Abstract

“We can see the way out”, ran the headline in last week's Sunday Express. Governments across Europe are increasingly optimistic. Ministers are looking visibly more relaxed. US President Joe Biden is now in the White House and he is serious about science, unlike his predecessor. Vaccines are being delivered at scale. Claims are now being confidently made that all adults in the UK will have been vaccinated by June or September, 2021. Although other countries have been slower to start, they will catch up. Summer vacation bookings are growing. If the current lockdown in the UK follows the same time course as last year, mandates might be modified as early as Feb 24—with the public being encouraged to take more outdoor exercise and workplaces beginning to open. On the basis of past experience, restaurants, bars, and other hospitality and entertainment venues could be open by April 14. Now is not then, of course. Vaccination will alter the characteristics of the evolving epidemic. But we are living through winter in the northern hemisphere, not spring. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has mutated into several more transmissible lineages, and further genetic variants should be expected. Public support for lockdown restrictions is not as high today as it was during the first wave of infection. Still, there can be no question that hope is returning. And that is why this moment is so dangerous. In Ford Madox Ford's The Good Soldier, wealthy American John Dowell tells the story of Captain Edward Ashburnham and his wife Mrs Leonora Ashburnham. It is, according to the opening line of the novel, “the saddest story I have ever heard”. Ford gives Dowell the authority to reveal “the Ashburnham tragedy” in a series of flashbacks that build to a devastating conclusion. But for the reader there is a parallel and even more disconcerting journey. One begins to distrust Dowell's account. Is the tale he describes an accurate representation of the facts? Or is it, as one progressively comes to believe, flawed? Towards the end of the book, Dowell concludes that “Society must go on, I suppose, and society can only exist if the normal, if the virtuous, and the slightly deceitful flourish, and if the passionate, the headstrong, and the too-truthful are condemned to suicide and to madness.” Which is Dowell—deceitful or truthful? And here is the point regarding this COVID-19 syndemic. As elation begins to colour our future, there may be a temptation to revise the story of the past year. To let sleeping dogs lie. To agree that no one could have predicted the consequences of this coronavirus. To look forward, not back. To forgive. To move on. This absolution, this desire for reconciliation, would be a colossal mistake. For now is the time to search for the truth. Now is the time to insist, to demand, that those who navigated our path through this pandemic are held fully accountable for their decisions and actions. First, China. What actually happened in Wuhan in 2019? The overwhelming majority of scientists believe evidence points to viral spillover from an animal to a human host. But a smaller number of scientists, together with a group of vocal politicians and journalists, argue that WHO's Independent Panel for Pandemic Preparedness and Response, co-chaired by Helen Clark and Ellen Johnson Sirleaf, must investigate the allegation that the virus originated in the Wuhan Institute of Virology. Outgoing US Secretary of State Mike Pompeo said last week that “Beijing continues to withhold vital information that scientists need to protect the world from this deadly virus”. It suits some critics to deflect responsibility for 2 million COVID-19 deaths away from their own culpability. But that motivation doesn't absolve Chinese authorities from working with WHO to produce a credible chronology of the origin and spread of SARS-CoV-2. For the rest of the world, now is the moment to prepare for national public inquiries into their COVID-19 responses. China successfully pursued a strategy of complete suppression to halt community transmission. A few other nations, such as New Zealand, did the same. But most western countries sought to mitigate the outbreak—to delay the epidemic surge and, to use UK Prime Minister Boris Johnson's words, to “take it on the chin”. Mitigation led to hundreds of thousands of avoidable deaths. Unreliable narrators can be eloquent and convincing. Beware their charming fictions.

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