1. I’ve been saying since February that we can’t afford to ‘live with this virus’.

Everything that’s happened was predictable and predicted by many scientists. Mutations were to be expected. And the higher transmission, the greater the chance of outliers.

So, what now?

2. If the NERVTAG estimates are correct and this variant makes a 0.39 to 0.93 contribution to R-value without any reduction in hospitalisation, morbidity or mortality rates, we can’t afford to live with it. This isn’t political opinion. It’s a statement of fact.

3. Cases in tier 4 areas were growing through lockdown and given the infection rates among teenagers highlighted by Matt Hancock and others, it’s likely it was spreading through schools. https://twitter.com/globalhlthtwit/status/1340695188575051776

4. Unlike Sweden, which kept most things open, the UK may have unwittingly created selection pressure to favour a variant that can be easily transmitted through schools. We’ll have to wait for evidence, but if so, it’s one of the many reasons why the UK’s schools policy is folly.

5. A highly infectious variant means we can open even less of society before hospitals are overwhelmed, which is why Matt Hancock was talking about Tier 4 regions remaining subject to restrictions until the roll out of vaccines. This is more folly.

6. We don’t yet know whether vaccines protect against this variant & even if they do, the roll out of vaccines will create selection pressure for escape variants that may already be circulating or new ones. If we want vaccines to work, we must cut cases. https://bylinetimes.com/2020/12/01/britain-cant-put-all-its-covid-eggs-in-the-vaccine-basket/

7. Borders must be closed until we can implement an effective isolation system. We must learn from New Zealand & Australia. Both accept incoming travellers who isolate in carefully monitored facilities at their own expense. Someone said the UK can’t afford such a policy.

8. Can it afford the current policy? The sooner we accept we’re in a pandemic & must make structural changes to beat this virus, the better. We can’t go back to the way things were until this virus is gone.

The government has done us a great disservice by pretending otherwise.

9. Border controls are essential to prevent new infection from overseas. Then domestic cases must come down. We know what works & we were almost there in summer when the government decided to open up early. This wasn’t an accident, it was policy, set out here by Chris Whitty. https://twitter.com/adamhamdy/status/1303616514457767941

10. Part of the reason we’re in this mess is because the government has been following its influenza pandemic plan. Wrong virus, guys.

Attempting to navigate a ‘middle way’ with a coronavirus leads you to...well, where we are. https://twitter.com/adamhamdy/status/1340606362125037568

11. We need to bring cases down to single figures with a proper lockdown. Then open up cautiously with an effective test, trace, isolate and support system. Copy the models that have worked in New Zealand, Australia, South Korea, Vietnam and elsewhere.

12. Lockdown areas where clusters emerge and test the heck out of them. Ensure compliance with isolation measures by offering proper financial support. Treat each and every infection seriously and get people used to the idea it is better to overreact than be complacent.

13. Schools need to go back to how they were running during the first lockdown with online learning for most and in-person learning for those who need it. They can reopen once we’ve got cases down and we’ve put the necessary safety measures in place.

https://schools.forhealth.org/wp-content/uploads/sites/19/2020/06/Harvard-Healthy-Buildings-Program-Schools-For-Health-Reopening-Covid19-June2020.pdf

14. I and others advocated for this over summer, but instead the government pulled a confidence trick and convinced people schools could open more or less as normal during a pandemic.

Late lockdown, early reopening, failure to protect care homes, schools, to provide PPE...

15. Every hardship we now face is a result of this government’s failure to act.

If it fails to act now, we will suffer yet more hardship. We’ve made life more difficult by allowing transmission at a level that’s seen the emergence of the new variant, but we are where we are.

16. The Johnson government has lacked the courage to confront the challenge. It has been following policies developed to tackle the wrong virus. One mistake has compounded another, and still it won’t learn.

17. We know what works. We can see what success looks like in many countries around the world. Let’s use the shock of this variant to change direction and join New Zealand, Australia, Taiwan and others in the winners’ circle. Let’s aim for #ZeroCovid