True breakthroughs are rare (the cause of Aids; Dolly the Sheep) and almost none is granted the kind of establishment send-off as the research unveiled that morning. For months, private briefings had teased the press regarding what was coming. The hospital installed answering machines to field the alarm it expected. And both its medical school’s dean and a top professor stepped forward with a mid-rank lab researcher to introduce a “study” that wouldn’t only stalk the nightmares of a generation of young parents, but shovel trenches for a war that has raged ever since.

“The study has identified a possible link between gut disorders in children and autism,” a press release explained, with 21 minutes of video clips to maximise TV pick-up. “In the majority of cases, the onset of symptoms occurred soon after the MMR vaccination.”

Ahh, MMR: the measles, mumps, and rubella shot. What Brit beyond their teens never noticed the fallout that rained from that morning’s event? Over months and years, vaccination rates slumped, and measles returned to kill or maim children as the most agonising health scare since the early years of Aids unleashed outbreaks of fear, guilt, and disease. That night, TV news tracked the Royal Free script:

“Questions were raised today about the safety of the combined mumps, measles, and rubella vaccine…”

“Claims there could be a link between a common childhood vaccine and autism…”

This was February 26, 1998, with the paper datelined to the following Saturday. Beneath a technobabble title, 13 authors were listed. But only one wrote it: Andrew Wakefield. Then aged 41, a bowel surgeon by training, he had a large-chested voice, a patrician manner, and what admirers described as “charisma”. Dressed in a black suit at a blue-clothed table, with the dean stood to his left and the professor sat to his right, he pitched a story to draft a page in medical history. He had gathered data from a series of 12 developmentally challenged kids, anonymised in the paper by number. They had been admitted to the Royal Free for an unprecedented five-day battery of tests he had devised, including needles into their spines, tubes deep into their guts, brain scans, x-rays, and blood work.

His first “finding” would echo down the decades like machine-gun fire in a cathedral. For eight of the 12 (aged from three to nine), the paper said their parents, quizzed by doctors running the tests, recounted a terrifyingly similar experience: a son or daughter was developing normally, received a shot of the three-in-one “live virus” MMR, and showed autistic symptoms within days.

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The paper further claimed discovery of a new medical “syndrome” of both brain and bowel disease in the children. All but one, it reported in text and tables, had developmental issues plus “chronic enterocolitis” — inflammation of both the large and small intestine. “It’s a moral issue for me,” Wakefield told his audience, calling for MMR to be suspended in favour of single shots for measles, mumps, and rubella. “I can’t support the continued use of these three vaccines, given in combination, until this issue has been resolved.” The dean equivocated, but the professor backed Wakefield. And so was born an intractable controversy as the paper was leveraged to launch a crusade: first against this vaccine, then later another… and another… all the way to SARS-CoV-2.

“It’s not a vaccine at all,” Wakefield would rail against the latter at the height of the Covid pandemic. “It’s actually genetic engineering.” Back in 1998, his ground had been firmer, even based on a mere dozen patients. Many medical insights begin with short case series. Autism: 11 kids in the Baltimore area, for example. Aids: five men in Los Angeles. That Thursday, it seemed possible the Royal Free had got lucky: maybe catching the first snapshot of a hidden epidemic of catastrophic injuries to kids. Massive studies around the world, however, found nothing to confirm this, leaving a whale of a riddle rotting on the beach. If parents of two-thirds of 12 children with developmental issues blamed the triple shot for the sudden onset of autism, why weren’t vaccine victims everywhere? Wakefield doubled down, claiming they were. But, while the medical establishment sought refuge in authority, urging the public to trust experts, not a lone-voice maverick, an old-school Sunday Times investigation, run by me, would pepper revelations across more than the next decade, revealing what this doctor had done.

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Our first report splashed in February 2004, almost exactly six years after the press conference. “Revealed: MMR research scandal,” was the front page, igniting a new media firestorm. We had discovered a monstrous conflict of interest that Wakefield kept hidden, then denied. For two years before his “moral issue” surfaced — and before any of the children set foot in the hospital — he had been payrolled by a small-town solicitor named Richard Barr to help lead an attack on MMR. Unlike expert witnesses, who give advice and opinions, the doctor was delegated to arrange the tests, building pressure for a speculative lawsuit.

“I have mentioned to you before,” Barr wrote to Wakefield, six months before the Royal Free event, “the prime objective is to produce unassailable evidence in court so as to convince a court that these vaccines are dangerous.” Barr filed the lawsuit at the Royal Courts of Justice eight months after the breathless press conference. Wakefield claimed fees of £150 an hour (about £254 an hour at late 2022 values), drawn from the government’s legal aid fund. So, as he recruited the children and wrote the paper, he had a financial incentive not only to trigger a client-grabbing furore, but to keep it going for as long as he could.

Those clients poured in — nearly 1,600 families — as journalists were duped to fuel the scare. And by late 2003, when Barr’s lawsuit collapsed, Wakefield had. been handed £435,643 (about £738,000, or nearly US $900,000, at last year’s values), plus expenses, in taxpayers’ money. But as he gazed into the glare of TV lights, his legal deal was only one of his secrets. As he’d made his call for a switch to single vaccines, he forgot to mention that eight months previously he’d filed a confidential claim at the London Patent Office for his own, supposedly safer, single vaccine.

His shot wouldn’t have worked. When I asked experts about it, they laughed. But four days after the Royal Free event, he put it to the medical school that they start a joint company to raise money for this, and other products he’d imagined, which only stood much chance of enticing investors if confidence in MMR was damaged. Yet this doctor wasn’t shy of shady stuff, even hopelessly suing me for what a High Court judge described as “public-relations purposes”. So I carried on digging for years, on-and-off, exposing secrets and lies by the bucket. “If my son really is Patient 11, then the Lancet article is simply an outright fabrication,” complained the father of a California boy brought to London for the tests, after I found the dad and showed him a copy. “I know that paper is not right and fraudulent,” the mother of another boy, from the north of England, emailed me. “I can see that from what was written about my son.”

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Confidential medical records (lawfully checked) confirmed the parents’ right to be angry. Some of the kids said to have symptoms days after MMR, actually had them before or up to nine months later. Some were reported with “autism” without this diagnosis. Tests for bowel disease came back normal. None of Wakefield’s data revealed enterocolitis: the chief gastrointestinal symptom was constipation. Parents blaming the shot, moreover, wasn’t even a “finding” — it was a covert qualification to take part. Records showed that not eight, but 11 of the kids’ families named the vaccine at the hospital (the 12th’s later joined them to file a claim in the lawsuit) — a give-away number, sure to provoke questions, if Wakefield hadn’t airbrushed the figures. The poisonous truth was that all but the American family had links with vaccine activists caught up in Barr’s plans, pointing them to Wakefield’s project. And, surprise, legal aid authorities at the time insisted that, for cases to qualify for public funding, alleged symptoms must follow within days.

Wakefield was finished, but he couldn’t say sorry. And when The Sunday Times ran with “MMR doctor fixed data on autism”, he fought back, denying all error. “The notion that any researcher can cook such data in any fashion that can be slipped past the medical community for his personal benefit is patent nonsense,” he argued, in one of countless lengthy rejoinders. He wasn’t alone in not wishing us well. Much of the medical establishment was aggrieved. “I will now defend the heretic Dr Andrew Wakefield,” sneered, for instance, Bad Science author Dr Ben Goldacre. “The media are fingering the wrong man, and they know who should really take the blame: in MMR, journalists and editors have constructed their greatest hoax.”

But tunes changed abruptly in May 2010, after a hearing longer than the trial of OJ Simpson in which the General Medical Council vindicated what we’d published and scrubbed Wakefield from the doctors’ register. The Lancet, which for 12 years defended the paper, retracted it. And, after opposing the GMC proceedings, the British Medical Journal highlighted the irony. “It has taken the diligent scepticism of one man,” the BMJ said in an editorial, “standing outside medicine and science, to show that the paper was in fact an elaborate fraud”.

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I won’t forget that, and not just for my name-check but because the establishment mobilised to vilify journalists rather than hold a mirror to themselves. How could it be that all the doctors and professors, royal colleges and government experts, steeped in more medicine than I’d know how to spell, failed to spot that the paper was a scam? It was as if they couldn’t accept the ugly truth was even possible. A chap wouldn’t do such a thing. So, in plain view of a dozen co-authors, platformed by a hospital and its medical school, and published after peer review in a most prestigious journal, he’d effortlessly exploited conceits and vulnerabilities that remain below the radar to this day.

Personally, I’d trust The Daily Mail before The Lancet (especially the football and TV data). But, if Wakefield had ploughed a field of less instant public interest — say, psychogeriatrics or kidney surgery — his chances of getting caught were close to zero. He might have published fake findings until the day he retired, and no newspaper reporter could have convinced their editors to pay for what it would take to prove what happened. So, the next time you read of some medical marvel, remember the lesson of the Wakefield scandal. As I put it in The Doctor Who Fooled the World, (published after he’d moved on to trashing Covid vaccines): “If he could do what he did — and I’ll show you what he did — who else is doing what in the hospitals and laboratories that we may one day look to for our lives?”

That was Wodehouse in 1941, from one of his Berlin broadcasts. But pretty much the same has applied 80 years later in Hong Kong, just with fewer Germans. If your goal has ever been to get locked in a room for weeks on end, then Hong Kong has become the place to be. The authorities would lock you up if you had Covid. They’d lock you up if you’d been close to someone who had Covid. At one point, they’d even lock you up if you’d been close to someone who’d been close to someone who had Covid.

You also got locked up just for getting into the country. You paid for the flight and the Hong Kong authorities would do the rest. Actually, that last bit wasn’t quite true: you had to book and pay for your room as well. But you get the point.

Brutal as it was — caring little for minor things like family separation or childcare — this system worked relatively well by its own standards until earlier this year. For extended periods there were no Covid cases at all and overall deaths remained low. But then Omicron broke through, as almost everyone knew it would: ironically, as the result of a cross-infection in a quarantine hotel, something the government had been warned about repeatedly.

There soon became too many cases to make asymptomatic people spend weeks in hospital and there were not enough isolation units to lock up close contacts. By the start of March, the death rate went through the roof, becoming the highest in the world at any point in the pandemic. They couldn’t process the dead quickly enough, with bodies stacked next to the living, in overrun, under-staffed, public hospitals. Hong Kong ran out of coffins as well as smugness. It became the premier place to be if you wanted to die from Covid.

The tragedy was how avoidable all this was. Having broadly succeeded in the initial stages of the pandemic, cutting down local case numbers down zero for months, Hong Kong had an opportunity — almost unique in the world — to transition, with as few deaths as possible, to a sustainable mitigation strategy.

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Its failure not to take that opportunity has now been widely noted — as has its recent announcement that it would begin to relax some of its stricter restrictions. From outside, this has been presented as a pragmatic shift away from its policy of “dynamic zero Covid” to something akin to co-existence. The idea of “living with Covid” was previously verboten here, a sign of Western decadence and a failure to care about the value of human life, so any such shift would be profound.

Yet from within Hong Kong the shift seems less significant and reaction to the policy changes here have been more muted than some of the overseas coverage might suggest.

This is partly because the details are less dramatic than the headlines. Schools were told they could go back to face-to-face teaching, only for the government to then announce that they need to have achieved a 90% vaccination rate among staff and students before they could return to full days, something many will find next to impossible to achieve in what remains of the school year. Some of the more extreme rules remain: mask wearing is compulsory outside, even if exercising, even in remote country parks. There are still stories of the police lurking behind bushes to catch out knackered joggers who have pulled down their masks to catch their breath.

While the outright country flight bans that previously existed are to be dropped from April, and quarantine has been reduced to seven days (until recently it was 21), it’s still seven days more than most of the world insists on and it is also open only to vaccinated residents — no visitors at all. At any point, if an airline is found to have brought too many positive cases into Hong Kong, they are banned from that route for seven days. Travellers then have to rearrange everything, including the quarantine hotel, which is often simply not possible given the demand, and means not getting into Hong Kong for months. All of this remains a serious problem for Asia’s self-proclaimed “world city”.

But my suspicion is that the real reason people here are less impressed goes beyond the details of the changes; it is now a broader issue about lack of faith in the government, and the absence of any strategy.

For some, this is inextricably linked to the protests in 2019 and the government’s heavy-handed response — something for which a fair few people have been locked up, and for longer than three weeks. A significant proportion of Hongkongers wouldn’t trust the government whatever they did. But even if you are one of those who thinks that the Hong Kong government was right in its approach, it is difficult to say that it has recently demonstrated competence. It is not just the failures to prepare properly for the current outbreak — although that alone should have been enough to have ended multiple political careers. There have also been constant U-turns on policy.

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Perhaps the worst recently was the announcement that all the school term dates were to change, bringing forward the summer holiday to Easter — I am not making this up — to allow school buildings to be used for a city-wide testing programme. Then it was floated that this might also simultaneously involve a lockdown, which triggered panic-shopping; only for the government to then decide that maybe they didn’t want to do any of it after all.

Given the U-turns so far it would be a brave person who would bet against another massive reversal of policy months down the line. What happens when case numbers start to rise again? Or there are the inevitable outbreaks in schools?

One common response to this is to say something like: “Of course, they can’t say they are going to live with the virus. That would involve too much loss of face. But that’s obviously what they are doing”.

But there are two problems with this argument. The first is that there is plenty of evidence that this is not what they are doing: at the same time as there is talk of reopening the schools and the borders, the government has also been building multiple new isolation centres. Mass testing may have been put on hold, but compulsory testing of people who have been in places with Covid cases has restarted. As case numbers have fallen to more manageable levels, so people have begun to get put back into isolation. None of this looks like living with the virus.

Second, even if this were true, it is never a good sign for any government to say it is doing one thing while doing another. Even if the people at the top of government think they are following a plan, it makes it less likely for there to be a proper alignment of strategy and implementation. Chief Executive Carrie Lam has said that Hong Kong’s struggle with Covid is akin to a war, so it’s worth considering what Clausewitz said about military strategy. It was “to identify the decisive point and to concentrate everything on it, removing forces from secondary fronts and ignoring lesser objectives”. We shouldn’t necessarily have expected the Hong Kong authorities to have read Clausewitz — but at times they act as if they have read him only so they can work out how to do the exact opposite. There is no identification of the decisive point, no concentration of resources, and there’s always a host of lesser objectives.

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In the same way that the massive focus on locking people up and keeping out those from overseas distracted what should have been the main priority of vaccinating people in care homes, only last week Lam argued that Hong Kong needed both to reopen the mainland border and to open up to international travel. Yet these are in direct tension. As long as the policy on the mainland is for Zero Covid, the mainland border won’t open up while there are outbreaks in Hong Kong — but if you allow international travel without quarantine, you will get outbreaks. “To govern,” as Pierre Mendès-France put it, “is to choose.”  Hong Kong’s administration cannot choose, and thus it cannot govern.

One of the curiosities about Hong Kong — at least to a polling junkie like me — is the almost complete lack of decent opinion polling here. When asking awkward questions can get you threatened with the National Security Law, it is difficult to ask tricky questions or expect honest answers, and to know what people really think.

But for many the tipping point has been reached and people are voting with their feet. A full 1% of the population left last month. Some may be coming back, but lots are not. And sure, in time, when all this is a distant memory, others will come in to replace them, but the immediate consequences are significant. Talent drains, organisations relocate, businesses fold. The infrastructure won’t return, the diversity is lost. It is said that the recent promised policy shifts came in response to pleas from the city’s great and good, worried that irreversible damage was being done to Hong Kong’s status as a financial centre. These pleas were too quiet, and, for many, too late.

“ICU Doctor here: I skied 4 hrs in an N95 + a ski mask on top of it! Did not get hypoxic or hypercapnic!” an anaesthesiologist named Ilad Sharifpour tweeted last month. The Centers for Disease Control (CDC) advises that “in general, people do not need to wear masks when outdoors”. But such is the enthusiasm for masking among some people, including medical professionals, that the doctor felt moved to boast about outdoing the CDC guideline while engaging in a solo sport that involves high-speed travel through wide-open spaces.

Last May, in a particularly striking example of the “permanent pandemic” mindset, two American doctors wrote an article arguing that masking should “remain with us, becoming part of our everyday lives even as the Covid-19 pandemic, science willing, subsides”. Yet that emotional attachment to masks is even more pronounced today, amid a backlash to the governors’ move and proposals to lift remaining mask requirements in public schools. The New York Times‘s Covid reporter David Leonhardt — a pro-vaccine, pro-masking moderate liberal — was denounced online by hundreds of people last week simply for pointing out that mask mandates involve tradeoffs.

It seems that for a certain group of pandemic diehards, the fact that the guidance on masking has been so overtly unreliable and politicised has actually made masks more, rather than less, potent as instruments of public policy. In less than two years, the CDC has changed its position on masks at least three times. The agency originally discouraged their use before endorsing it, before finally acknowledging the cloth masks used by most Americans cannot stop the fine aerosols that spread Covid — which is exactly what Dr. Anthony Fauci wrote in a private letter from February 2020.

Given that we now know that these public health decisions are not rooted in The Science, the crucial question remains: Why did tens of millions of people willingly give up their freedoms and embrace the ever-changing dictates of such transparently incompetent and undeserving authorities?

So far, two types of answers seem to hold the most explanatory power. The first focuses on the psychology behind the mass adoption of fear-based emergency measures. The second looks at material rather than psychological factors, using the formula favoured by Lenin: “Who, whom?” In other words, which groups have benefited from the Covid regime, and at whose cost?

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The most compelling account of the “permanent pandemic” mindset, it seems to me, is one that recognises the confluence of these two forces. The Covid regime provided a grand life-or-death psychological drama that enlarged the power of the government and its partners in the tech industry, while enabling the destruction and economic displacement of small businesses that make up the base of the Republican party. Some 20% of small businesses and roughly 41% of black-owned small businesses in the US have been forced to close since the start of the pandemic. In the first year of the pandemic alone, there were an extra 200,000 business closures above historical levels. Hardest-hit, according to the Wall Street Journal, were: “Barber shops, nail salons and other providers of personal services.”

One popular psychological theory of the pandemic is ‘mass formation psychosis’, also known as mass formation hypnosis or, simply, mass formation. Developed by Mattias Desmet, a psychology professor at Ghent University in Belgium, it posits that the response to Covid in countries with strict policies illustrates how people can be brought into a collective trance that makes them easy to manipulate and prone to acting in ways that are contrary to reason and evidence.

Such mass formation can only occur, according to Desmet, when four conditions are met: the society has to be atomised and lacking in social bonds; most people living in it must feel a pervasive sense of meaninglessness about their own lives; they must also feel a free-floating anxiety that is not attached to any particular cause; finally, there must also be high levels of free-floating frustration and aggression that, again, have no specific source.

It’s plausible that these conditions were met in the United States when the pandemic broke out. A survey of 10,000 adult American workers taken between July and August 2019 found that three out of five reported being lonely, a 13% increase from the previous year. The number was even higher for heavy social media users, 73% of whom reported feeling lonely. Then came the pandemic, one year into which Americans reported having fewer close friends. In circumstances like these, Desmet argues, mass media can inculcate a narrative that provides the public with a fixed object for its ambient anxiety, drawing otherwise isolated individuals into a common cause in confronting the supposed menace.

The theory, with its obvious evocations of 20th-century totalitarian movements, was popularised when it was brought up on Joe Rogan’s podcast by Robert Malone, a scientist known for his warnings about the risks of mRNA vaccines. That interview may have been the beginning of the end for Rogan. Something about the mass formation hypothesis clearly struck a nerve with state authorities and information commissars and it was almost immediately censored and scrubbed from Google results. Desmet neither denies the existence of Covid nor attacks vaccines. He merely argues that the response to the pandemic has entailed a series of unscientific overreactions that have whipped the public into a dangerously susceptible state.

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People disposed to strictly rational explanations of large-scale events will find Desmet’s mass psychology unconvincing, but much of what has happened over the past two years defies rational accounting. Why did certain drugs such as hydroxychloroquine and ivermectin become stigmatised as politically untouchable and subject to gross distortions in the press, with CNN calling ivermectin, a Nobel prize-winning drug that had previously been used to treat over 100 million people across the world for ailments like River Blindness, a “horse dewormer?” These kinds of hyper-polarised rituals resemble past collective frenzies and moral panics.

Yet there are obvious limits to what psychology can account for in the past two years. There’s no psychological phenomenon sufficient to explain why the pandemic has been so beneficial to financial capital or led to the technology industry making a record-setting $1.4 trillion in 2021. As Marketwatch put it in a recent headline: “Big Tech’s pandemic year produces mind-boggling financial results”.

It’s not simply that the rich have gotten richer, though that’s certainly true as America’s billionaires added $2.1 trillion to their net worth during the pandemic. It’s Silicon Valley corporations with close ties to the Democratic party, like Google, that have benefited most.

While the tech companies have few actual employees compared to older productive industries, their largesse now directly subsidises whole sectors of the professional class economy, including journalism. Individual professionals may not have become richer during the pandemic but, unlike hundreds of thousands of American workers who lost their jobs — many of whom worked in the small businesses that were shuttered over the past two years — their employment was mostly secure.

Perhaps it’s not surprising, then, that those professionals would instinctively internalise Covid policies that enriched their tech oligarch patrons as a personal victory and defence of their own status. Few would put it that way, of course. Instead, they accuse protesting truck drivers of being fascists and call for them to be arrested because they recognise that medical mandates provide a ruthlessly efficient — yet morally sanctioned — means for sorting the populations between rulers, who deserve to monopolise power, and subjects, who can follow the rules or be crushed. That seems to be the underlying logic animating Juliette Kayyem, a former homeland security official under Obama who spoke for many in her circles when she recommended the best way to deal with the protests: “Slash the tires, empty gas tanks, arrest the drivers, and move the trucks.”

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Recently Toby Green and Thomas Fazi, both self-described Leftists, posed a series of questions about the Left’s relationship to Covid policies that had been devastating to the working class and global south. “Why has the mainstream Left ended up supporting practically all Covid measures?” they asked on UnHerd. And how, they wondered. did the Left end up ridiculing the very notion that there might be motivations from the vaccine manufacturers other than “the public good” at play?

The answer, it seems, is fairly clear: the Left did this because the Public Good has become, along with The Science, largely a costume worn by the professional classes who, quite rightly, suspect that they have more in common with a Moderna executive than an anti-vaccine mandate truck driver.

Its latest such gambit is a claim that the Office for National Statistics’ data shows “a significant rise in the death rate for adolescent males over the last eight months”. HART have put together an “open letter to Sajid Javid, Chris Whitty, Patrick Vallance and the relevant public health bodies”, saying that “the concern is that this time period coincides with the rollout of vaccinations to this age group”.

There’s a saying in journalism that you should play the ball, not the man. And I will play the ball, but I want to play the man a bit first. HART has form for suggesting that vaccines kill people: on p35 of its ‘Covid-19 Response’, still prominently linked on their website, they suggest that the second peak in deaths “coincided with the mass roll-out of novel mRNA/DNA vaccines” and that “whilst we cannot infer causation from correlation, the mRNA/DNA vaccines had not been tested on this cohort” and it would be “negligent” not to ask whether “the rise in deaths during this period is linked in some way to the vaccine roll-out”. (The second peak in deaths was, in fact, caused by the second peak in Covid cases which preceded it by a fortnight or so.)

HART is populated by odd people who believe strange things: one of its publicly listed members worried, in a since-leaked private chat, that the vaccines were literally making people magnetic. Other leaked messages show a member suggesting that the group “seed the thought that vaccines cause Covid”, and that the vaccine rollout is “a crime against humanity” and part of a plan for “massive scale depopulation”. It’s worth noting that while these people may seem to be cranks, they also seem to have some influence with senior Tory backbenchers.

But let’s look at the ideas, as well as the people. After all, stopped clocks are right twice a day, and there have been plenty of stopped clocks in the pandemic. So: what’s the evidence that vaccines have been killing young people?

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Here’s HART’s case. They say that according to ONS data, there were 402 deaths among 15 to 19-year-old boys between May and December last year, and that that’s about 65 more than the average for that period over the years 2015 to 2019. I’ve looked into it, and these numbers are about right. In fact, they are a slight understatement of reality: you can see the figures for 2021 here, and the five-year average here. This is, the ONS acknowledges, a “statistically significant” increase.

HART thinks, or at least heavily hints, that the extra deaths are caused by myocarditis, an inflammation of the heart muscle which has been seen in rare cases following vaccination with the Pfizer jab: “​​a connection cannot be excluded,” they say, and it would be “a grave dereliction of duty” not to investigate. They took the ONS to the High Court to get them to release more data, including the age, gender, and vaccination information of everyone who died between the age of 12 and 19 since 1 May last year[1. The ONS is looking into it, but they can’t release the data easily: so few people die at that age that if they gave much more information about them then individuals would be identifiable. The High Court agreed that they shouldn’t release it.].

HART are not the only people to worry about this. In the US, there are regular outbreaks of concern around the mRNA vaccines and myocarditis. But is there anything in it?

For the record, HART is right that the number of recorded deaths in that age category is unusually high. I spoke to the ONS, and they agree — a spokesperson told me that there has been an increase of recorded deaths, compared to the five-year average.

That said, it’s not clear that the rise is real. The ONS only becomes aware of deaths when they are officially registered, which — if the death is referred to a coroner — could be weeks or months after the death itself. Young people’s deaths are much more likely to be referred to the coroner, and in 2020, coroners’ offices were under enormous strain from the pandemic. The spokesman also speculated that there might be a simple backlog from the previous year. There may be all sorts of other reasons, and until the coroners’ reports are in we won’t know.

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Another problem for the myocarditis hypothesis is that, although HART says that the “time period coincides with the rollout of vaccinations to this age group”, it doesn’t really. The first mass vaccinations for under-18s didn’t start until August, and even then only began relatively slowly: only about 40,000 people a day were being given first doses in that period, down from a high of 600,000 in March. HART also says that the real risk is second doses, and under-18s wouldn’t have received those until September. Admittedly, 18 and 19-year-olds would have had their jabs somewhat earlier, but not that much earlier: even 30-year-olds were unable to have theirs until the end of May.

And looking at the data that HART themselves cite, there doesn’t seem to be an obvious spike after younger people get the vaccine: while the number of deaths does seem to go up after about May, there’s no spike in August when large numbers of young people started getting vaccinated.

The ONS spokesperson said that there have been adverse vaccine reactions mentioned on death certificates — but only 13 of them, and the ages ranged from 35 to 94. Perhaps there’s been a rash of unreported myocarditis cases, or other vaccine reactions, among young men, but it would be a bit surprising given the attention on the issue.

But let’s grant HART’s premise. Let’s imagine that some percentage of these excess deaths are not statistical artefacts, and are caused by myocarditis. What would that mean?

The main conclusion wouldn’t change: vaccines save lives. Look at this Our World in Data page on the risk of death for vaccinated vs unvaccinated people, in various countries. An unvaccinated American is around 100 times as likely to die as a triple-vaccinated one; an unvaccinated Swiss is about 165 times as likely to die. Similar if less extreme numbers can be seen in Chile and England, although OWID doesn’t yet have data on the effects of boosters in England.

Of course, that’s across all ages. But when you look at 12 to 17-year-olds in the US (the only country where there’s a reasonable amount of data), about one in every 100,000 unvaccinated died each week. That would be about 250 a week, if everyone were unvaccinated. It’s well over ten times the risk to vaccinated children of that age.

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By Vinay Prasad

The US CDC assesses the risk like this: if 100,000 children are vaccinated, they’d expect around five to seven cases of myocarditis, likely mild. But if they weren’t vaccinated, they’d expect about 5,500 of them to be infected with Covid in the following three months, and about 50 of them to be hospitalised. Out of the 25 million or so 12 to 17-year-olds in the US, that would be around 12,000 hospitalisations in three months. Perhaps ironically, a fair number of them would develop myocarditis: the UK government says about 18% of hospitalised Covid patients suffer myocardial injury.

The point is: even if some non-trivial number of young people have died of myocarditis because of the vaccine, the odds are that more would have died without it — and likely very many more would have suffered a really nasty illness and ended up with some quite long-term effects from it. And, of course, they’d have been more likely to pass it on to other, more vulnerable, people, including their own families.

It is easy to say “even one death is too many”. Of course, each death is a tragedy; but two deaths is twice as big a tragedy, all else being equal. I hope that the ONS is able to find some hint of what caused the apparent increase in deaths among adolescent males; I sincerely doubt that it’s the Pfizer vaccine. But even if it is, the likelihood is that it saved many more lives than it cost. 

Luckily, I think the battle over vaccines has largely been won — more than 90% of UK adults are now vaccinated. But groups like HART have influence over serious people on the fringes of real power, despite being deeply strange people who think those who advocate vaccines for children “need shooting”.

The trouble is, HART’s data is superficially convincing, and takes work to rebut. There are still many thousands of children, and others, who have yet to have their vaccine: if some of them die unnecessarily because of this nonsense, that really would be a tragedy.

I am an associate professor of epidemiology and biostatistics, as well as a practising physician, and I firmly believe that it would be a mistake to censor Rogan under the guise of combating “misinformation”.

Rogan is not a scientist, and, like everyone else, he has his biases. But he is open-minded, sceptical, and his podcast is an important forum for debate and dialogue. It is not enough, moreover, to simply dismiss Malone and McCullough as conspiracy theorists. They are controversial and polarising figures, but they do have real credentials. Malone is a physician who has worked in molecular biology and drug development for decades, while McCullough was, until recently, an academic cardiologist and researcher.

Both speakers made accurate and useful points on Rogan’s podcast — as well as unsupported, speculative, alarmist, and false ones. The correct way to deal with incorrect ideas in biomedicine, if they rise to a level of prominence that warrants rebuttal, is to rebut them.

In what follows, I attempt to assess their main claims, explaining what they get right and what they get wrong. I cannot address every point that the two of them made — both episodes are close to three hours long — but I hope that I can provide some clarity in a debate that often lacks it.

Claim: The risks of mRNA vaccination are underdiscussed and boosters should be debated

Early in his interview, Malone is critical of the scientific and media discussion of vaccine safety, noting that “no discussion of risk is allowed”. Later, he says that the pejorative label of “anti-vaxxer” is used to stifle legitimate debate over vaccines. Malone and McCullough both warn that mRNA vaccines, such as Pfizer and Moderna, can cause myocarditis, especially in young men who are at low risk from the virus. Given these and other alleged risks, they warn against recommending — or requiring — boosters for the general population.

I believe they are correct in these sentiments. In April 2021, the first reports of myocarditis were noted in Israel, with the majority of cases occurring in young men who had recently received an mRNA vaccine. Since then, the evidence for vaccine-related myocarditis has grown. We know now that boys are more likely to be affected than girls. We know that Moderna has higher rates than Pfizer. We know that dose two causes more myocarditis than dose one. The precise estimate of risk is now thought to be between 1 in 3,000 to 6,000 for males in the target range (roughly age 12 to 30), and researchers have shown that the CDC’s method to study this underestimates myocarditis risk.

Such concerns are not limited to the fringe. Marion Gruber and Phil Krause, the former director and deputy director, respectively, at the US Food and Drug Administration, resigned last autumn over White House pressure to green-light boosters. Paul Offit, a prominent vaccine advocate and the director of vaccine communication at the Children’s Hospital of Philadelphia, recently told the Atlantic that he advised his own 20-something son not to get boosted. Other nations are taking the myocarditis concern seriously, too. Several have banned or discouraged the use of Moderna in young men. Others advise two doses spaced further apart, and some have held off on a second dose entirely for younger age groups.

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It is perfectly valid to question the wisdom of boosters, at least in young people, though I do think they are beneficial for older and more vulnerable people. Like Malone, I have seen researchers smeared as “anti-vaxxers” for simply suggesting that myocarditis is a real safety concern, or that we don’t know the optimal duration and dosing strategy of vaccination, particularly for young and healthy people and those who have recovered from infection. Malone and Rogan are correct that the media dismisses concerns over myocarditis by claiming that most cases are “mild”, when in fact it is too early for us to know the full effects.  And I agree that this is an area of live debate that has not been adequately covered by the media.

Claim: Vaccines have lots of other dangerous side effects

At other points in his interview, Malone alludes to many potential side effects of vaccination, claiming it can result in seizure and paralysis, and that the menstrual irregularities associated with the vaccine suggest it is a “major threat to reproductive health” for women. He suggests that vaccination can suppress T cells, raising the risk of unusual cancers.

To date, I have seen no evidence to support any of these claims, and I believe it is a mistake to raise them. First, they are irresponsible — Malone’s rhetoric verges on fear-mongering — and second, they distract from his legitimate points on myocarditis in young men.

McCullough suggests that vaccine-related deaths and injuries in the US are severely underreported by the Vaccine Adverse Event Reporting System (VAERS). While I agree that there are problems with VAERS, I find it difficult to believe the numbers McCullough offers of 45,000 dead and 1 million injured. Here is why.

VAERS is a voluntary collection network that is prone to two types of biases. First, it may undercount vaccine-related events because providers did not recognise them or lacked motivation to report them. But it can also overcount them. Bad things can happen after vaccination, such as heart attack, that are entirely coincidental but that still might be reported.

Trying to find safety signals due to vaccination requires comparison against base rates, or how many events are expected to occur without vaccination. Even very unusual events, such as the blood clots that happened after the Johnson & Johnson vaccine, stand out fast. Similarly, elevated myocarditis rates in young men, especially after dose two of Moderna, jump out of the data.

Death signals are trickier to parse, and require knowledge of the ages and medical problems of people getting vaccinated. Even then, they must be weighed against data that shows vaccines reduce a big cause of death — death from Covid-19. For these reasons, I think it is premature and misleading to talk suggest that the vaccine caused 45,000 deaths. If McCullough wishes to make this case, the best forum would a scholarly publication, where other researchers can examine and critique his methodology.

Claim: US vaccine policy ignores the science on natural immunity

Malone and McCullough both make valid points that vaccine policy has not accommodated scientific knowledge of natural immunity. Should vaccines be required for people who have already been infected with Covid? If a healthy young person had one dose of the vaccine and then got Omicron, do they need a second? What if a person had two doses and Omicron — should they need to receive a booster, as some workplaces now require? These are open and legitimate questions.

Proponents of vaccines and boosters for those with a prior Covid-19 infection often point to antibody titers — blood tests showing that a recently vaccinated or boosted person has higher levels of Covid-19 antibodies than someone with natural immunity. But this is not persuasive.

Antibodies are a means to a clinical end, which is preventing someone from getting re-infected, becoming very sick, becoming hospitalised, or dying. Antibodies, especially in the short term, are bound to be higher the more you dose an individual, but the scientific burden is to show that these doses further improve the clinical endpoint in randomised studies. This burden has not yet been met.

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Yet, here too, Malone goes over the top. He and Rogan refer to “multiple studies” showing that those who get vaccinated after being infected with Covid are at a two-to four-times greater risk of having an adverse reaction to the vaccine; later, Malone describes Rogan’s friends who are encouraging him to get vaccinated as asking Rogan to put himself “at higher risk” and “take more risk for your health in order to join their club”. There is a dialogue to be had about whether Rogan might benefit from zero, one, or two doses, but the overall risks of vaccination remain low, particularly for a 54-year-old man such as Rogan.

At times, Malone refers to accurate studies, but I worry the audience draws the wrong inference. Malone, for instance, claims that natural immunity is six to 13 times more effective than the vaccine at preventing hospitalisation and 27 times more effective against developing symptomatic disease. I assume he is referring to this August 2021 study from Israel. This study does indeed suggest that natural immunity is more protective than vaccines against the Delta variant, though it also suggests that natural immunity plus a single vaccine dose is more protective than natural immunity alone.

While this has implications for the number of doses a Covid-19 survivor might consider getting, it should not be misconstrued to mean that infection is preferable to vaccination for an adult who has yet to experience either. Vaccination is almost surely preferable for most un-immune adults.

At one point in his interview, Malone says: “Think twice about giving these jabs to your kids.” While I can understand how many will be angered by this statement, the truth is other nations, such as the United Kingdom, are thinking twice — at least for healthy 5 to 11-year-olds, the group with the lowest risk of bad outcomes from Covid. As of this moment, the UK’s advisory panel has said that only 5 to 11-year-olds with comorbidities should get vaccinated.

Claim: Effective early treatments, including hydroxychloroquine and ivermectin, are being suppressed

McCullough and Malone are proponents of early treatment for Covid-19, specifically with ivermectin and hydroxychloroquine. Both allege that public health authorities have intentionally suppressed the use of these drugs. McCullough states that early in the pandemic, “there was no focus on sick patients”, while Malone speculates that hospitals don’t want early treatments because they profit when people are hospitalised and claims that “probably half a million excess deaths” have happened in the United States through the intentional blockade of early treatments.

These are entirely false and insulting allegations, and Malone’s in particular are flat-out conspiratorial. Academic hospitals attempted all sorts of disparate treatment protocols in the hopes of helping sick patients. Many physicians did not wait for randomised control trials — the gold standard of medicine — to act; they simply acted. In fact, a Harvard hospital recommended hydroxychloroquine prior to randomised data.

The problem was not that there was no appetite for early treatment. The problem was that when the randomised trial data came in, they suggested the drugs favored by Malone and McCullough were ineffective. A pooled analysis of all such studies by Axfors and colleagues suggests patients treated with chloroquine and hydroxychloroquine had increased risk of death.

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And ivermectin has not shown persuasive evidence of benefit in randomised trials to date. Of course, a randomised trial cannot prove that a therapy can never work under any circumstances, just as you cannot prove that Santa Claus doesn’t exist. But the burden is on proponents to show when and how their therapy helps, and they have not met it.

Rogan, Malone and McCullough are wrong to claim that ivermectin and hydroxychloroquine are known to be secretly effective, but they are correct that these drugs have been unfairly demonised. The truth is that they are neither particularly dangerous nor effective. The media labelling ivermectin a “horse drug” or “horse dewormer” was particularly absurd. Ivermectin is a well-known drug taken by humans all over the world.

Claim: Public debate over Covid-19 is often unfairly censored

Malone, Rogan, and McCullough are all correct on one topic: there is an effort to suppress information and censor debate on social media. The clearest example is that for more than a year, Facebook banned all discussion of the lab-leak hypothesis, until articles by Nicholson Baker, Nicholas Wade, and Donald McNeil broke the dam. This was a remarkable suppression of free speech.

Previously, I investigated the mechanism by which Facebook polices pandemic “misinformation” through third-party investigators. I found, in several cases, that the expert designated to fact-check a claim had already stated their opinion on it prior to being selected. This is a deeply problematic mechanism, as the person who selects the fact-checkers can scour the Internet to an expert who agrees with them, and there is no external review, appeal or oversight.

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Malone discusses a controversial October 2020 email from National Institutes of Health director Francis Collins to Anthony Fauci in response to the Great Barrington Declaration. In it, Collins called three of the declaration’s authors “fringe” epidemiologists and demanded a “quick and devastating published take down of its premises”. I completely agree this was problematic.

As I have argued elsewhere, 2020 was a time of deep uncertainty about the science surrounding Covid-19 and the appropriate policy response to the pandemic. Collins is not an epidemiologist, and he has no standing to decide what counts as a “fringe” view within that field. As NIH director, his job is to foster dialogue among scientists and acknowledge uncertainty. Instead, he attempted to suppress legitimate debate with petty, ad hominem attacks.

***

The efforts to censor Malone and McCullough have massively backfired, with both men gaining prominence and publicity from the attempts to shut down their speech. More generally, I strongly disagree with efforts to censor scientists, even if they are incorrect, and no matter the implications of their words, as I believe the harms of censorship far exceed any short-term gains.

One problem, which has been on full display in this controversy, is that censorship may draw more attention to incorrect ideas. Another is that in the middle of any crisis, the answers to many scientific and policy questions will be uncertain. Disagreement on these questions is natural, and attempts to suffocate “harmful” speech run the risk of stifling critical debates, including by silencing third parties who may have important contributions but who fear the professional or reputational consequences of speaking up.

Perhaps the most serious objection to censorship is that the censors themselves are not fit for the task. Censors are unaccountable. They may be biased, misinformed or undereducated. They may lack perspective. In short, they are as fallible as the people they are trying censor. This is especially true in science, where, as history shows us, consensus views can turn out to be false, while controversial or heretical ideas can be vindicated.

Finally, in the modern world, where the censor is so often a giant technology company, there is tremendous potential for abuse. The same tools used to suppress scientific “misinformation” may someday be used to solidify political power and stifle dissent.

Today, little has changed. The NHS’s looming vaccine mandate — requiring that employees are vaccinated against Covid before April — has inspired grim warnings about the debilitating impact of an exodus of staff: the effect on waiting times, on overworked doctors and on vulnerable patients. But what’s been ignored is the disproportionate number of women it could affect.

At its heart, of course, this is simply business as usual: women are no strangers to coercion in healthcare, and the NHS’s relationship with its predominantly female workforce has long been problematic. While women make up 76.7% of the NHS’s 1.3 million employees, only 45% of doctors are female; despite recruitment drives, fewer than 30% of surgeons are women, while two-thirds of consultants are male. No doubt that goes some way to explaining why male doctors earn 20% more than their female counterparts. Figures show that, out of 212 NHS trusts, 198 have a gender pay gap and in 125 the gap is worsening.

But this isn’t simply a money issue: the NHS also has a dismal record on employment rights, discrimination and abuse of its staff. In just one year, nearly 1 in 10 of Unison’s NHS members reported rape, sexual abuse or harassment at work, with 1 in 3 describing such incidents as a “frequent” or “regular” occurrence. Only 15% felt their case was dealt with adequately.

Nor is it just female employees who are affected by the sexism of the NHS. Female patients regularly face discrimination, with their concerns often dismissed as “women’s problems”. For instance, studies have shown how healthcare staff routinely underestimate and undertreat the pain reported by female patients, largely thanks to institutionalised stereotypes about women being oversensitive or over dramatic. Only last year, a Health Minister was forced to admit that “women are not listened to” by the NHS.

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Yet in light of multiple reports of systematic failings in maternity care, including harrowing descriptions of how thousands of women have been subjected to “birth rape” — doctors performing vaginal examinations on women without their consent — it’s hard not to conclude that the problem runs deeper than women simply not “being listened to”. In fact, as we’ve seen during lockdown, the medical establishment seems to have all but forgotten that women exist. At the start of the pandemic, a UN report warned that Covid lockdowns could have “serious consequences to women’s health”, including disruption to reproductive and sexual health services, as well as services to combat gender-based violence. But even its authors couldn’t have foreseen the horror of women being forced to miscarry and give birth on their own, while their partners waited in car parks.

Similarly cruel scenarios played out in the realm of contraceptive rights. For the past two years, many providers of contraception have refused to meet women face to face, even if it meant a woman was unable to remove her interuterine devices (IUDs). As with all battles over reproductive choice, this only pushed the problem underground: this time in the form of grim TikTok videos teaching women how to pull IUDs from their uterus at home.

But such sexism was present in almost every aspect of Covid response, up to and including the manufacturing of vaccines. Male bodies are assumed to be the “default” during clinical trials; even on the rare occasions, such as the Covid vaccine trials, when women are included, questions tend not to be asked about specifically female concerns, such as changes in menstruation.

It was hardly surprising, then, that reports of menstrual irregularities following the jabs were downplayed for months, despite tens of thousands of women reporting changes. Rather than being listed as a side effect or investigated promptly, such concerns were often belittled and diminished. For many women, the only available information they had on the menstrual side effects was via social media — hardly a comforting (or reliable) source of information.

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It is only now, more than a year after the vaccine rollout began, that researchers have begun looking at the extent and cause of the link. It is likely that the changes to menstrual cycles are benign; a number of possible causes have been suggested, with some also occurring with other vaccinations.

But this comes as scant consolation for the women who’ve experienced unexpected side effects and have, yet again, had to fight to be heard. Distrust can be infectious, and many women have been left feeling understandably uncertain about the ability and willingness of healthcare providers to listen to their concerns and to research the effects of the vaccine on their bodies. Is it any wonder that young women remain one of the cohorts most likely to refuse the jab?

So it seems natural that the NHS vaccine mandate would strike a particular chord with female staff. The policy might not be intrinsically misogynistic — after all, it will affect male staff too — but it’s not inconceivable that female staff will feel particularly alienated. Women possess an already precarious grip on their own bodily autonomy, and for many, their relationship with the NHS, both as patients and as employees, is beset with mistrust and coercion. The constant battle to try and retain control of their own healthcare decisions and the encroaching powerlessness they feel has now begun to even seep into their career.

And yet, it seems peculiar that the same people who pride themselves on supporting a woman’s right to choose in other settings — such as abortion — find no issue in coercively demanding retrospective changes to contracts that further strip the rights of its predominantly female workforce. The progressive emphasis on the right to choose, it seems, only applies if you decide to make the right choice.

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Whether or not the NHS vaccine mandate goes ahead — and it seems increasingly doubtful that an overstretched NHS can afford to sack 70,000 employees — for many women who feel deeply resentful of the mandate, the damage has already been done. To them it must seem galling that, after demanding so much from staff, including expecting them to work in Covid-ridden hospitals with minimal protection, the NHS now feels entitled to discard them for the sin of attempting to cling on to their bodily autonomy.

Even if the threat is removed, the continuing willingness of the NHS to disregard women, now with the encouragement of those who were once allies, will be the final straw for many. As its female staff are now discovering, the NHS remains institutionally sexist — and it will take more than a few rainbows and ‘claps for carers’ to cure it.

Covid-19 doesn’t discriminate, or at least does so on the basis of age and health conditions rather than politics. Why, then, have views on how we should manage it — and particularly how we should treat vaccination — become so heartless, judgemental and politically tribal?

We have a milder case of it in Britain than some countries. But there’s a correlation between (broadly Remain-affiliated) liberal urbanites and the new hygiene-authoritarianism. This has been emerging for a while: back in 2020 the research group UK In A Changing Europe noted that while “it’s not the case that all Leavers are lockdown sceptics” nonetheless “it’s pretty much the case that all lockdown sceptics are Leavers”. More recently, 99 Tories voted against Covid passes before Christmas, compared to 22 in Labour.

In the US, analogous (and angrier) patterns emerge. Free-wheeling, mask-optional Republican Florida is pitted against Democrat California, which mandates indoor mask-wearing, including for all children over the age of two, and announced in October that vaccination would become mandatory for in-person school attendance. Vaccination is already mandatory for employment in the police force and healthcare on public-health grounds.

More interesting than arguing for either one side or the other, though, is what the arguments reveal about our ongoing political realignment. In particular, it sounds the death-knell for a relatively mild-mannered twentieth-century version of progressivism characterised by a desire to ensure the world is fair, and to avoid harming others.

What’s emerging to replace it is more bellicose, more ruthless — and increasingly religious. So-called “secular liberalism” has, in other words, stopped pretending to be secular. It’s been received opinion since the end of World War II that authoritarian religiosity was exclusive to the Right. Theodor Adorno’s 1950 The Authoritarian Personality cited batteries of research to argue that fascism, and the Holocaust, could be explained by the prevalence of an ‘Authoritarian Personality Type’. This ‘personality type’, he argued, was characterised by blind allegiance to conventional beliefs about right and wrong, respect for submission to acknowledged authority, and a tendency to project one’s own feelings of inadequacy, rage and fear onto a scapegoated group.

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In turn, Adorno’s conviction that these behaviours are characteristic of the Right crops up again in a far more recent, but also influential book: Jonathan Haidt’s 2012 The Righteous Mind. Here, Haidt argued that the reason ‘liberals’ and ‘conservatives’ routinely misunderstand one another is that there exist five ‘moral foundations’ on which we all base our political views: care/harm, fairness/cheating, loyalty/betrayal, authority/subversion and sanctity/degradation. Haidt argues that liberals are only interested in care/harm and fairness/cheating, while the Right is attuned to all five foundations.

Does this apply in the Covid debate? Certainly at the surface, calls for coercive measures tend to start off with arguments about protecting people. For example, Scottish public health adviser Jason Leitch told BBC Good Morning Scotland that the aim of Covid passes was “to allow people to attend events and environments safely”.

At the core of this argument is the not unreasonable point that when it comes to physical wellbeing, we can’t be wholly individualistic. The moment you get ill or injure yourself as a consequence of having taken some risk (for example after breaking your leg skiing), you need care and are thus, by definition, no longer taking sole responsibility for your wellbeing.

Does this mean vaxx authoritarians have a point? Hiltzik points out that mandates have long existed on other health grounds where risk-taking imposes costs on wider society, such as seatbelt-wearing, smoking, or drink-driving. Insisting on the individual right to choose whether or not to be vaccinated therefore “places a perverse conception of individual “freedom” in opposition to the communal interest”.

We might simply shrug, and say this is just another data point for that 2021 study which showed that contra Adorno, there is abundant evidence for authoritarianism among left-liberals. Certainly, calls from self-identified progressives to “crush the resistance” to vaccines by making the lives of the unvaccinated a “total misery” might challenge the idea that the ‘authoritarian personality’ can only flourish on the Right.

But it’s the character and chosen terrain of the emerging progressive authoritarianism that’s distinctive. For it’s not merely a matter of progressives waking up to the possibility that they, too, may use coercive measures to pursue their chosen ends. It’s also the nature of those ends. Consider, for example, the fact that in 2020 fentanyl killed more Californians than Covid. But unlike Covid, the drug epidemic inspired few coercive measures — only safe injection sites, billboards encouraging users to take drugs with friends or programmes that pay them not to use.

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If avoiding harm justified coercive interventions, surely we’d have seen more of them in Californian drug policy. But their absence in the case of drug abuse, and fervent application in the case of virus control, suggests there’s a different motive at work than the prevention of harm.

In an Evening Standard piece last week, former editor Emily Sheffield argued that our capital city’s unvaccinated residents should “pay with their freedoms, not ours”. And on social media, we saw the same punitive ferocity recently when one American mother reported that when her son tested positive she didn’t just quarantine him but also “took the X-Box”, a measure more consistent with chastisement than infection control. The only reason she didn’t also confiscate the phone, she says, “is so he can text for food and water”.

Recently, we’ve had news that Omicron appears to be more infectious but milder, and research that indicates vaccination does very little to prevent transmission of the virus. So rationally, none of these vengeful attitudes make much sense. What’s going on?

The recent furore over the entry into Australia of (unvaccinated) tennis superstar Novak Djokovic offers a clue. One Melbourne journalist tweeted about how, since he was allowed into the country, fans “won’t want to come” to the tennis matches. Objectively, one single unvaccinated tennis player would make a negligible difference to someone’s risk of catching Covid; the only possible reason someone might skip the Australian Open because of Djokovic’s presence is if the fear was of a subtler, more metaphysical contagion.

In the Bay of Kells, in Ireland’s County Kerry, there’s a small secret graveyard that until recently was overgrown with brambles and largely forgotten. It was a place where grieving parents buried babies who died before they could be baptised — for the unbaptised were spiritually unclean, and therefore not permitted burial on a churchyard’s consecrated ground.

In Eugenics and Other Evils (1922), GK Chesterton observed that “it seems quite natural to our politicians to enforce vaccination; and it would seem to them madness to enforce baptism”. Today the prescience of Chesterton’s remark is clear, as is the convergence in terms of social meaning between vaccination and baptism.

The growing tendency for ‘the vaccinated’ to treat ‘the unvaccinated’ as other or impure recalls the willingness of an earlier age to deny others simple forms of inclusion on the basis of baptism. Never mind what studies say about the efficacy of Covid vaccination in protecting us from severe illness (which evidence strongly suggests it does) or mitigating further infection (perhaps more debatable). Increasingly, vaccination carries a social meaning as well as a medical one. It’s a ritual infusion — albeit via injection, not anointment — of sacred liquid, whose application confers freedom from spiritual taint.

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Perhaps it’s just that the correlation between left-liberalism and secularism in both Britain and America has left progressives especially hungry for something to fill the God-shaped hole, and the yearning for measures that speak to the fundamental moral instinct Haidt calls ‘sanctity/degradation’. This might help account for the ongoing, fruitless, rationally debunked but nonetheless persistent obsession Tom Chivers recently noted, with disinfecting surfaces ‘because of Covid’ despite mounting evidence that the virus is airborne.

An increasingly post-Christian West, then, finds itself grabbing gratefully onto Covid hygiene theatre, in pursuit of a purity more metaphysical than bacterial. And as we’ve now spent two years clapping for carers, sharing dancing nurse videos, and creating window iconography and even altar-cloths to venerate medical professionals, it’s probably a bit late to rein this blossoming spiritualisation of hygiene.

For to imagine we can do so would be to say we still live in a world of reasoned debate. And when ‘experts’ offer ‘evidence’ to counter rumours of Covid propagandising, only to be met with derisive accusations of using fact-checking to propagandise, we might as well abandon ‘reasoned debate’ altogether and, in the words of Edmund Blackadder, stick two pencils up our noses and wear underpants on our heads.

Or, alternatively, start praying. Progressives spent half of the twentieth century telling us that this was pointless: the search for metaphysical purity was low-status, ‘authoritarian’ or simply obsolete, and reason replaced all that. Their children, though, have discovered that purification rituals don’t have to be confined to the individualistic realm of ‘juice cleanses’ or ‘clean eating’, but can be imposed on entire societies.

We can expect them to go on chasing that high. And meanwhile, it seems enough of the rest of us like having something to worship, and a suitable group of sinners to despise. If you don’t already pray, you might as well start; we all once again live in a religious world.

Perhaps the least interesting thing about this talented young couple is that they are unvaccinated against Covid-19. When I meet them at their house in a wooded suburb outside Vienna, I am almost embarrassed to ask about it. But they carefully explain how, for reasons of mistrust, caution and, as they see it, integrity, they have decided not to take the Covid vaccine — and how this fact is suddenly defining their whole lives.

Since Monday, unvaccinated Austrians are not allowed to leave their homes except to go to work, to buy essential supplies, or to take exercise: it’s the world’s first “lockdown for the unvaccinated”. It was introduced in response to rapidly rising cases and a lack of excess capacity in Austrian hospitals. “It is not a recommendation, but an order,” announced the Interior Minister Karl Nehammer at a press conference. “Every citizen should know that they will be checked by the police.”

It is, essentially, a ratcheting up of the regime of vaccine passports that exists already in many countries across Europe, whereby unvaccinated people are already excluded from restaurants, museums and theatres. But to place a minority of the population under partial house arrest does seem to cross a new line.

The Brazilian-born Mia has already had Covid and, in the Austrian “2G” system, proof of recovery affords you the same status as if you had been vaccinated — albeit for a period of six months. So, for now at least, she is allowed out and about. Chris is stuck at home. He describes it as a “brainfuck”. Attempting to remain philosophical about it, he explains how he tries to tune out the relentless fear coming out of the TV and keep control of his own mental state. “I don’t want to be dependent on these kind of things to be happy.” But the sense of alienation and unease is palpable. What will the future look like? He is supposed to be performing in Paris before Christmas; who knows if he will get there.

Back in the old town, alongside the fancy boutiques of the Kärntner Straße, it’s a very different world. Affluent shoppers are out and about in the crisp November air, and they are more than happy to share their views with us.

“I think it comes much too late,” says one woman. “They’re crazy. All the trouble we have is due to those people that believe in, I don’t know, that the earth is flat… If the majority of society depends on idiots, then they can’t be helped and it’s the end of society!”

Her view is typical — there is very little sympathy here, and a good deal of frustration. Only a few voices take the opposing view, and they tend to be passers-through more than the wealthy locals; the doormen and deliverymen we try to talk to just shake their heads. One man simply describes the latest lockdown as “bullshit”.

What is striking is that very few think the policy will actually work. Covid levels per capita have shot up in recent weeks, and Austria now has one of the highest case rates in Europe. The rationale behind the lockdown is that it will increase the level of vaccination (low for a Western European country at 65%); but even supporters of the move predict that it will be followed up by more universal measures soon enough. The Austrian Chancellor Alexander Schallenberg openly explains that the policy is a heavy-handed “nudge”: “My aim is very clear: to get the unvaccinated to get vaccinated, not to lock up the unvaccinated,” he told ORF radio station.

On a practical level, though, the logic of the new rules does not withstand much scrutiny: unvaccinated workers are permitted to travel to and from work, and they work disproportionately within the hospitality sector. This means that they are currently allowed into restaurants and bars to serve, but not to consume. In any case, if there were only vaccinated people in a venue, that wouldn’t necessarily make it Covid-free. Many places require daily testing for non-vaccinated staff, yet not for the vaccinated, leading to the odd situation where the unvaccinated are “safer” than the patrons.

It feels like a bit of a stand-off. The vaccine issue has become a show of strength, a test of principles. As Ivan Krastev, a political scientist at Vienna’s Institute for Human Sciences, tells me: “When some of the anti-vaccine people said, ‘we are ready to defend our freedoms’, the basic message of the Government was, ‘Okay, let’s see what price you are ready to pay for them.’ The idea of this measure is to make people uncomfortable.”

One peculiar feature of this dramatic new measure is the silence of the liberals. Why are the bien-pensant Viennese, usually so concerned with the rights of minorities, so relaxed about a measure that in other contexts would seem outrageously draconian?

Somersaults of logic have been performed to assert that the policy is more liberal than the alternatives. For one thing, they say, it stops short of an actual vaccine mandate, which just about keeps alive the notion of personal choice; for the majority, it offers the hope of avoiding another lockdown, so seems to them to be a lesser intervention. And, unlike in neighbouring Italy, the unvaccinated can still work, with tests being provided at public expense. In Austria, across the West, there is no one left to assert the rights, or even try to understand the motivations of this despised minority, the anti-vaxxers. They are the new deplorables.

To interrogate this seeming contradiction, I visit Professor Manfred Nowak, one of Europe’s pre-eminent human rights lawyers, at the University of Applied Arts in Vienna. He has dedicated his whole life to the upholding of human rights and the defence of oppressed minorities against arbitrary detention and mistreatment. Former Special Rapporteur to the UN on Torture, current Secretary-General of the European Campus of Human Rights, activist against Guantanamo Bay, UN Independent Expert on Children Deprived of Liberty — the list continues. I expect him to be a little concerned about the potential direction of travel in his home country of Austria.

He wasn’t. He thinks the policy doesn’t go far enough. “From a human rights perspective, you always have to balance the obligation to protect the right to life, the right to health, with interfering with other rights such as personal liberty,” he tells me.

He wants to make vaccination mandatory, with refusal equivalent to a traffic offence, resulting in a fine rather than a criminal record. He is also worried about how this partial lockdown might affect an already divided society — but he is unconcerned about the human rights or civil liberties implications. Do you not even have a twinge of anxiety about the shift in democratic norms, or whether such discriminatory policy might be applied in different settings, I ask? “No, not really,” he says, with admirable candour.

The final component in this lockdown mix is, of course, politics. In most European countries there are no mainstream political parties that could be described as “anti-vaccine”, but Austria has the populist, right-wing Freedom Party, which was part of the coalition government until 2019; it has made vaccination choice a central issue. The FPÖ organises regular rallies in cities around Austria, and its new leader Herbert Kickl is gaining popularity by condemning Covid policies as “corona fascism”.

Having thus turned vaccine hesitancy into a “right-wing” political campaign, Kickl has managed to put a face to the dissenting minority — and it’s not one that many people like. As a result, instead of thinking of the unvaccinated as a vulnerable, if misguided, group and one worthy of protection and respect, they have become viewed as an extreme political enemy who must be defeated.

It would be hard to think of anyone less threatening or extreme than Mia and Chris. Alternative, certainly; anti-establishment, yes. But good people who in any healthy, confident culture would be cherished and celebrated. Allowing them, and millions like them, to drift into a caste of untouchables, separated from the mainstream, all for the sake of a marginal gain against a virus that is rapidly becoming endemic, may prove to be a grave miscalculation with effects that will be felt for years to come.

This piece was originally published in November.

At one stage he even says: “When speaking to a contemptible idiot who is kind of evil, don’t call them a contemptible idiot who is kind of evil! Many contemptible idiots find that language insulting.” But he continues to do it, and frequently segues into lengthy digressions about how stupid and harmful the idiots’ beliefs are. Presumably you would not feel that the author had really taken his own advice on board

This is very much how I feel about How to Talk to A Science Denier, by the Harvard philosopher Lee McIntyre.

McIntyre wants to help us change people’s minds. Specifically, to help us change the minds of these strange, incomprehensible people called “science deniers”. He addresses five main groups of “deniers”: flat earthers; climate deniers; anti-vaxxers; GMO sceptics; and Covid deniers.

This is, on the face of it, an important project. It’s a truism that the world is polarised, and our sense of shared reality is under attack. If there is some way of learning how to talk across difference, and to persuade without attacking, that might go a long way to bridging our various divides, not just the five he discusses.

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The framing is that McIntyre goes and meets representatives of these groups and tries to persuade them out of their wrong beliefs. He goes armed with social-psychology research about how best to persuade people. His big trick (which I think is a good, if limited, one) is asking: what evidence would it take to make you change your mind?

But the whole book is premised on one idea: McIntyre is right, and the people he is “talking to” are wrong. 

And it’s true that all five groups are wrong, or at least their central claims are. The earth is in fact an oblate spheroid; the climate is warming, due to human influence, and will likely have severe negative impacts; vaccines work; GMOs are safe; and Covid is real.

The trouble is that by using these groups, McIntyre is playing on easy mode. When your example of a “science denier” is a literal flat-earther, it’s easy to say “look over there at the crazy deniers”.

Even with climate change scepticism, sure, there are people who literally don’t believe that anthropogenic greenhouse gases are warming the planet. But those people are relatively rare. People who believe that anthropogenic greenhouse gases are warming the planet, but that the emissions are going to be hard to stop because of economic growth in the developing world and it would make more sense to concentrate on adaptation rather than mitigation, are much more common. Are they “deniers”? Certainly they’re often called deniers. But McIntyre himself acknowledges that China is by far the largest emitter of greenhouse gases and that the IPCC says the sweeping global changes required to cut emissions sufficiently to avoid a 1.5°C warming are unprecedented.

McIntyre constantly wants to make a clean distinction between “science deniers” and non-deniers. So, for instance, he says that there are five “common reasoning errors made by all science deniers” [my emphasis]. They are: cherrypicking, a belief in conspiracy theories, a reliance on fake experts, illogical reasoning and an insistence that science must be perfect. If you don’t make all five of those errors, you’re not an official McIntyre-accredited science denier.

Hang on, though. A “belief in conspiracy theories”? McIntyre spends a lot of time talking about the tobacco firms who manufactured doubt in the smoking/lung cancer link, and the oil firms who did the same with the fossil fuel/climate change link. He says that the spread of Covid denialism through the US government was driven by Republican desire to keep the economy open and win the election. Aren’t these conspiracy theories?

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Ah, but for McIntyre these aren’t conspiracy theories, they’re conspiracies. The distinction is “between actual conspiracies (for which there should be some evidence) and conspiracy theories (which customarily have no credible evidence).”

So, since some anti-vaxx conspiracy theories like the polio vaccine giving children polio, or the CIA using fake vaccination stations to take people’s DNA, are true, does that mean anti-vaxxers don’t believe in “conspiracy theories” but “conspiracies”?

Obviously not. But the point is that there’s not some clear line between “real conspiracies” and “conspiracy theories”. When Alex Jones says that chemicals in the water are turning frogs gay, he’s referring to real claims that endocrine disruptors are affecting sexual development in lots of animals. It’s not easy to draw a line between real and fake, evidence-based and not evidence-based.

I think the basic problem is that McIntyre is a Popperian. That is, in hugely oversimplified terms, he believes that no amount of evidence can confirm a theory: but evidence can falsify it. “If we find only evidence that fits our theory, then it might be true,” he writes. “But if we find any evidence that disconfirms our theory, it must be ruled out.” 

I, on the other hand, am a Bayesian. I have some prior belief and I assign some level of probability to it: “climate change is real and dangerous”: 90%; “the world is flat”, 0.1%. And then each new piece of evidence shifts my belief a little: if next year NASA say “we got new photos in, looks like Earth is sitting on the back of a turtle”, then I’ll upgrade my belief in a flat earth to, I dunno, 1.5% (but also upgrade my belief in there being mad people at NASA to 95%).

So I don’t need to draw a bright line between “denial” and “reality”. I can say: “I think it’s likely that tobacco firms conspired over lung cancer, but I think it’s pretty unlikely that NASA faked the moon landings.” And I can update my beliefs as new evidence comes in. I don’t have to “rule anything out”, I can simply downgrade how likely it is.

McIntyre, though, is stuck with two categories: things that might be true; and things which have been “disconfirmed”. If you believe things that have been disconfirmed, then you must be a “denier”. And so he needs to find ways of explaining why these “deniers” are so different from the rest of us. 

He has various ideas about “inflated self-confidence, narcissism, or low self-esteem”. But if you reject the idea that there are two groups of people, “deniers” and “non-deniers”, then you can avoid the need to explain it at all, beyond saying “some people are better than others at working out what’s true”. 

But we’re not just here for his epistemology: we’re here for a masterclass in how to persuade people out of false beliefs. Over the course of the book he meets various people — the flat earthers; two coal miners; a couple of hippyish friends of his — and tries to talk to them about their beliefs, using the methods he has learnt. His solution is to listen, to be respectful, to meet people face to face, and to do so over several meetings. Does his approach work?

In short: no. Hilariously, both of the coal miners he meets cheerfully accept the reality of climate change, but say that the economic value is worth the potential damage to the climate. His first hippyish friend is entirely pro-vax and only slightly GMO-sceptical; the other one is anti-GMO but on anti-corporate grounds rather than safety ones. 

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So he falls at the first hurdle: he not only doesn’t convince anyone, he doesn’t meet anyone who unambiguously disagrees with him, except the flat earthers. (He also struggles to be respectful, at least in the book itself. There’s an astonishing line on p77 in which he says “When speaking to them, we should remember that it is an insult to use the word ‘anti-vaxxer.’” There are 109 uses of the term “anti-vaxx” in the book. Occasionally he remembers and says how important it is that we listen and pay attention, then he immediately reverts to calling, say, Covid scepticism “ridiculous conspiracy theories and partisan nonsense”.)

But there’s a bigger problem. McIntyre’s big question, as mentioned, is asking: What evidence would it take to change your mind? But at no point does McIntyre ever ask himself what it would take to change his mind. 

For instance: when he was talking to the Pennsylvania coal miners, he accepted that they were just trying to feed their families. I assume he’d also acknowledge that Chinese coal mining is allowing that country to get richer and improve its citizens’ way of life. But I don’t think I’m misrepresenting him when I say that he thinks coal mining is a disaster.

When he talks to a friend of his about GMOs, though, that friend says that even though GMOs can save lives now (in the form of golden rice), they’ll cause disaster in the future. McIntyre says, OK, so the kids who can’t get the golden rice now, they’re just going to die? And his friend says yes. McIntyre says that’s easy for him to say, “because he had money and wouldn’t be one of the ones who suffered”.

The exact same question, though, can be asked about coal mining. Sure, McIntyre can say stop using coal, and it’ll help prevent future disasters. But it will also presumably mean some number of tens or hundreds of millions of Chinese people losing electric lights and functioning hospitals, and a smaller number of Pennsylvanians losing their jobs. McIntyre himself would be fine, except for somewhat higher electricity bills. 

Is the tradeoff worth it? McIntyre clearly thinks so (and I think I do too): but what would change his mind? I can tell you: I would update my beliefs significantly if you showed me a utilitarian calculation showing that more people would be harmed by ending coal mining than by continuing it. But McIntyre never asks himself the question. He is stuck on transmit, never on receive.

What’s sad is that he sometimes comes close. He recognises that beliefs are part of people’s identity, and that that makes it hard to change them – but again, applies the lesson only to the weird, wrong, other people, not to himself and people like him. The near-total lack of introspection renders the whole grand project largely meaningless. I am right, you are wrong, the only thing we need to discuss is how to make you realise how wrong you are. The idea of working together to establish a shared reality is hamstrung by his certainty that the reality that needs to be shared is his one.

It’s mainly a book designed to tell readers that people they already think are dumb are, in fact, dumb. It is, really, How to Talk to A Contemptible Idiot Who Is Kind of Evil.

This piece was originally published in August. 

Yet still it hurts. He’d also developed a moisture lesion, the start of a pressure sore, on his lower back — a consequence of not being repositioned regularly. Joseph’s death wasn’t caused by anything we did, but what we were unable to do. Had we had our full team of staff, I’m sure that we could have moved him more regularly and perhaps have prevented the lesion, which no doubt hastened his decline.

One of us could have sat with him and fed him, listened to him and held his hand. But we simply don’t have the time. The loss of one permanent member of staff a few weeks ago because she refused to be vaccinated, and the resulting reliance on agency staff, has had a devastating impact on the standard of care in our home. When it becomes compulsory next April for staff to be jabbed unless they have a medical exemption — at the moment care homes can decide their own policy — the situation will only deteriorate. Some estimates suggest more than 100,000 unvaccinated care home workers could be forced to quit.

Tonight’s shift is intensely busy, as always. We have 30 residents in our private care home in Sheffield. They all need feeding, washing and changing — and I don’t stop for a moment. It’s six hours into my shift when I’m stopped by my colleague Lisa. Grabbing my arm, she practically throws me into the room and onto the sofa and tells me to sit down for five minutes.

“You’ve not stopped,” she says. “Eat something!” I check the clock. She is right. It is almost 1.30am and I haven’t eaten a thing since I clocked on at 7pm. The only time I’ve stopped is to pop to the toilet and take a few sips of cold coffee. It is time for a quick break.

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I sit down to eat a sandwich, but a pile of paperwork sits on my desk and I can’t ignore it. As the senior member of staff on duty that night, it’s my responsibility to be in charge of the medications, so I might as well audit the drugs paperwork while I eat my dinner. It will save time later.

Barely five minutes have passed when another colleague, Sheila, asks for some help moving one of our residents, Anne, who has soiled herself. Many of our residents are incontinent and accidents are common, but it’s often impossible for care workers to move residents on their own, particularly when they’re only 5ft 2ins like Sheila. If we don’t clean and move them swiftly, bed sores can develop and that’s when residents are at risk of infections which can be fatal.

We find Anne in some discomfort and distress. Who knows how long she’s been lying in her mess? The staff tonight are spread even more thinly than usual: Clare, one of the younger members of the team, called in sick and no agency nurse has turned up. We clean Anne up and make her comfortable and she sleeps.

It’s a small consolation. I have worked in the care sector for ten years and while we’ve always been busy, it’s becoming clear that things are dangerously close to breaking point now. The pandemic was stressful but now we have the added burden of being short-staffed. Carly, the unvaccinated nurse, left a fortnight ago and we are unable to find a permanent replacement.

Carly is one of many careworkers who refuses to have the Covid vaccination. She’s not what you’d call an ‘anti-vaxxer’ because she’s had other vaccinations such as flu; she simply didn’t trust this one. She felt it hadn’t been tested rigorously enough and could harm her health in the future. I’ve no idea why. The rest of us tried to persuade her that it was safer — for the residents, herself and us. It felt like another level of protection.

But for whatever reason, Carly was adamant she didn’t want it. She initially thought the Government might perform a U-turn but when it became clear they wouldn’t, she looked for a new job. She’s working in a school now.

Of course, it’s a shame. She loved her job and she was good at it. But if she’s going to put others at risk, I can’t blame the Government for wanting her out.

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Yet her departure leaves us in the lurch and it makes me nervous about what lies ahead. Although I have a 36-hour-a-week contract, I’m regularly working up to 60 hours — all for £9.60 per hour and I’m exhausted. There’s no bonus for overtime. I suppose I should count my blessings. I know of another home that has lost four members of staff who refused to have the vaccine.

Once Anne is cleaned, I return to the staffroom to finish the drugs paperwork. I’m always terrified of making a mistake when I’m tired. Only two weeks ago I’d been so busy rushing from room to room that I’d forgotten to give someone his epilepsy drug. He ended up having a seizure and although we found him in time and he was fine, I felt dreadful. I held my hands up. I knew it was my fault. But with so few staff, mistakes are going to happen. Not long ago a lady fell in our lounge area and broke her hip. I watched it happen, almost in slow motion but I couldn’t get to her in time. Would that have happened if we’d had enough staff members? Possibly. But I couldn’t help but feel she might have been saved if someone had been able to keep a closer eye on her that day.

I thought things might improve when the pandemic started to subside this spring. Like many frontline workers, we had little in the way of PPE at first and had no idea what we were dealing with. Watching people deteriorate when they got the virus was horrific. I’ll never forget them desperately gasping for breath, as if they were drowning. We couldn’t do anything except prop them up on their side or turn them over onto their fronts. That seemed to help. But we lost seven of our residents and there would be many nights where I’d go home in tears.

The terror and paranoia of bringing the virus home has never really left me, even now. After my shift ended, I would undress at work and put my uniform in a tightly sealed bag to take home and boil wash. But when I got home, I was fearful that I still had the virus on me, so I’d strip off in the hallway and rush up to the shower to scrub myself clean before I went anywhere near my daughters. My husband would grab the bag, put the uniform in the washing machine and then thoroughly scrub his hands.

When the vaccine arrived, it felt like we’d been saved. I managed to have mine early in the year and I’ve now had all three. I don’t think anyone should be forced to have the vaccine, but I still can’t understand how people in our sector are reluctant to get jabbed. We have people in our homes in their 90s who are completely bedridden with dementia. Even though they’ve been vaccinated, they will be among the most vulnerable if this new Omicron variant takes hold, as it looks like it will.

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For the moment we’re relying on agency staff to plug the gaps but this is never ideal. Although they’re competent enough, the people who need the care can become upset if they see a face they don’t recognise. There’s no continuity of care. Last week, one of our more vocal residents got spooked. She doesn’t speak much English and was screaming and crying about the new staff member.

And so I feel pessimistic about the next few months. We are currently Covid-free in the home but I don’t expect that to last. Our residents have all been vaccinated so we know they have some level of protection and that’s reassuring. But it’s the ‘stepdown beds’ — people who arrive in the home for temporary care straight from the local hospital — who we constantly worry about. Although they are tested before they arrive and they’re put in isolation and tested again on Day 5 of their stay, we’re all worried that one of them will bring in the new variant.

Then what do we do? Will it mean another lockdown? Families unable to visit their loved ones again? Although I hope it doesn’t come to that, we are all expecting it.

Don’t get me wrong: I love this job and I don’t want to leave. But there have been many nights where I’ve come home — sometimes after 16 hours on my feet — and I wonder if it’s worth it. We are all scrambling. And things are only going to get worse.

Only 40% of the South African population has been jabbed against Covid — a slow take-up which is euphemistically described as “vaccine hesitancy”. It is anything but: it is enraged rejection.

There are a number of reasons why it is so hard to get South Africans to take the umjovu, the injection: appalling technical management of the outbreak, a prevailing scepticism towards science, wariness about the Government and a wide-spread apprehension by the poor and marginalised that this is at best another form of repression and at worst witchcraft. It is a dangerous brew in a country already in a state of great political, social and economic instability.

In common with the rest of the world, South African epidemiological estimates of fatalities at the outset of the coronavirus outbreak verged on the fantastical. Initial predictions were for between 87,000 and 350,000 fatalities in the first phase. There were 103. Two years later, with the virus in retreat, fatalities attributed to Covid (but by no means vouchsafed) are only now beginning to touch the lowest initial estimates.

Yet the South African Government imposed one of the longest and most severe lockdowns, supported by a baying national and social media. The decision has proved inappropriate in nature, premature in timing and catastrophic in impact. In a country where many depend on ad hoc daily or weekly subsistence wages, the sudden cessation of economic activity wreaked havoc amongst the poor and self-employed. A failing state was unable to deliver on its promise of subsidies, responsible policing or effective containment.

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It took more than a year for the first subsidies to individuals or small businesses to start coming through. And even then they were erratic, corruption-prone, inadequate, and according to many attested reports, distributed on a racially biased basis. Nearly a quarter of small businesses have gone to the wall and unemployment has rocketed.

An entire section of the population was effectively criminalised: in the first four months of the outbreak, 230,000 citizens, 0.4% of the population, were charged with infringement of the Disaster Regulations for breaking the restrictions, 311 of them policemen. All the charges were later dropped: the criminal justice system simply could not cope.

For every reported infection to the end June last year, seven citizens were arrested for breach of regulations; for every 100 infections, one police officer was arrested; and for every 1,200 infections there was a High Court urgent application. Seven people had been killed in heavy-handed enforcement.

When two doctors working in a Government hospital were forcibly interned in one of the state’s make-shift rural isolation camps, the High Court ordered they be allowed to self-isolate at home: it accepted the doctors’ deposition that they stood more chance of dying from the conditions of incarceration than from the virus.

Small surprise, then, that the general population, particularly the poor, headed for the hills. Take-up of the crucial HIV-Aids retroviral dropped from 95% to 30%; malaria medication showed the same path. Attendances for tuberculosis screenings dropped by two-thirds, while consultations with GPs were down 60% and tens of thousands of urgent surgery procedures were postponed for the coronavirus patients who never arrived.

Emergency procurement of personal equipment, meanwhile, opened the door to the corruption lurking in every interstice of the State. The  heir-presumptive to President Ramaphosa has resigned: a state investigatory agency accuses him of directing a R350 million (£16.6 million) Personal Protection Equipment account to friends. The Gauteng Health Department, industrial heartland of the nation, is embroiled in a R560 million (£26.5 million) fraud inquiry. The female whistle-blower was assassinated within days of the inquiry’s launch.

The begging question, whether President Ramaphosa, a decent man, is presiding over a ruling party in the throes of a Robert Kennedy versus The Mob has at least been definitively answered.

At the same time, a public service already perilously compromised by patronage, corruption, incompetence, and the dismissal of key white personnel for affirmative action reasons, went into a long recess. Two years later it has still not properly returned.

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Enforcement of traffic licencing rules have also been in abeyance for 18 months as 500,000 drivers’ licences await clearance. Estates cannot be closed, forensic inquiries completed, crimes prosecuted (including culprits in the so-called State Capture project of former President Jacob Zuma) and property transferred. More than half a million school children have quite simply not returned to school.

As for the burden of this failure of service delivery, it has been carried disproportionately by the poor, mainly black but increasingly also by white citizens, judged by the street corner beggars. There is little doubt that the effect of the containment strategies advocated by South Africa’s warrior scientists facilitated the July Troubles this year, which claimed 357 lives in a scourge of looting, arson and violence and has directly accounted for the drastic decline in ruling party support in last month’s municipal elections.

South Africans have endured, if never condoned, the absurdities and atrocities of this misjudged, exploited and needless panic to date. The ebb and flow of the global debate about the course of the pandemic has been intensely watched here by the literate and online portion of the community.

They have followed, like many others in the world, the way the arrogant scientific certainties that locked up the world are dissolving in the face of measured science and empirical fact. They understand one cannot follow a “science” when the scientists are hopelessly at odds. They are aware of the abuse of both language and statistics, particularly the new phenomena of snatch-stats whereby mortality from other causes is snatched for Covid-19, or the natural path of an expiring virus is used to justify the efficacy of an antidote or Excess Deaths are annexed to justify a lost cause.

They note the irony whereby their government, correctly, tells the world not to be alarmed by the Omicron variant, while it simultaneously contemplates a grievous assault against the rights of its citizens to contain it, egged on by the usual howling suspects who demanded total lockdowns. Citizens have minutely followed recent reports of how Pfizer arm-twisted their desperate government into signing legal indemnities for its product: who ever heard of citizens being forced to be vaccinated when the supplier is absolved of any responsibility for the consequences?

Most South Africans are not conspiracy theorists but their history teaches them one certain thing: uncontained power always gets one screwed. And many feel screwed now by a confluence of forces (not a conspiracy) that — from Big Pharma, to Big Tech to authoritarian governments — seeks rent from this incomparable tragedy.

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But another, far more important constituency of hesitaters and rejectionists exists. Those who take the time to talk to the black poor and marginalised are astonished by the extent to which, scarred by their lockdown experiences, they regard the current scare as yet another means to oppress them. Curfews, liquor and tobacco bans and the outlawing of political meetings under the guise of fighting Covid-19 support their case. And, for many, the umjovo is nothing less than ubuthakathi or witchcraft.

President Ramaphosa enters dangerous territory here. Take-up of vaccines is higher among the minorities for a variety of reasons and it is a section of the white minority who are the most vociferous supporters of vaccinate-at-all-costs. Banning access to public spaces will instantly translate, as it always does, into a political and racial rumpus. Pieces of paper that permit or restrict certain people’s movements have a terrible record in this country’s history: a bitter resonance for every black person.

Proven and restless forces in South Africa are today looking for chances to reignite the insurrection of July. These are people who do not protest by way of orderly marches, posters and pram-pushing. They seek only opportunity; the consequences brought by the human attempts to contain the pandemic is a revolution.

But revolutions always eventually consume their children. Time will certainly consume the reputations of the architects of this epochal tragedy: the scientists, pharmaceutical companies, politicians and media. And if Ramaphosa isn’t careful, it could also consume the fragile nation of South Africa.

Judging by the stream of recent headlines, petitions and open letters, parents of 12 to 15-year-olds could soon be heading for a showdown over the “right to be vaccinated against Covid”. The UK’s Chief Medical Officers this week announced a plan to offer them jabs — despite the Government’s Joint Committee on Vaccination and Immunisation’s advice that the direct benefits for healthy children were too marginal.

And while parents will be required to give their consent for their child to be vaccinated, a child will be able to override their parents’ refusal providing he or she is deemed to have “enough intelligence, competence and understanding to fully appreciate what’s involved in their treatment” (otherwise known as being Gillick competent).

Covid-19 has always been a crisis in search of a culture war, and the response to this announcement has been no exception. When such luminaries as Gillian McKeith and Laurence Fox, and groups with titles such as Family Defence League and Lawyers for Liberty, start advising parental resistance, you know it’s about more than the scientific specifics of just one jab. Suddenly it is about personal freedom, the rejection of state interference in family life and the principle that a parent should decide what is right for their child. It is about where you stand politically and how you want to be perceived.

I’ll be honest: I do not want to be standing alongside Laurence Fox. I know which “side” of this debate I am meant to be on — which one suits both my political persuasions and my parenting style. And it is that, more than any in-depth medical knowledge, which tempts me to declare myself fine with my own children overriding my consent (were it not for the fact that this in itself constitutes a form of giving consent — the eternal paradox of liberal parenting).

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I find the idea of a child ending up in mediation with their own parents over the right to be vaccinated not just unlikely, but bizarre (the idea of slammed doors, mealtime sulks, plaintive cries of “but EVERYONE else has had one!”). Yet for others, the anxiety is real, with schools being inundated with letters from parents fearful that vaccinations will take place behind their backs.

Perhaps I’m unusual, but ever since I was allowed — just allowed! — to take my firstborn home from the hospital, I’ve been sceptical about the idea that parents know best.

Parental decisions are informed not just by love, but politics. We know this, though we tend to tell ourselves it is those other parents — those of the opposing political tribe — who are getting it wrong. This inconsistency is particularly glaring in current debates on the treatment of young people with gender dysphoria. There are parents who support social transition, the prescription of puberty blockers and/or the use of binders, and parents who don’t — with both sides insisting they are motivated by an understanding of their child inaccessible to anyone else. In accounts of raising trans children, or opposing a child’s desire to transition, “I know what’s best for my child” merges with “any loving parent in my position would make the same choice” (or, at the sharp end, “any parent who would not make the same choice obviously wants their child dead”).

It is uncomfortable to admit that your love, and what is in the “best interests of the child”, is tainted by your own background, self-image, friendship groups and even personal traumas. Yet I know mine is, even when I think I’m right. Indeed, it is by watching the Covid vaccination debate play out that I’ve felt, more than ever, how much more attractive it is to cling to our slogans rather than admit how little we know.

I have my own self-defeating list of things that I, as a parent, should and should not be allowed to do. Not allowed: smacking children; restricting access to contraception and abortion (providing safeguarding checks are made); vetoing access to good sex education (I decide what “good” is). Allowed: vetoing access to dodgy sex education (I decide what “dodgy” is); intervening where a treatment constitutes self-harm (I decide what “self-harm” is).

I know this is provisional and shaky, riven with qualifications, making the bodies of my children (and yours) a testing ground for my politics. I do think there are areas — such as the administration of physical punishment, or the use of breast binders — where it is possible to make a more objective case for harm being done, but the template of “parents’ rights” is unhelpful. With the proposed Covid vaccinations, the situation is different still; the play-off is not between potential losses and gains for one’s own child, but potential gains for other people, perhaps even yourself.

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Here we have an example where the primary beneficiaries of a treatment may not be — indeed, most probably are not — those receiving it. As a result, the simplistic concept of individuals, or their parents, knowing what’s best for them falls apart. Writing in The Independent, Victoria Richards argues in favour of “competent” children making the final decision on vaccination using the principle of “knowing best”:

“Some children under the age of 15 will be deemed “Gilick competent”, some won’t… Parents or carers know their children best — so chances are, you know which camp your child would likely fall into. If you’re a parent who’s vaccine-hesitant, I can understand why you might feel upset – even angry — about such a scenario. But what I really feel is that we should trust our kids; many of whom are mature, intelligent and information-savvy well before the age of 12.”

I think my children are mature, intelligent and information-savvy; the trouble is, I don’t think the debate over having a Covid jab is a test of these qualities. This is a complex situation, hijacked by narratives about state control, science and freedom. It is also one in which moral pressure is being exerted on children, one that might come from schools, but which could also come from parents who want their children to be vaccinated. Coercing children — however subtly — to do something with their bodies which isn’t primarily for their benefit is questionable. But so, too, is making that body the site for spurious, abstract arguments about liberty and parental infallibility. Neither side is coming off well.

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Richards goes on to invoke the principle of “my body, my choice”: “We can’t very well teach our children that they have the right to say “no” to unwanted physical contact one minute, and then demand they kiss an aged aunt the next… And if we are teaching our kids that their bodies (rightly) belong to them, then that should go for whatever it is they decide about the vaccine, too.”

But this is a reversal of our usual message regarding consent, because the focus is on the right to say “yes”, not “no”. There’s something telling in the way that liberal leanings push us towards making the dominant message “you have the right to override your parents if they say no”, rather than “you have the right to override them if they say yes”. It smacks — just a little — of an uncomfortable political division on consent, whereby some of us only want to focus on the giving rather than the withholding. For all the accusations of illiberal moral panic one might throw at those raising alarm about the vaccine, “my body, my choice” is a slogan that would seem to me to apply better to the children saying no for themselves. Suddenly, unexpectedly, I find myself veering, ever so slightly, Laurence Fox-wards.

I am not going to fight with my children over the vaccine; they want to have one and I will not stop them. But there are bigger questions to ask, not just about what influence parents should have, but what we are using our children for. Children have been asked to make significant, necessary sacrifices for adults; it is not necessary to use them to fight our own culture wars.

At one stage he even says: “When speaking to a contemptible idiot who is kind of evil, don’t call them a contemptible idiot who is kind of evil! Many contemptible idiots find that language insulting.” But he continues to do it, and frequently segues into lengthy digressions about how stupid and harmful the idiots’ beliefs are. Presumably you would not feel that the author had really taken his own advice on board

This is very much how I feel about How to Talk to A Science Denier, by the Harvard philosopher Lee McIntyre.

McIntyre wants to help us change people’s minds. Specifically, to help us change the minds of these strange, incomprehensible people called “science deniers”. He addresses five main groups of “deniers”: flat earthers; climate deniers; anti-vaxxers; GMO sceptics; and Covid deniers.

This is, on the face of it, an important project. It’s a truism that the world is polarised, and our sense of shared reality is under attack. If there is some way of learning how to talk across difference, and to persuade without attacking, that might go a long way to bridging our various divides, not just the five he discusses.

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The framing is that McIntyre goes and meets representatives of these groups and tries to persuade them out of their wrong beliefs. He goes armed with social-psychology research about how best to persuade people. His big trick (which I think is a good, if limited, one) is asking: what evidence would it take to make you change your mind?

But the whole book is premised on one idea: McIntyre is right, and the people he is “talking to” are wrong. 

And it’s true that all five groups are wrong, or at least their central claims are. The earth is in fact an oblate spheroid; the climate is warming, due to human influence, and will likely have severe negative impacts; vaccines work; GMOs are safe; and Covid is real.

The trouble is that by using these groups, McIntyre is playing on easy mode. When your example of a “science denier” is a literal flat-earther, it’s easy to say “look over there at the crazy deniers”.

Even with climate change scepticism, sure, there are people who literally don’t believe that anthropogenic greenhouse gases are warming the planet. But those people are relatively rare. People who believe that anthropogenic greenhouse gases are warming the planet, but that the emissions are going to be hard to stop because of economic growth in the developing world and it would make more sense to concentrate on adaptation rather than mitigation, are much more common. Are they “deniers”? Certainly they’re often called deniers. But McIntyre himself acknowledges that China is by far the largest emitter of greenhouse gases and that the IPCC says the sweeping global changes required to cut emissions sufficiently to avoid a 1.5°C warming are unprecedented.

McIntyre constantly wants to make a clean distinction between “science deniers” and non-deniers. So, for instance, he says that there are five “common reasoning errors made by all science deniers” [my emphasis]. They are: cherrypicking, a belief in conspiracy theories, a reliance on fake experts, illogical reasoning and an insistence that science must be perfect. If you don’t make all five of those errors, you’re not an official McIntyre-accredited science denier.

Hang on, though. A “belief in conspiracy theories”? McIntyre spends a lot of time talking about the tobacco firms who manufactured doubt in the smoking/lung cancer link, and the oil firms who did the same with the fossil fuel/climate change link. He says that the spread of Covid denialism through the US government was driven by Republican desire to keep the economy open and win the election. Aren’t these conspiracy theories?

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Ah, but for McIntyre these aren’t conspiracy theories, they’re conspiracies. The distinction is “between actual conspiracies (for which there should be some evidence) and conspiracy theories (which customarily have no credible evidence).”

So, since some anti-vaxx conspiracy theories like the polio vaccine giving children polio, or the CIA using fake vaccination stations to take people’s DNA, are true, does that mean anti-vaxxers don’t believe in “conspiracy theories” but “conspiracies”?

Obviously not. But the point is that there’s not some clear line between “real conspiracies” and “conspiracy theories”. When Alex Jones says that chemicals in the water are turning frogs gay, he’s referring to real claims that endocrine disruptors are affecting sexual development in lots of animals. It’s not easy to draw a line between real and fake, evidence-based and not evidence-based.

I think the basic problem is that McIntyre is a Popperian. That is, in hugely oversimplified terms, he believes that no amount of evidence can confirm a theory: but evidence can falsify it. “If we find only evidence that fits our theory, then it might be true,” he writes. “But if we find any evidence that disconfirms our theory, it must be ruled out.” 

I, on the other hand, am a Bayesian. I have some prior belief and I assign some level of probability to it: “climate change is real and dangerous”: 90%; “the world is flat”, 0.1%. And then each new piece of evidence shifts my belief a little: if next year NASA say “we got new photos in, looks like Earth is sitting on the back of a turtle”, then I’ll upgrade my belief in a flat earth to, I dunno, 1.5% (but also upgrade my belief in there being mad people at NASA to 95%).

So I don’t need to draw a bright line between “denial” and “reality”. I can say: “I think it’s likely that tobacco firms conspired over lung cancer, but I think it’s pretty unlikely that NASA faked the moon landings.” And I can update my beliefs as new evidence comes in. I don’t have to “rule anything out”, I can simply downgrade how likely it is.

McIntyre, though, is stuck with two categories: things that might be true; and things which have been “disconfirmed”. If you believe things that have been disconfirmed, then you must be a “denier”. And so he needs to find ways of explaining why these “deniers” are so different from the rest of us. 

He has various ideas about “inflated self-confidence, narcissism, or low self-esteem”. But if you reject the idea that there are two groups of people, “deniers” and “non-deniers”, then you can avoid the need to explain it at all, beyond saying “some people are better than others at working out what’s true”. 

But we’re not just here for his epistemology: we’re here for a masterclass in how to persuade people out of false beliefs. Over the course of the book he meets various people — the flat earthers; two coal miners; a couple of hippyish friends of his — and tries to talk to them about their beliefs, using the methods he has learnt. His solution is to listen, to be respectful, to meet people face to face, and to do so over several meetings. Does his approach work?

In short: no. Hilariously, both of the coal miners he meets cheerfully accept the reality of climate change, but say that the economic value is worth the potential damage to the climate. His first hippyish friend is entirely pro-vax and only slightly GMO-sceptical; the other one is anti-GMO but on anti-corporate grounds rather than safety ones. 

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So he falls at the first hurdle: he not only doesn’t convince anyone, he doesn’t meet anyone who unambiguously disagrees with him, except the flat earthers. (He also struggles to be respectful, at least in the book itself. There’s an astonishing line on p77 in which he says “When speaking to them, we should remember that it is an insult to use the word ‘anti-vaxxer.’” There are 109 uses of the term “anti-vaxx” in the book. Occasionally he remembers and says how important it is that we listen and pay attention, then he immediately reverts to calling, say, Covid scepticism “ridiculous conspiracy theories and partisan nonsense”.)

But there’s a bigger problem. McIntyre’s big question, as mentioned, is asking: What evidence would it take to change your mind? But at no point does McIntyre ever ask himself what it would take to change his mind. 

For instance: when he was talking to the Pennsylvania coal miners, he accepted that they were just trying to feed their families. I assume he’d also acknowledge that Chinese coal mining is allowing that country to get richer and improve its citizens’ way of life. But I don’t think I’m misrepresenting him when I say that he thinks coal mining is a disaster.

When he talks to a friend of his about GMOs, though, that friend says that even though GMOs can save lives now (in the form of golden rice), they’ll cause disaster in the future. McIntyre says, OK, so the kids who can’t get the golden rice now, they’re just going to die? And his friend says yes. McIntyre says that’s easy for him to say, “because he had money and wouldn’t be one of the ones who suffered”.

The exact same question, though, can be asked about coal mining. Sure, McIntyre can say stop using coal, and it’ll help prevent future disasters. But it will also presumably mean some number of tens or hundreds of millions of Chinese people losing electric lights and functioning hospitals, and a smaller number of Pennsylvanians losing their jobs. McIntyre himself would be fine, except for somewhat higher electricity bills. 

Is the tradeoff worth it? McIntyre clearly thinks so (and I think I do too): but what would change his mind? I can tell you: I would update my beliefs significantly if you showed me a utilitarian calculation showing that more people would be harmed by ending coal mining than by continuing it. But McIntyre never asks himself the question. He is stuck on transmit, never on receive.

What’s sad is that he sometimes comes close. He recognises that beliefs are part of people’s identity, and that that makes it hard to change them – but again, applies the lesson only to the weird, wrong, other people, not to himself and people like him. The near-total lack of introspection renders the whole grand project largely meaningless. I am right, you are wrong, the only thing we need to discuss is how to make you realise how wrong you are. The idea of working together to establish a shared reality is hamstrung by his certainty that the reality that needs to be shared is his one.

It’s mainly a book designed to tell readers that people they already think are dumb are, in fact, dumb. It is, really, How to Talk to A Contemptible Idiot Who Is Kind of Evil.

This has largely been borne out across the world. For better or worse, countries such as Britain and France have been relatively united around their political leaders. Any perceived failures have largely been forgiven thanks to the sense that they were doing their best under difficult circumstances. There were even strange moments of forced unity: in the case of the UK, there was weekly applause for the NHS.

The only country in which this was not the case was the United States. From the start of the virus, the pandemic became as highly politicised as everything else. Aware that a roaring economy was one of the central pillars of his return to office, President Trump was unwilling from the start to respond drastically. He was, perhaps, the world’s most reluctant leader to concede to lockdowns or mask-wearing — and, as a consequence, both of these issues fell, like everything else, along entirely partisan lines.

Many who hated Trump became dedicated to mask-wearing precisely because the President was not. Single, double, or triple mask-wearing — even when engaged in an activity like jogging — suddenly became an even better way of displaying your political sympathies than wearing a “Biden-Harris” t-shirt.

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Likewise, the rejection of mask-wearing and an opposition to lockdowns became the mark of a Republican with a strong Trumpist sensibility. During a visit to the States ahead of the election I was struck by how New York, Los Angeles, Seattle and other Democrat cities were filled with mask-wearing lockdown enthusiasts. Towns in Florida, by contrast, resembled party destinations in an especially frenetic holiday-season.

There was a feeling throughout all this that the cause resided in the White House. Once Trump was gone, so the argument went, so the obscene divisiveness of American politics would recede and there might at least be some unified narrative on Covid and the national response to it.

Unsurprisingly, this did not happen. Trump may be long gone, but the polarisation of America’s pandemic politics remains. Vaccine hesitancy, in particular, has become an issue that divides the Left and Right. For example, one poll carried out last month found that while 86% of Democrats had received at least one Covid jab, while only 45% of Republicans had — and while a mere 6% of Democrats said that they would most likely avoid being vaccinated an extraordinary 47% of Republicans said the same.

It isn’t quite analogous to compare this situation with Labour and Conservative voters in the UK; this is clearly more than a political dispute. But even if you transpose the Democrat-Republican vaccine divide on to the most divisive British counterpart argument of recent years —Brexit — the divide is less pronounced. A poll carried out by YouGov in April found that vaccine hesitancy in the UK saw only a five-point difference between people who had voted Remain and those who had voted Leave.

There are a range of possible explanations for this. The first is that the UK’s Brexit divisions have begun to heal, if not completely. People who voted Remain have, by and large, accepted the new reality and do not in large numbers believe that they can continue to overturn the 2016 vote.

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In America, by contrast, more than half of Republican voters still believe that Trump won the last Presidential election and that the Democrats stole the vote. Around three in ten Republican voters believe that Trump will be reinstated as President this year. In other words, they believe the election was stolen, but that the facts are going to come out, forcing Biden to step aside.

And yet it is not only about politics. From the start of the pandemic, it was striking that reactions to the pandemic in America fell across a quasi-philosophical line. Most Americans have lived all their lives better acquainted with the concept of risk than their British and European counterparts. In part this is because of the absence of the European-style model of the welfare state. In Europe, life’s game of snakes and ladders exists in a much more sanitised form. But in the US, the reality is far more extreme.

The American Right’s suspicion of the state and state agencies remains more pronounced than it is on the European right. Ever since the British and European Right made their peace with the welfare state, there have been those who have wished to reduce the size of it, but no significant figure who has wished to abolish it. The same cannot be said for the US.

Ultimately, political polarisation has become a way of life, one that is more than capable of surviving the rotation of Presidents. Indeed, as a phenomenon I suspect it will only become more pronounced. At the end of last month, the CDC advised all Americans, including people who are fully vaccinated, to once again wear masks in a number of scenarios. And this week, more than a dozen large US corporations, including Walmart, Google and United Airlines, announced that their workers would be expected to demonstrate that they have had the vaccine in order to work for them.

So off the American cultural divide goes again. America may have survived the worst of the pandemic — but the deep divisions which it has highlighted look increasingly irreparable.

Husband and wife Geoff Manaugh and Nicola Twilley did most of the research for Until Proven Safe before the Covid-19 pandemic struck. Perhaps they felt strangely lucky, then, as the world descended into the current age of lockdowns and self-isolation, their study of “the history and future of quarantine” taking on a sharp new relevance.

Reading the book, there’s a case to be made that the just-to-be-sure quarantining began in fourteenth-century Dubrovnik, where travellers from areas known to be infested with the Black Death weren’t allowed to enter the walled city until they’d spent a month on a nearby small island. Similar schemes were adopted for maritime visitors to Venice, where you can still visit the lazarettos — quarantine hospitals — that were built especially for this purpose. Even lacking the germ theory of disease, the powers-that-be in these ancient cities intuited that separating was a way of protecting.

In the modern era, with a much better understanding of germs, we sometimes quarantine humans when we don’t really believe it’s necessary: recall the famous photo of the Apollo 11 astronauts, having just returned from their successful moon landing, meeting Richard Nixon from behind a window in a sealed metal box. They were quarantined for three weeks just in case they’d brought back some unknown alien pathogen from the moon — even though it was strongly suspected that (as we now know) the surface of the moon was sterile, and no such pathogens existed.

We’ve been less strict when it comes to the animal kingdom, where we can see some of the most drastic consequences of not quarantining playing out. Think of the episode of The Simpsons where Bart sneaks his pet bullfrog into Australia, whereupon it promptly escapes, reproduces, and devastates all the crops in the country. Manaugh and Twilley remind the reader of the UK’s terrible foot-and-mouth disease crisis in 2001, which originated in pigs who had been fed illegally imported pork from Asia. They also describe how Florida’s citrus industry has been in decline for years due in large part to the insect pest known as the psyllid. Only extremely strict quarantine of incoming plants by the state of California has stopped something similar happening to its famous oranges.

And remember the “friendship tree” that Donald Trump and Emmanuel Macron planted on the White House lawn in 2018? Being from France, its roots were specially wrapped in plastic so as not to spread anything nasty to the US — and it was immediately dug up and sent for a two-year quarantine as soon as the cameras were switched off. (In a definitely-not-metaphorical development, it died before it was returned).

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It might seem to be stretching the term, but we quarantine some non-living objects, too: containers of radioactive waste are “quarantined” deep underground until they’re no longer dangerous. That, as Manaugh and Twilley explain, might be a very long time — long enough that scientists have tried to develop universal signs and symbols to communicate with civilisations thousands of years in the future who might have languages very different from our own: “there is bad stuff here – it is dangerous”.

So, animal, vegetable, and mineral: we routinely quarantine them all. Until Proven Safe argues that quarantine is a fundamental part of how societies deal with uncertainty. The lazaretto, the quarantine greenhouse and the concreted-over mine facility full of radioactive waste are, as the authors put it, “what results when abstract arguments over risk are given architectural form” — our best attempts at seeking the certainty we so badly need in the face of terrifying, and sometimes existential, dangers.

But the book left me with one massive unanswered question. If quarantine is such a well-understood process, with such a long history, how come we fumbled it so badly during Covid-19?

The will-they-won’t-they history of the UK Government’s decisions about border quarantine is recounted in a long document by the Home Affairs Select Committee from August 2020. As the disease began to spread outside of China in February last year, our government put in place some relatively light measures: those who had been in Wuhan, Iran or some parts of South Korea were asked nicely to stay at home after arrival at a UK airport, even if asymptomatic; those who had been in Northern Italy or a few other locations where cases had been found did “not need to undertake any special measures” unless they had symptoms. Even though there was to be no UK lazaretto, at least there was a gesture towards keeping incoming high-risk guests apart from the population at large.

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Then, on 13 March, this advice was completely dropped. As the outbreak began to spread into Europe, our government decided to remove some of its advice for border quarantines. As a Select Committee report five months later put it: “The decision to lift all Covid-19-related guidance for international arrivals on 13 March, just as other countries were expanding their border measures, is inexplicable.”

It would be 10 days until the first lockdown began in the UK — ten days in which thousands of people with Covid-19 entered the country and wouldn’t have had to isolate at home (as everyone would, when lockdown later came in), and certainly wouldn’t have to be tested as they arrived at the border. Even after lockdown began, there wasn’t the slightest question of us instituting a mandatory quarantine, despite other countries at the same time requiring incoming travellers, few though there were by this time, to stay locked in a hotel or other special facility for periods of as many as 21 days (that being, at one point, the length of the mandatory quarantine in Hong Kong). Incredibly, the UK only began a mandatory hotel-based quarantine on 15 February 2021 — and only for some countries — more than a full year since the first Covid case arrived on our shores.

Calling the decision inexplicable is understandable. But let’s try to explain it. Perhaps some thought that, since border measures like quarantine wouldn’t stop all cases, they weren’t worth instituting. This all-or-nothing argument has certainly been made in other contexts — for masks or even vaccines — and it betrays a magic-bullet mentality: defeating a contagious disease takes a lot of different measures, none of which will ever be 100% effective. Manaugh and Twilley note the irony that if a quarantine works — if it stops disease transmission — then it will in retrospect be seen as an overreaction.

Was quarantine thought to be a bit too disruptive, a bit too difficult, to institute? Perhaps, though of course we did eventually end up instituting it, and if the story of vaccines has shown us anything, it’s that we can move mountains to get something done if we feel we really have to.

Were some scientific advisers, and perhaps politicians, unable to decouple the idea of border quarantine (or indeed travel bans) from politically-unpalatable views in their minds? The authors of Until Proven Safe do note the political angle: treating foreigners, immigrants, or refugees as if they were carriers of disease (or were a disease themselves) has been the preserve of authoritarian, racist, populist leaders. Could an innate aversion to being like those bad people have skewed the experts’ judgement?

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There is some evidence for this, with Sage fretting early in the pandemic that border measures would need to be “draconian” to hold back the spread — a choice of words that clearly indicated disapproval. In fact, those measures may have been the proverbial stitch in time that would’ve saved, well, a lot of lives — and to draw comparison between actions taken during a pandemic emergency and those in “normal” times is irrational in any case.

Or maybe there’s an even more disturbing explanation: that quarantines weren’t instituted because, at the start of the crisis, the UK’s scientific advisers thought it would be a good thing if as many people as possible caught the disease. The idea that a strong quarantine system could render the “herd immunity” plan unnecessary doesn’t seem to have occurred, even though it did to policymakers in Hong Kong, New Zealand and elsewhere.

In any case, few of the lessons from history described in Until Proven Safe were applied during the history we’ve just lived through. The simple idea that “keeping people in quarantine, even if you’re not sure they’re infected, helps to hold back a contagious disease” seems to have been lost in the morass of counter-intuitive thinking that swirled around the start of the pandemic.

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Maybe we can learn the lessons for next time: what of the future of quarantine? Manaugh and Twilley say that it might not look like quarantine at all. They discuss DARPA’s Prometheus project, where the idea is to develop a way of predicting whether someone, once infected with a disease, will be contagious. One of the nastiest things about Covid is, of course, that people can still spread the disease before seeing any symptoms — if they get symptoms at all. Such a system could help us pinpoint the people who need to be isolated — and would, to return to the theme, help reduce a big source of uncertainty.

But anyone who’s had a visit to the pub cancelled because of the UK’s “pingdemic” should know that technological solutions are wont to go awry; we can predict endless angry debate over the rate of false-positives and false-negatives from a Prometheus-like system should it ever come to be used. Far from putting all our eggs in technology’s basket, we should be open to the central point of Until Proven Safe: although the low-tech idea of setting possibly-contagious people apart could be made more effective, more equitable, and more humane — we wouldn’t have a history so full of quarantine if it didn’t really work.

As the leaders of the EU’s member states prepare to meet tomorrow for a European Council meeting, I suspect few believe it will be another “touching moment of unity”. For the truth is that the “European success story” has been anything but.

Even at the last meeting of the European Council, roughly a fortnight before Von der Leyen’s victory lap, the mood was hardly buoyant. During the all-night session, the representatives of the member countries failed to agree on everything except for the fact that a no-deal scenario was the most likely outcome of the Brexit process — another EU prophecy that has since unravelled.

Yet there remains a sense of solemnity to these European Council meetings. They are, after all, often convened in times of crisis. And whether it’s the collapse of the Eurozone, the sudden wave of migrants or the emergence of a new deadly coronavirus, if the past decade has taught us anything, it’s that the EU has never been short on crises.

Of course, not all of these disasters are of the EU’s own making — though some certainly have been. But throughout each of them, a remarkable trend has emerged: that no matter how bad the situation is, the EU always finds a way to make it worse.

When, for example, the Eurozone crisis hit in 2010, the federalists were intent on showing that only the EU could save the Mediterranean countries from economic collapse. Far less important for Brussels was the fact that Greece, in particular, would not have been in this mess if it had not been accepted into the Eurozone in the first place. Similarly, when the immigration crisis peaked five years later, Brussels insisted that only a unified block could respond to such a challenge. Predictably, it failed to take into account that it was failures at an EU level — in particular its unilateral approach to migration policies — that had exacerbated the problem in the first place.

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And now we are seeing the results of the EU’s botched handling of the Corona crisis. Despite Von der Leyen’s promise of vaccine success, Paris has just gone into another lockdown and Germany is set to implement nationwide restrictions over Easter. Meanwhile, the vaccine roll-out across the majority of the bloc remains calamitously slow.

Yet while it’s easy to criticise individual governments and leaders for mistakes in their countries, we must not lose sight of how the EU’s decision-making has often amounted to nothing more than a catalogue of errors.

First there was the whole issue of vaccine development, with French and German companies both being protected by their respective governments even as they preached a message of unity. Then there came the procurement disaster, in which Franco-German protectionism once again delayed production. Then there was the disaster of the roll-out, where the bloc’s efforts to ensure that nobody raced ahead meant that every country advanced at the slowest rate possible. In the meantime, the Commission still found the time to order raids on laboratories and threaten to seize AstraZeneca manufacturing plants.

The Commission has, of course, apologised after every misfire. But on no occasion has it looked as though it has learned its lesson. At present, the EU seems more focused on the bloc’s “bad boys”, notably Hungary, for going their own way and acquiring massive quantities of the Russian and Chinese vaccines. Yet in Hungary, the country’s vaccination rate has raced ahead with around 16% of its population having received at least one jab, as opposed to a mere 9% average in the bloc as a whole.

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By Peter Franklin

In the face of these facts, one would expect tomorrow’s Council meeting to be a sombre if not sobering affair. But as those who have attended previous Council meetings can attest, they rarely are any such thing — for the simple reason that the Council is incapable of absorbing criticisms which cast any negative light on its own direction of travel.

Evidence from around the world suggests that countries which are limber and independent — such as Israel, Singapore and Britain — have been able to act swiftly during the pandemic, particularly with regard to vaccinations. Indeed, there is no logical reason why EU countries could not have been allowed to pursue independent vaccine development, procurement and roll-out. Except for the fact that any such conclusion runs counter to the heart of the EU’s fundamental principle: that its members must act in concert.

In Brussels, it has already been decided that an EU-wide approach is always the only approach. And as we are seeing, it will doggedly remain committed to the wrong answer even when that answer has been proved wrong. There are, of course, issues on which a multilateral approach are needed, as there are issues on which unilateral policies are required. But once you have decided that there is never — and never will be — an alternative, you are bound to encounter problems which you cannot solve.

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How the EU humiliated itself

By Peter Franklin

In recent years, critics of the EU have repeatedly noted that while there was much criticism in Brussels of the UK for leaving the bloc, there was no self-reflection over why we might have chosen that decision. There were none of the procedures in place that would normally allow a political entity to consider criticisms and adapt accordingly. Why is this? Because if you believe that the answer to everything is an “ever-closer union”, then contemplating the benefits of a more relaxed arrangement is an impossible task.

All of which grates somewhat, given how the EU repeatedly asserted that it was Brexiteers who were the immovable ideologues; when, as Brussels’s recent behaviour has shown, in reality it is the EU that is riddled with blind obstinance. So when the European Council meets tomorrow, expect it to blame everyone but itself. And as a result, when the next crisis comes around, expect it to fail yet again.

But if you thought that Emmanuel Macron’s floundering over the Covid crisis, and especially his drunken sailor pas de deux with Angela Merkel over the AstraZeneca vaccine, might ring in a measure of rarely-seen humility among the French ruling elite, think again.

No matter that one day Le Président says the Oxford jab is unproven and useless on the over 65s, only to perform the mother of all reverse ferrets three weeks later, and forbid vaccinating the under 55s with it, after a four-blood-clots scare over 15 million shots. No matter that the instant Mutti blinks and decides to suspend AZ vaccinations in Germany, France’s Covid Conseil de Défense, after being interrupted by a telephone call from Our Man In Berlin, rules that France will blindly follow suit.

In the immortal words of a thousand French novelty aprons and fridge magnets, Même quand il a tort, le boss a toujours raison (“even when the boss is wrong, he is still right”). Our President, who last year took most decisions on the handling of the crisis alone, whether following or contradicting the Scientific Council, found early on the ideal piñata: les Anglais, which in French means the British (with apologies to Celtic readers). Because we love to hate the English, too.

He has been helped in this strategy because the groundwork being generously laid for almost five years over Brexit. Emmanuel Macron, toujours lui, was still harping on about it for his New Year wishes last January, assuring Britain that France remained her “friend and ally” despite her choice to leave in a Brexit born of “lies and false promises”, coming across like a man moaning about custody rights and alimony during a family reunion five years after his divorce.

And while we usually protest that French ill-feeling towards the British is nothing, nothing compared to British naked aggression about all things French — yes, that Up Yours, Delors still rankles — the truth is that we love casser du sucre sur le dos des Anglais (to break sugar cubes over the backs of Brits, a popular colloquialism for badmouthing).

You may have invented the wrong sort of leaves to excuse your pathetic excuses for proper trains (for which read: French trains); we can discourse for hours about the wrong way in which Brian Moore won tries, and matches, over a technically better French rugby team. We could have invented the term “beautiful losers”, because even when France loses, it is with so much more élan than when the English win. Oh, and Emmanuel Macron even said for a long time that Britain actually vaccinated the wrong way, and France had performed better in terms of the proportion of people getting the full two-jabs. (No, I don’t understand the maths either; it’s all about “taking dangerous risks”, and he may not have been entirely correct.)

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The likelihood that the AZ vaccine would have been similarly targeted by a series of damaging official statements if it had not been invented in Britain seems close to zero. The urge to do down les Rosbifs was too strong, even at the risk of encouraging antivaxxers over the Continent. In fact it’s the one cultural trend France has successfully exported in recent years: while we used to be Europe’s leaders in vaccine scepticism, with 43% of the population unwilling to take the needle, that number is now up to 61%; but similarly, 55% of Germans would now refuse the AZ vaccine (up 15%), as well as 43% of Italians and 52% of Spaniards (up 27% in each). And a good deal of it was born of the age-old French uneasy contempt for the British.

We don’t understand you. We don’t trust you. We don’t trust those among us who suffer from that terrifying disease, l’Anglophilie. There’s a certain kind of bon chic, bon genre French bourgeoisie who dress their daughters in kilts, send their children for a couple of terms in minor public schools in the Home Counties so that they’ll speak English more fluently than almost all our presidents, who mourned the disappearance of Marks & Spencer from Paris, and worship the Royal Family unironically. Just as Remainers pine for Provence and Tuscany after the second glass of Prosecco, France’s social equivalents wax lyrical about Glyndebourne, serve Pimms in the wrong sort of glasses, and think longingly to this day of Tony Blair. This sort of Anglophilia is not a vote-winner with the rest of the country, as politicians from Valéry Giscard d’Estaing to Édouard Balladur have found out.

A quick vox pop among friends hit unexpected Yellowstone-sized geysers of animosity. It starts with use of unregulated longbows at Agincourt, encompasses burning Joan of Arc at the stake, finds its stride with Pitt’s flooding fake assignats to devalue French paper money during the Revolution (typical of the perfidiousness of Albion in all things financial, and probably present in the subconscious of Brussels regulators as they deny City financial institutions either passporting or equivalence rights), but truly flourishes when it comes to Napoleon.

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By John Lewis-Stempel

“Les Anglais conspired to break the Peace of Amiens in 1803, led the entire continent into war, and managed to pin it all on Napoleon!” one friend raged. And on to St. Helena, to Kitchener’s stand-off against Marchand at Fashoda in the Sudan in 1898, and of course to the sinking of a good chunk of the French Navy at Mers-el-Kébir on 3 July 1940 by the Royal Navy, rather than risking it fighting on for Vichy. Yes, we do hold grudges.

But a great deal of Anglo-French antagonism is probably due to a discomfort on both sides as to who, really, is coolest — not that anyone will openly admit to failure. From the 1960s onwards Paris has played second fiddle to London, home to the Beatles and Rolling Stones and countless other musicians — even Berlin has at times appeared more cutting-edge — but with fashion Paris remains king. Even London’s couturiers, graduates from St Martin’s School, have not truly made it until France’s warring luxury titans, Bernard Arnault of Dior and Givenchy or François Pinault of Gucci and Chloé, had given them whole Paris ateliers to play with. Frenchwomen may be better dressed than their British opposite number, but Englishmen of a certain class beat too-dapper Frenchmen in narrow suits hollow — although no one would say that of all Englishmen.

We win at food, but you steal our chefs. It’s worth it, in order to escape your legacy of baked beans for breakfast, of frozen peas the colour of hazmat suits with the consistency of grapeshot, boiled meat falling in lank grey strands on the plate into congealing gravy, and at puddings you could play rugby with. We eat your fish (not so much these days, because Brexit spite trumps le brunch du dimanche) but you drink our Bordeaux and our champagne, one clear instance where you win hands down. Mostly, the French do not understand Marmite; but some cultural practices must just remain a mystery.

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Why French teachers are afraid

By Agnes Poirier

Sport is more complicated: a friend cursed you twice, once for stealing Eric Cantona from us, the second for returning him. Business is even worse: thirty years on, one of the negotiators over the Channel Tunnel contracts was still smarting over British “cheats”. “How so?” I asked. “The minute they’ve signed, they endlessly amend, change, revise contracts! It’s like trench warfare! You think you’ve got something to rely on, they want to adapt and adapt all the time!”

As we hashed it over, it became obvious that two entire philosophies were clashing: British pragmatism against French theory; British nimbleness against French top-down hierarchy. “Business in England starts when 20 shopkeepers get together in a café near the docks, and decide to finance a ship to the West Indies,” he said: “They find a captain, networks, information, insurers. In France, you go to the King; he gives you letters of marque against a cut in your profits; all is done in his name. Nothing has really changed: today, most large cross-border deals need the approval of the Direction Générale du Trésor at the Ministry of Finance.”

It was a perceptive point, and explains a lot of the different ways that Britain and France have handled the Covid vaccination effort. For the French, les Anglais appear to have won the war, despite losing so many earlier battles; but we cannot help that feeling there is something perfidious about it.

France’s president has shredded his reputation more than any other person in the age of Covid (and with some competition). First Emmanuel Macron cast doubt on the effectiveness of the AstraZeneca vaccine, calling it “almost ineffective” for the over-65s, the sort of reckless comment even Trump might have thought a bit excessive. Then, thanks to his lockdown policies, the Economist downgraded France to a “flawed democracy”, along with all the Visegrad bad boys and Modi’s India.

Now the country has, inexplicably, halted AZ vaccinations because of a miniscule number of blood clots, fewer than you would get with the contraceptive pill. But then perhaps it hardly matters, since France leads the world in vaccine scepticism, and conspiracy theories more generally. It is a country maddening in its strangeness, and that at least partly explains English antipathy to the place, which goes back centuries.

When Britain left the EU last year it followed decades of press hostility in which Francophobia was the strongest component, far more than hostility to the Germans. Perhaps the most famous example was the notorious Sun headline from November 1990, Up Yours, Delors. At the time EU commissioner Jacques Delors had become something of a bogey figure to the British Right, and after he had criticised Britain’s increasingly isolated position in Europe, the Sun chimed in by pointing out how “They tried to conquer Europe until we put down Napoleon at Waterloo in 1815” and “They gave in to the Nazis during the Second world War when we stood firm”. It called for all “frog-haters” to shout “up yours, Delors!” and that those on the south coast would be able to smell the garlic from across the Channel.

(Delors was not the only French politician to antagonise the English at the time. The following year, prime minister Edith Cresson stated her belief that one-quarter of “Anglo-Saxon men” were gay, to which Tory MP Tony Marlow replied “Mrs. Cresson has sought to insult the virility of the British male because the last time she was in London she did not get enough admiring glances”. Afterwards, the tabloids pointed out that Frenchmen kiss each other and carry handbags.)

Of course, the Sun might not speak for England, but it was probably speaking for a large section of its readers, because while England’s relationship with France is complicated, it is heavily tied up with our class system; the English middle class obsess over France, while the English working class have traditionally hated everything about it.

As far back as the French Revolution, well-bred radicals were excited and inspired by events in Paris, with Whig politician Charles James Fox crying “How much the greatest event it is that ever happened in the world!” when the Bastille was stormed.

Yet it was not simply that they favoured the revolution’s ideology; it was because it was French. And even as France descended into anarchy and then tyranny, Britain’s intelligentsia still sympathised with it. Fox’s nephew Lord Holland publicly supported Napoleon, while his wife Lady Holland even sent him books when he was sent to St Helena. William Wordsworth lamented of his own country that “Oh grief that Earth’s best hopes rest all with thee!”

In contrast, among working-class Englishmen there was virtually no support for the revolution and when volunteers were called up to fight France, the country managed to enlist 20% of all adult males, three times the French rate and a huge endorsement of opposition to Napoleon. It wasn’t just that they were fighting for English liberty against a revolutionary system. It was because it was against the French.

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Why monarchies are more tolerant

By Ed West

Men were recruited into local militias, and when in 1804 the authorities organised a mock training battle in Wood Green, Middlesex, they got the Islington Volunteers to be the British and the Hackney and Stoke Newington Volunteers to play the French. However, the Hackney men so objected to having to even pretend to be French that a fight ensued with several people injured, one being stabbed in the leg.

That’s because they were cockneys. A middle-class volunteer militia would have revelled in playing the French, rattling on about the latest pseuds being venerated on the Left Bank and emphasising all the correct pronunciations like they were reporting for Radio 4.

Our relationship with France is, of course, formed by an inferiority complex stretching back to Norman rule, and perhaps a lingering suspicion among the proletariat that the toffs deep down are still French (and English people with Norman-French names are still richer than the rest of the population, even after 950 years).

This complex deepened with the French cultural domination of the 18^th century when Versailles court etiquette was imitated by English-speaking elites, and petit-bourgeoise English sensibilities were horrified by French sexual morality. Louis XV had over one hundred mistresses — including five sisters — which made even England’s leading royal philanderer, the half-French Charles II, seem emasculated in comparison.

There is sex, and then there is the food, a French obsession which is endearing and sort of baffling. As far back as the 15^th century, when the English ruled much of France, their power began to collapse after they held a coronation of the infant King Henry in Paris and overcooked the chicken; even the poor queuing up for scraps complained how bad it was. Within a few years, the French had rebelled and kicked the English out.

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My dog is ruining my life

By Ed West

Only in France would football fans protest that a local restaurant had lost a Michelin Star, as happened in Lyon two years ago. Only in France would an expedition to the Himalayas — of huge national importance — fail because it was weighed down by eight tonnes of supplies, including 36 bottles of champagne and “countless” tins of foie gras. And only in France would you get actual wine terrorists, the Comité Régional d’Action Viticole, who have bombed shops, wineries and other things responsible for importing foreign produce.  This is a country which only reluctantly in the 1950s stopped giving school children a nutritious drink for their health, by which the French meant not milk but cider.

This is a country where mistresses are so much part of life that they can legally inherit, and where murder doesn’t really count if it’s done for love. One of France’s most famous socialites, Henriette Caillaux, shot dead the editor of Le Figaro just before the First world War and received just four months in jail because it was a crime passionnel. So that’s all right then.

France’s last duel, meanwhile, was in 1967, when Marseille’s mayor Gaston Defferre insulted another politician, parliamentarian René Ribière, calling him “stupid”. The latter was wounded, first emotionally and then literally.

It is all part of that sense of honour, which also manifests itself in its sense of national pride — probably the biggest cause of British frustration within the EU, when many felt we could have managed with the Germans and Dutch. Anti-French animus likely motivated some opposition to the EU, and certainly our otherwise dismal lives were cheered up slightly last year with the possibility of skirmishes between French sailors and the Royal Navy.

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We all break lockdown in France

By John Lewis-Stempel

But the truth is that France, “that sweet enemy”, has by and large been our closest ally. How many of those fighting at Waterloo could have foreseen that, when the guns fell silent, it would be the last time the two countries ever fought, and the start of 200-and-counting years of friendship, a military alliance far stronger than the supposed “special relationship” with the US? A generation later the British and French fought together in the Crimea, where Lord Raglan continued to refer to them as “the enemy”, and since then we have fought continuously side by side, in two world and many minor wars, from Suez to Libya.

This year we won’t be visiting France, and honestly, I’m really glad about that. I don’t write that in bitterness. I’m really glad I’m going to Bognor, which has got the third lowest rainfall in the UK. Why on earth would I want the Languedoc?

But we’ll be back, if not this year, then next, a line of cars heading down the A26 on that long, endless journey to the middle-class English Valhalla beyond the Loire.

There is still a faded Friends of the Earth “Nuclear Power— No Thanks” logo painted on a property near my home, a slogan that exemplified this sentiment. I also struggled to share their concern with genetically modified crops, particularly if they could help feed impoverished people on our planet.

Now climate change has pushed Green issues firmly back up the political agenda. Yet a new poll has revealed a strange quirk: some people inspired by scientific evidence to fight against climate change do not seem to trust Covid-19 vaccines created by other scientists to save society in a pandemic.

This curio comes from a new Oxford University survey that found a sharp rise in the number of Britons saying they are “very likely” to be vaccinated, with about nine in ten willing to have the jab. There are, however, still some pockets of concern, driven by age, ethnicity, income — and political affiliation. It is hardly surprising there was most hesitancy among supporters of the antediluvian anti-lockdown Reform Party founded by Nigel Farage. But the study also detected significant scepticism among voters backing the Green Party, who are at least 14% less likely to accept the jab than people supporting the Tories, Labour, Liberal Democrats or Scottish National Party.

Such scepticism is another depressing indication of the breakdown in trust between citizens and the institutions that shape lives. And this matters since a successful vaccination policy — and escape from this dystopian nightmare — relies on mass inoculation to minimise the potential host bodies for the wretched virus to infect. So why would nearly one in four people identifying with Green politics be so mistrustful — and what does this mean for the environmental lobby?

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The WHO's Covid shame

By Ian Birrell

Perhaps the findings merely prove that there is some truth to that hoary old stereotype of hippy environmentalists, besotted with their healing crystals and hooked on the absurdity of homeopathy. Such folk clearly still lurk in the undergrowth of the Green movement. These are the sort of people fixated by “natural” remedies, forgetting that Mother Nature can be such a deadly force; bear in mind that measles was the biggest killer of children under five in Africa until the arrival of vaccinations. One Green MP in New Zealand even advocated use of homeopathic medicines in the 2014 West African ebola epidemic.

In Britain, the Green Party has long been dogged by anti-science views. Its solitary MP Caroline Lucas has admitted using homeopathy and once signed a parliamentary motion in support of such treatments, while Natalie Bennett, her successor as leader, insisted the bogus medicines had a place in the NHS. Meanwhile, its 2019 election manifesto argued rightly that the science is clear on climate change, yet dismissed nuclear power as a “distraction” from renewable energies. It also demanded a moratorium on production and import of GM foods. So while misguidedly saying Britain should ramp up aid spending under a “moral imperative” to “alleviate suffering”, they ignored how science ensures rising global populations have fed themselves through advances in farming.

Crucially, Green voters are more likely to be young — another group showing greater hesitancy over Covid injections since the virus is more lethal to older people — and sceptical of a capitalist system they see as destroying the planet.

Ben Ansell, the professor of Comparative Democratic Institutions at Oxford who led the study, told me he found that Greens responded in a similar style to other opposition party voters in their verdicts on government performance, rollout of vaccines and in deference to scientists (unlike Farage’s fan club, who are suspicious of experts). But they had less faith in government scientific advisers and were more wary of the regulatory system. “This may be down to mistrust of Big Pharma rather than scientists in general,” he said.

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The toxic British worship of the NHS

By Ian Birrell

It is all too easy for lack of trust — in the authorities, in capitalism, in experts — to tip over into scepticism over vaccines. Jill Stein, the US Green Party’s presidential candidate in 2016, sparked worry over her ambivalent vaccine stance after saying people had “real questions” over side-effects. Michèle Rivasi, deputy leader of the French Greens and a former Greenpeace chief, attracted controversy after issuing an invitation to Andrew Wakefield, the British doctor struck off for his discredited paper linking the MMR jab to autism. She has called also for an end to the “quasi-religious” cult of vaccination.

During the pandemic, there have been concerns in Australia over anti-vaxxers infecting the Greens after data found an overlap between low immunisation rates and high levels of party support. “There certainly are people who hold concerning views about vaccination,” said Sarah Hanson-Young, a senator for the party. “To those people I say we are a party of science, we are a party of evidence, and we are a party of making sure the community is looked after. The public health response needs to be underscored by science.”

She is right. One leading British activist argued to me there is a generational divide between younger supporters — who have strong faith in science since it has informed their deep-held views on importance of climate issues — and the remaining vestiges of an old guard who were alarmed by issues such as GM crops and nuclear power. Yet both sides seem to coalesce around antipathy to capitalism, evidenced by their shock troops of Extinction Rebellion, despite its crucial importance in the climate change battle.

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Turning off the lights won't save the planet

By Tom Chivers

Behind these issues of scepticism over science and capitalism lies a profound question for the party, one which I first came across in my post-graduate study days. My journalism thesis pondered if Green politics might take off in Britain, which felt prescient when the Green Party surged to 15% vote share in the 1989 European elections. Yet my conclusion was negative. First, I thought the party unlikely to thrive in our two-party system, since mainstream rivals would simply shift positions if Green issues became embedded in the electorate. Second, behind the media-friendly face of Sir Jonathon Porritt, the Green Party’s best-known figure at the time, I saw too many hardliners and obsessives to permit the sort of compromises needed to gain or even influence power.

Sure enough, the impressive surge soon turned out to be a blip as the party slid back in polls. It still struggles with this internal conflict: is it serious about changing the world or content to remain a fringe force, stuffed with too many cranks, conspiracy theorists and loopy ideas to be taken very seriously? Only last week, one of the party’s two peers called for a curfew on men after 6pm in response to Sarah Everard’s death. Baroness Jenny Jones told the Lords that this “will make women much safer, and discrimination of all kinds would be lessened”. Perhaps she may be right. But her draconian solution is not likely to be an election-winning proposal with at least half the electorate, let alone underline their credentials as serious political players amid the soul-searching over women’s safety.

Ultimately this is a party divided between “watermelons” (green skins but red in the middle) and the more pragmatic “mangoes” (green exteriors but yellow, like Liberal Democrats, in the middle) — as seen so disastrously in the splits when it won its first big local authority in Brighton. This has long been the problem for Green politics, even in Europe where it has made more advances by capturing major cities and participating in governments. Charismatic German leaders claim to have reshaped politics by transcending the left-right divide. But Winnifred Kretschmann, branded the world’s most powerful green politician after running Baden-Württemberg for a decade, had to see off fresh challenge at the weekend from a new party founded by activists who deem him too cosy with big business.

It might feel a long way from an Oxford study on vaccination scepticism to ructions in the politics of a German powerhouse state, but they are linked by a common thread — the difficulty of reconciling people with conflicting outlooks who are united only by their concern for the environment. Climate change has become the third most important issue in this country after health and the economy as Brexit fades in importance, yet the Green Party remains a largely irrelevant force in Britain. Yes, its leading lights have stood firmly in favour of vaccination. But the level of hesitancy in their ranks shows the pressing need for a sharp injection of reality if they really want to shape our nation’s future.

The outrage was the subsequent blame-shifting manoeuvre by the European Commission. While the accusation that AstraZeneca was diverting vaccine supplies from the EU to the UK was absurd, the consequent threat to impose a hard border on the island of Ireland was shockingly irresponsible. Widespread condemnation forced the Commission to back down.

The scandal is what happened next. For a start, and despite the fiasco and the outrage, no one has resigned — least of all Ursula von der Leyen, whose cool-and-calm exterior conceals a heart of beating ineptitude.

Then came a spectacular display of sour grapes. After all the fuss about not getting enough of the Oxford AZ vaccine, various EU powers-that-be have undermined its reputation.

It all kicked off with a report in Handelsblatt on the 25 January. The piece featured a claim — from a mysterious source within the German government — that the vaccine was only 8% efficient among the over-65s. Unsurprisingly, this made headlines around the world.

Could this possibly be true? No, said AstraZeneca, the figure had no basis in their research or anyone else’s. So where did it come from? An investigation for the BMJ by Hristio Boytchev tried to get to bottom of the matter, but all we can say for sure is that an unnamed source in the German health ministry was very keen to get the fake news out there.

In any case, the murkiness soon became manifest. Within days of the anonymous briefing, the German and French governments announced that they would not be allowing the use of the vaccine among the over-65s.

In comments to the press on the 29 January, Emmanuel Macron made it clear what the French attitude would be: “everything points to thinking it is quasi-ineffective on people older than 65, some say those 60 years or older.”

But “everything” did not point to that conclusion. The British had already approved the vaccine (on the 30 December) and had been successfully using it since. On the same day as Macron’s remarks to the press, the European Medicine Agency (EMA) also approved the use of the vaccine — among all adult age groups. Furthermore, they specifically addressed the issue of older age groups:

“There are not yet enough results in older participants (over 55 years old) to provide a figure for how well the vaccine will work in this group. However, protection is expected, given that an immune response is seen in this age group and based on experience with other vaccines…”

As Tom Chivers explained for UnHerd here, it’s entirely reasonable to expect encouraging results from trials conducted mostly on younger age groups to hold true for their seniors, too. And yet the President of France saw fit to state that “the real problem on AstraZeneca is that it doesn’t work the way we were expecting it to.”

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Europe is waiting for its Napoleon

By Peter Franklin

If anything, the vaccine has exceeded expectations. Results from England show that inoculation has cut the risk of serious illness in the over-80s by around 80% — building on similarly impressive results from Scotland. That Handelsblatt claim wasn’t just wrong, but wrong by an order of magnitude.

Note, also, that these results are for a single shot of the vaccine. The second shot should produce even better outcomes. Nevertheless, the degree of protection already achieved has triumphantly vindicated the decision to spread out the shots in order to vaccinate as many vulnerable people as possible. More reason, then, for Macron to eat his words — because as well as pouring doubt on the efficacy of the virus, he poured scorn on the UK’s first shot first strategy, stating: “I’m not sure that it’s very serious.”

Well, it is serious, as are the consequences of the EU’s sour grapes. The irony of the supply dispute with AstraZeneca is that shots of the vaccine are now going unused in the EU, because intended recipients (like the older under-65s and health workers) are worried there might be something wrong with it. In Germany, regional governments are pleading with Berlin for permission to reassign doses to people in lower priority groups who are willing to take it.

The contrast with the British experience becomes more embarrassing by the day. Though one would expect Covid deaths to fall as a result of the UK strict lockdown, they’ve been tumbling fastest among the most extensively inoculated age groups — compelling evidence that our vaccine strategy is working.

The Europe Union is now waking up to what it needlessly missed out on. Worried EU governments are now desperately reassuring their populations that the Oxford AZ vaccine is safe and effective. The French have just relaxed the restriction on the vaccine’s use among the over 65s. The Germans are likely to follow suit. Thomas Mertens, head of Germany’s  expert panel on vaccine use, has promised an “update” to the current regulations. He was at pains to point out that the existing restriction were never about safety concerns and added that “somehow the whole thing went kind of badly wrong.” Yeah, “somehow”.

In the latest blow to European solidarity, Denmark and Austria have chosen to go their own way, obtaining vaccines via Israel; Slovakia has joined Hungary in acquiring the Russia Sputnik vaccine, believed to be safe although yet to be approved by Brussels; while Poland is considering a deal with China.

And yet the EU’s leaders continue to send the wrong signals. Last week, Angela Merkel said that she would not take the Oxford AZ vaccine herself. Her British defenders point out that this is only because she is 66 and thus just above the age at which the current restrictions kick-in. But, as usual, her apologists miss the point. The rules — which she is ultimately responsible for — are ridiculous and should not exist in the first place. As leader of her country, millions of people will follow her lead.

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The death of the idle rich

By Peter Franklin

Of course, hers is not the only screw-up in this pandemic. There isn’t a country in the world that hasn’t got it wrong repeatedly — and the UK is clearly no exception. However, it’s important that we distinguish between the different kinds of mistake.

About a year ago, Britain should have gone into lockdown at least two weeks before it actually did. However, our Government was acting on official scientific advice that was unfortunately wrong. Other failures arise out of the sheer scale of the challenge, test-and-trace being a prime example. We can test at scale, but tracing is supremely difficult when transmission is so widespread. It might have helped if we’d closed our borders at the outset — but that’s an illustration of a third kind of mistake, those that happen when governments are faced with impossible dilemmas. Choosing the lesser of two evils isn’t easy when they’re both overwhelmingly horrible.

The mistakes made by Brussels, Paris and Berlin over recent weeks have been of a different type, and were entirely avoidable. In deciding policy towards AstraZeneca and its vaccine, the scientific advice (from the EMA) wasn’t wrong, the challenges weren’t insurmountable and the choices far from impossible. There was no question as to the safety of the vaccine. There was a degree of uncertainty as to its effectiveness, but good reason to expect a beneficial outcome. After all, for millions of elderly and vulnerable Europeans the alternative isn’t a better vaccine, but no vaccine — a famously ineffective treatment.

The mistake made in this matter was not an honest one. There’s only one motivation that fits with the facts — spite.

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Why the EU lost the vaccine war

By Bruno Macaes

As an institution, the EU displays a pattern of behaviour that in an individual would be diagnosed as petty narcissism. We all know the type of person: the character flaw isn’t obvious at first, but they soon give themselves away. In place of the usual give-and-take of a healthy human relationship, they think they’re doing you a favour just by allowing you to interact with them. Furthermore, you will be expected to pay for the privilege. This means abiding by their rules; having to guess what they want without being told; prioritising your relationship with them above any other attachment. Resist their nonsense and you’ll be accused of being the unreasonable one.

If an impasse is reached or you walk away, they won’t wish you well. Indeed, like Jean-Claude Juncker insisting that “Brexit cannot be a success”, they’ll want to you fail without them. And, of course, that’ll be your fault, not theirs. It’s abusive and manipulating, but ultimately self-destructive.

Instead of bullying and then belittling AstraZeneca and the UK, the EU could have chosen the path of cooperation. Even if they genuinely did have questions about the vaccine and the UK’s vaccination strategy they could have kept an open mind — and thus the option to follow suit. As it is, they’ve ensured that any change of mind can only come with a maximum of political embarrassment and humiliation.

Well, never mind — let them pay with their blushes. After all, their people are paying with their lives.

Having met Blair and his team several times to discuss how to address jihadist terrorism, I understood their temptation to veer towards safety and security over life and liberty. But the truth remains that those who trade liberty for security invariably end up with neither. Sadly, many of the debates we had then about how to balance our safety with our freedoms are resurfacing now in the name of beating Covid. But it is not as if we haven’t been down this route before.

During my years spent largely unsuccessfully lobbying successive governments on extremism policy, I met Blair, Brown and Cameron. My work was mainly informed by my own survival of the War on Terror-era encroachments against liberty. I believed I was granted such audiences precisely because I had survived the human rights abuses of that decade only to emerge as a critic of my own former Islamist dogma, while advocating the universality of human rights.

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In 2002, during my time as a Prisoner of Conscience in Egypt, I witnessed British and other detainees tortured in the name of the War on Terror. I do not know of any UK involvement in my own treatment, but my experience did inform my desire to work for an end to British complicity in such abuse anywhere in the world. Blair’s Labour government was in fact implicated in the “extraordinary rendition” of suspects to third countries, where they were tortured for intelligence. When this practice was eventually investigated, Parliament’s Intelligence and Security Committee went so far as to say that “British agencies continued to supply intelligence to allies despite knowing or suspecting abuse in more than 200 cases”.

It was also Blair’s government that criminalised the right to silence at British ports. Thanks to Schedule 7 of the Terrorism Act 2000, to this day any person may be detained and questioned, with no need for reasonable grounds. It remains a criminal offence not to answer questions during such an interrogation. These laws were originally intended for Irish Republicans, and came to be used largely for jihadist terrorism — but typical of government mission creep, they were eventually applied to obstruct controversial journalism. The most publicised example of this occurred in 2013, when Glen Greenwald’s partner David Miranda was detained under these powers at Heathrow airport for nine hours.

It took New Labour’s successors, a Conservative-led government, to soften these Schedule 7 powers by including a reduction in the maximum period of detainment from nine hours to six, extending the rights to consult privately with a solicitor and to have a person informed of the detention, as well as the repeal of power to take a DNA sample. Staying silent, however, remains a criminal offence.

In 2006, upon my return from Egyptian prison, I too was detained and interrogated at Heathrow airport under Schedule 7. My DNA was taken from me by law. This is why, during my work around challenging Islamist extremism, I sought to use the limited platform that I had gained to challenge these powers and advised their repeal.

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Sadly, civil liberties were not a priority for Blair. He tried and failed to introduce national identity cards, even insisting that the scheme should go ahead as a question of “modernity”. Blair also tried to extend the detention of terror suspects without charge for 90 days, the amount of time it took the Egyptian regime to charge me, after placing us in solitary confinement once they removed us from their torture dungeons. After being defeated by Labour backbenchers and the Tory opposition, Labour still managed to secure 28-day detention for suspects, which remains the longest period of pre-charge detention of any common law country.

I have always maintained that the answer to extremist speech is counter-speech, not proscription. In fact, PM Gordon Brown cited my views as a reason, when challenged by the then leader of the opposition, David Cameron, why certain extremist but non-terrorist groups had not been banned. Blair, more recently, co-signed a letter along with David Cameron and religious leaders from the three Abrahamic faiths asking for the taking down of extremist speech online, the argument being that it creates a “climate conducive to terrorism, hate crime and violence”. I fear the lines here are in danger of becoming increasingly blurred.

But Tony Blair’s biggest error committed in the name of “keeping us all safe” is one that requires no further elaboration. His decision to invade Iraq under the guise of “national security” and finding weapons of mass destruction will probably remain one of his biggest policy failures. That it was committed during a global emergency with bipartisan consensus should serve as a sobering lesson for all during today’s emergency and its increasingly dogmatic Covid consensus.

Having failed at securing national identity cards, Blair has seen an opportunity with our understandable fear for our health. He now asks us to surrender our civil liberties “for the common good” by advocating for the introduction of digital domestic vaccine passports on our smartphones. The idea is that we would scan them for entry to bars, theatres, restaurants and so forth. For those who do not have a smartphone, Blair suggests that the venue could take a photo to check against a database of people who have been vaccinated. I am less animated here about such passports for international travel, since such things already exist to deal with illnesses like yellow fever, but implementing these measures domestically is an unsettling prospect.

I have been injected against my will, while in jail in Egypt. To this day I do not know what they put inside my body. Any sort of state coercion on the issue — up to and including compulsory vaccination — fills me with horror. Indeed, Article 6 of the Universal Declaration on Bioethics and Human Rights concerns “consent”, and states (my emphasis): “Any preventive, diagnostic and therapeutic medical intervention is only to be carried out with the prior, free and informed consent of the person concerned, based on adequate information. The consent should, where appropriate, be express and may be withdrawn by the person concerned at any time and for any reason without disadvantage or prejudice.”

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As well as the core human rights questions involved in Blair’s suggestion to make digital vaccine passports a condition of reentry into everyday life, there is also the prevailing issue of minority mistrust. In the UK white people are more than twice as likely to have been vaccinated as black people the same age, and three times as likely as people from mixed ethnic backgrounds. There are a number of reasons for low minority uptake, but among Asians one must surely be the medical malpractice carried out during the War on Terror. As most Pakistanis know, in 2012 the CIA used a fake Hepatitis B children’s mass vaccination programme, reportedly to illegally collect DNA for intelligence purposes in the hunt for Bin Laden. Such was the outrage that the discovery of this fake vaccine programme provoked an alliance of 200 US aid groups to write to the then head of the CIA David Petraeus in protest, linking the agency’s behaviour to the ongoing polio crisis in Pakistan.

But the legacy of this fake vaccine campaign in Pakistan has understandably not been easy to overcome, and trust in public health officials and programmes has been irreversibly eroded. The Taliban promptly issued a fatwa against vaccination. The country’s polio cases among children have not recovered since. Sadly but predictably, the CIA’s actions in Pakistan formed the core justification for an armed backlash against immunisation workers, leading to 56 deaths between December 2012 and May 2014. To this day, local leaders believe that vaccination drives are Western spying programmes.

But Tony Blair’s advocacy here appears blind to any understandable concern around abuse and discrimination. The spectre of non-vaccinated minorities being turned away from shops is not one that any government should willingly embrace. And so, just as during the War on Terror we all did our bit while remaining critical of government overreach, I believe it is our duty now not to simply surrender before every encroachment being suggested.

The natural extension of all of this euphoria has become the need to prove that you’ve been immunised. And so the concept of the “vaccine passport” has been born; a digital document or smart phone app, a magic ticket that will allow you to hop on a plane, go to the theatre or pop to the pub.

Only last week, after facing pressure from countries reliant on summer tourism – including Greece, Italy and Spain — European leaders confirmed their intention to create an EU-wide vaccine certification scheme that would record people who had received approved jabs. “Everyone agreed that we need a digital vaccination certificate,” Angela Merkel, the German chancellor, said after a virtual summit. “This will make travelling within the EU possible and could pave the way for further travel from third countries into the EU.”

It’s hardly surprising, then, that an array of British start-up companies is now jostling to produce a bewildering collection of “travel passes”, “immunity certificates” and “health passports”. But what, exactly, are they? And how will they work?

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First, it is important to remember that proof-of-vaccination documents are nothing new. Seasoned travellers have long been required to have certain inoculations before being granted access to some countries. These have, however, never existed in the context of a pandemic; so, in the past, if you had not had a jab against yellow fever, then you would have been barred from only a handful of countries — if you haven’t had a Covid vaccination, the effect on your travel plans could be much more profound.

The vaccination passports currently being mooted are broadly divided into two types: those intended for international travel and those you might be required to show if you wanted to access an office or entertainment venue — though the best solution (if, indeed, you regard such passports as a “solution” at all) would be for a vaccine passport to be recognised both by national border officials and pub bouncers.

Whatever their purpose, all these documents and passports do have one thing in common: they provide verification of a person’s identity — usually through biometrics or facial recognition — as well as up-to-date access to medical records showing their vaccinations, boosters and so on. Some also record whether a person is positive for antibodies, indicating that they have already had Covid-19.

In the UK, it’s worth noting that this path was not always inevitable. In fact, a succession of ministers initially said vaccine passports were not being considered by the government. But, with the prospect of lockdown being lifted now on the horizon, they have rowed back in the past couple of weeks. Indeed, in spite of the government’s initial reticence, almost half a million pounds in grants had already been awarded to eight companies working on variations of vaccine passports before Johnson’s “roadmap” was announced.

Among them is Logifect, a “global digital health solutions provider” which has received £37,000 to help develop a smartphone app to confirm immunity. Before the pandemic, Logifect was already involved in what it described as “the next generation of digital health”, which would enable individuals to access their medical records, receive healthcare advice and manage medical devices from their smartphones.

Its immunity passport, says Commercial Director Sean Power, would be a spin-off of that. First you would download its app to your smartphone. Using your camera within the app, you would be asked for a scan of your passport or driving licence, and then to have your picture taken for comparison and verification. Then, when you needed to demonstrate that your vaccines were up to date, you would open the app and give permission for your vaccine record to be accessed and for a QR code to be produced. This could then be read by the checker’s smart device, which would display a message with your photo confirming your vaccine status.

“Your picture links you to that record — your name doesn’t even appear,” says Power. “The communication is fully encrypted at both ends for complete security and then everything is deleted in seconds.

“We see this as a way of making a positive contribution to the community, with our costs being covered by a small fee — probably pennies — to the venue or authority that requests the information. It would cost the user nothing.”

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Meanwhile, iProov, a biometrics ID company that lists the US Department of Homeland Security and the UK Home Office as clients, and cybersecurity firm Mvine, which has already worked on projects with the Cabinet Office and NHS, have been given a joint £75,000 grant to develop an app that would perform a similar task to Logifect’s.

iProov’s founder and CEO Andrew Bud tells me their system involves the creation of a certificate to demonstrate that you have been vaccinated. They have developed a number of options, some of which will need the involvement of the Department of Health.

Currently, vaccination records are held by the National Immunisation Management System, which is run by Public Health England, Scotland and Wales independently of the NHS, and within GP surgery patient records. The iProov/Mvine system proposes storing these vaccination records using cloud technology, so they are neither held on your phone nor within existing NHS record systems.

“One of the defining features of the Mvine/iProov system is that it is designed for privacy,” says Bud. “It doesn’t require a name or address or date of birth or National Insurance number or any other irrelevant data. Our system is designed to associate the existence of a valid vaccine certificate with a face.”

Other companies that have received grants include: EAS Technologies (£137,877), which is focusing on vaccine verification for sporting events; the Hub Company (£49,448), which features PayPal and IBM among its clients; Enduring Net (£49,678), which says it usually focuses on technology “in humanitarian work”; and Verifiable Credentials (£89,000), which is planning to create “Covid-19 certificates” that cannot be forged.

But they are not only runners in this race. In fact, the UK Government is undertaking a three-month review of “vaccine passport” technology and may even consider repurposing the pre-existing NHS app — separate to its track and trace app — which gives people access to their medical records.

However, according to Phil Booth, co-ordinator of medConfidential, a campaign group promoting best practice in safeguarding the confidentiality of medical records, this would likely be unpopular among NHS staff.

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“It would essentially turn the NHS into a clearing house for information requested by the private sector,” he says. “This would find great resistance among those responsible for NHS Login [the online portal that patients can use to access a host of services and see their GP medical records]. Being forced to be a certification authority in the midst of all their other pandemic work would be a massive drain on resources and, frankly, a distraction.”

Moreover, Booth says, it is unclear what the purpose of all this technology would be: “It would be impossible for the government to partner up with private companies to produce vaccine passports until everybody had had the offer of a vaccine — otherwise requiring a passport to get through everyday life would be discriminatory.

“But the vaccine take up is so great — about 90 per cent in the higher age groups — that by the time everybody has been offered one, we will probably have reached herd immunity. So, what’s the point of having a passport that will get you into a pub in those circumstances?”

Still, that hasn’t deterred countries across the world from investing in this technology. Israel was one of the first, followed by Greece, Malta, Portugal, Israel, Estonia, Sweden and Norway. None of these countries has said that foreign internationals without proof of vaccination would be refused entry, but instead would be subject to other — more laborious and time-consuming — testing or quarantine regimes.

Domestically, Israel is the only country to have vaccinated enough people to have a system that is already functioning. About half of its 9.3 million citizens have received the two jabs required to qualify for a “green pass” that they can display using a Health Ministry app on their phones — people with such passes are already being granted access to restaurants, shops and theatres.

Airlines, too, are getting in on the act, courtesy of the pre-existing International Air Transport Association (IATA) Travel Pass app. This provides information to travellers on the Covid requirements of the country they are travelling to, tells them where they can get tested if required, enables labs to send results directly to passengers, and, crucially, provides for the creation of a digital vaccination record once governments make them available.

Among those already trialling aspects of it are Singapore Airlines, Etihad, RwandAir, Emirates, Qatar Airways, and Air New Zealand. Moreover, on top of all these initiatives is a whole host of private sector travel and vaccination record schemes, among them IBM’s Digital Health Pass, Daon’s Verifly (currently being trialled by BA and American Airlines) and Microsoft’s Vaccination Credential Initiative.

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But with the creation of so many disparate apps and vaccination confirmation systems, surely we will need some kind of international co-ordination for them to be practicable. And there is currently only one body that has an internationally-recognised proof-of-vaccination scheme — the World Health Organisation’s Yellow Card. Indeed, it increasingly seems that the WHO will be called upon to provide a solution to all this apparent chaos.

Already it has teamed up with Estonia — arguably the country with the world’s most efficient joined-up governmental IT architecture — to come up with a system that would enable national “vaccine passport” solutions to work in an international setting.

At the forefront of this partnership is Marten Kaevats, National Digital Adviser to the Estonian government and a member of the WHO’s Digital Health Technical Advisory Group. He says no new technology would be needed for an international system to work. Instead, building up trust among nations, so that they can rely on the information provided by others, would be paramount.

“We currently see most of the different governments deploying various sorts of their own technologies,” he tells me. “In order for these technologies to be able to co-operate with each other, we need to agree upon common global standards and principles.”

The WHO has set up a Smart Vaccination Certificate Working Group in order to achieve this. But, says Kaveats, “the WHO doesn’t currently have a mandate to become the global anchor of trust for cross-border health data services. It could be given that at the end of May when the World Health Assembly [the decision-making body of the WHO] next convenes.”

With the threat of other Coronavirus variants — or entirely new viruses and pandemics — continuing to loom over us, it certainly seems only a matter before an international solution such as the WHO’s is devised. In the meantime, the race for a vaccine may be over. But the race to create vaccine passports has only just begun.

In the year and a bit since then, there haven’t been many opportunities to write straightforwardly upbeat things. So it is with great relish that I write that the vaccines are now unambiguously saving British lives.

One (so far not peer-reviewed) study looking at 5.4 million people in Scotland — that is, basically all Scottish people — found that vaccinated people were 85% less likely to end up in hospital than unvaccinated ones. The Oxford/AZ vaccine and the Pfizer vaccine were statistically indistinguishable; despite ridiculous and confected European concerns about the Oxford vaccine, it is stopping people from dying just as well as the Pfizer one. And in Scotland the AZ vaccine has been mainly used in older people, to great effect.

Another smaller, UK-wide study looking at infections in healthcare workers found that the Pfizer vaccine was about 70% effective at reducing infections 21 days after a first dose, and 85% shortly after a second dose. Further analysis suggests that even if you do get infected you’re about half as likely to get seriously ill or die, suggesting that it’s somewhere up in the 80-90% region against severe disease.

We’re not mucking around trying to reverse-engineer pharma industry press releases and proxy immune responses any more; this is the vaccine out in the field, doing what it was made to do, and doing it well. One of the most heartening graphs showed that the number of severe cases in the elderly was dropping at a far faster rate than cases in younger age groups; when we came out of Lockdown 1, they stayed stubbornly high for a long time. There was some slight concern in the Scottish data that the response started to weaken a bit once you got past 28 days from the first dose, but it wasn’t clear and it didn’t seem to appear in the other study, so I’m not very worried about it.

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When you add in that cases are dropping day by day – the seven-day rolling average is down to around 11,000 positive tests a day, the lowest it’s been since the beginning of October – I think we are allowed to be cheered.

All that might make you think that the road ahead is clear — but there are still reasons to be cautious.

The chief scientific adviser, Sir Patrick Vallance, in a briefing to journalists ahead of the release of the roadmap, said that it is important, as we come out of lockdown, to do it in stages: open up a few things, wait for a few weeks, and watch how R changes; the basic scientific thing of changing one variable at a time.

Schools are the big unknown. It’s nearly a year since schools were closed in the first lockdown, and despite them being opened and closed again since, we still don’t really know what impact they have on transmission. I think it’s pretty clear that they do drive R upward somewhat, but it’s not clear how much. I get different answers depending on which scientists I ask.

In the roadmap, we will open schools on 8 March (plus a few other things which are probably fairly inconsequential from a transmission point of view), and then see what impact that has. Vallance suggested we should leave four to five weeks between new measures, in order to see what the impact is: under the roadmap, we’re leaving just three weeks before further measures are introduced on 29 March, which disease models presented to SAGE suggest would be “unlikely [to] allow the effect of step 1 to be clearly discernible before step 2 takes place”.

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The measures introduced on 29 March seem unlikely to be major causes of transmission: the reintroduction of “the rule of six” outdoors, outdoor sport starting up again. And they will coincide with the start of the Easter holidays. More major changes will come at least five weeks after the schools reopen. But still, this isn’t being overly cautious: if anything, it’s sailing somewhat close to the wind. 

You might, reasonably, say that it doesn’t matter that much whether schools raise R that much, because the vaccines will stop people dying. But not everyone will be vaccinated, and the vaccines are not perfect, so a huge outbreak will lead to a gigantic surge in cases. The SAGE models suggest that if we were to reopen fully all at once, we would end up with the NHS overwhelmed far more than it was even at the peak of spring 2020. 

Slower relaxation, obviously enough, leads to slower growth in cases. And given the uncertainty, especially around schools, coming out slowly is obviously wise. I understand the wish to come out of lockdown quickly: by one measure, we currently have the most restrictive measures in the developed world. But I’d suggest that’s probably at least partly a result of coming too quickly out of previous lockdowns, not a reason to come out quickly now.

There’s another concern, which is that the more infections there are, the more chances there are for the virus to mutate. There are already somewhat vaccine-resistant strains out there. “If we see big outbreaks and exponential growth,” says Rupert Beale, leader of the Cell Biology of Infection group at the Crick Institute, “you might get a more complete vaccine-escape mutant. It’s relatively unlikely, but each new infection is like giving the virus a lottery ticket.” It only needs to be lucky once.

So the roadmap seems sensible: finally Boris Johnson has learned how to pass the inverted marshmallow test.

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A couple of points, though. First, it is baffling that it is “irreversible”, as briefed a few weeks ago. If we reopen schools, they drive R way above one, and we find ourselves in an unexpected new surge, then the sensible thing to do will be to close schools again. It will be awful for a lot of people, but better than a huge second outbreak and the need for a much longer lockdown.

Second, there are missed opportunities here. The number of cases is falling, and that’s a good thing. But as Adam Kucharski of the London School of Hygiene and Tropical Medicine points out, it means that we have only a short window to find things out about the virus. When there are very few cases in the community, it becomes impossible to tell what effect your interventions have: if you tested a vaccine on a population with no disease, then you’d get zero cases in your placebo arm and in your treatment arm. The same applies if you are trying to see the effect of, say, lateral-flow testing.

So now, while there are still a reasonable number of cases, would be an excellent time to do some randomisation. Try lateral-flow tests in schools in a randomly selected 50% of boroughs. Or try new ventilation techniques in half of schools but not in others. Then measure the impact. It is very unlikely that this will be the last we see of Covid, in either this form or some variant; knowing more about how it spreads, what we can afford to leave open and what we definitely need to close will help us when numbers come back up again. 

Third, there was something that Vallance said which caught me up short. We can’t expect the vaccine to be entirely successful, he said, because even if it’s 80% effective, we’re only vaccinating 80% of the population – adults – and 80% of 80% is only about 65%.

Which is of course true, but it made me think: perhaps … we … ought … to … vaccinate … children?

It’s just a thought, but 100% of 80% is 80%. The vaccines are amazingly safe in adults, and I don’t know of any reason why they’d be less safe in children. I was worried that there’d be some Joseph Heller-style situation where we can’t do safety trials on children because we don’t know that it’s safe to do so, but it turns out that Pfizer have already recruited participants. We’re going to have to live with this disease for a long time. Vaccinating people on their 16th birthday forever is not ideal, especially if it’s still circulating in schools. It might not be the most immediate priority but I’d like to know if it’s safe.

I sincerely doubt that this will be the last time I write “coronavirus” in my life, or even the last time this week. But the vaccine news does make me think that, if we do come out of things cautiously, then perhaps this time next year, I’ll at least be writing it less often.

But why is that? No doubt that’s the question governments across the world are currently attempting to answer, in the hope of replicating some of Israel’s success. But the truth is that the country’s vaccination rollout has been a unique victory — one that has emerged from a confluence of factors which, while individually common in other countries, Israel is alone in having.

Some of those factors are structural. Israel’s universal health system, for example, is built on a regulated service provided by four competing non-profit health service organisations, called “sick funds” — a bit like having four versions of the NHS. Every resident must be a member of a fund, which are financed by a small progressive health tax that ranges from 3-5% of a person’s income. In effect, the system combines the benefits of universal coverage with competition, though it is hardly alone in the world in doing so.

Far less common, though, is the extent of digitisation in the Israeli health system. Each fund maintains a fully digitised records and appointments system, integrated with smartphone apps, websites, and automated phone systems. Crucially, these records are directly connected to the Ministry of Health’s universal vaccination database. This meant that when the time came for organising Covid vaccination appointments, there was no new infrastructure to set up. Appointments were organised automatically for the people who most urgently needed them on platforms that were already familiar.

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But none of that would have mattered without an adequate vaccine supply. And this is where the Israeli government stepped in. Well before any vaccines were approved, senior officials were already signing deals with Moderna, Pfizer, AstraZeneca and others — as well as funding a domestically produced vaccine, which is still in clinical trials. They also began securing a large supply of syringes and needles, an element of the vaccine strategy which was surprisingly overlooked by other countries, most notably Japan.

Of course, many countries put in early bids for vaccines before they were tested or approved. But while EU procurement was focused on leveraging the bloc’s enormous purchasing power to lower the price of vaccines, the Israelis knew there was little hope that a small peripheral country could drive a hard bargain. Working on the assumption that the costs of further lockdowns and hospitalisations would dwarf an inflated vaccine price, Israel prioritised buying as much of it as possible in the swiftest period of time. Exact figures are yet to be made public, but reports in the Israeli press suggests the government paid between double and triple the going rate.

Yet Israel did not just offer more money to get to the front of the queue. It also offered pharmaceutical companies anonymised real-time data on vaccine distribution, side effects, and efficacy — in effect turning its population into Phase IV trial. Data on this scale goes far beyond anything drug companies could obtain in even the largest clinical trials.

Still, while an adequate supply is crucial for a successful vaccination program, it hardly guarantees one. Indeed, it is Israel’s logistical operation, rather than its digitised record system and political decision-making, that ultimately ensured the country’s vaccination program was a success.

As soon as the vaccines arrive at Israel’s Ben Gurion Airport, they are taken straight to a centralised ultra-freeze facility just outside the airport. From there, three times a week, coordinated shipments of vaccine pallets are sent out to the four Israeli health organisations, as well as hospitals, prisons, army bases, purpose-built centres, drive-through facilities, and even mobile units stationed on weekend hiking trails. All are staffed by nurses from local hospitals and clinics which have seen reduced demand during the pandemic, as well as by paramedics and those specially trained to provide extra capacity in the months before the first vaccines arrived.

These centres process, on average, at least eight patients per hour per nurse. Last week, that meant that more than half of Israelis have received their first dose and more than a third have already received both — a figure made even more impressive when you consider that 30% of the population are under 16 and therefore ineligible for any vaccine (pending clinical trials on younger subjects).

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Israel’s approach has also adapted when necessary. Early on, a call centre to report possible side effects was established to prevent the telephone appointment system being clogged up and, even more important, to reduce A&E visits to a bare minimum. Meanwhile, messaging for Israel’s diverse population has become more targeted: faced with low turnout in the first weeks in the Arab and ultra-Orthodox communities, authorities turned to social media and other outlets with tailored messages.

But, given that much of Israel’s vaccine roll-out benefitted from pre-existing infrastructure and policy decisions that are now too late to copy, is there anything that other countries can still do to try and replicate some of its success? The simple answer is: nobody knows for certain. But regardless of how easy they are to copy, there are two aspects of Israel’s vaccine operation that bear noting.

First, the criteria for the initial rollout were very broad and very simple. There was no list of at-risk professions and no list of pre-existing medical conditions that meant certain people were prioritised. Had there been, it’s safe to assume that call centres would have been deluged by those seeking exceptions, exemptions or early appointments. Instead, anyone over the age of 60 — a much lower cut-off than any other country — was invited to get vaccinated in the first three weeks, together with medical staff and anyone in “institutionalised” living (mostly care homes).

Though people in their 60s are not at a significantly high risk of dying from Covid, by vaccinating them early, the Israeli health organisations attended to most of the relevant pre-existing conditions, particularly diabetes and obesity. “The low initial age minimum covered nearly all of the co-morbidities anyway,” Dr Boaz Lev, who heads the Ministry of Health’s Advisory Committee on Pandemics and Vaccines, told me. “And it generated early momentum in a way that stricter criteria could not have.”

Such simple criteria were easy to understand and hard to resent. And the result was that, in the first month that vaccines were available, Israel and Denmark were the only countries where supply actually became an issue. In the rest of Europe and North America, unused vaccines sat in freezers or, worse still, thrown away.

Which brings us to the second crucial aspect of the Israeli operation that observing governments should take to heart: from the very beginning, there was a strict policy of no wastage. Indeed, if there’s one motif to the entire Israeli effort, it’s the idea that one discarded vaccine constitutes a systemic failure. This meant that in small towns where there were leftover vials at the end of the day, residents received text messages inviting them to be vaccinated. Anyone near a vaccination centre where too many vials had been defrosted was also encouraged to get a jab. Even people under 60 could show up at the end of the day and, in the event that there were extra doses, could get vaccinated.

The no wastage policy has had three benefits. It will save money in the long term, as fewer vaccines will need to be purchased than would have been the case if many had been spoiled and discarded. It relieved pressure on the appointments system by discreetly giving vaccines to those people who, for whatever reasons, wanted them earlier than the criteria would allow and who would otherwise have burdened the system with phone calls. And, perhaps most importantly, it quickly introduced more of the vaccine into the community much earlier than would otherwise have been the case — thereby reducing the virus’s transmissibility.

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By Giles Fraser

What’s remarkable about this most Israeli aspect of the whole Israeli operation is how little consideration was given to it. When I approached officials from the sick funds, the Ministry of Health, and nurses on site with questions about the no wastage policy, they all spoke of it as being common sense; something almost automatic. Israelis who hear the story of Hassan Gokal, the Texas doctor fired for ensuring ten thawed doses would be injected rather than discarded, assume that they have stepped through the looking glass.

These aren’t, of course, logistical innovations that stand alone. A low minimum age at rollout can only really work where the initial supply is suitably large, and a policy of no wastage is only conceivable in a system of fully integrated and readily accessible digital records. In Israel, a leftover dose could be given to someone who happened by a vaccination facility because the nurse was able to swipe that person’s magnetic medical card and see that they have no allergies, no contraindications for the vaccine, no positive tests for the virus — and the person would leave with the appointment for the second dose already booked in the system.

It’s also worth noting that, in retrospect, Israel’s decision to push hard in the first three weeks was also a huge gamble. Indeed, it might have been more prudent in the first weeks of the vaccine rollout to ensure that they went only to those most acutely in need — those over 80, overweight, and over in assisted living facilities. No one knew for sure there would be a steady supply after the first batch.

But, as it turned out, it was the momentum of those initial three weeks and the reliable data it provided that convinced Pfizer and others that a steady airlift to Israel was worth their while. Before this was settled, it seemed that Israel might even have to pause first doses after the third week doses until further shipments could be secured.

As it turned out, talk of a vaccine shortage spurred even more people to show up, as citizens began to worry that they might end up waiting until late February or March to be eligible again. “I swear we didn’t plan it that way,” an official from the Ministry of Health who worked on a number of the vaccination PR campaigns told me. “But the truth is, it did more to sustain momentum and interest than any of the influencers we contracted.”

The question for Israel now is whether it can complete the task. Pandemic fatigue has set in, and the most recent lockdown has already been lifted despite the infection rate remaining far higher than it was when either of the previous two lockdowns were ended. And while Israel’s dense population and efficient public health system have proved invaluable, some of its demographic problems will be challenging to surmount. Vaccination rates are still lower in the Arab and ultra-Orthodox communities, precisely the places where infection rates are higher.

An even bigger challenge is Israel’s young population. Even if all Israeli adults were vaccinated, that would only amount to about 70% of the population, far below what experts estimate is necessary for herd immunity. By summer it is believed that a vaccine will be approved for those aged 12 and up, but the incentive structure for vaccinations will be flipped.

It is easy to persuade vulnerable 80-year-olds to sign up for a vaccine for a disease that might kill them. Whether parents of teenagers will be similarly inclined for an injection that, while absolutely necessary for society at large, only protects their child from what is likely a minor illness, remains to be seen. Meanwhile, for the rest of the world, such a dilemma is yet another cause for envy.

As a piece of messaging, “no jab, no job” has much going for it. Like its progenitors “no hard hat, no work” and “no mask, no entry”, it takes an instance of risk-aversion most of us can at least see the sense in, frames it as a value-free universal truth, and adopts the threatening syntax of officialdom to convey its contempt for the public. Add to that the phrase’s enchanting monosyllabic alliteration, as well as the fact that many people will find the idea completely outrageous, and it becomes hard not to see it catching on.

But is it discriminatory? Having an unequal effect that correlates with a “protected characteristic” is not the only way for a policy to be bad, of course. But a claim on those grounds is a nuclear weapon in Employment Law — and a way for employees with less than two years’ service to attack an unfair dismissal — so it’s a good place to start.

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The Equality Act says there’s no discrimination if a requirement is “a proportionate means of achieving a legitimate aim”. One such aim might be the requirement in Section 3 of the Health & Safety at Work Act 1974 — alluded to by both Mullins and the Telegraph’s Cabinet source — to look out for anyone whose health might be negatively affected by your firm’s activities. As for proportionality, perhaps there’ll be an exemption for pregnant women and Christian Scientists — although presumably not for BAME people, who, for reasons no one has yet plausibly explained, are on average considerably less keen on the idea of this vaccine.

But the trickiest question in the discrimination issue is the same one raised by those who would object to a ‘no jab, no job’ policy altogether: namely, is the increased risk of Covid-harm from unvaccinated plumbers sufficient to justify sacking people for refusing to undergo a medical procedure they don’t want?

Now, if we were only talking about, say, doctors and nurses, there might be a stronger argument for compulsory vaccination: the increased risk to others is greater in their case; they’re a small minority of the population; and there are, after all, many other ways to earn a living. Let’s not forget, it has long been impossible for most doctors in the UK to do their jobs without being inoculated against Hepatitis B. But it isn’t only doctors and nurses, and it isn’t only plumbers.

Almost every employer will want to reduce the risk of transmission among its customers and staff — out of an admirable sense of public duty no doubt, and also out of a desire for protection against legal claims, reduced sickness absence, and competitive advantage. And if every employer adopts the “no jab, no job” mantra, Mullins’ argument that workers who don’t comply can “go and work for someone else” rather loses its force.

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And the fact that the ‘no jab, no job’ rule could be applied to almost everyone is a strong indication that it has no intrinsic connection to most people’s jobs at all. Yes, unvaccinated plumbers, and shop assistants, and bus drivers — even tree surgeons — increase the risk of spreading the disease. But so do unvaccinated podcasters with private incomes when they stand in the queue at the post office. Why should the latter be the only kind of person we allow to make a genuinely free choice about the vaccine?

At this point we might start to wonder whether the rubric of employment law — depending as it does on a motley national collection of badly written policy documents and one-sided contracts — is really the appropriate field for planting public health requirements. Might it not be more honest for our Government to use instead the traditional system for the administration of life-ruining penalties: the criminal law?

Statutes create crimes by saying that something is “an offence”. And while those magic words open the door to harsh consequences (although mostly less harsh than being made permanently unemployable — only 5-10% of sentencings each year involve custody) they also guarantee various protections far beyond what’s available at the Employment Tribunal, let alone at an internal disciplinary hearing. The big difference is the higher standard of proof (‘sure’ rather than ‘on the balance of probabilities’) but there are many others, all of which make it much harder to convict someone of a crime than to sack them.

And it’s noteworthy in this context that the criminal law, by means of the Rehabilitation of Offenders Act 1974, seeks to mitigate the dire consequence of unemployability. You can go to prison for six months and a couple of years later, if you apply for a job, you are entitled to tell them nothing about it. “How long will it be on my record?” is a question all white-collar clients ask when they’re offered a plea deal. If they were facing the sack, outside of the criminal jurisdiction — for, say, refusing a medical procedure — the answer might very well be “forever”.

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There’s a clear analogy here, isn’t there, with Free Speech. If everyone you might conceivably work for — manufacturers of everything from ice-cream to razor blades, every ancient Public School, every guardian of the nation’s architectural heritage – requires you to uphold “their” “values” in all visible areas of your life, you will have little choice but to comply. It might start with a particular company, or industry, with a particular need to maintain strict speech codes. Soon, others, noticing the benefits of such policies, follow suit. Before long a deep-sea diver loses his livelihood for sharing an edgy meme on Facebook.

Of course, a plumber with a barbarous social media output might not be as dangerous as a plumber with a higher-than-average chance of carrying Covid, but the principle and the process are the same: individual employers seek to reduce a potential harm by threatening dismissal, and the collective effect is of a national rule. That rule applies across the social spectrum, with potentially life-ruining consequences for transgression — though accusers need not prove anything beyond reasonable doubt — and often with little prospect of rehabilitation.

I have represented, in Professional Disciplinary Tribunals, many men and women who have said — or sent — inappropriate things. Some manage to hang on, some don’t. Those that don’t are often just as devastated by the consequences as the criminal client who has to leave the dock by the back stairs after a guilty verdict. But almost none of them have done anything they could sensibly be prosecuted for. The ever-reducing frequency with which that fatuous free-speech stick-man strip gets posted suggests that the downside of this phenomenon is beginning to sink in.

To treat these issues as something for employers’ discretion rather than as a matter of Public Law not only deprives us of the appropriate protections in the trial process, but also — and more worryingly — evades proper consideration (public and parliamentary) of the balances to be struck.

When it comes to free speech, the Law Commission is currently considering responses to its consultation on Hate Crime legislation. Some of the proposals provoked considerable alarm across the political spectrum —  particularly regarding the plan to extend hate-crime laws into private homes — but as the Chief Executive of the Index on Censorship Ruth Smeeth said, “We need to have a proper national debate if we are going to start putting restrictions on language like this.” Well quite.

As with Free Speech, so with vaccines. I hope Charlie Mullins was right when he said, winsomely, “the entire thing will very soon be a non-issue”. But in case he’s wrong, we must not allow compulsory vaccination to be quietly smuggled in through the back door in ten thousand workplace health policies. The Telegraph reported a Government source as saying that where there is an “unjustified” fear of the jab, “we have got to help people get into the right place”. I do hope that isn’t a euphemism for “force them to take it”. But if it is, there’s a right and a wrong way to attempt to do it.

The choice made by Green, the head of animal testing compliance for one of the world’s biggest pharmaceutical companies, is one increasingly being made by biomedical researchers across the world — but not because of financial constraints, ethical considerations or scientific limitations.

It is all because of a shortage of monkeys.

On almost every continent, pharmaceutical research is being undermined by a dearth of primates caused by an export ban introduced by China last year to restrict the spread of Covid-19. It’s a measure that was initially welcomed in the West, but which is now being seen as an existential threat to biomedical research in the UK, Europe and the US.

Scientists fear that unless this shortage is addressed, the West will become dangerously reliant on China to test new treatments for heart disease, cancers and neurological disorders. More worryingly, come the next global pandemic, the ability to affect which vaccines are approved — and how quickly — could lie firmly in the hands of the Communist Party of China.

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“It isn’t too dramatic to say that this could be the beginning of the end for biopharmaceutical research in the West,” says Green. “I believe China’s long-term aim is to become the world leader in the sector, the place you will have to go to if you want to test your products. But you have to ask yourself whether you want China to be in control of such an important part of our lives — and to have access to so much of our intellectual property.”

The past 12 months have well demonstrated China’s growing influence on the West. But while attention has been focused on Covid-19, Huawei’s involvement in the UK’s 5G rollout and the threat to democracy in Hong Kong, its impact on Britain’s research sector has slipped under the radar.

Despite protests from critics, the testing of drugs and treatments on “Non-Human Primates” (NHPs), as scientists call them, cannot be replaced by computer modelling. It remains a requirement for many new drugs — including the Oxford-AstraZeneca and Pfizer-BioNTech Covid-19 vaccines — before trials can be allowed in humans.

In 2019, 2,015 new NHPs were used in experiments in the UK. Only 220 of them were not imported; most being bred under licence at a government breeding facility at Porton Down in Wiltshire. Some 1,154 came from breeding centres in Africa, largely from the island of Mauritius. And 782 came from Asia — roughly 75% of which came from China.

So when, in January last year, China imposed a ban on the export of all animals, the flow of a sizeable number of NHPs — roughly a quarter of those needed in the UK — was suddenly switched off. But that was only the beginning. British researchers also carry out a significant portion of their research through companies in other, worse-hit countries. And as a result, they have been left scrambling around to find the animals they need to complete their research.

US biotech companies were especially hard-hit. The US relies on China for 60% of its monkeys — some 35,000 a year — and because most of the big pharma companies are multinational, shortages in one area have resulted in bottlenecks in others, including the UK. Desperately in demand, the average price of the animals most-often used — rhesus macaques, cynomolgus macaques and marmosets — has doubled to $10,000 in the past year.

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Kirk Leech, executive director of the UK-based European Animal Research Association, which represents contract research organisations (CROs) — private labs that conduct animal research on behalf of pharmaceutical companies — has seen rare cases of desperate firms paying $30,000 a-head for monkeys.

“As China is the primary source of NHPs purpose-bred for scientific purposes, this ban has had a dramatic impact on both the supply and the cost of NHPs around the world and the ability of researchers to access the animals essential for the development of new vaccines and medicines,” he says.

“This export ban is a clear and present danger to human health, creating obstacles to, and additional expenses for, the development of vaccines and therapeutics, including for Covid-19. The Pfizer-BioNTech vaccine relied on preclinical data generated by BioNTech in Germany, using rhesus macaques. The Oxford-AstraZeneca vaccine and the Janssen vaccine have also relied on preclinical testing with NHPs for safety and efficacy.”

In the event of another global health crisis like the one we are experiencing, he warns, the repercussions could be severe: “Imagine a new pandemic; we would need a global response, we would need vaccine research and we would need to use NHPs. If shortages grow worse due to China’s actions, UK researchers would not be able to respond as they have to the Covid-19 pandemic. That is a real fear.”

Surely, then, the answer is simply to breed more monkeys outside China? In the long-term, that certainly seems to be the solution. But for at least half a decade, numbers will remain finite. More important, decisions to increase breeding could, counter-intuitively, make matters worse.

“The problem is we can’t simply increase the numbers of monkeys we have for sale,” one major Mauritian breeder told me, on condition of anonymity. “For every 100 breeding females, only around 60 babies are produced, and they are usually sold at two years. In order to increase the numbers, we would have to hold back females for breeding instead of selling them, and that would add to the shortage.

“We would have to hold them back for a further three years until they were mature enough to breed, and a female will produce only one baby every 18 to 20 months. A monkey generation [the time it takes for an animal to be born, reach adulthood and procreate] is five years, so that’s a whole generation taken out until numbers can be increased.

“Since the Chinese export ban, we’ve been receiving calls from researchers all round the world begging for monkeys. Some people sound desperate, but there’s nothing we can do in the short term.”

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But if the situation is so potentially-damaging to the UK’s life sciences, why isn’t the research sector issuing dire warnings over its future ­— or lack of one?

According to senior industry insiders, there is a two-pronged reluctance to publicly debate the problem. First is the memory of violent demonstrations against the animal research sector at the turn of the century, when staff at Huntingdon Life Sciences (HLS) in Cambridgeshire were targeted by extremists. Brian Cass, managing director of HLS was beaten outside his home by three men; the company’s marketing director, Andrew Gay, was temporarily blinded in a chemical spray attack; and the homes of workers and contractors were firebombed.

Violent animal activism has since all but evaporated. Yet memories endure of its peak in 2006, when extremists dug up the body of Gladys Hammond, a member of the family which ran Darley Oaks in Staffordshire, a farm which bred guinea pigs for the research industry. Three people who “ransomed” the body in return for the farm halting its business were jailed for 12 years each, but the fear of attracting such levels of violence and hatred remain.

Second, and more significantly, there is concern among CROs that if it became public knowledge that they were being affected by primate shortages, their pharmaceutical clients might turn elsewhere — probably China.

Only one CRO in the UK was prepared to comment publicly, yet anonymously, saying the Chinese ban “will result in global demand exceeding supply and what initially began as a US issue will also negatively impact the European research sector. The lack of access to NHPs due to the China ban will create obstacles to the development of vaccines including for Covid-19 and therapeutics globally.”

Leech — who represents the CROs, as well as pharmaceutical companies, private researchers and some universities — has called upon the British government and the European Commission to demand China lifts the ban, arguing it is in breach of World Trade Organisation General Tariffs and Trade rules. He says importing countries had bio-safety arrangements in place within a month and that the ban could have been lifted by then. The UK and European Commission say they are conducting internal discussions but have not yet agreed to act.

As for why China would deliberately starve the US and Europe of such a vital resource, I twice asked the Chinese Embassy in London to address the accusation that its actions were designed to undermine research in the West, but it failed to reply.

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It is worth noting, however, that such allegations about China’s quest for pharmaceutical dominance are nothing new. In 2016, David Cyranoski, writing for the journal Nature, was granted access to the Yunnan Key Laboratory of Primate Biomedical Research near Kunming in south west China. In his article “Monkey Kingdom”, he described a research nirvana where animal rights activism doesn’t exist and bureaucracy presents no obstacles.

“With support from central and local governments, high-tech primate facilities have sprung up in Shenzhen, Hangzhou, Suzhou and Guangzhou over the past decade,” he wrote. “These centres can provide scientists with monkeys in large numbers, and offer high-quality animal care and cutting-edge equipment with little red tape.”

He described how “many [researchers] have since sought refuge for their experiments in China… Some of the Chinese centres are even advertising themselves as primate-research hubs where scientists can fly in to take advantage of the latest tools, such as gene editing and advanced imaging.”

Finally, and with estimable prescience, Cyranoski concluded: “With China fast becoming a global centre for primate research, some scientists fear that it could hasten the atrophy of such science in the West and lead to a near monopoly, in which researchers become over-reliant on one country for essential disease research and drug testing.”

Deborah Green agrees. “When you look at China’s stated intentions for their industry, there have been a number of moves that seem intended to drive research towards it,” she says. “That’s everything from their control over lab supplies, PPE, research animals and so on. You can look at what China is spending on pharmaceutical research and development. The US is the biggest investor in this sector but China is now very close, and that number has gone from a very low number to rivalling that of the US in a very short time.”

“This all adds up to a reason to believe that China is trying to take control of this sector,” says Green. “Between the moves to push research towards China, and the animal rights activity in Europe and the US, we are going to see a continuing diminishing of research in the western world and a shift of it towards China. There are already researchers from major academic institutions in the US, and Europe sending their primate work to China. It’s cheaper, there is less regulation and they have the capacity to do it.”

But if major institutions and drug companies start sending highly advanced and hugely sensitive research to be advanced in China, isn’t this a risk every bit as great as that posed by Huawei, whose role in Britain’s 5G infrastructure is now being blocked by the UK government?

“I think this all presents serious issues when you look at China’s attitudes to intellectual property (IP), in that it has a very poor record on respecting IP rights,” says Green. “There is a great risk in taking the products that we develop and sending them over there for testing”

One solution, she says, would be for Western governments to help to create the infrastructure to breed NHPs. “These animals can’t simply be bred anywhere,” she admits. “They need sub-tropical conditions because ideally from a welfare point of view, they should be raised outdoors in large spaces. But where this is possible in parts of the United States and southern Europe, a bit of government protection from animal rights activists would be welcome. In the meantime, we’re hanging on, but we’re losing by inches.”

And if the West does lose, it seems there will be only one winner: China.

I suppose what some people mourn is the passing of time and the disappearance of a generation, but Capt Moore was also able — unusually — to cross over two different types of British patriotism, symbolised on one hand by the Spitfire and on the other by the NHS rainbow, and in doing so acquired a sort of symbolic status.

These two types of patriotism, like so much of the British psyche, date to the Second World War, and are the sort of yin and yang of collective identity — warfare against a common enemy, and welfare for the weakest. The Tories feel more comfortable with the former, Labour with the latter, and I wonder if the Capt Tom effect will come to be seen as the holy grail of politics from now on. 

Patriotism is something that Labour has particularly struggled with in recent years. The latest thinking is that the party must make “use of the [union] flag, veterans [and] dressing smartly”, which makes many MPs and activists uncomfortable or angry.

From a strategic viewpoint the leadership is right, since the number of people who don’t feel at all patriotic is pretty small, and concentrated in safe seats where the party can afford to leak a few votes to the Greens or some crankish minor party.

And yet even the most inoffensive and saccharine appeals to patriotism by Labour politicians attract criticism from a section who view all patriotism and nationalism as essentially as morally suspect, and anti-Left-wing.

Jeremy Corbyn personified this worldview, a man for whom patriotism was not just repulsive but almost inexplicable. The Corbyns of this world cannot understand why a person would prize their own country, and its citizens, over another. There’s nothing immoral about it — it’s just that most people don’t feel the same way, and successful politicians can’t really get away with publicly admitting to deeply unpopular opinions.

Labour moderates argue that by not embracing patriotism they risk ceding it to the Right (and extreme Right) — just as once happened to the Union Jack. By this reckoning patriotism is a social good, as opposed to nationalism, its darker cousin; indeed patriotism might almost act as a vaccine against nationalism, inoculating us against its dark magic.

This argument was most strongly articulated by Orwell, who famously distinguished between the two in his 1945 essay Notes on Nationalism, in words which are often treated like gospel. Patriotism, he wrote, was “devotion to a particular place and a particular way of life, which one believes to be the best in the world but has no wish to force on other people. Patriotism is of its nature defensive, both militarily and culturally. Nationalism, on the other hand, is inseparable from the desire for power. The abiding purpose of every nationalist is to secure more power and more prestige, not for himself but for the nation or other unit in which he has chosen to sink his own individuality.”

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Orwell was writing during the dying days of the Second World War, and someone’s views on nationalism in war is probably going to be as jaded as someone’s view of love in the middle of a painful divorce. And the distinctions between the two, of good patriotism and bad nationalism, seem pretty arbitrary. Patriotism has such positive connotations that when Clive Lewis condemned flag-waving he said “it’s not patriotism; it’s Fatherland-ism”, even though that is literally what patriotism means.

Patriotism is a bit of an Alice in Wonderland word that can mean whatever someone wants it to mean, often in a very solipsistic way. What some people say makes them feel “patriotic” about their country are really feelings about a political system or ideology. For certain types of liberals, it was the 2012 Olympic Games and its opening ceremony, representing globalism, liberalism and multiculturalism. For some socialists it is the various radical political movements that flourished from the Civil War to the 19^th century, such as the Diggers and Chartists. (Then, I suppose, if your vision of patriotism is filled with kings and castles, you are also buying into a certain ideological idea of England, too.)

Nationalism, in contrast, is largely viewed as a mindless, Right-wing hostility to all things foreign. Yet this certainly hasn’t always been the case – indeed the opposite was once true.

Modern nationalism begins with the French revolution, with the “patriots” who wished to overthrow the old monarchial and clerical order. Nationalism and liberalism went hand and hand, and although it seems counter-intuitive now, Adam Ryan wrote in On Politics that in central Europe “liberal nationalism was not merely common but during the nineteenth century [was] the most prominent, if not the most passionate, form of nationalism”.

Liberalism and nationalism were condemned together by Pope Pius IX in his Syllabus of Errors in 1864, seen as twin evils of the modern world that threatened the reactionary establishment.

The link between liberalism and nationalism began to dissolve partly because the Right were able to offer a more satisfying version of nationalism — satisfying until your leg is blown off in a trench, that is — while in contrast liberalism became more and more internationalist.

The parting of ways began to show 150 years ago when Germany was united in Versailles. As Katya Hoyer writes in her recently published history of the Second Reich, Blood and Iron: the brutal militarism of the ceremony, with the Kaiser leading his princes in military uniform, “was a far cry from the democratic unification of which the liberals had dreamed. At Versailles, there were no reminders of 1848 — no tricolour, no ‘Deutschlandlied’. Just marching bands and formalities in the heart of a humiliated enemy.”

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While liberals increasingly began to see the ugly side of nationalism, the Right became aware of how much they could use it, and present their opponents as unpatriotic. In 19^thGermany, socialists were called vaterlandslose Gesellen (fellows without fatherland); in our time Norman Tebbit called the BBC the “Stateless Person’s Broadcasting Corporation”, while Theresa May’s “citizens of nowhere” speech upset lots of people who were collectively choking on their [insert vaguely foreign foodstuff].

Socialism, unlike liberalism, is internationalist by definition, so the criticism is often valid, yet the nation-state is the best mechanism for carrying out social democrat policies, especially the welfare state, which in Britain was mostly created during a period of intense patriotism after 1945. It’s also the best environment for liberalism, which thrives where competing identities play a minimal role in politics; there is a reason that liberalism first flourished in Amsterdam and London, not in multicultural Constantinople or Beirut.

And so progressive politics and nationalism are mostly certainly compatible, as long as the latter is micro-dosed. It is often lamented that Scottish nationalists get a pass that other nationalists — especially English ones — don’t, but Scottish nationalism is arguably a more authentic, liberal form of nationalism than most. There is nothing contradictory with liberal-minded people supporting a nationalist movement.

And nationalism has real, practical benefits, the vaccination programme being a very obvious example. Nation-states have clearly proved to be the most effective at enabling the mass production and distribution of vaccines; the supra-national EU in contrast has turned out to be hopelessly incompetent and, when that has proved evident, has behaved in a bullying manner reminiscent of past empires. The most successful vaccinating country of all, Israel, is the one western state that, for tragic historic reasons, takes nationalism very seriously. This sort of vaccine nationalism has been effected — without contradiction — through international cooperation and the work of scientists from dozens of nations working together, with government support. Liberal nationalism at work.

There are no limits to the number of vaccine shots that can be produced, just as there aren’t huge limits to how wealthy a country can become (up to a certain point, of course). One nation-state’s success is not usually another’s loss, yet it is still a competition in which we wish to outdo our rivals.

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Few people wouldn’t prioritise their own country’s vaccine roll-out because most of us are neither pathologically internationalist, as much as the WHO would like us to be, nor are they xenophobic. Of their neighbours most people take the view of Sir Bronn of the Blackwater: they like them, they just like themselves more.

Nationalism is the understanding that political systems are best shared among a group with enough of a commonality that good government can flourish; most importantly of all, that loser’s consent exists. You might argue that patriotism is the active ingredient required, or that patriotism is whatever you are prepared to die for, but it is hardly a separate, distant idea.

Most people, Labour and Conservative, have contrasting ideas of what they like and dislike about their country, but most understand that there is still something worth preserving and celebrating. And I suppose, for many people, Captain Tom Moore personified that.

Its brain eventually erupts into a cylindrical fruit, which pushes its way, like an exploring finger, from the ant’s head to release its spores on the breeze and infect nearby colonies. The ant’s survival is not an evolutionary concern of the fungus; all that matters is its ability to totally manipulate the ant’s functions, and to spread its spores as far as possible, at whatever cost to its host.

Such is the British state after forty years of exposure to neoliberal ideology. After four decades of privatisation and outsourcing, it hesitates to close the borders to a lethal pandemic because feeding a few thousand travellers in airport hotels is beyond its capacity; it can’t produce a functioning track and trace system; when the pandemic began, it had no stock of PPE and wasted millions trying to procure essential supplies from private profiteers. Even supplying free school meals to quarantined children transpired to be beyond the capacity of the fifth-largest economy on earth, leaving the government hostage to the ineptitude of the profiteers to whom it outsourced the role, and humiliated by a Premier League footballer’s PR advisor. Even as the British state is brought to the edge of destruction, it cannot shake itself free of the ideological parasite of outsourcing, deregulation, and  privatisation which controls its every action.

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All because the British state has been hollowed out to the point that it can barely be said to exist. Its survival, even within the short term, is doubtful: but then the host’s survival, and that of the colony to which it belongs, was always secondary to the parasite’s desire to reproduce itself and unleash the free-floating spores of capital.

A recent academic paper by the political scientists Lee Jones and Shahar Hameiri lays out, in forensic detail, how Britain’s record-setting death rate from Covid derives from the failures of what they term the “neoliberal regulatory state”, whereby both Conservative and Labour governments have retreated from active “government” in favour of hands-off, vaguely-directed “governance”. This has, they explain, resulted in “the deliberate reduction of popular expectations of public authority; the outsourcing of responsibility to technocratic, private and quasi-autonomous actors, weakening lines of control and accountability; and the hollowing-out of state capacities and authority to the benefit of frequently inept large-scale corporations.”

Over the course of decades, “state apparatuses were… reconfigured to reduce their responsiveness to popular demands.” State-owned industries were privatised and “authority and control over resources were extensively transferred to unelected technocrats, independent regulators, quangos (quasi-autonomous nongovernmental organisations) and public-private partnerships.”

The results, once this mutilated state was faced with a deadly virus, are clear to see: 100,000 dead and counting, and a devastating economic collapse. Yet there was nothing inevitable about this outcome. The destruction of the British state was a conscious, willed decision by successive governments, who adopted a naive and idealistic faith that deregulation and privatisation would make us richer, happier, and above all freer. The state, they declared, was unwieldy, bureaucratic and wasteful: shifting governance to market forces would be more cost-effective, responsive and, above all, efficient.

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As we now see, this was pure fantasy, a construct of radical ideology marketing itself as “common sense”. Marketisation, however, has not led to the eradication of waste and inefficient bureaucracy, but to the vast growth of both, taken out of democratic control and oversight. As Jones and Hameiri observe, and as any of us can see every day, “the neoliberal regulatory state is actually characterised by greater bureaucracy and considerably higher governmental spending (including on welfare) than its predecessor”.

Costs and bureaucracy have risen exponentially, even as capacity and accountability were frittered away: “neoliberal states may be highly functional for large-scale, internationally-oriented capital, but they have clearly become dysfunctional for solving very basic social problems.”

Modern society is not, as was promised, based on a self-regulating market, correcting itself and achieving desirable outcomes through some “hidden hand” — a faith which betrays its roots in Enlightenment Deism. Instead, it has become a construction of purely parasitic private enterprises, the outsourcing firms and consultancies which waste vast sums of taxpayers’ money on the inept delivery of services that are rightfully the state’s domain. We have rendered what is Caesar’s to Deloitte and SERCO, and are presented with the bill in the daily litany of deaths announced on the evening news.

The reality of neoliberalism, Jones and Hameiri underline, is that “precisely because markets are not natural and spontaneous phenomena, they have required extensive state de- and re-regulation in order to create and maintain them, spawning vast, complex bureaucracies”. Yet at the same time, “rising government spending has often been directed to maintaining this burgeoning ‘quangocracy’ and related private-sector consultancies, and the outsourcing of public services to capitalist enterprises.” Today, they point out, the state has become so dysfunctional it has entered “an asymmetric relationship of co-dependency,” with the British state and its outsourced parasites locked together in a downward, deathly spiral of decline.

This is not a bug, but a feature of today’s society. As the left-wing writers Nick Srnicek and Alex Williams observed in their 2015 manifesto for radical futurism, Inventing the Future, “contrary to its popular presentation, neoliberalism differs from classical liberalism in ascribing a significant role to the state. A major task of neoliberalism has therefore been to take control of the state and repurpose it.” Like the Cordyceps, these enterprises depend entirely on the state for their survival — whether to bail out their failed adventures on the free market, or, functioning as a pure parasite, compelling the state to act as an accomplice in its own destruction.

It wasn’t always like this, Srnicek and Williams remind us, and it doesn’t have to be this way. “In its origins, neoliberalism was a fringe theory,” they observe, “its adherents found it difficult to gain employment, were often untenured, and were mocked by the Keynesian mainstream.” As the historian Peter Hennessy notes, before its spores infected Thatcher’s Conservative party, neoliberalism’s ideologues were mocked and marginal figures, frustratedly complaining about the “Tory paternalism and a dash of dirigisme” which marked her predecessors, and Macmillan’s “Tory government with a large chunk of socialism built into a consensus,” which emphasised state capacity and growth through government-directed investment in core strategic capabilities. The nation’s needs came first: the remorseless, destructive power of the market was kept at a cautious distance, where it belongs.

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It took the oil crisis of the 1970s and the collapse of the Trente Glorieuses of post-war reconstruction for neoliberalism to achieve Western hegemony, the cultural and political dominance by which such a radical and unlikely ideology was adopted as “common sense”. Yet the dystopia in which we now live vastly overshadows the Winter of Discontent, the crisis used to justify this new order in Britain, in its severity. We are enduring the worst disaster since World War Two, and its effects have been vastly amplified by the deconstruction of the state. Now, the pendulum must swing the other way: our essential task is to revive the British state before its total collapse.

After all, who can say with a straight face that the British state of 1971, or of 1961 or 1951, would not have dealt with the Covid crisis more effectively than our current collection of hapless outsourcers? As Fukuyama observes, it is the functioning state bureaucracies, with their legacy of top-down dirigisme, of South Korea and Taiwan, that have performed best in this crisis, and we must turn to them as our example.

There is a tragic irony in observing today’s ideologues helplessly lament the British state’s incapacity on Twitter, like the sorcerer’s apprentice at the mercy of the forces he unwittingly unleashed. This is the country they built. And now that their ideas have failed, it’s up to us to rebuild our state in a way that works. It is time for a new hegemonic understanding, a new common sense, of the necessity and desirability of the state directing private industry and national resources in the pursuit of strong national capacity.

Jones and Hameiri remark that the one functioning arm of the British state in this crisis has been the armed forces, the one sector shielded from the destructive logic of the free market. To this we must add the marked success of the government’s programme of vaccine research, procurement and delivery. It has been a top-down marriage of private industry, the intellectual resources of Oxford University and the capacity of the NHS — directed by government under the realm of a politician, Matt Hancock, who we must now reassess as a serious and competent state functionary worthy of praise.

In the success of Britain’s vaccine programme we can discern the outline of a certain dirigiste future: not an enemy of private enterprise, but its director in the service of the national good; not the creative destructor of the state’s capacity, but its rebuilder in a modern, efficient and effective form. It is a return to a hegemonic understanding of the state’s role expressed by Macmillan himself in a diary entry that “[the] forces at work [are] now too complicated, [the] risks of setback too great to leave to market forces and laissez faire. Dirigisme. But it must be creative dirigisme.”

It may be too late for the British state, but we must try. The state is too weak to host its parasitic accretions any longer. Like the ant colony which discovers the Cordyceps infection amongst its number, we must remove the baneful ideological spores of self-destruction from our government if we intend our nation to survive.

He wasn’t alone. The Archdeacon of Croydon, the Ven Rosemary Mallett, then issued a similar statement: “I also hear that there are a number of people from black and minority ethnic communities who are finding themselves really worried about the vaccine… Please, please, get yourselves vaccinated.” The Diocese of Southwark went one step further, bringing in an urban epidemiologist, Professor Tolullah Oni, to lead an online forum to try and disabuse churchgoers of their fears.

As a priest with a black majority church in the same diocese, I am also making every effort to reassure people that the vaccine is safe.

It seems, however, that the same cannot be said of the very people whose jobs it is to promote the “public understanding of science”. Take Professor Alice Roberts, the Professor of the Public Engagement in Science at the University of Birmingham, who is also the President of Humanists UK. At the same time as Bishop Karowei and others were pleading with their communities not to see science as a threat, she was doing her level best to ridicule people of faith.

Without any consideration for whether now is an appropriate time to go on the offensive, Professor Roberts, displaying that jocular, superior tone so beloved by professional religion haters, took to social media to sneer about the resurrection, the virgin birth and so on. It “all seems a bit … makey-uppy,” she proclaimed.

Here, of course, Roberts is following in a tradition well-established by another former Professor of the Public Understand of Science, Richard Dawkins. He famously denounced God as “a vindictive bloodthirsty ethnic cleanser, a misogynistic, homophobic, genocidal, phillicidal, pestilential, meglomaniacal, sadomasochistic, capriciously malevolent bully”. This too from the person paid to promote the public understanding of science: “Science is interesting and if you don’t agree you can fuck off.”

Such a callous attitude is symptomatic of the growing “facts don’t care about your feelings” school of thought. But those tasked with the public understanding of science surely need to do a lot better than “fuck off” if they are to win over the sorts of communities who see in science some sort of threat.

That was, after all, one of the chief concerns of the “public understanding of science” movement that took form following the Bodmer Report, commissioned by the Royal Society and published in 1985. On its opening page, it explained that “many personal decisions, for example about diet, vaccination, personal hygiene or safety at work or at home, would be helped by some understanding of the underlying science”. Concerns about vaccination scepticism were there on the very first page. That’s partly why it recommended that “scientists must learn to communicate with the public, be willing to do so, and indeed consider it their duty to do so”.

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This is undoubtedly a noble aim. But in recent years, what began as considerate public engagement has become tainted by a new group of public intellectuals who, comfortable in their own echo chambers, understand their role as preaching to the choir.

Roberts and Dawkins are not the only ones who have taken it upon themselves alienate religious believers. Brian Cox, Professor for Public Engagement in Science at the University of Manchester, argued on the Joe Rogan podcast only last week that physics “ruled out” the existence of the soul. Likewise Jim Al-Khalili, Professor of Public Engagement in Science at the University of Surrey and former President of the British Humanist Association, has said that “someone of a religious faith will just stick their fingers in the ears and say: ‘I’m not listening, there’s nothing you can say that will make me change my mind.’” So too Professor Richard Fortey, Collier Professor for the Public Understanding of Science and Technology at the University of Bristol, has suggested that proponents of Intelligent Design should be known as “IDiots”.

On and on it goes. Indeed, it was in this spirit that, back in 2019, the National Secular Society successfully lobbied Public Health England to remove a suggestion from their literature that some people, worried about vaccinations, might like to seek advice from “faith leaders”. Following his victory, Stephen Evans, the NSS’ Chief Executive, crowed: “Advising people to approach religious leaders on healthcare decisions is incompatible with the best interests of individual patients and the wider public.”

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Certainly it is true that not all faith leaders are taking the sort of lead exemplified by the Bishop of Woolwich. But the scornful rhetoric used by the NSS is equally unhelpful. “Some of these fanatics are obstinate, some are deluded or exploitative,” was how one author on the their website described religious attitudes towards Covid-19.

It doesn’t matter how many mosques and cathedrals open themselves up as vaccination centres; there will always be those who want to turn the complex relationship between religion and vaccination into some sort of culture war — using the present situation to leverage more condemnation of religious belief. And that is profoundly unhelpful, not least because it ultimately undermines the efforts of religious bodies to explain to their communities that science is their friend.

Some people just can’t move on from those tired, old, 19th-century debates surrounding science and religion. In fact, we’ve almost come to expect it from anti-religious campaigning organisations like the NSS. But what we should not expect, let alone accept, is the fact that so many of those now tasked with increasing the public understanding of science regard it as part of their brief to attack religion — it can seriously undermine the communication of all the good that science can do to people who may not share the same world view.

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The current pestilence has powerfully reminded us that we are all in this together, and that, unless vaccination is going to be imposed by law, people have to be persuaded about its importance. This is, after all, precisely what the entire public understanding of science movement was intended to achieve, as opposed to being used as a Trojan horse for the advancement of attacks upon religion.

Perhaps it’s high time we had someone in one of these roles who believes in God. This is not an argument about religious privilege — nor one about greater inclusivity. It is simply an argument about public health.

According to one estimate, more than 65% of Nobel Prize-winning physicists in the 20th century were Christians or had a Christian background – a figure which rises to more than 72% for chemists. Yes, a Christian background isn’t necessarily a sign of faith. After all, Professor Roberts went to a church school herself — and sends her children to one. But surely it is not beyond the wit of the scientific community to find someone who can communicate with religious people without resorting to condescension. And if it is, perhaps they should call upon Bishop Karawei.

That is slightly how I feel about reports coming out of the EU saying that 1) the Oxford/AstraZeneca doesn’t work and 2) complaining that they haven’t been given enough of it.

We’re all desperate for the vaccine to arrive, and to release us all from this year-long limbo. The desperation is making us jumpy: people are panicking, convincing themselves that this vaccine doesn’t work, there are side-effects, the rollout is taking too long. It’s not true; the vaccines work, they’re safe, and here in Britain, at least, the rollout is going remarkably smoothly. But the tension is real.

It’s not just in the UK. In the last couple of days, a vaccine trade war has been threatening to break out: AstraZeneca not supplying the EU with all of the vaccine it promised, and the EU threatening to sit on its own supplies of the Pfizer vaccine in response. People in the biotech industry have muttered to me about the possibility of this conflict shutting down supplies of raw materials. Vials, reagents, nucleotide bases and so on are all made in different places, and if countries stop cooperating, it suddenly gets much worse for everyone.

And where all this started was a bitter little row about whether or not the Oxford vaccine works in older people. On Monday, it was reported in the German newspaper Handelsblatt that the Oxford vaccine was only 8% effective in people over 65. 

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This is simply false. The 8% figure is biologically implausible and entirely without sourcing, and Oxford University, AstraZeneca and the German health ministry have all said that it is wrong. It’s really important to stress this, because there are already people who should know better out there saying silly things about the vaccine being more risky than the disease. The vaccines work; they work in all age groups; if you get offered one you ought to take it.

There is, it is true, very little clinical data on the Ox/AZ vaccine in older people. That is because they were recruited later to the trial and in smaller numbers. But there is good clinical data in younger age groups. And you can analogise from those younger groups to the older ones by “immunobridging”. 

To do this, the Oxford/AstraZeneca trial looked at other measures: whether the numbers of neutralising antibodies, T-cells, B-cells and so on go up after the dose. You do that in older people as well as younger people. With some diseases and vaccines – notably flu – the immune response is much weaker in older people than in younger people; but with Covid, or at least with the Ox/AZ vaccine, the immune response remains surprisingly consistent.

The trouble is that you don’t know whether these proxy measures really correlate with protection. Often they do, but without clinical data you don’t know.

So you “bridge” from a group in which you have both the clinical data and the immunogenicity data — in this case younger people — to a group in which you only have the immunogenicity data – in this case older people. You assume (with good reason, because it has worked so often in the past) that that will give you a reasonable picture. And that isn’t an 8% efficacy.

My understanding is that the figure is one of, essentially, two things: someone taking a figure from a very wide uncertainty interval; or someone simply reading a number wrongly. The later is what’s being floated by the German health ministry. They apparently suggest that 8% of the total number of participants in the trial were between 56 and 69, and that someone has misinterpreted that as the efficacy level in over-65s.

That seems an implausibly basic mistake to me. It does fit with the numbers in the December Lancet paper: 56-to-69-year-olds made up 974 out of a total of 11,636, or 8.37%, of the total. But as far as I can tell the thinking is literally just “they said 8%, here is an 8% in the paper, are they the same?” It’s not even the right age group. 

Besides, a Handelsblatt journalist denies that’s what’s going on, and the newspaper has doubled down on its claim, quoting a “high-ranking official” saying “It is impossible to mix up the numbers. According to the data we have so far, the effectiveness in people over 60 is less than ten percent.”

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My preferred hypothesis is that someone has looked at some clinical data in the over-65s, with a very small number of cases and therefore a very wide confidence interval, seen 8% at the bottom end of that confidence interval, and leaked that. It must be unpublished figures, because the Lancet papers had no “over-65s” group, and besides, they only had five cases in over-55s, which is not really enough to give any sort of estimate. But even so, it doesn’t make sense since the “immunobridging” data lets us be confident that it is reasonably effective in older groups. 

So the 8% figure appears to be bunk. But it’s interesting bunk, because it fits into a wider tension between AstraZeneca and the EU, with the UK either caught in the crossfire or engaged in the conflict itself, depending on who you ask. 

The German newspaper Bild reports that the European Medicines Agency will not approve the use of the AstraZeneca vaccine for the over-65s, out of fears that it will be less effective. And at the same time, there are manufacturing problems at a Belgian factory making the vaccine on license. The EU may get 60% fewer vaccine doses than it asked for; around 31 million instead of around 80 million by March.

(“This vaccine is terrible!” “Yeah, and such small portions.”)

In an interview for La Repubblica, Pascal Soriot, the CEO of AstraZeneca, explains some of this. The production of viral-vector vaccines like the Ox/AZ one is a biological process, like fermentation, not a straightforward chemical engineering. Slightly different processes will end up with different outcomes. The Belgian plant, which makes the batches of vaccine to be taken somewhere else and put into vials, found that its batches were coming out with a lower-than-expected yield of the active ingredient, the adenovirus, in the solution. 

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For the record: it would make sense for the EMA not to use the AstraZeneca vaccine in older people, since they have loads of the Pfizer vaccine and good data that it works in older people, and not so much of the AstraZeneca one and no clinical data. The cost-benefit equation is different in the UK, because we have loads of the AZ vaccine and (for the reasons discussed above) good reason to think it will work in older groups. 

But the shortage has led to a row about whether AstraZeneca ought to deliver some of the doses it produces in its UK factory to the EU. At the moment, all the UK-produced doses will remain in the UK; in response the European Commission is tightening controls on exports of the vaccines it does have, such as Pfizer. The Commission says it won’t sue, because that takes time, but they’re not happy. 

Rob Blackie, a strategist who works with biotech firms, thinks that AstraZeneca will have been behind the decision to keep UK-produced doses here: “I don’t think it’s a government decision,” he says. “The implication of lots of things people have said is that the drug companies are in control. My assumption was that it would be strange to do anything so nationalistic, because the problem of pissed-off governments is so big.” But a biotech industry source speculated that there was probably significant pressure from the UK government, because it has bet so heavily on AstraZeneca.

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Soriot, in his La Repubblica interview, says that AstraZeneca’s contract with the UK was signed three months before its contract with the EU, and that their contract with the EU simply demands that they make their “best effort” to provide as many doses as possible. But, clearly, emotions are running high – hence the strange German claims about 8% efficacy (Soriot sounds baffled by it) and the simmering threat of a trade war.

It’s not just about the EU stopping exports of Pfizer. If this develops into a full-blown vaccine trade war, then entire supply chains could end up getting disrupted. My biotech source agreed that this is not an implausible outcome. AstraZeneca has a stockpile of the raw materials for its vaccine, but some of those materials keep better than others, so it may become difficult if supply dries up. Even small delays in the vaccine rollout could cost thousands of lives, so this matters.

Avoiding a vaccine trade war, then, seems a really good idea. AstraZeneca says it can produce 300 million doses a year in its Wrexham plant – that’s 25 million a month. Elsewhere it says it should be producing two million a week already. If these numbers are anything like accurate, then it seems unlikely that the main bottleneck in vaccine distribution will be the manufacture. 

According to Soriot, the contract with the British government called for the doses from the Wrexham plant to go to the UK first: “As soon as we have reached a sufficient number of vaccinations in the UK, we will be able to use that site to help Europe as well.” But that implies that the UK government could offer to give some to Europe first; as my biotech industry source says, “In vaccine manufacturing, possession is nine-tenths of the law. If the vaccine vials are sitting in the UK, we can choose to how use them.”

I can understand the UK being wary — vaccines are made in batches, millions of doses at a time, not on a production line; so if one batch goes wrong, you lose a hefty chunk of your supply. But enlightened self-interest seems to suggest that we keep the EU sweet rather than start a war, so if we do have spare vaccine, handing some of it over with a smile on our face seems a wise idea. The food actually isn’t terrible, but it would be good if we can give them larger portions.