Plane that crashed into the sea shortly after takeoff. 62 people were on board. Now on bbc news, hardtalk. Stephen sackur speaks to british epidemiologist professor neil ferguson, whose early modelling of covid 19 made him an influential advocate of the lockdown strategy. The uk is back in lockdown and infections are surging, what has gone wrong and why have other countries done better . Welcome to hardtalk. Im stephen sackur. Covid 19 is a Global Pandemic but its impacts have varied markedly. While countries like vietnam and south korea have effectively controlled the virus, others have been much less successful. Britain is back in nationwide lockdown as infection rates surge and the death toll approaches 80,000. Britain is back in nationwide lockdown as infection rates surge and the death toll approaches 80,000. The hope is that the roll out of vaccines will vanquish the virus but for now, the terrible cost of covid continues to rise. My guest is neil ferguson, an epidemiologist who has advised the uk government. Did britain get covid wrong . Theme music plays. Professor neil ferguson, welcome to hardtalk. Thank you for having me. How bleak would you say is britains covid situation right now . I think its probably second only to the situation we were in on 22nd of march before lockdown in terms of really the prospects going forward. And in some ways, bleaker still. The new variant of the virus everybody will have heard about transmits considerably more effectively than our previous variance, probably 50 70 more transmissible, and that means control measures which have worked in the past to contain the spread may not work in the future. The one silver lining, of course, is that we are rolling out vaccines now in the uk and the faster we can do that, the faster we can protect people and reduce the toll of the disease were seeing currently. Would it be fair to say that the scientists did see this coming. I mean, you refer to the new variant of covid 19 which clearly has affected the uk arguably more than any other country in the world, may have originated here it seems it did. But the scientists were warning as early as the summer that the winter was going to be extremely difficult for the United Kingdom. So, this really isnt a surprise, is it . I would go back even further. We always anticipated even back in february and march of the initial analysis of how this virus spread and how transmissible it was that whilst lockdown measures and social distancing measures could be effective as weve seen in italy and china, they only work for as long as theyre in force. And so if you relax those measures and relax them, there comes a critical point where transmissions starts resurging and thats exactly what we saw really across europe in the autumn. Very fair point, not limited to the uk by any means. 0ne looks at the per capita figures for deaths by covid in countries like italy and belgium, we are not alone, but in absolute number terms we are the worst or perhaps by some measures the second worst in all of europe. And i come back to this point and youve already raised it. Would you say the politicians, the managers of the response policy on covid i9, have got it wrong . I think a lot of what we see in terms of the death totals is really down to how quickly countries responded. Undoubtedly, countries like the uk but also spain, italy, and france had much more infection spreading in those countries in february and march than our Surveillance Systems picked up because we didnt switch on surveillance soon enough, and that explains that first wave death toll. Unfortunately, the same mistakes were made again in multiple countries in the autumn as well. I mean, the consensus around social distancing was breaking down clearly politically. There are many people who are very well aware of the economic and social costs of it, and so talking to scientists, my friends and colleagues across europe, they were all in the same position of advising government one thing but government feeling unable to act until they really saw evidence of hospitalisations and death rising. And of course by the time you see that, its almost too late. What is the real, if i may, what is the real problem here . You are a scientist who for some time sat on the sage Advisory Panel advisory advising the government on covid response, you still sit on the nervtag committee which looks at the response to covid. So, you know the relationship between politicians and scientists are well. How can it be that the Prime Minister of Great BritainBoris Johnson just three days ago assured the nation that schools would stay open because, in his words, there is no doubt they are safe, and then just a day later declares that all schools as part of a new National Lockdown are going to be closed till mid february . Im afraid i dont have detailed insight into the thinking at number 10 or cabinet office. I think theres a general issue that. I mean, often particularly epidemiologists like myself, other people on sage, we try to give the best foresight we can analysing data and often, there is a lot of uncertainty initially. And its only when, i think, sometimes when politicians see the actual trends you know, hospitals filling up, ever increasing case numbers that they feel they have in some sense the Political Capital to act unfortunately. And again, this is not a criticism of the uk government at the moment. Its equally been an issue in many countries and of course in some countries despite rising case numbers, politicians have felt unable to act regardless. But isnt there something about learning lessons as we go along . I mean, back in march, you acquired this tag in some of the tabloid press in the United Kingdom of being professor lockdown because you were urging a lockdown at a time the government didnt want one and you said, look, if we dont take action, up to half a Million People could die. And you then said in evidence to a Parliamentary Committee in the summer that because the government delayed by, in your view at least a week, in your calculation, that cost many thousands of lives. So, im asking you in your view, has the government not learned that its reluctance to act on scientific advice does cost lives . I think that message has got through and if we just focus on the new variant, that came out of the blue, i think the government did act and respond really quite rapidly to that. Crosstalk. Hang on. With respect, professor ferguson, ive looked back at the record. On december 8th, there was a key meeting of the expert scientists and Public Health officials about what they were seeing in the south east of england. Yes, i was part of it, yes. You know, you were there. Throughout that month of december, the government insisted that schools, and lets highlight this issue of schools because its very important, schools must stay open. On december 22nd, the Sage Committee of scientific advisers said that there was no way the infection rate, the r number, could be kept below one if schools were kept open. December 22nd and yet in earlyjanuary, we still had the Prime Minister insisting that schools would stay open. Whats gone wrong in the relationship, the communication between you, the scientists, and the leaders of government . Well, first of all, i dont think i and other scientists directly communicate with government. That goes clearly through people like patrick vallance, chief scientific adviser chris whitty. I think that the move yesterday to lockdown the country was very much stimulated by all the chief medical officers moving the country as a whole, the uk, to whats called alert level 5. Look, im not an apologist for the uk government. What i try to do is give the best scientific advice i can based on analysis of data in real time. It is inevitable that when anything new happens and something changes in the characteristic of the virus or the epidemic overall, data is initially noisy, theres not that much of it, and when it comes to very significant decisions being made which affect a lot of peoples lives, some people want more evidence than you initially have at the very first time. Its not an excuse but its understandable. I suppose the counterargument would be the economic and educational and social and emotional costs of going into a lockdown for a third time, particularly a lockdown with the schools closed, will be very considerable. I dont think anybody, professor ferguson, would underestimate how difficult these decisions are. Theyre extraordinarily difficult. But youre a data analyst apart from anything else and i said that in the summer, you calculated that the governments delay in imposing the first lockdown had cost thousands of lives you said, actually, at the time that the number of deaths could have been halved had the government acted more speedily. Can you put a number on the number of deaths you think have been caused by successive reluctance of government to impose a second and third lockdown, the decision on schools which saw all primary pupils, or pretty much all of them, go back to school for one day at the beginning ofjanuary . Its not something i spent a lot of time thinking about. Undoubtedly, i would say delays here is difficult to assess the impact in schools only reopen for a day and most of the heavily affected areas were in near lockdown anyhow being in tier 4. I would actually point out that there was a cost to delaying the lockdown in england to november instead of acting earlier in the autumn when it was clear case numbers were rising. And whilst all European Countries have had a very difficult autumn, difficult winter and weve been particularly badly affected by this new variant which is spreading everywhere but much more advanced here. Nevertheless, if you just look at multiple other countries such as germany, such as most of the scandinavian countries, they clearly have kept per capita mortality and hospital demand at a fraction of what weve seen throughout the whole epidemic. And thats the benefit of acting earlier, really. You have over a period as weve discussed told the government it needs to act quicker on lockdowns but isnt the truth that if one looks at the countries which have done best if i can put it that way through the covid crisis, and im thinking of many countries in asia for example, south korea, taiwan, vietnam, one could argue china as well and certainly australasia, new zealand and australia these countries havent really relied on lockdowns at all. What they have relied upon is systematic, extremely efficient track, trace, isolate systems. Theyve also really controlled their borders and who is coming into their country and ensuring that every person who comes in is tested upon arrival. They have also delivered clear and consistent Public Health policy messaging. Wheres britains standing on all of those measures . Yes, i mean, epidemiologically the situation was very different. I completely agree. I mean not all Southeast Asian countries but the countries you mention have achieved control because they never let infection numbers in their country get to high levels, and thats the critical point. If you only ever have small numbers of infections, you can invest an enormous amount of resource in tracking them down, tracking contacts and basically almost eliminate the virus within your borders and thats what many of those countries have done. But we could i mean, i say we. Britain, other western nations, the United States could have focused on that, couldnt they . But for some reason didnt. I mean, and thats where the, i think, the biggest error came about. There was too much. In order to really control it in that same way for the uk, for the us given the travel volumes we have, we would have probably had to act to restrict travel dramatically more than we did all the way back injanuary. But beyond that, there was a mistake made really across europe with perhaps the exception of germany in not ramping up surveillance within our countries at an earlier stage. So, there was a lot of focus injanuary and february on testing travellers in a few countries to see if they had covid if they reported symptoms. We missed most of the people coming in from other European Countries with infection, and we let infection get established in our country invisibly without noticing. And by the time we got to that stage, i mean track and trace, weve never got infection levels low enough for the vietnamese, even the korean style model to be highly effective. Theres been too many cases. Hang on, chinas part of this argument. I mean, they clearly did have the big arguably the origin problem of this virus in wuhan and they faced many thousands of cases in december. But a tiny, tiny number i mean, we have more cases now happening per day. We had more cases happening per day frankly in end of september than china reported in their entire epidemic. Yeah, we dont know if those numbers are reliable but my point is that you have looked at china and rather controversially said, you know what . China is a communist one party state and we scientists originally said we couldnt get away with what they were doing in europe. But then, we realised we could. Now, some libertarian minded politicians in the uk worry about statements like that. You appear to be saying that the chinese approach, a deeply intrusive surveillance across all sectors of society, all kinds of public movement, is the sort of thing that you see in the future for the United Kingdom and western democracies. Is that right . Im not saying that at all, i should say. Back in february and march, we werent even sure it was controllable. I mean, china led the way in locking down. The surveillance, the contact tracing, Everything Else followed but the impact of the lockdown in wuhan on driving case numbers down was what really then informed the italian response which was the First Western country to implement similar measures. And it was also effective there, and thats what really informed the rest of the world. Yes, i mean, china and many other countries have implemented measures which we might not tolerate in terms of that balance between Public Health and freedom. Liberty, yeah. Liberty. But thats a slightly separate issue from the effectiveness of social distancing measures which is what i was talking about. Lets move to the vaccine because obviously as an epidemiologist, you want to see this disease conquered. And it seems right now the best hope weve got is the rapid roll out in 2021 of various vaccines which are now in the works across the world. In your view, what percentage of the population has to be vaccinated, immunised, before the kinds of restrictions we still see in many western nations can be significantly eased . So, its not an all or nothing thing, its a continuum. I mean, people talk about. Theres a lot of debate in america at the moment about the herd immunity threshold. What proportion need to be vaccinated to completely go back to normal . Im not sure if we can really estimate that reliably particularly with a new variant, but it is probably in excess of 80 of the population. I think the more relevant issue. Im sorry, hang on, just to stop you there. If its around 80 of the population, its going to be many months before thats achievable in the United Kingdom. Yeah, and if you let. I mean, ill explain the nuances. Thats why not an all or nothing thing. There are both direct and indirect effects of vaccination. The direct effect is protecting people from getting ill, particularly getting seriously ill. So, once weve vaccinated everybody over the age of 50 and other clinical at risk groups, we would expect if we managed to get for instance 80 90 coverage in those groups, then we would expect to drive mortality down just keeping all those measures we have in place exactly as they are drive mortality down by 80 90 . Now, of course, we dont want to keep in lockdown forever. So, the trade off, and this is not completely predictable ahead of time, that the trade off will be as we protect more and more people, how much can we relax social distancing . And clearly, the more people we protect, the faster we can do it but i dont think we can make very accurate predictions about exactly how quickly we can relax measures partly because a critical aspect of how the vaccine works is not well understood. Mainly, how much it blocks transmission as well as just protecting people against disease. Exactly, we dont know whether it blocks transmission, do we . We also dont know to be honest whether new strains, variations, mutations on this virus weve talked about the british one but theres a very worrying one in south africa could threaten the notion that these vaccinations protect us. The Health Secretary in the uk says hes very worried about the South African mutation. Are you . Im concerned about it. I mean, we just dont have the data at the moment but the immunologist, structural biologists ive talked to certainly are more concerned about that variant than the new variant in the uk just because there are changes to the critical receptor binding sites of the spike protein which is the thing vaccines target. But again, even if vaccines are less effective, its unlikely they will be completely ineffective. Its more well see a reduction in efficacy. I think looking forward more than just the immediate next two or three or even next six months, we are going to be living with coronavirus indefinitely. We are never going to eliminate it in the human population. It will if off, and we will have to probably maybe even a little bit like influenza regularly update our vaccines. But the key issue is getting the scale of manufacturing capacity of vaccines and the delivery into peoples arms such that we can reduce the burden of disease we are now seeing. And there will be many people watching this around the world thinking, well, hes talking from london, the uk is rolling out a vaccine programme, but the chances of me getting a vaccine if i live in west africa, latin america, wherever, its going to take a very long time because my country hasnt got the same resources, its not got its delivered vaccines already arranged, and im extremely worried. Do you believe there is going to be an International Cooperative effort to make sure everybody around the world wherever they live does get this vaccine as soon as possible . Well, there is an International Collaborative effort called covax coordinated by the world health organization, but i would say in my view it is woefully underfunded. The commitment from, frankly, high Income Countries to allow particularly the poorest countries in the world to get access to the vaccine has not been sufficient so far, and it will at this rate take many years for even the most vulnerable at risk groups to be vaccinated in the poorest countries of the world. I mean, theres some silver linings. You will be aware that countries like brazil and india, two very large middle income, low middle Income Countries actually have a lot of vaccine manufacturing capacity themselves and they have their own vaccine industries. And i think they will be scaling up and are currently scaling up production of vaccines like the 0xford astrazeneca vaccine right now. So, i mean, its not all bad news but undoubtedly, this is going to highlight like most crises do the inequity not just within countries but between countries. Let me ask you if i may a personal question at the very end. Youve been through a pretty extraordinary 12 months yourself. Youve become a major voice in the debate about responding to coronavirus in the uk. You were vilified because of a personal decision you took to entertain a woman friend during a lockdown in the uk when it wasjudged by the public and the press that you had previously outrageously broken the guidelines for lockdown. Youve also been criticised for advocating lockdowns which, as weve discussed, threaten fundamental liberties of a democratic nation. What is your conclusion about the way in which the public and scientists interact . I think its hard to summarise that in a single sentence. I mean, i think the attacks on me started well before my own grievous error ofjudgement as you mentioned it, particularly from as you say, some at the libertarian right end of the spectrum. I think its perfectly acceptable for people to have different opinions on what is the appropriate response. What is that balancing point between liberty and control of spread and Public Health, and people will have different judgements, and thats a judgement for politicians and everybody to make. And i dont actually think that scientists have any unique role beyond anybody else in society in making that judgement. Where i have been disappointed, lets say, in some aspects of the debate is just the polarisation leading to basically disinformation around the science of trying to undermine notjust me, but scientists in north america, in germany, trying to undermine scientists who are identified as being on one side of lets say the science policy debate. The other thing is being the sense that almost some Media Outlets presenting what i would call false balance, and weve seen it before in Climate Change debate of trying to give an impression that you have almost two equal sides, camps of scientists and Public Health people one who are for lockdown for instance and one for lets say the Great Barrington declaration of shielding the elderly and letting the disease run through the population. There has never been that sort of balance. I would say 90 95 of the Public Health community has actually really come behind both the science which has been done, and there is a lot of scientific consensus, but also behind the policies which have been adopted. So, yeah, there have been disappointing elements. Its been at times difficult personally and for many of my colleagues notjust at Imperial College but in many institutions around the world. Its also been a very rewarding year though in terms of hopefully making a difference notjust in the uk. The centre i run advises countries around the world and has a global remit. And, yes, at being at the heart of a crisis quite of this magnitude. Well, it isnt over yet sadly but professor neil ferguson, i thank you very much indeed for being on hardtalk, thank you. Hello. After what has been a code wea k hello. After what has been a code weak both by day and by night, we will start to see changes to our weather now, particularly across Western Areas with less cold air moving in. It is pretty chilly for the rest of today across the south and east. It started off rusty with dense fog around. The cloud is thickening up in the west is a persistent rain affecting the north and west of scotland, a bit of snow on the high ground. Temperatures recovering 8 degrees. In and glasgow. Further south, recovering 8 degrees. In and glasgow. Furthersouth, low single figures for most. A degree also on yesterday. Tonight, theres temperatures continue to climb, more cloud pushing in from the west, a breeze picking up. Very wet across the north and west of scotland, perhaps some localised flooding. You can see temperature wise, away from the south east, it is a frost free night. Loads of seven or 8 degrees for parts of scotland and northern ireland. This week it will be milder than the weekjust gone. They will bea than the weekjust gone. They will be a bit of rain at times, mainly across Western Areas, some snow over the hills in the north. This is the pressure chart form and they can even see low pressure chart form and they can even see low pressures pressure chart form and they can even see low pressures of the north of the country. Outbreaks of rain. The milder air making inroads for most of the country. The cold air will turn some mothering into snow over northolt and scotland. It could be quite heavy. Father south and west, ploughed around, most of the rain will be across Western Areas, some dry interviews in the south and east. Temperatures higher than they have been of late. The milder air holes on as we head into tuesday across southern and Western Areas but that plume of cold air moves south across scotland. Here, itll be dry and bright with sunshine for a few coastal showers. Whether front and milder heirloom across the south and milder heirloom across the south and the west and here rather grey, damp, io ii. And the west and here rather grey, damp, io ii. That rain spreads across the country on wednesday, turns a bit dry by the end of the week. You can see temperatures much milder. This is bbc news with the latest headlines. Fresh warnings that the nhs under increasing pressure could soon be overwhelmed by coronavirus cases. The Health Secretary says people should all play their part in helping stop the spread. We can all do something to help, which is to stay at home because every time you try to flex the rules, that could be fatal and we all have a part to play. And we all have a part to play. It comes as the government says a symptomatic testing is set to be made available across england this week and tens of thousands of people over the age of 80 have been invited to book vaccines. But the British Medical Association wants more focus on also vaccinating