacy of the existing vaccines is insufficient for the variants]
At a time when ministers‚Äô instinct is to wave the British flag and talk of businesses reopening, families reunited and summer holidays, this is a tough constraint to accept. They yearn to make unconditional promises, ink release dates indelibly into the calendar, and get the country ready for the party of the century.
But they can‚Äôt. They just can‚Äôt. This vicious virus has lost the battle of the vaccine, but has not yet conceded defeat in the war. It has unfinished business with humanity and will harness all the frenzied, sleepless forces of evolution to come out on top.¬†¬†
Even now, scientists in the US are investigating the latest stunt pulled by this tiny serial killer ‚Äď a ‚Äúrecombination‚ÄĚ event, whereby two variants have joined forces ‚Äď the Kentish version and a new Californian flavour ‚Äď to form a specially-mutated hybrid.¬†
It‚Äôs too early to say if this synthesis is responsible for the recent spike of cases seen in Los Angeles. But the discovery of the first recombination of Covid-19 isn‚Äôt a happy omen.¬†
Odd as it might sound, most of the government figures I spoke to in preparing this story steered me towards realism. They know that the vaccine is a big success story but they have learned to fear complacency the hard way.
In the words of one Cabinet minister: ‚ÄúI feel bad about this, but there are times when I want to warn people not to get too cheerful, too soon. The jab is a miracle. But it‚Äôs not the end of the story.‚ÄĚ
He‚Äôs right. The mutants are still on the march, still polluting the stream of optimism and relief, still scheming and plotting in their microscopic hives.¬†
Now more than ever, as our prospects brighten a little, we must hope that the might of science can stay ahead of the blind but deadly force of evolution; and that the tectonic plate of uncertainty, shuddering ominously beneath us, does not suddenly, and terribly, erupt.