Living with coronavirus will not be easy even with a vaccine

THERE are two future conditions faced by the world today. One with a vaccine against coronavirus and one without a vaccine.

We pretty much know what the latter will be like. Very like right now, with just a controlled easing of restrictions for the younger, greater use of face masks and the old and vulnerable shielded.

But the hope is that at some time there will be a vaccine. There seem to be two views of when. One says it could be within months; the other that it may well be much longer than a year.

Either way it is not a magic bullet. We shall not go from lockdown to normal life overnight. No way.

If a vaccine is found and proven to be effective and safe (big Ifs) it has to be produced. And delivered. And since you clearly cannot do everyone at the same time there has to be a priority list.

Examining this is scary. The flu vaccine is administered to scores of millions of people each year. The estimate for the 2019/2020 season (this winter gone) was between 162 million and 169 million doses.

Who gets the flu vaccine in the UK? Front line health staff and the elderly. The best figure I could find was about 500,000 health workers and about 4-5 million elderly or vulnerable people. If we call it 6 million we shall not be far off.

But the industry currently produces some 190 million shots per year for the flu season. And they are in full-time, non-stop production. So that means they could produce up to 3-4 million shots a week. For a global market. The same as would be the case for coronavirus.

A month after production started there might be 16 million doses available. For the whole world.

I cannot find evidence for this but I would guess that at least one production plant is in the UK. If we could harness that to our needs and expand production might we hope for 2-3 million of our own in a month? Who knows.

But that is the minimum we need to contemplate any sort of significant relaxation of lockdown. Why?

Well the first group to be vaccinated must be the front line health workers – at least all those without immunity. That will be a good 400,000 doses and will take many days. Then come their most likely customers – the old and high risk. We know that is 1.5 million people. That will take even longer. After that comes the over 65 and other higher risk people. 3-4 million? Probably, so another few weeks.

So when could we lift the lockdown, even a little?

Well once the NHS staff and care home staff have been covered we know we can cope with some level of infection. So maybe shops and schools, factories and offices could re-open and people allowed to exercise. BUT only with face masks since it would still be possible to start a new epidemic.

Then, after a few weeks cafes, restaurants and even pubs might re-open and all forms of work be re-started. But major vanues and places of mass congregation would still be risky – no cinema, theatre, football, rugby, cricket etc.

Finally as the vaccine gets out into the wider population everything can return to what it was – a new normal.

But at the best estimate this will not be soon. If the vaccine arrives it would be at least 4-5 months before it would be really safe.

Then we would start to live with coronavirus in the environment but a bit more like influenza. If it mutates like flu then a new vaccine will be needed every year or so.

No vaccine and a real return to 'normal' is not really possible. We might risk the young and allow them, with face masks perhaps, to return to work. But without customers the shops, cafes, restaurant and pubs are unlikely to be able to function. But some activity could re-commence and begin to re-build the economy. That must happen sometime and sooner rather than later.

But to allow that we have to get the re-infection rate right down and that means ensuring the NHS can operate. That means keeping old and high risk codgers like me under lock and key for the foreseeable future. It is grim. I yearn to travel. I miss France. I need Spain in winter. But I am too much of a risk.

People like me guarantee the need for ICU, oxygen, a ventilator. At least for a while. And we infect the health workers, removing from the front line those we need most .

Sources: ONS, WHO, NHS England.