My Coronavirus swansong
Hip, hip, hooray,
this is the very last of my Coronavirus updates.
They started in October 2020 as a one-off piece
concentrating on the bioethical issues of vaccines made
with the help of tissue components derived from aborted
human foetuses. They were never meant to stretch
to Part 2 let
alone Part 20.
So why stop at Part 20?
It is certainly not because Covid-19 has gone
away. Even in the UK, there has been a recent
resurgence of cases. Nor is it particularly
because of a lack of Covid-19 news, but this has,
perhaps inevitably, become somewhat samey – a new surge
here, a sub-variant there, new vaccines here, something
weird there. By now, we are all familiar with
these sorts of themes. And moreover, by now, I
think I have said all I want to say about the wretched
virus. I want to move onto new projects.
During this 20-month sojourn, I have sought to report on
and interpret the fundamental topics – vaccine safety,
Covid-19 symptoms, serious human trials, novel
strategies, likely causes, promising treatments,
potential cures, and so on. Nor have I shied away
from censuring anti-vax rhetoric, conspiracy theories
and diverse doubters. Overall, I have taken a
mostly cautious, risk-averse, scientific approach.
Some have disagreed with my stance, but thankfully, more
people have expressed their appreciation. I am
grateful for all who have bothered to read these
articles and contact me. It has been a fascinating
and educational road trip. Thank you! Until
the next pandemic!
Welcome to the UK’s
Coronavirus statistical switchback. Most of June had
been a month of consistent decline in Covid-19 cases,
hospitalisations and deaths. A very encouraging
trend. But then, in late June, the unexpected
reverse occurred. This contrary virus and its
adverse symptoms were back with seeming vengeance.
By the end of June, the latest figures from the Office for
National Statistics estimated that 2.3 million UK people
were infected. That is about one in every 30 people
– an increase of 32% on the previous week, after rises of
23% and 43% during the preceding two weeks. What has
been happening? The rise is thought to be
predominantly due to two fast-spreading sub-variants of
Omicron, known as BA.4 and BA.5. These two now
account for more than half of new Covid-19 cases in the
UK. We are firmly in the grip of a third wave of
This upward trend may have been partially caused by
increased socialising over schools’ half terms and the
Queen’s platinum jubilee weekend celebrations. By
contrast, the recent transport strikes and their
associated increases in WFH (working from home) may yet
bring about a statistical fall.
The weekly death toll in the UK during mid-June was 334
bringing the total pandemic figure to 180,800. Will
it ever reach that quarter of a million mark?
Hospital admissions have also been creeping up to almost
6,400 from 4,200 in May. The big vaccine roll-out
continues with 150 million jabs given to 53 million people
– that means about 93% of those aged 12 and over have
received at least a first dose. Some 50 million
people have had second jabs and 39 million have had
booster doses. An extra autumn booster jab roll-out
for the over-75s and the vulnerable is about to get
Globally, the figures are mixed, but mostly gloomy.
According to the Johns Hopkins Coronavirus Resource Center
the worldwide totals are now 550 million cases with 6.3
million deaths. At the end of June, the USA was top
of the league table with 87 million cases and 1.02 million
deaths. The UK was in eleventh place with 22.8
million cases and 180,800 deaths.
There seems little point in rehearsing more details.
Instead, remember that unremitting refrain – this Covid-19
pandemic is not over. Much of the world is still in
What has Covid-19 taught us?
We have now lived through more than 2 years of the
Covid-19 pandemic with some 6.5 million, but perhaps as
many as 15 million, deaths and about 550 million
cases. In addition, we have witnessed this tiny
microorganism destabilise healthcare systems, unbalance
economies and confound government leaders worldwide.
The pandemic has indisputably changed our world.
This has been a long and uncertain journey. Yet we
now seem to have arrived at a crossroads. The
pandemic is subsiding in many places. Restrictions
are being lifted. Testing has dwindled. The
return to something like pre-pandemic life and work is
evident. In other words, we have begun to move
from living under Covid-19
to living with Covid-19.
Where do we go from here? It is a baffling
question. Some months ago we thought that if we
tolerated a few lockdowns and some personal
restrictions, the pandemic would blow over. But
that has clearly not been the case. The pandemic
marches on and we have yet to experience Covid-19
True, reported cases and deaths have been declining in
many countries, but more than 3 million cases are
regularly reported each week. Even that, because
of less surveillance and testing, is a numerical
underestimate. Global deaths hover around 10,000
each week. Covid-19 is killing hundreds of people
every day. This is a miserable and unsustainable
situation for both the rich and the poor of this world.
Though we wish otherwise, the virus persists. But
there are now other pressing issues to occupy our brains
and news media – Brexit, national strikes, monkey pox
and polio, a global recession, rising inflation, the
cost of living crisis, abortion in the USA, war in
Ukraine. Small wonder that Covid-19 is so easily
supressed or disregarded.
Yet the pandemic is not over – maybe it never will
be. So, what has the wretched virus taught
us? Or, more significantly, what have we learned
from it? Here are four weighty lessons.
First, have we been too parochially minded?
Covid-19 is not equality driven – its unequal toll has
left tens of millions in poverty and its greatest
effects have been exerted on already-disadvantaged
groups. The world has not suffered evenly, so
while we in the UK, and the West in general, may think
that Covid-19 is largely over and wish to forget it,
many other countries are still in the thick of it –
think China, North Korea and most African
countries. And do not forget that every
devastating pandemic is followed by a devastating
Second, have we been too smug? We in the rich
world have been offered, and mostly accepted, effective
vaccines and other treatments, such as anti-viral
medicines. They can reduce the risk of severe
symptoms, hospitalisation and death. Yet these
have not been universally available and effective global
protection strategies have not been implemented.
The World Health Organization (WHO) once had the aim of
vaccinating 70% of the world’s population by June
2022. That policy had clearly hit the
buffers. Whereas, some 60% of people have now been
double jabbed, in at least 40 countries less than 20%
have. Good intentions are praiseworthy, but robust
policies and workable systems are needed to deliver
Third, are we sufficiently variant-aware? The
possible / probable emergence of new and dangerous
variants is a continuing threat, even for those fully
vaccinated. Think of the Omicron BA.4 and BA.5
sub-variants first reported in South Africa and now
potently dominant here in the UK and elsewhere.
Mutations creating new Covid-19 variants with high
transmission rates, more severe outcomes and the ability
to bypass the antibody protections from vaccines and
previous infections could rock our world again.
New and better targeted vaccines will help. But
immunity forever wanes. Will our world need to be
Fourth, are we now planning for the next pandemic?
Think monkey pox and polio, though their reach is
probably limited. Nevertheless, surveillance and
preparedness are key. These will require tough
science (what is long Covid, etc.?) and resilient
healthcare plans (who should get booster vaccinations,
etc.?). It will all cost money, but hopefully
well-spent money, not like the eye-watering financial
wastes in the wake of the current Covid-19 pandemic –
the UK bill presently stands at £321bn with an
additional £55bn due soon. Learning from the
mistakes and failures over Covid-19, we should be
personally, nationally and internationally better
prepared to face the next biological onslaught.
The official UK Inquiry into the Covid-19 crisis should
be revealing as well as educational. However, its
publication is unlikely to be before 2024. Too
late? Not really. We already know largely
what to do for a better future. Wash hands, avoid
crowds, isolate if positive – you know the drill
whenever it will be needed. We have already
learned great lessons, but our general ignorance is
Omicron sub-variants BA.4 and
BA.4 and BA.5 were first designated as Variants of
Concern in the UK during mid-May 2022. They
appeared to be more infectious than the previously
dominant Omicron BA.2 variant. The UK Health
Security Agency (UKHSA) now reports that BA.5 is growing
35% faster than BA.2 whereas BA.4 is growing only 19%
faster. In other words, BA.5 is likely to become
the prevailing variant in the UK.
Is this of concern? Researchers at Beth Israel
Deaconess Medical Center of Harvard Medical School think
so. They have recently reported that BA.4 and BA.5
appear to escape antibody responses among people who had
previously had Covid-19 infections and among those who
have been fully vaccinated and boosted with the
Pfizer-BioNTech vaccine. The levels of
neutralizing antibodies produced were several times
lower, by a factor of 21, against the BA.4 and BA.5
sub-variants compared with the original coronavirus.
The relevant paper is entitled ‘Neutralization Escape by
SARS-CoV-2 Omicron Subvariants BA.2.12.1, BA.4, and
BA.5’ by Nicole Hachmann et al.,and
was published in the New England
Journal of Medicine (22 June,
The researchers concluded, ‘These data show that the
BA.2.12.1 [the dominant variant of BA.2 in the US],
BA.4, and BA.5 sub-variants substantially escape
neutralizing antibodies induced by both vaccination and
infection. Moreover, neutralizing antibody titers
[concentrations] against the BA.4 or BA.5 sub-variant
and (to a lesser extent) against the BA.2.12.1
sub-variant were lower than titers against the BA.1 and
BA.2 sub-variants, which suggests that the SARS-CoV-2
omicron variant has continued to evolve with increasing
neutralization escape. These findings provide
immunologic context for the current surges caused by the
BA.2.12.1, BA.4, and BA.5 sub-variants in populations
with high frequencies of vaccination and BA.1 or BA.2
In other words, if BA.4, and especially BA.5, become
dominant within a population, will the antibodies
elicited by both vaccinations and previous infections be
sufficient to destroy them? Or will these
sub-variants slip through the defensive wall and wreak
When will we get the next jab? The UK’s spring
booster programme for vulnerable people and over-75s is
still running. The autumn booster programme will
start in September and is likely to include the over-65s
as well as vulnerable people. Government advisers
are weighing up whether to extend this to the
over-50s. Younger people are unlikely to be
eligible. The advance campaign is already
underway. The two mRNA vaccines selected to be
used are from Moderna and Pfizer-BioNTech. GP
practices will soon be invited to sign up for this
autumn booster roll-out now that NHS England has
confirmed it will offer a fixed payment per jab with a
supplement for housebound patients.
By September, Moderna’s new vaccine should be available
for UK residents. This is a bivalent jab that
consists of the original Moderna vaccine plus a
newly-formulated component designed to boost protection
against the BA.4 and BA.5 variants. The current
contract with Moderna ensures that the UK will
automatically receive the newest version of the
vaccine. Other companies are gearing up too.
Pfizer-BioNTech has recently announced enhanced results
for its tweaked vaccine, though it may not be ready by
September. A new bivalent vaccine jointly
developed by the French and British drug firms, Sanofi
and GSK, has also been shown to generate substantial
immune responses against some Coronavirus
variants. Other manufacturers are working on joint
influenza-Covid-19 vaccines, but they are unlikely to be
obtainable before late next year.
The push to boost immunity across rich income, developed
populations, before the winter sets in, has become a
large-scale crusade. Countries, such as Germany
and Israel, have started their autumn booster
roll-outs. Others, like the USA, are on the cusp
of announcing their intentions.
Covid-19 is not a one-off disease. Everyone
currently has a different level of immunity depending on
their infections, vaccinations, both or neither.
Some people have had two jabs, others four.
Different mixes of different manufacturer’s vaccines
have also been deployed. A report from the Office
for National Statistics (ONS) in May suggested that
Covid-19 infections provide a stronger and more durable
protection against further infection compared with
This is important because most people have by now had
their Covid-19 antibody levels raised naturally and/or
artificially. So reinfection, or what has been
termed ‘Covid rebound’ has become a key issue. The
ONS report showed that people who had been infected with
Omicron (or the BA sub-variants) had a 77% reduced risk
of reinfection. Those infected by Delta had 57%
protection, the Alpha figure was 41% and that of the
early Wuhan strain was 40%. Strange to say, having
a disease apparently offers advantages.
Loss of smell
Anosmia, or loss of smell, was once an early diagnostic
feature of Covid-19 infections. As the virus has
evolved this effect has become less important.
An interesting study entitled, ‘Decreasing Incidence of
Chemosensory Changes by COVID-19 Variant’ and conducted
by Daniel Coelho and colleagues at the Virginia
Commonwealth University has been published in Otolaryngology
- Head Neck Surgery (3 May
These researchers surveyed a database of 616,318 people
in the United States who had had Covid-19. They
found that compared with people infected with the
original virus, those who had contracted the Alpha
variant were 50% less likely to lose their sense of
smell. Moreover, such chemosensory disruption was
44% for the Delta and only 17% for the Omicron variants.
As the authors concluded, ‘These data strongly support
the clinical observation that patients infected with
more recent variants are at a significantly lower risk
of developing associated chemosensory loss.’
There is bad and good news. Smell problems can be
long lasting – perhaps for years. As Valentina
Parma, a research psychologist has stated, ‘For these
people, help can’t come soon enough. Simple
activities such as tasting food or smelling flowers are
now “really emotionally distressing”.’
The positive news is that our understating of the
interaction of Covid-19 and anosmia is improving, but
still inchoate. Accumulating evidence suggests
there may be some genetic mutations, specifically in two
genes called UGT2A1 and UGT2A2,
in anosmatic people. Or are structural changes
somehow caused by Covid-19 in the brain’s olfactory
centre the cause?
Nevertheless, treatments are elusive. Small
clinical trials are currently testing a range of
potential remedies, including steroids to reduced
inflammation, and blood platelet-rich plasma that
contains many therapeutic biochemical compounds.
For the moment only ‘smell training’ is on offer, but
maybe additional and improved therapies will soon become
available. The estimated tens of millions of
patients with lingering smell difficulties will
certainly hope so.
Vaccinations for children
Children are not adults. True. This is an
important distinction when it comes to drug testing and
drug administration. Moreover, the volunteers in
clinical trials have long been predominantly men, often
students of a certain age. In other words, women
and children have typically been side-lined. If a
new medicine is designed to treat whole populations then
it should be rigorously tested on the representative
whole. Age and sex are important.
So, early on in the development and production of
Covid-19 vaccines, it was clear that the distinction of
child and adult medicines must be recognised. And
for children the demarcation has arbitrarily been
regarded as from 5 to 15 years old. In the UK, the
NHS recommends two ‘adult’ doses for that age group,
with a 12-week intervening gap. Similar strategies
have been authorised elsewhere, for example, in the USA.
And so attention has now turned to the under-5s.
And, of course, in the medically-informed USA, this has
been a hot topic of concern. The upshot has been
that during mid-June, the White House announced a
highly-anticipated Covid-19 vaccine roll-out plan for
children aged between 6 months and 5 years – the first
nation in the world to permit such a medical
practice. This means that an extra 18 million
people in the US will now be eligible for Covid-19
The US Food and Drug Administration (FDA) has authorised
the use of both the Pfizer-BioNTech and Moderna vaccines
for these young children. The Pfizer-BioNTech’s
vaccine for children aged six months to four years old
is a tenth of the adult dose and requires three
shots. Moderna’s vaccine for children aged six
months to five years old is a quarter of the adult dose
and requires two shots.
Vaccine hesitancy is a potent American trait. Only
67% of US adults, 60% of children aged 12 to 17 and 29%
of 5 to 11 year olds have been fully vaccinated.
So, unsurprisingly, only 18% of parents plan to have
their under-5s vaccinated right away, while 38% want to
wait and see how the vaccine roll-out progresses.
Meanwhile, 27% say they will definitely not
proceed. So how successful will this childhood
vaccination campaign be? At the moment, it looks
The greatest loss from Covid-19
Who, or what, should have the last word in this series
of Coronavirus updates? Let it be the children,
the next generation, who must live with the fallout of
this current Covid-19 pandemic.
The pandemic has brought about many devastating losses –
of human life, global economies, healthcare practices,
and so on. But perhaps the greatest and
longest-lasting impact will be on education, namely
The United Nations (UN) estimates that more or less all
– all of the 1.6 billion schoolchildren in the world –
have suffered an average loss of 4.5 months of formal
education, mainly because of school closures during the
pandemic. Most may well catch up, but for too
many, especially among disadvantaged and vulnerable
children, that loss will be the most damaging legacy of
Covid-19 because it will never be salvaged. That
is indeed a sad end.