22 Jan 2021

Economic Q&A replay: How will the Covid-19 vaccine rollout impact the UK economy

Phil Shaw

Chief Economist

Professor Michael Barrett

Institute of Infection, Immunity and Inflammation, University of Glasgow

The United Kingdom is just over a month into its mass vaccination programme. Despite the reported success, Britons remain in lockdown and the NHS is under strain. We welcomed back Professor Michael Barrett of the Institute of Infection, Immunity and Inflammation at the University of Glasgow. He joined Investec's chief economist, Philip Shaw, in our latest webinar to give his insight on the path to recovery.

Watch the full replay below, or read the summary here:

An update on the UK economy, Brexit and recent key events


- Phil Shaw, Investec Chief Economist


 


 


The Covid-19 vaccination programme is in full swing, what happens next for the UK?


- Professor Michael Barrett, Institute of Infection, Immunity and Inflammation, University of Glasgow


 


The Covid-19 vaccination programme is in full swing, what happens next for the UK?


- Professor Michael Barrett, Institute of Infection, Immunity and Inflammation, University of Glasgow


 


Q&A with the panel


- Professor Barrett answers questions on the effectiveness, rollout and safety of Covid-19 vaccines; comparisons to Israel's vaccine programme; the outlook for social restrictions; anti-vaccine sentiment; and tackling pandemics in the future. Philip Shaw also addresses questions on the UK economy, the inflation outlook and the prospects for US government stimulus.


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Covid variants complicate UK’s exit strategy

As a winter spike in Covid-19 cases dashes hopes of an imminent exit from lockdown restrictions, we welcomed back Professor Michael Barrett of the Institute of Infection, Immunity and Inflammation at the University of Glasgow. He joined Investec's chief economist, Philip Shaw, to provide an update on the fight against coronavirus which has been complicated by the detection of new, more infectious variants.  

“The detection of coronavirus variants has knocked the UK’s efforts substantially and signalled a long winter of severe lockdown restrictions,” said Professor Barrett.

 

The variant news arrived against a bleak global backdrop of coronavirus cases close to 100 million, with more than two million deaths recorded. 

 

“We now have over 3.5 million cases in the UK, and deaths approaching a tragic 100,000 milestone. Meanwhile, the virus is out of control in the US, with deaths predicted to surpass 500,000 in the coming weeks. Previously a beacon of hope in terms of a light-touch approach to restrictions, Sweden has seen cases and deaths soar,” he said. 

 

Professor Barrett explained that while this is a grave situation in the UK, it could have been far worse without restrictions. 

 

“I believe we could have lost half a million people in the UK this year, had we not locked down. Locking down was, and remains, absolutely essential.” 

Ahead of the game

It is not, however, all bad news. Professor Barrett said the swift roll-out of vaccines in the UK has been a remarkable effort from a logistical and public health perspective.

 

“The UK has licenced, approved and distributed several coronavirus vaccines, including the Oxford-AstraZeneca, Pfizer-BioNTech (both already being distributed) and Moderna vaccines (approved awaiting rollout), with tremendous speed and agility, while other countries have delayed – potentially missing a vital window to stem the virus. 

 

“In this regard, the UK has been ahead of the game. We have now injected 4.5 million people so far with a single dose of coronavirus vaccine, in the UK’s largest-ever vaccination programme. This shows what can be achieved when the will is there.” 

The research so far has indicated the vaccine-induced responses are neutralising new variants. But Professor Barrett said we have to be very cautious of this.
Attack of the variants

The key reason for the government’s lightning action on rolling out the vaccines has been the appearance of more transmissable variants, said Professor Barrett. 

 

“We saw this happening in real-time at the beginning of September thanks to our enhanced testing capabilities. Alarmingly, the proportion of new variants compared to the old variant was growing and growing."

 

For Professor Barrett, by the middle of December, it was crystal clear the new variants were being transmitted much more rapidly than the old variant.

Behind the science: two good theories on why we may have variants

  • The mutation within the protein means the virus binds more tightly to our receptors, which means it can get into our bodies and take hold more effectively. 
  • The mutant virus seems to replicate more in the upper respiratory tract – which is a pathway for enhanced virus transmission as people breath, cough and sneeze and release more of the new variant than older ones. 

Professor Barrett said despite the fact the variants transmit more quickly, there is no evidence to indicate they are more virulent or they affect young people more adversely. 

 

However, what is concerning is whether the new variants will evade the recently authorised vaccines. 

 

“We have seen South African and Brazilian variants creating mutations that make transmission easier. We are also seeing additional mutations appearing in the spike or ‘S’ protein. 

 

“The reason we worry about the vaccines is they are aimed at the S protein. The more you change the S protein, the more risk it will begin to evade immune responses aimed at the original S protein,” said Professor Barrett.  

 

The research so far has indicated the vaccine-induced responses are neutralising new variants. But Professor Barrett said we have to be very cautious of this and be careful new variants do not continue to change in ways where they become ever more remote from the original sequence.

Avoiding escape mutants

This, he said, would create ‘escape mutants’, against which the vaccines, all aimed at the S protein, that we have would not protect us. Fortunately, we are not there yet, and most immunologists do not predict this outcome. 

 

The good news, said Professor Barrett, is we have a number of augmented vaccines coming along, although this will require a process of months to approve and distribute.  

 

Longer-term, he says the picture looks more encouraging, as a number of new vaccines which use the whole virus (killed and thus not able to cause disease) will eventually come into the arsenal in the battle against coronavirus. 

 

“This will mean injecting a whole array of different antigens against which the immune system can respond. One hopes, therefore, we will be able to keep ahead of the game,” he said. 

Not all vaccines are the same

Professor Barrett stressed there are differences between the Oxford-AstraZeneca and Pfizer-BioNTech and Moderna vaccines in their basic structures. He explains the fundamentals:

 

  • The Oxford-AstraZeneca vaccine contains a coronavirus gene for the S protein, which induces an immune response when introduced into the body. The S protein is inserted into a different virus, an adenovirus, that has been crippled – when putting this vaccine into a person, the adenovirus is released but cannot replicate itself. Crucially, the S protein has been genetically engineered so the adenovirus produces the immunity-inducing protein for a relatively long time.
  • Meanwhile, mRNA vaccines such as the Pfizer-BioNTech or Moderna vaccines instruct our cells how to make a protein – in this case, also the S protein – that triggers an immune response. However, the RNA hangs around in the human body for less long than the Oxford-AstraZeneca adenovirus – so the body stops producing the protein against which it is making the antibody response more quickly.  

It turns out the biology behind the adenovirus vaccine tells us waiting longer before receiving a second booster shot is better. This is because we can continue to produce the protein for longer. However, Professor Barrett warned any changes in times between the first shot and the booster must be thought through carefully.

 

“All current vaccines were trialled with a second dose included. This is where success in the trials was seen – in the three to four-week period after vaccination. It is important this process is replicated as we understand how the vaccines behave in this scenario. There is evidence that a 12 week wait for the Oxford-AZ vaccine is fine.  But such evidence is lacking for the Pfizer-BioNTech or Moderna vaccines.

 

“Practically, given these dynamics, I think it better that people should continue to shield for three months after receiving the first dose to ensure they have adequate protection.”

“Unfortunately, there may be more bumps along the road, and we will have to live with restrictions for some time yet. I hope in late spring, early summer we will be in a much better position.”

Test, trace, repeat

Alongside vaccination efforts, tests are still vital in the battle against Covid-19, said Professor Barrett. 

 

“On the positive side, we have seen advances in rapid tests. They are not as accurate as the PCR test, which amplifies very small numbers of viruses – but we are seeing other higher-accuracy detection methods coming online, which will give quicker feedback.”

 

Lateral flow tests have been controversial due to questions over accuracy, but they have their place if used properly, believes Professor Barrett. Crucially, positive results should be followed by isolation and contact tracing.  Negative tests, however, should be considered as potentially false, and people should continue to abide by distancing rules. The problem with the track and trace system has been that without proper implementation, potential spreaders are not isolated until it is too late. Tracing and isolation have been inadequate.

 

“As long as a Covid-positive person acts accordingly and is quarantined, and their contacts are traced and quarantined, it has a benefit. Otherwise, the question must be why test at all?” 

 

“I do think the government is now understanding the importance of rigorous testing. There has been more aggressive rhetoric from senior politicians about people not sticking to the rules – as the result of not sticking to the rules has been calamitous.”

 

Testing has continued with the Lighthouse Labs, he said, and “mega labs” are being created to build a longer-term testing capability to try to make sure this does not happen again. 

 

In summary, Professor Barrett said the new variants really took everybody by surprise – but we will turn the tide eventually on the virus. 

 

“Unfortunately, there may be more bumps along the road, and we will have to live with restrictions for some time yet. I hope in late spring, early summer we will be in a much better position.”

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