This article is part of our 'What's next? Key issues for the Sixth Senedd' collection.
Over the past year we have learned more about the virus, how it spreads, what treatments are effective, and developed vaccines. But where are we on the journey of the pandemic? And what might be around the corner for the new Senedd and Welsh Government?
For more than a year the world has been gripped by the COVID-19 pandemic. It is one of the biggest public health challenges of our time, and the wider social and economic impact is exceptional.
On 11 March 2020 the World Health Organisation (WHO) first described COVID-19 as a pandemic. Less than two weeks later everyone in the UK was told to stay at home to protect the NHS and save lives. While restrictions were eased over the summer, cases began to rise again in the winter months and the stay at home rules came back into force.
The four governments of the UK introduced a range of measures to tackle the virus and, while broadly following the same strategy, they have often taken different steps at different times.
The current state of the pandemic
The pandemic changed our lives in ways that would have been unimaginable at the start of 2020. Our freedoms, life plans, and opportunities have been restricted for long periods of time, some of which will have far-reaching consequences.
The restrictions have largely been underpinned by laws, which are reviewed every three weeks, alongside detailed guidance.
The previous Welsh Government set out a coronavirus control plan, which consisted of four alert levels. The plan was updated in March in light of the more transmissible Kent variant of the virus and the impact of the vaccine rollout.
Over the last few months Wales has slowly moved from the highest alert level 4 and into alert level 3. The then First Minister, Mark Drakeford, set out a more detailed timeline of how restrictions will be eased through to the middle of May.
The roll out of COVID-19 vaccines started in December. Since then (at the time of writing) more than 1.6 million people have received a first dose of a vaccine (which is 51% of the Welsh population), and more than 550,000 have received both doses (17% of the population). The previous Welsh Government aimed to offer a vaccine to all adults by the end of July.
The immediate challenges
There are a number of immediate challenges facing the new Senedd and Welsh Government due to the pandemic.
The vaccine programme
The four UK governments have been in a cycle of imposing and easing restrictions for over a year. The vaccines are hailed as an end to these lockdowns, but will this actually be the case?
While the vaccination programme is progressing at speed, there are still some issues.
So far, vaccine uptake has been lower than average among some ethnic groups and in deprived areas, following patterns seen in previous vaccination programmes. Public Health Wales has raised concerns about the “significant inequalities in coverage of COVID-19 vaccine”. The biggest cause for alarm is that the same groups with lower levels of uptake of the vaccine are also the ones who are at a higher risk of death from COVID-19.
A resurgence of the virus is likely because many people are not protected from COVID-19, either because they haven’t been vaccinated or because the vaccine won’t prevent all infection or illness. This means that communities where uptake is lower will be particularly at risk from an increase in the transmission of COVID-19.
The Pfizer and AstraZeneca vaccines are showing early signs of reducing the risk of hospitalisation. AstraZeneca are also reporting that its vaccine has the potential to reduce asymptomatic transmission of the virus by 67%.
But new variants of COVID-19 are emerging and one of the biggest risks is that “they may be more transmissible or they may bypass the vaccines”. The UK Government’s Scientific Advisory Group for Emergencies (SAGE) warns of the threat posed by new variants to the UK even if a high proportion of the population were vaccinated.
It’s hoped that the vaccines can be tweaked to tackle a variant, with the possibility of a booster jab being provided later in the year if necessary. But the problems with vaccine uptake among certain communities will be harder to solve.
And what role could ‘vaccine passports’ play in the coming months as the economy and society open up? There are ethical, privacy, and legal issues as well as human rights concerns that will need to be considered alongside any such policy.
Keeping the virus under control
At the beginning of 2021 a number of scenarios were modelled, with all outcomes resulting in a third wave of the pandemic. But more recently some scientific advisers to the UK Government have suggested that a third wave might not be as large as initially projected.
Imperial College London stated that “due to eligibility and vaccine hesitancy, vaccination alone will not be sufficient to keep the epidemic under control”, and advised that restrictions should be lifted slowly, with some remaining in place throughout 2021.
SAGE advises that it’s easier to maintain control of the epidemic when levels of prevalence are low because “it provides more time to respond to increases before healthcare systems are overwhelmed [and] allows test, trace and isolate systems to operate more effectively”.
Wales’ Test, Trace, Protect (TTP) system will continue to play a crucial role in maintaining control of the virus to identify who has COVID-19 and their recent contacts and requiring them to self-isolate to stop transmission. Testing and subsequent genomics also help identify new variants and their characteristics.
England and Scotland published timelines for easing restrictions early in 2021. A key issue for the new Welsh Government will be balancing the scientific advice for a slow and cautious reopening against various social, economic, and political pressures.
The long term issues and recovery
Attention will soon turn to the longer term handling of the pandemic and managing its impact.
Some argue for a ‘zero COVID’ or elimination approach to break the cycle of lockdowns, similar to New Zealand. But not all believe it’s possible to achieve given that countries will have to open up their borders at some point. Others advocate ‘herd immunity’ due to the harms caused by lockdowns, yet the threshold to achieve this is currently unknown and likely to be very high.
The pandemic accelerated innovation in digital technology and reshaped how we work and learn. But the backlog in the NHS is now the worst on record and there are concerns about the effect of delayed treatments on patients’ wellbeing.
Many children have experienced a year of disrupted learning with the gap in educational attainment growing. Some people have been disproportionality affected by the pandemic with existing inequalities being exacerbated. While the response of the four UK governments in controlling the virus has thrown light on devolution across the UK with the differing rules between nations.
Although we’re starting a new Senedd, the virus is still with us and presenting the same challenges as we’ve faced in the past year, along with some new ones. But there’s an opportunity to look to the future and to shape a post-pandemic Wales.
Article by Lucy Morgan, Senedd Research, Welsh Parliament
