England is about to take a huge gamble.
On Monday, July 19, the country is ditching all of its remaining pandemic-related restrictions. People will be able to go to nightclubs, or gather in groups as large as they like. They will not be legally compelled to wear masks at all, and can stop social distancing. The government, with an eye on media coverage, has dubbed it “Freedom Day,” and said the lifting of safety measures will be irreversible.
At the same time, coronavirus cases are rapidly rising in the UK. It recorded over 50,000 new cases on Friday, and its health minister says that the daily figure of new infections could climb to over 100,000 over the summer.
In theory, a full reopening during a surge in cases sounds like a combustible mix. But the UK government is betting that this time won’t be like the others because of its vaccination program.
Researchers say it’s extremely difficult to predict what will happen next, with multiple overlapping, complex factors at play. So let’s examine what we know, what we don’t know, and what we need to keep an eye on over the coming weeks.
What we know: the vaccines are working
The UK’s vaccination program is still under way, but it has been broadly successful so far. In all, 52% of the adult population is fully vaccinated, and about 87% of adults have received their first dose (this includes the 52% who have had both doses). Just 6% of Brits are hesitant about getting a shot, according to the Office for National Statistics.
There is still plenty of cause to be nervous, however. The country is months away from fully inoculating the entire adult population. Young people are particularly vulnerable; the over-18s have only just started to receive their first doses, and only a quarter of 18- to 39-year-olds have had both shots. And unlike the US and much of Europe, the UK has not started vaccinating children.
“That’s dangerous,” says evolutionary virologist Emilia Skirmuntt. “We need to vaccinate teenagers urgently, especially before they return to school in September.”
This matters because the overwhelmingly dominant strain of covid-19 in the UK right now is the delta variant. While fully vaccinated people have relatively little reason to worry about delta—with both Pfizer and AstraZeneca vaccines offering over 90% efficacy against hospitalization, according to data from Public Health England—the variant is bad news for those who have only had one shot or are unvaccinated.
It’s about 60% more transmissible than the alpha variant, which was previously dominant in the UK, and almost twice as likely to lead to hospitalization, according to Scotland’s public health body. A single dose of either the AstraZeneca or the Pfizer vaccine is just 33% effective against the delta variant, versus 50% for alpha, says data from Public Health England.
“This reopening is going to lead to a lot of avoidable damage,” says Deepti Gurdasani, a clinical epidemiologist at Queen Mary, University of London. “We should be halting easing up until all adults and adolescents have been offered both doses of the vaccine.”
What we don’t know: when cases will peak
It’s clear that the UK is experiencing yet another wave of the pandemic. What we don’t know is just how bad it’s going to get—or how lifting restrictions will change that. Even the top experts in the field can’t say for sure.
“It is very hard to know what is going to happen after July 19,” says Graham Medley, professor of infectious disease modelling at the London School of Hygiene & Tropical Medicine and chair of SPI-M, a group of scientists that advises the UK government on pandemic modeling.
A lot depends on public behavior, and that is notoriously very tricky to predict. While some will enjoy their newfound freedoms with gusto (a tendency that was on full display last weekend during the final of the European soccer championships), others will be far more cautious.
Many people are frustrated at the ditching of masks, one of the most basic and effective public health measures. An Ipsos Mori poll found that a sizable majority of British people plan to continue to wear masks in stores, and on public transport. If people follow through on this, it may help curb the spread somewhat: Israel, which also has high vaccination rates, had to reimpose mask-wearing indoors last month due to a steep rise in cases.
Regardless, it is very likely that cases will continue to rise for at least a few days, if not a few weeks. And that means more hospitalizations and deaths are inevitable, according to Medley. The big question is how high this wave gets.
In a webinar on Thursday, Dr Chris Whitty, the chief medical officer for England, said that the country could see “quite scary numbers again” and “get into trouble again surprisingly fast.”
But the government seems to be betting that not all numbers are equally scary. It hopes that hospitalizations will stay low enough to stop the National Health Service from being completely overwhelmed. It is making the assumption that the link between cases and hospitalization rates has been weakened, if not broken.
“This wave is very different to previous ones,” says Oliver Geffen Obregon, an epidemiologist based in the UK, who has worked with the World Health Organization. “The proportion of hospitalization is way lower compared to similar points on the epidemic curve before the vaccination program.”.
But not everyone agrees. NHS bosses are already sounding the alarm over capacity, and more than 1,200 scientists have signed a letter in The Lancet arguing that Britain should care about the huge rise in infections, regardless of the rates of deaths and hospitalizations.
Gurdasani, the epidemiologist, is one of them.
“Cases matter,” she says, pointing to two main dangers: the increased chance that large numbers of people will develop long covid, and the risk of new, vaccine-dodging variants.
What we know: more people will get long covid
The UK already has a significant long covid problem. More than two million adults may already have—or have had—complications which persist for 12 weeks or more, according to a major study from Imperial College London. But long covid is poorly understood, with over 200 symptoms ranging from fatigue to shortness of breath to memory issues, according to the largest study of it yet, recently published in The Lancet.
About one in 10 of those who catch covid-19 go on to develop long covid, according to the WHO. That means if another million people in the UK catch covid during this wave—a feasible scenario by most estimates—there could be another 100,000 people with long-term issues.
Whitty is worried. “I think we will get a significant amount more long covid, particularly in the younger ages where the vaccination rates are currently much lower,” he said on July 6.
That could place huge pressure on the NHS, businesses, and society in general, let alone cause untold misery for vast numbers of individuals.
“Some symptoms may persist for years, and there’s a chance we’re exposing a whole generation to very bad health for the rest of their lives,” says Skirmuntt.
What we don’t know: if this could all spawn another dangerous variant
The big fear for many experts is that this approach by the government is creating an ideal breeding ground for the emergence of a vaccine-resistant variant.
On July 5, Steve Peterson, co-director of the Centre for Genomic Research at the University of Liverpool, summed up the concerns in a tweet: “Letting a virus rip through a partially vaccinated population is exactly the experiment I’d do to evolve a virus able to evade immunity.”
The Download: Introducing our TR35 list, and the death of the smart city
Spoiler alert: our annual Innovators Under 35 list isn’t actually about what a small group of smart young people have been up to (although that’s certainly part of it.) It’s really about where the world of technology is headed next.
As you read about the problems this year’s winners have set out to solve, you’ll also glimpse the near future of AI, biotech, materials, computing, and the fight against climate change.
To connect the dots, we asked five experts—all judges or former winners—to write short essays about where they see the most promise, and the biggest potential roadblocks, in their respective fields. We hope the list inspires you and gives you a sense of what to expect in the years ahead.
Read the full list here.
The Urbanism issue
The modern city is a surveillance device. It can track your movements via your license plate, your cell phone, and your face. But go to any city or suburb in the United States and there’s a different type of monitoring happening, one powered by networks of privately owned doorbell cameras, wildlife cameras, and even garden-variety security cameras.
The latest print issue of MIT Technology Review examines why, independently of local governments, we have built our neighborhoods into panopticons: everyone watching everything, all the time. Here is a selection of some of the new stories in the edition, guaranteed to make you wonder whether smart cities really are so smart after all:
– How groups of online neighborhood watchmen are taking the law into their own hands.
– Why Toronto wants you to forget everything you know about smart cities.
– Bike theft is a huge problem. Specialized parking pods could be the answer.
– Public transport wants to kill off cash—but it won’t be as disruptive as you think.
Toronto wants to kill the smart city forever
Most Quayside watchers have a hard time believing that covid was the real reason for ending the project. Sidewalk Labs never really painted a compelling picture of the place it hoped to build.
The new Waterfront Toronto project has clearly learned from the past. Renderings of the new plans for Quayside—call it Quayside 2.0—released earlier this year show trees and greenery sprouting from every possible balcony and outcropping, with nary an autonomous vehicle or drone in site. The project’s highly accomplished design team—led by Alison Brooks, a Canadian architect based in London; the renowned Ghanaian-British architect David Adjaye; Matthew Hickey, a Mohawk architect from the Six Nations First Nation; and the Danish firm Henning Larsen—all speak of this new corner of Canada’s largest city not as a techno-utopia but as a bucolic retreat.
In every way, Quayside 2.0 promotes the notion that an urban neighborhood can be a hybrid of the natural and the manmade. The project boldly suggests that we now want our cities to be green, both metaphorically and literally—the renderings are so loaded with trees that they suggest foliage is a new form of architectural ornament. In the promotional video for the project, Adjaye, known for his design of the Smithsonian Museum of African American History, cites the “importance of human life, plant life, and the natural world.” The pendulum has swung back toward Howard’s garden city: Quayside 2022 is a conspicuous disavowal not only of the 2017 proposal but of the smart city concept itself.
To some extent, this retreat to nature reflects the changing times, as society has gone from a place of techno-optimism (think: Steve Jobs introducing the iPhone) to a place of skepticism, scarred by data collection scandals, misinformation, online harassment, and outright techno-fraud. Sure, the tech industry has made life more productive over the past two decades, but has it made it better? Sidewalk never had an answer to this.
“To me it’s a wonderful ending because we didn’t end up with a big mistake,” says Jennifer Keesmaat, former chief planner for Toronto, who advised the Ministry of Infrastructure on how to set this next iteration up for success. She’s enthusiastic about the rethought plan for the area: “If you look at what we’re doing now on that site, it’s classic city building with a 21st-century twist, which means it’s a carbon-neutral community. It’s a totally electrified community. It’s a community that prioritizes affordable housing, because we have an affordable-housing crisis in our city. It’s a community that has a strong emphasis on green space and urban agriculture and urban farming. Are those things that are derived from Sidewalk’s proposal? Not really.”
Rewriting what we thought was possible in biotech
What ML and AI in biotech broadly need to engage with are the holes that are unique to the study of health. Success stories like neural nets that learned to identify dogs in images were built with the help of high-quality image labeling that people were in a good position to provide. Even attempts to generate or translate human language are easily verified and audited by experts who speak a particular language.
Instead, much of biology, health, and medicine is very much in the stage of fundamental discovery. How do neurodegenerative diseases work? What environmental factors really matter? What role does nutrition play in overall human health? We don’t know yet. In health and biotech, machine learning is taking on a different, more challenging, task—one that will require less engineering and more science.
Marzyeh Ghassemi is an assistant professor at MIT and a faculty member at the Vector Institute (and a 35 Innovators honoree in 2018).