This lockdown is far from over if we really want to protect the NHS

Everyone wants to know when the lockdown might end. We are all eager to try and get back to some sort of normality and from my own straw poll of friends and colleagues, this time round feels a lot harder going.

The vaccine has been hailed as the silver bullet to all our woes. The impression given by the ever upbeat Matt Hancock is that we just need to hold on for the vaccine to do its thing and vanquish the virus for good.

At some stage ministers are going to have to level with the public that this sort of Hollywood ending is not the reality. In the real world, many scientists are worried that expectations around the impact of the vaccine have been set too high.

As hard as it is, we need to face reality. One of the primary reasons for the lockdown was to prevent the health service from being overwhelmed and to prevent large numbers of deaths among vulnerable groups.

But new research by experts at the University of Edinburgh, the University of Warwick, Imperial College London and London School of Hygiene and Tropical Medicine makes for grim reading.

According to Mark Woolhouse, professor of infectious disease epidemiology at the University of Edinburgh, even if we can get nine out of 10 of the most vulnerable people vaccinated, that would still leave around one million who are most at risk from becoming severely ill or dying, unprotected from the virus.

That is more than the total number of those groups infected so far at this stage in the pandemic, he warned. Relaxing the restrictions after this vaccination level is reached would lead to a third wave of deadly infections and crucially hospital admissions.

After the relentless battering it has taken over the last 12 months, the NHS simply cannot afford to be hit again. One in four doctors have sought mental health support during the pandemic, nurses are exhausted and staffing levels are unsafe across many wards and hospitals.

There is also the impact on other patients to consider, those with cancer or who need urgent tests and surgery for hip replacements, for example. We already have more than 200,000 patients waiting over a year for routine surgery, allowing hospitals to become overwhelmed again is a non-starter.

Even with 30 million vaccine doses, relaxing all restrictions was labelled “disastrous” by Professor Matt Keeling from the University of Warwick, who said such a move could lead to “massive peaks of both daily deaths, and hospital admissions”.

These are not predictions, but scenario-based modelling. That means there are assumptions being made that feed into the result. While the scientists considered hundreds of scenarios, the effect was broadly the same.

If the vaccines prove effective at stopping transmission of the virus, that could help significantly but we are months away from knowing if that really happens. The government’s decision to delay doses for up to 12 weeks could also impact on how effective the vaccines are.

But what is clear is that vaccination is not a panacea to the problems of Covid-19. It is our best hope but if the uptake of the vaccine is poor, and vaccine scepticism is sadly a very real problem, then it’s likely we will see more waves of the virus throughout the next year.

For our battle-weary health service, that is the worst possible news.

Ministers could consider making vaccinations mandatory – that is something Matt Hancock has floated before – but such a move would be a significant trespass on individual rights.

Immunity passports have also been floated as a way to relax rules, but only for those who can prove they have had the jab. Again, this is not without significant consequences to those left behind or unable to have the vaccine, not to mention the enforcement nightmare it would be.

There are no easy paths ahead and ministers need to start levelling with the public about the choices that will have to be made. False expectations will fuel mistrust and ultimately erode compliance with the rules, meaning things spin out of control quickly, with potentially devastating consequences again.