Our Western leadership has failed miserably at managing the risks of the COVID-19 coronavirus. Not one government in Europe or the Americas can claim a single success in protecting their populations not only from the pandemic but also from the consequences of their botched lockdown measures. The bumbling, stumbling farce that has become our government reactions could be likened to the Keystone Kops: falling all over themselves, frenetically failing and getting up to trip once again. For my 2020 year-end review, I am cataloguing many of the KeystoneCorona crises caused by the failure of our authorities to implement basic risk management tools. Part 7 of this series looks at how most Western leaders, after having given up trying to manage the coronacrisis, put all of their hope into the arrival of a vaccine saving humanity. But in Keystone farce tradition, they also failed to manage the vaccine strategy, either by failing to roll out the vaccine administration properly or by bungling the communications up to the point where the public uptake looks insignificant at best. They might as well let the anti-vaxxers handle the implementation.

Waiting for the Vaxalvation

It was some time in October 2020, as many European countries slipped into a second wave of infections (and lockdowns), that I believe our authorities just gave up trying to manage the virus. Pure capitulation. As most Asian economies were returning to normal, we were arguing about the value of sending children to school. It was too hard for our governments to implement tracking tools to control and isolate superspreader events (the Asian success story); too hard to identify and isolate vulnerable populations; so instead they locked everyone down again and pinned their hopes on the COVID-19 vaccine as their only strategy. But the virus didn’t wait.

As “The Waiting” continued through November and December, the death tolls in the West from the skyrocketing infection rates during the cold, dark months were inexcusable. Risk management involves making hard decisions from a wide array of scenarios – the objective is to prevent loss of benefits while protecting vulnerable populations. Implementing these risk reduction measures to As Low As Reasonably Achieveable is proactive and incessant. Simply waiting and watching as the warm summer months of 2020 ended (and the R-number spiked to the point of locking up societies again) was shamelessly irresponsible.

Worse, some authorities were blaming their populations for not following guidelines and accelerating the spread (but if you lock people up and beat them down like rabid dogs, what do you expect?). To tell the populations they would stay locked down until the vaccine arrives is anything but leadership; it is anything but intelligent; and it is anything but effective. These KeystoneCorona buffoons tried lockdowns in March – they didn’t work. They tried again in October – they didn’t work. Here we are in January and because of a new variant strain (Gee … there’s something nobody had thought would happen) the plan is … Yes … even stricter lockdowns.

Please stop all of that barking!

What insightful leader actually thought that putting all of their hopes on a vaccine introduction at the height of a raging pandemic would have the effect of flicking a switch? Worse, a shattered, shell-shocked community now sees we have the vaccine and is not waiting for the “All clear!” to get back to normal. It will take at least until the return of warm weather (May or June) and increased outside activities for the death rate to come back down. Until then, the authorities should be using every management tool at their disposal to reduce risks for the hundreds of millions of Europeans, including introducing:

• Tracking tools similar to what most Asian countries used so that superspreader events can immediately be isolated and contained.
• Better testing and tracing.
• More research on improving treatment techniques.
• More investment in hospitals and treatment centres.
• More data on levels of COVID-19 antibodies to know the extent of the affected populations.
• More communications and empowerment of populations to prepare for surviving infections.

This is risk management. Risk management involves examining all potential scenarios, evaluating all risk reduction vectors and taking courageous decisions to protect the vulnerable while preserving societal goods. The precautionistas have got used to the lazy process of saying “No!” and systematically stopping or banning anything they are uncertain about. They have grown accustomed to the docilian accolades for taking the safe (easy) way out. But we need courageous leadership in the time of pandemics, not cowardly shepherds.

Right now it really stuns me to think that Western countries have no idea of the levels of infection rates / antibody data among our population. Right now it really stuns me that, a year into this pandemic, most European countries still don’t have a clear risk management strategy (except to lock down populations when infections go up while waiting for more vaccines). Right now it really stuns me that there has been so little discussion about the societal consequences of our lack of risk management. Some would find these KeystoneCorona antics comical; I don’t.

The vaccines will eventually play a role as an important tool in the risk management strategy, but this vaxalvation approach (leaving the vaccine as the only hope of returning to “normal”) is now leaving communities feeling complacent. We have the vaccines so now we can go out with friends, travel, relax preventative measures, visit grandparents… It is rather hard, after months of promising that the vaccine will save Western societies, to still tell those same, tortured individuals, that while the vaccines have arrived, they’ll have to wait just a little bit more. What a cock-up!

The vaxalvation strategy will only (eventually) work if there is sufficient vaccine uptake to reach herd immunity. But what if less than half of a community gets (both) jabs (and fewer get boosters in the autumn)? What if social media stories of known brutal side effects after the second jab accelerate vaccine hesitancy? What if the anti-vaxxers continue to grow in strength to become a political majority imposing their political will (as we saw briefly in Italy)? What if developing countries never get sufficient vaccines and the virus spread festers, outbreaks resurface and lockdowns frequently return? (Will COVID-19 be the “dengue for rich, white people”?)

These are basic risk management scenarios that I’m sure our risk-savvy authorities have considered … right?

With the level of KeystoneIncompetence in the West, I’m not feeling good about any of these worst-case scenarios at the moment. Of course one way (probably the only way) to prevent a total failure of the COVID-19 vaccine uptake is to implement a proper public trust and vaccine communications campaign. Surely our heroic Keystone authorities could get that one right!

The KeystoneCorona Communications Strategy

This series started with outrage at Anthony Fauci voluntarily pouring doubt and mistrust on the UK regulators’ rolling review of the Pfizer-BioNTech vaccine. Several years back I wrote a series on anti-vaxxers where I argued how we had created these anti-vax monsters through our litany of risk communication failures. So why should it be any different with a major vaccine rollout at the height of a pandemic?

There have always been anti-vaxxers (as long as there have been vaccines) but the recent spike in numbers and influence could come down to two key events: the failure to properly implement the H1NI (swine flu) vaccine and the growth of social media communities. It might be an idea to accentuate this shift with a story from an earlier time.

I remember my first day at Solvay’s head office. The head of communications for the pharma division (which produced a leading flu vaccine at the time) said at a meeting: “Our products go inside of people’s bodies! You don’t get more personal than that. You have to treat that trust they give you as sacrosanct.” I realised then, more than two decades ago, that trust was the key element in any risk perception and frankly, behind any and all decisions.

How did we preserve trust back then? When I was working on a document to celebrate the 50th anniversary of our main flu vaccine, I recall that it was recommended for vulnerable people (and those coming in contact with them). It was voluntary and we stressed the benefits. Two decades ago, we were not demanding that parents would need a flu jab certificate to get their kids into class. Two decades ago, we did not preoccupy our time reinforcing the argument that our vaccines were not dangerous or caused other diseases.

Since that time, many missteps were made. After the 2001 anthrax threat, the US government concluded they had insufficient vaccine production capacity (the Predatorts had literally litigated the US pharmaceutical industry dry) so the Bush administration created a litigation shield to encourage companies to return to vaccine production. This was perceived by activists and conspiracy theorists as government collusion to cover up corporate malfeasance – the seeds of doubt had fertile soil. With a large number of companies moving into what was a sleepy part of the pharmaceutical business, they opened up new markets for new products and new government guidelines / regulations. The rise of detected cases of autism (amid loud MMR-autism denial campaigns) left parents feeling more and more uneasy at the multiplication of required vaccines. By the time of the 2009 failures in properly rolling out the swine flu vaccines, the anti-vaxxers became more than just a fringe movement.

Then came social media and the naturopaths found an easier way to manufacture fear and doubt.

Ten years later, with global anti-vax NGOs flush with funding, networks of naturopath gurus cementing their narratives, public trust in science declining further and an open communications tool enabling trust silos and echo chambers, we find ourselves with an even more daunting challenge to get the message right on a COVID-19 vaccination rollout.

So how has trust, as a commodity, been communicated to a potentially vaccine hesitant population at the time of a global pandemic? Until now, not very well, I’m afraid.

During the summer I was yelling out loud at my laptop as Western leaders were doing everything they could, it seemed, to sabotage vaccination efforts.

• Donald Trump was promising a rushed vaccine well in advance of the presidential election;
• pharmaceutical company share prices would swing wildly on vaccine trial news, encouraging bias;
• so-called science communicators are demanding that any dissenting views on vaccines be censored;
• airlines are talking about prohibiting unvaccinated people from travelling;
• vaccine vigilantes have started doxing people who express vaccine hesitancy.

How would any of this help develop public trust in vaccines or encourage uptake of any COVID-19 vaccines? People have the right to decide whether to let your product go into their bodies; that trust has to be earned, not burned.

So while Asian countries managed the pandemic with risk management tools (pre-vaccine), our Western authorities blame the incessant spread of the virus on the dogs they had tortured and abused. So while the scientific community provides a solution to the pandemic with a choice of effective vaccines developed in record time, our leaders pilfered away what was left of public trust in inoculations (and are getting ready to blame anti-vaxxers rather than their own incompetence). So while innocent people suffer the devastating social and economic consequences of lockdowns, European and American governments try to cover up their failures with largesse, indiscriminately passing out trillions of printed euros or dollars like they were peanuts. What could possibly go wrong?

But with the New Year came the vaccine. Let’s once again, with tragically comic optimism, put our hope in the hands of our KeystoneCorona heroes.

The Great Roll … Out

The Moderna and Pfizer-BioNTech achievements in 2020 will be one of those great scientific stories sadly not told by scientists. Scientists on these teams set a standard for innovation, coordination and professionalism. It will certainly be seen as one of science’s brightest moments (until our Western leaders snuffed out the lights). Unfortunately, not even a month into the rollout and the Risk-Monger’s forehead is bruised and beaten from repetitive face palms.

On January 6, the Dutch government confessed they had not yet started vaccinations because (and I wish I were making this up) they were expecting another vaccine to have been approved first and they did not have sufficient cold-chain technology to administer the vaccine (two months after the trial results were announced). OK so while the Netherlands has one of Europe’s highest infection rates and a population suffering under one of the strictest curfews, this was completely understandable – the government authorities were all on their Christmas holidays (in Greece!). At the same time, as the UK and Israel had vaccinated over one million vulnerable people, Belgium (with the highest per capita COVID-19 death rate) had only vaccinated several hundred vulnerable people, and in all of France … less than 500 had received the jab. Even more astonishing, seniors in certain German states have to move very fast to register online for their potential vaccine slot for the week. The 15,000 slots would sell out in less than 15 minutes. Sorry but have you ever seen vulnerable, elderly people move fast on a laptop? Survival of the fittest I suppose.

Rumours are already spreading, at time of publication, of vaccine supply shortages and delivery delays. Cue the hoarding and fighting.

Even back in December, politicians started making, well, political decisions. Former UK prime minister (and amateur vaccinologist), Tony Blair, suggested that the UK could save more lives if they only administered the first of two jabs for the time being. Other excited politicians piled in while the Pfizer-BioNTech spokesperson quietly recommended following the evidence from the trials. Then someone else reckoned they could squeeze seven jabs out of a bottle instead of the recommended five. Others, against US FDA advice, were mixing the half-dose overfills. Who needs to listen to experts when we can share ideas with each other?

Going against the scientific advice does not build trust in populations nervous about vaccines. In fact it sets the scene for further vaccine skittishness. Soon some authorities will start suggesting the vaccines can be stored in normal A+++ freezers or maybe propose that children should only get half a dose. With such a high efficacy rate, what if we dilute the vaccines? Who is to stop government officials from being irresponsible (they have got away with it until now)? Each day I am more terrified by how incompetent Western leaders can be at risk management, risk communications and simple governance. Two decades of using the precautionary principle by default have made them lazy and irresponsible.

And there’s one more curious thing I keep wondering about. Weren’t all of these great and the good leaders talking about sharing the vaccines with developing countries? Six months ago, they were making such inspiring speeches about social justice and how we are all in this together. I remember I welled up at their emotional declarations of responsibility and commitment. What happened to that righteous solidarity? I suppose our governments have been waiting too long for their asses to be covered by this vaxalvation to think now about such grand gestures. I suppose we will have to wait until GAVI, the Gates Foundation and J&J step forward to keep their promises. Remind me once again why so many of these hideous, small-minded activists hate industry…

I am so done with these bumbling precautionistas! Good Night, Nurse!

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A note about the image from the 1918 film, Good Night, Nurse. Roscoe “Fatty” Arbuckle was perhaps the greatest comic of the silent era … until this Keystone Kop became an early victim of a vicious cancel culture.