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New Necessary: How We Future-Proof for the Next Pandemic
From the Introduction: "Covid-19 [coronavirus disease 2019] has raged for over a year, its path littered with destruction. Lives lost, livelihoods destroyed, economies shaken. It has changed us in ways we may not even be able to comprehend. All of this, and still the challenge of the pandemic endures. With emerging strains of the virus and the race to vaccinate the world more like a marathon than a sprint, no immediate end appears in sight. [...] Two competing objectives have been at the forefront of government responses to date: How do we protect lives and simultaneously keep economies afloat? [...] In this paper, we draw on these successes and identify gaps in response to focus on an emerging third objective. 'How do we prepare for future pandemics?' This objective has taken on a more imminent importance. The next pandemic is likely not a new virus or plague, but a mutant strain of Covid-19 that is more deadly, more transmissible or resistant to antibodies. It could be all three. Therefore, the most important lesson of the last year has been the need to prepare."
Tony Blair Institute for Global Change
Dace, Hermione; Miller, Brianna; Ramli, Rania . . .
2021-02-26
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Long-Term Plan for Long Covid
From the Overview: "We last wrote about Long Covid [coronavirus disease 2019] when we published 'Long Covid: Reviewing the Science and Assessing the Risk' [hyperlink] in October which was followed up by a blog [hyperlink] from members of Long Covid support groups. Since then, various studies and research have confirmed what many suspected in October: that Long Covid will have a significant impact on the lives and livelihoods of thousands of people, regardless of the severity of their initial Covid-19 infection. [...] In our previous report we set out a series of recommendations on how the government could make progress in responding to Long Covid. These recommendations covered: [1] Addressing the need for further research on Long Covid. [2] Launching an awareness campaign. [3] Improving diagnosis of Long Covid. [4] Putting in place specialist support for sufferers. [5] Using the Covid Symptom Study data to screen for those likely to develop Long Covid. 'Below we include': 1. More detail on the recommendations we made. 2. An update on what has happened in each area. 3. Where appropriate, what more could be done."
Tony Blair Institute for Global Change
Miller, Brianna; Sleat, Daniel
2021-03-12
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Passing the Test: How to Safely Reopen the Economy
From the Overview: "The government has published its plan to reopen the country. And with an ending to this phase of Covid-19 [coronavirus disease 2019] nightmare now in sight, optimism has returned. But this plan can only become a reality if it takes a number of careful steps. [...] This paper sets out: [1] The progress the UK has made on mass testing. [2] What rapid tests are now available. [3] Why the critical element of our testing capacity will be rapid tests. [4] The role of testing, using the right tests for the right purpose. [5] How we incentivise people to test and, where necessary, isolate. [6] How we get testing in schools right. [7] How testing links to an overall digital health passport. Things we thought impossible at the beginning of this crisis have now become reality. We must continue to be ambitious in our thinking and embrace innovation and new ideas. This paper sets out the 'moonshots' the UK and others should focus on when it comes to monitoring the spread of Covid-19, and also proposes a new 'testing wallet', where people are paid to be tested. Our recommendations offer a way forward for the country that will allow the economy to revive and lives to be protected. It offers an alternative to the blunt instrument of lockdowns and a way for the government to truly ensure that this latest exit out of lockdown is indeed irreversible."
Tony Blair Institute for Global Change
Beacon, Rosie; De Boer, Joanna; Miller, Brianna . . .
2021-03-06
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Risk Calculus of Covid-19: How We Avoid a Second National Lockdown This Winter
From the Overview: "Covid-19 [coronavirus disease 2019] is still with us. As we enter autumn and when winter closes in, it will remain with us. It will be there next spring and likely summer too. It will be an enduring presence that we must learn to live with and alongside. This necessitates a risk calculus that restores confidence for people to safely participate economically and socially. It is a constant balancing act: Shut down all risk and cause irreparable harm to the economy. Accept too much risk and hospitals quickly become overwhelmed."
Tony Blair Institute for Global Change
Miller, Brianna; Sleat, Daniel; Wain, Ryan
2020-09-12
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From Science Fiction to Science and Fact: A Realistic Route to Mass Testing
From the Introduction: "Both the prime minister and health secretary have been clear in committing to a strategy of mass testing. This so-called moonshot should be welcomed in ambition, but even the most ardent supporter of the government will have lost faith in its ability to deliver it. The idea has, in the government's hands, become confusing. To have an at-home daily test is not feasible yet because the technology hasn't advanced that far. We should incentivise its acceleration, but the moonshot is presently beyond reach. [...] In this paper, we set out a series of short-term measures to boost testing capacity and a set of medium-term actions to be pursued in parallel. Together, these will restore the public's confidence in testing and present a realistic route to mass testing, which remains the only way back to some level of normality."
Tony Blair Institute for Global Change
Miller, Brianna; Sleat, Daniel; Wain, Ryan
2020-09-28
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Long Covid: Reviewing the Science and Assessing the Risk
From the Overview: "There is still much we don't know about the risk of Covid-19 [coronavirus disease 2019]. We know people who are poor, elderly or have underlying conditions have higher risks of death. Public understanding of the risks, combined with the style and content of the messaging and the perceived trustworthiness of the source of the information, will all improve the level of compliance with measures such as mask-wearing and social distancing. [...] In this paper, we combine data from the Covid Symptom Study with emerging evidence from the broader scientific community to understand what we do and - as importantly - don't know about those suffering with long-term symptoms of Covid-19. The Covid Symptom Study is unique as it has one of the largest sample sizes of Covid-19 studies with more than 4 million participants, but it is important to note that the data is collected and analysed based on self-reported symptoms recorded through an app. New findings from the study, which will be published in full by King's College later this month, indicate that around 10 per cent of those taking part in the survey had symptoms of long Covid for a month, with between 1.5 and 2 per cent still experiencing them after three months."
Tony Blair Institute for Global Change
Sleat, Daniel; Wain, Ryan; Miller, Brianna
2020-10-05
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Covid-19 Testing in the UK: Unpicking the Lockdown
From the Foreword: "This paper outlines the importance of testing and the suggestion of a new structure around decision-making to get it at scale with speed. It is not a criticism of government efforts up to now. Everyone within government is working with enormous energy and commitment in dealing with a crisis, unique in complexity and difficulty, global in nature, and where the strategic decisions involve agonising trade-offs in the assessment of the public interest."
Tony Blair Institute for Global Change
Wain, Ryan; Macon-Cooney, Benedict; Insall, Lizzie . . .
2020-04-06
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Architecture of Containment: Getting to Gold
From the Foreword: "Britain has to have a coherent strategy for living with Covid-19 [coronavirus disease 2019], which will last until there is a vaccine available that is able to be scaled for the whole population. That is the stark reality. But the economic and health costs of lockdown are so immense that we need at the same time to get as many people back to work and have as much of 'normal' life return as possible. The only viable solution is to build a containment infrastructure that is comprehensive and that embodies the best technology and practice. A gold standard, if you like. Despite the progress which has been made, Britain is still significantly short of attaining that standard. Whether we reach it depends on the decisions taken now. In this paper we set out the different elements of such an infrastructure. Lockdown won't eliminate the virus on its own. It does, however, give us time to prepare and to build so that we can open up as widely as possible and as safely as possible. Otherwise we will find that the economic, social and health devastation of the lockdown has an impact as serious or, in some ways, more serious than the disease itself."
Tony Blair Institute for Global Change
Yiu, Chris; Wain, Ryan; Bennett, Andrew . . .
2020-05-16
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Changing the Game on Testing
From the Foreword: "Britain is unfortunately in a different and worse position than most comparable countries. We are opening up with a death rate and level of new infections that are comparatively high. The risks are obvious. In addition, even if existing strategy succeeds completely in suppressing the disease during the summer months, we face along with all countries the possibility of fresh outbreaks of the disease in the autumn and winter. We need to prepare for this now. We believe this requires a radical and urgent shift in government strategy. In earlier reports we have suggested a series of containment measures, including the provision of masks, wearable devices to alert people to early signs of Covid-19 [coronavirus disease 2019], a different approach to track and trace and provision of oximeters to people suffering symptoms, and we have of course highlighted the importance of testing. Today we make a more fundamental suggestion. This is that the government change its testing strategy from one that is targeted to certain groups and those with symptoms, is reliant on lab-based tests and will therefore only test a minority of the population to mass testing using available and soon-to-be available rapid on-the-spot antigen and antibody tests, which do not require lab processing, so that a majority of the population can be tested and regularly. We believe this should be at the core of the containment strategy."
Tony Blair Institute for Global Change
Insall, Lizzie; Wain, Ryan; Sleat, Daniel . . .
2020-06-05
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Role of Face Shields in Responding to Covid-19
From the Overview: "In recent weeks there has been increased discussion around the potential use of face shields as a tool to help exit lockdown and prevent further spikes in infections of Covid-19. [...] Face shields provide a high level of protection for the wearer. Given they cover the whole face - the mouth, nose and eyes - a high percentage of viral particles are prevented from reaching the wearer. Face shields are arguably best at protecting from coughs and sneezes. [...] For this reason we recommend that face shields are procured and supplied to key groups such as teachers, health-care workers, emergency services staff, transport workers and those working in education."
Tony Blair Institute for Global Change
Wain, Ryan; Sleat, Daniel
2020
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Hidden Pandemic: Long Covid
From the Foreword: "Long Covid remains, in many ways, the hidden pandemic. While 130,000 people in the UK have died from Covid-19 [coronavirus disease 2019] to date, it is estimated that more than 1 million have experienced or continue to experience ongoing symptoms from their original infection, known as Long Covid. As the pandemic continues, these numbers will continue to grow. The scale of Long Covid means that there are countless individual stories of people affected physically and mentally, but a macro picture also emerges that has a significant impact and implications for the future of our health services and the economy. The government has made a number of pledges regarding its approach to Long Covid but much work still remains to be done to see if this is effective. This paper clearly brings out the nature of Long Covid as a global problem, requiring governments around the world to take the right action to respond to it."
Tony Blair Institute for Global Change
Miller, Brianna; Sleat, Daniel
2021-06-17
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Risks and Restrictions: Striking the Right Balance
From the Overview: "Cases of the virus continue to rise in the UK, as do deaths and hospitalisations. While the vaccination programme is providing substantial protection, it does not remove the danger of the NHS [National Health Service] being overwhelmed again, and there are associated risks of additional pressures that come from all the untreated conditions and waiting lists that have accumulated over the course of the pandemic. Infections will continue to rise, putting an increasing number of people at risk of developing Long Covid [coronavirus disease]. [...] The problem with the government's present strategy is that it risks generating confusion that will undermine the efficacy of its approach. Our view is that everything is simpler to understand and implement if we are clear in the distinction between vaccinated and unvaccinated people. Otherwise we are in danger of loosening restrictions too extensively, for example, in relation to mask-wearing, while being too rigid in other instances, for example, the isolation provisions around NHS Track and Trace. We go on to explain here what we consider to be a far more balanced approach to risks and restrictions."
Tony Blair Institute for Global Change
De Boer, Joanna; Britto, David; Miller, Brianna . . .
2021-07-18
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Two Barriers to Normal
From the Overview: "The UK has done a remarkable job in its vaccine rollout. More than 53.3 million jabs have been administered and 17.8 million people have been fully vaccinated - equivalent to almost 27 per cent of the population. Based on our modelling [hyperlink], we are on track for herd immunity by September 2021, which will mean the lifting of most restrictions. After one of the toughest years in our country's history, the end is in sight. [...] Much of the work ahead will be global and draw on the UK's power and influence abroad. But there are two things that are within our power domestically. We call these the two barriers to normal and, as set out in this paper, there is action we can take now to navigate them."
Tony Blair Institute for Global Change
Beacon, Rosie; Chimboza, Rishon; Innes, Kristy . . .
2021-05-12
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Global Opportunity to Combat Preventable Disease: How to Use Covid-19 Infrastructure to Transform Public Health Worldwide
From the Executive Summary: "Over the coming years there will be a range of new vaccines not only for pathogens like Covid-19 [coronavirus disease 2019], but also for tuberculosis, malaria, HIV/ AIDS, dengue and other diseases. Given recent advancements in the development of therapeutics, we should also push the traditional definition of a vaccine to include preventative injectables for conditions including HIV, cardiometabolic disease and common cancers. At least 10 million deaths per year are attributable to diseases with existing or forthcoming adult vaccines and preventative injectable therapies - deaths that could also be reduced through a system of adult public-health interventions. But Covid-19 has exposed some chronic deficiencies in the global architecture for delivering such a huge programme."
Tony Blair Institute for Global Change
Alkasir, Ahmad; Berry, Tamsin; Britto, David . . .
2022-01
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