For the last two years, UEA academic PAUL HUNTER has been the region's leading authority on Covid. As the final restrictions are removed, he looks back on how the UK has coped and considers whether the crisis really is over
I remember the time I first heard of this new infection.
It was the first week of January 2020 when I received an email telling me about several cases of an undiagnosed chest infection in a city in China.
It quickly became clear that this was caused by a new coronavirus and the disease was given the name Covid-19.
Early on, I believed it would probably follow the course of the previous coronavirus epidemic known as SARS, which caused a pandemic in 2003 and 2004.
SARS started in late 2003 and was over by the following August.
But by the end of February 2020, it was clear that we were not going to be so lucky this time around.
In the earlier SARS pandemic, people were mainly infectious a week or 10 days into their illness when they were in hospital and could be nursed in isolation.
The fact that Covid could be spread before people knew they had it and even before they had become unwell meant that eradicating it was going to be impossible.
That catching the virus or vaccination does not provide long term protection against further infection is another reason why it was never going to be eradicated.
Herd immunity was never going to be achievable for Covid if people are able to catch and spread it only months after vaccination or infection.
Fortunately, both infection and vaccination provide longer-lasting protection against severe disease and death.
So that after vaccination people can still catch the infection but are much less likely to need hospital care or to die.
Prior to the advent of Covid, the UK was widely recognised as being one of the two best prepared countries in the world for pandemic preparedness. This should have given us a leading advantage in protecting our citizens.
We even had a specific coronavirus pandemic plan.
Unfortunately, as had been found in 2016 during the 'Exercise Cygnus', we had failed to maintain the necessary supplies of essential equipment such as personal protective equipment (PPE) and ventilators.
In the event, we also ignored the coronavirus pandemic plan and instead followed the influenza pandemic plan. The result was that we were late to react.
By the time the UK realised we were going to have a serious problem with Covid, global demand for PPE was seriously outstripping supply, leaving many hospitals and care homes short of necessary equipment.
Despite an early lead in developing diagnostic tests, we didn’t build the laboratory capacity fast enough to test all cases.
The results of this poor planning were seen in the large number of deaths in care homes during March and April 2020. Many of these deaths were not even properly diagnosed and recorded as Covid deaths.
Also, many health care professionals and other care workers died.
In my view, many of these deaths were preventable and would have been avoided if we had maintained our preparedness.
On the other hand, the UK has led the world in so many areas during the pandemic.
The recovery trials, led by Professor Peter Horby from Oxford University, set out to identify those treatments that saved lives and - just as importantly - those that did not.
The study showed that using Dexamethasone could reduce deaths by more than 30pc in patients who had started being ventilated because of Covid.
On the other hand they showed that hydroxychloroquine did not reduce deaths.
The Office of National Statistics (ONS) infection survey has been truly world-leading. Every week this study has tested tens of thousands of randomly chosen people for Covid.
This study has been vital in understanding who is at risk of infection and how effective vaccines are at reducing that risk.
Of course, the most impressive achievement during this pandemic has been the development, testing and rollout of safe and effective vaccines.
These vaccines, including the UK’s Oxford AstraZeneca jab, have saved hundreds of thousands of lives worldwide and without them we would still have been in a very difficult situation today.
But the success of the vaccine campaigns has been marred by global vaccine inequality.
Wealthy countries like the UK and the US have been able to monopolise access to vaccines and have been able to roll out jabs to lower risk groups and roll out booster doses whilst there are still many vulnerable people in poorer countries who have not yet been able to get their first dose.
But what of the future?
The virus that causes Covid is here to stay. Our grandchildren’s grandchildren are still likely to be catching the infection. But that doesn’t mean that 'Covid-19 - the disease' will be with us forever.
This is not the first large pandemic due to a coronavirus. What was probably the last one was the Russian flu in 1890, some 130 years ago.
That started pretty much like Covid and killed about one million people is a much smaller global population than now. The virus that probably caused that pandemic is still with us.
This virus typically infects us every three to six years throughout our lives but is almost always just another cause of the common cold and many times causes no illness at all.
Over a year ago Nature magazine surveyed many of the world’s leading coronavirus scientists and the large majority believed that that is the way Covid will go.
The infection will become endemic and eventually just be another cause of the common cold. We can see this happening already.
Fewer people who get Covid now have the classic symptoms seen in the early days, fewer end up in hospital and fewer die. We have the vaccinations to thank for that.
We will undoubtedly see further waves of infection that will probably be worse in winter and better in summer.
But those future waves are almost certainly going to lead to fewer hospital admissions and deaths than we have seen in the past.
Already the mortality rate from Covid infections are similar and maybe even lower than we see with influenza.
Clearly, we cannot predict what future new variants may do, but so far even though immunity to infection from those new variants has been bypassed, immunity against severe disease has been more robust.
There are good grounds to expect immunity against severe disease will still be largely intact in future variants.
Nevertheless, we still need to be concerned for those people who may be more vulnerable to severe disease.
We need to ensure that they are not forgotten and still have access to diagnostic tests and, if appropriate, antivirals.
Although I doubt that vaccine will be rolled out to everyone again, further boosters for older people and people with a medical condition are likely for some years to come.
The pandemic is not yet over, but there are sufficient grounds for optimism that the worst is behind us.
Paul Hunter is a professor at the UEA's school of medicine and an expert in epidemiology and viral diseases
PROFILE: PAUL HUNTER
Coronavirus has made Prof Paul Hunter one of the region's most prominent individuals.
He has regularly appeared on national television and radio - as well as on the pages of this newspaper - to give his opinion on the progress of the pandemic.
His views have been sought as he is a leading expert on epidemiology - the study of how diseases spread.
His particular specialisms include how infections can be spread by drinking water, recreational contact with water and food.
But he is also an expert in zoonotic diseases - those which are spread between animals and humans. Covid-19 is thought to be a zoonotic disease, although research is still going on to find out more about its origins.
Prof Hunter has studied at the University of Manchester and the Open University and has worked in public health laboratories in Manchester, Cardiff, London and Chester. He is now a professor in medicine at the Norwich Medical School, at the UEA.
He has published research into Covid throughout the pandemic.
Previous study topics have included the potential food safety risks of using water in British agriculture, the use of face masks in controlling the spread of flu, and an analysis of health risks in Vietnam.
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