What did you do in the pandemic, Mummy and Daddy? Memoirs by battered veterans of the Covid-19 wars are likely to be a growth industry in the coming year. These two, among the first, are both revelations in their own way. Vaxxed, by the two women who led the development of the AstraZeneca vaccine, is a tale of hard work and victory against steep odds, a unique insight into vaccines generally – especially eye-opening, I suspect, for anyone worrying that Covid jabs were made too fast, or that we don’t know what’s in them (the book includes a list of ingredients, with explanations).
Spike, a top scientific insider’s account of the political handling, and mishandling, of England’s pandemic, is a different tale entirely. That tale isn’t over, either, as Boris Johnson was determined to lift all pandemic controls, despite rising cases and scientists’ appalled protests. His insistence on making Covid control an individual choice – an absurdity when infectious disease is by its very nature profoundly a collective problem – simply confirms one of Spike’s main messages: from the start, people died unnecessarily in England because political leaders rejected any science that didn’t suit their extreme libertarian ideology.
Jeremy Farrar’s title, Spike, brings to mind both the abrupt surges in case numbers and the protein the coronavirus uses to infect our cells. He has spent decades on the frontlines of “emerging” – meaning new, and worrying – disease and now runs the Wellcome Trust, one of the world’s biggest charitable foundations for medical research, controlling £29bn. He sits on the Scientific Advisory Group for Emergencies (Sage), the secretive committee advising the British government on the pandemic. The book, he says, aims to “shed further light” on how that has gone.
Not well, basically. Farrar wants an inquiry now, not next year as currently planned. Last autumn he even worried whether continuing to advise this government made him complicit in its deadly mistakes. If it did, he will be redeemed if this account triggers changes that prevent those mistakes from being repeated in the next pandemic. Which, he reminds us, could happen at any time.
Farrar recounts how Sage repeatedly issued timely prescriptions for action, yet ministers repeatedly ignored them – and people died as a result. Sage never discussed the now notorious “herd immunity” plan – that apparently started in the government’s behavioural insights unit, hardly epidemiologists. A week’s delay in the initial lockdown cost 20,000 lives. He is especially livid about Downing Street’s “unforgivable” refusal to lock down again in the autumn of 2020, when the data made it abundantly clear that this was needed, causing tens of thousands more unnecessary deaths.
Libertarian fantasy repeatedly trumped facts. Farrar cites Dominic Cummings’s account of Johnson’s admiration for the mayor in the movie Jaws who kept the shark-threatened beaches open, and his insistence that lockdowns “don’t work”. Yes, they do: in England as elsewhere, lockdowns reduced case numbers. Of course you then need testing and containment to keep the numbers down. Oops. Farrar calls Dido Harding’s test and trace “a grave error”.
To be fair, the initially secret minutes of Sage’s meetings seem to have misleadingly soft-pedalled the group’s conclusions. “Many of us wish we had been blunter or clearer,” Farrar laments. Why weren’t they, and how do we fix that? Scientists do often use overly cautious language, but they are quite capable of being frank. One Sage member’s comment on herd immunity was: “If the plan is chicken-pox parties, we’re fucked.”
You know you’ve got a failure to communicate when Cummings is described as “a force for good” in conveying Sage consensus to Downing Street, even though his presence at the meetings was decried as political involvement in science. Farrar thinks politicians should at least be involved enough to understand what the scientists are saying. That may be optimistic, when their real attitude to scientists was probably revealed in the shabby venues Sage was assigned, one “strewn with unwashed cups that looked like they had been there for weeks”.
Clearly the system by which science speaks truth to power needs a thorough, non-secretive overhaul. The truth was out there. Farrar repeatedly cites detailed, confidential emails he sent colleagues at crucial moments, lamenting the government’s plan, or lack of one, and saying what should be done.
I found myself yelling: “Couldn’t you have told us that?” Sage scientists were attacked by Dominic Cummings and other senior Whitehall officials for talking publicly about the science, and Farrar never mentions Independent Sage, frustrated scientists who decided to conduct their own, public analyses of the pandemic situation. A government might well swear scientific advisers to secrecy, so it won’t be held to account for not listening – but is that in our interests?
Farrar doesn’t suggest a solution for this problem, though he does list the new kinds of international organisation we desperately need to face the next pandemic, and is helping set up a global “radar” to detect outbreaks. He doesn’t, however, suggest ways to discourage countries from being secretive about disease, which disastrously delayed our response to Covid. What did China know, and when, he asks.
And nations aren’t the only ones with secrets. Farrar uniquely reveals how scientific journals’ competitive, pre-publication secrecy also delayed vital information. Some scientists were too fearful of censure for breaking confidentiality rules to release game-changing, unpublished data that would have helped. Far less secrecy all round – as well as the better diagnosis, surveillance, vaccines, wildlife management and the high-level global disease authority that Farrar calls for – are some of the solutions we need in order to address the problems that memoirs such as this reveal. And we need them soon.
Anti-vaccine propaganda could be one of the toughest issues. Sarah Gilbert, Oxford’s redoubtable vaccine inventor, and Catherine Green, head of the university’s lesser known Clinical Biomanufacturing Facility, presumably called their book Vaxxers in riposte to the anti-vaxxers who stymie efforts to end this and other diseases.
Those who invent wild inaccuracies about vaccines – some politically funded – are a problem because they make a much larger number of normal people uncertain about life-saving jabs. There have been too few vaxxers explaining how real people, not faceless elites, devise and make the things. Few can explain that better than these two, and this book is the tale of how the Oxford-AstraZeneca Covid vaccine was designed, grown, purified and produced, reliably and in millions of doses, under the extreme pressure of a pandemic. It’s a gripping yarn.
It does get a little technical in places, although many readers, I suspect, don’t really mind that when it’s about something important – been in any offside-rule discussions lately? The authors alternate chapters, with distinctive voices, and Green especially tries to demystify the science with cooking analogies that generally work, the one involving sourdough being especially apt for this pandemic.
While a lot of this applies to many vaccines, some revelations are unique to the AstraZeneca jab. The first results of trials in people were complicated, with two dramatically different levels of protection, because some groups got half-doses. This was widely reported as a “mistake”, but the pair explain it was the result of resolving a (temporary) measurement problem to maximise safety. Meanwhile a German journalist gets one number horrendously wrong, and Germany bans the vaccine for the elderly, when no data warranted that. It is little comfort to know that other countries get science wrong too.
Much of the AstraZeneca story could apply to the development of any vaccine and the real revelation here is that funding for vaccine development now happens in a ramshackle and time-wasting way that vastly slows the response to new – and old – disease. The Oxford team succeeded despite it. That must change.
I especially loved the book’s personal moments – vaccine makers have families and fears and health issues and lockdown struggles and domestic wasp invasions, as well as a globally vital, urgent, lifesaving mission that requires their full commitment. I dare anyone to read this and not come away impressed. And convinced that we need to be able to do this much more routinely with much needed vaccines.
Both books remind us that there will be another pandemic, and it could be more severe. We need memoirs like these, and we need to learn what they are telling us. Quickly. Meanwhile I’m sending Vaxxers to an octogenarian, ageing hippie who still isn’t sure about getting vaccinated. We can’t all save lives on the scale vaccine makers do, but we can do our bit.