How quickly could vaccines allow us to reopen the economy?

Boris Johnson has suggested that vaccinations could allow restrictions in England to be eased from March. But is this feasible? Or would it represent another policy mistake? Ben Chu investigates

Are ministers in danger of, once again, being overly optimistic about success in the battle against the disease? (AFP/Getty)

We’re told ministers remain reasonably confident of meeting their official target of vaccinating 14 million of the most vulnerable people in the UK with initial doses by the middle of February.

This would require daily vaccinations of some 300,000 people. Despite a dip in recent days this rate was being achieved at the end of last week and on 19 January, assisted by the somewhat controversial decision to administer single doses to more people earlier.

The overall speed of the UK vaccine rollout – which is certainly much faster than European governments – is raising the question of how soon society and the economy will be able to reopen.

National lockdowns across Britain are expected to remain in place at least through February, but Boris Johnson has suggested restrictions in England could start to be eased in March, with a return to the regional tier system.

But is this feasible? Will the vaccination programme really have reduced pressure on the health service – which is currently in an unprecedented crisis - sufficiently by March to enable restrictions to be eased by then?

Will 14 million vaccinations confer a level of herd immunity that makes it safe to allow sectors such as hospitality and retail to reopen without the risk of another lethal spike in infections?

Or are ministers in danger of, once again, being overly optimistic about success in the battle against the disease? Could they be about to make another major policy error?

A group called the “Covid-19 Actuaries Response Group”, made up of actuaries and epidemiologists, have attempted to model the impact of the government achieving its February vaccination target on hospitalisations and deaths.

Their model makes various assumptions about the effectiveness of the vaccine, its take-up by the population and the prevalence of the virus in the community.

The results are a mixed bag. While the model shows hospital deaths falling rapidly from the middle of February, and declining by almost 90 per cent from today’s tragically high levels by the end of March, the decline in the number of hospital and intensive care admissions is much less encouraging.

The model shows intensive care unit [ICU] admissions at only a third lower than now by the end of March.

This seems to be mainly because the number of cases falls by just 15 per cent by that date.  

A still significant number of unvaccinated people aged below 70 would be catching the disease and being admitted to ICU. Their risk of death is lower than the vaccinated older group but they can still get quite seriously ill.

The upshot is that, if this analysis is correct, there will continue to be serious pressure on the health service well into March.  

That could well restrict the ability of the government to ease restrictions. Or, if they do so prematurely, ministers might need to rapidly reimpose them to protect the NHS, in a repeat of the pattern after the Christmas Day relaxation.

“The stresses on the health service, and particularly ICU units, will not be completely addressed by this first phase,” argues John Roberts, of the actuaries modelling group.

“The need to manage this through some degree of continuing non-pharmaceutical interventions will undoubtedly be a challenge.”

One way in which the actuaries’ results might prove overly pessimistic is that mass vaccination could reduce the transmission of the virus, which is something the team did not incorporate into their modelling assumptions.  

Yet the group adds that this would make little difference to their results over the next two months because the majority of the population would still not be covered.

Asked on Wednesday on Sky News how many people would need to be vaccinated before we can remove restrictions the government’s chief scientific adviser, Sir Patrick Vallance, suggested the UK would need vaccine coverage of “70 per cent or more” to get “some degree of immunity across the whole population”.  

This is a level of vaccination coverage that would certainly not be reached before March and would probably not be hit before September at the projected roll-out pace.

And reports suggest members of the Sage advisory committee are advocating for continued restrictions until most people are vaccinated.

On the face of it that suggests many more months of lockdown or severe restrictions.

However, Ian Mulheirn of the Tony Blair Institute has also done some new modelling which suggests that speeding up the vaccine roll-out – vaccinating some 600,000 people a day from March rather than 300,000 – would have a dramatic effect on the ability of ministers to safely reopen the economy.

A more rapid rollout, he estimates, would enable the UK to move down to tier 1 level restrictions (with non-essential retail and hospitality open) in April, rather than June.  

He also calculates that vaccinating at this faster rate would allow almost all restrictions to be lifted by 15 May, rather than late September on current projections – so a full four months earlier.

“The economic benefits of accelerating rollout are significant since it would mean being able to lift heavy restrictions sooner,” argues Mr Mulheirn.

“This analysis shows just how much there is to gain if we can be ready for accelerated rollout.”

John Roberts agrees. “Continued vaccine rollout, at pace, is needed to get the country back to as close to normal as is possible at the earliest opportunity,” he says.

There are two major obstacles to ramping up vaccinations. The first is the logistics. 

Ten mass vaccination centres have opened up this week and high street pharmacies can now offer the jab as well. Is it feasible that more could be done? It would be a challenge, but Israel has vaccinated 1 per cent of its population a day this year, which would be equivalent to 700,000 getting the jab daily in the UK.  

The second obstacle is supply. Would pharmaceutical companies be able to manufacture and deliver vaccines in a sufficient quantity to double the daily inoculation rate? The answer is unclear, although Downing Street has been stressing in recent days that “supply is the limiting factor”. 

Yet with other major policy levers such as the test and trace system still running into serious problems it would seem that the quickest route back to some form of social and economic normality is indeed to step up the rate of vaccination.