The high Covid-19 death rate is even worrying the Conservative press. But they don’t want to think too deeply about why, preferring to see the answer in Boris Johnson’s personality, or a list of unconnected managerial failures and accidents.

But the real answer is that this is a public health emergency, so needs the strongest response from the public health and welfare institutions.

Instead Johnson and his Tory predecessors repeatedly went for “free market” and privatised responses, which let the virus run riot. Covid-19 has only been contained where the government has been forced back to using and supporting public institutions.

Conservative Covid-19 failures go back before the outbreak. Cost-cutting meant PPE stocks weren’t maintained, and we had too few nurses and doctors. The generally poor state of public health – exacerbated by the “austerity” years – mean the population was more vulnerable.

When the outbreak happened Johnson wasted time and money on Dido Harding’s privatised test and trace service. By handing private contracts to “crony” firms like lab company Randox or generic privatiser Serco, the government failed to create a shield against the virus.

Public officials and organisations – like directors of public health, local authorities or NHS Labs which should have been at the core of an effective response, were sidelined.

Poor public welfare provision – including low levels of sick pay and low benefits – also prevented proper isolation of the virus.

Johnson may get a big increase in support from successful vaccination, but the programme is the product of these public institutions, not the “free market.”

The vaccine is being successfully delivered by existing NHS structures, in stark contrast to the poor performance of the shonky privatised “test and trace” system.

The vaccine itself is a product of public sector institutions.

“Big Pharma” has not invested much in vaccines, leaving the public sector to fill the gap: the main vaccine used in Britain was designed by the University of Oxford’s publicly funded Jenner Institute.

Oxford scientists started working long hours last January on a Covid-19 vaccine: for context, that same January and February Johnson missed five emergency Cobra meetings on Covid-19. In March, as the Oxford scientists worked on, Johnson was still talking about “herd immunity” and insisting he shook everybody’s hand in hospital.

The Oxford scientists were adapting an older vaccine that had been developed for a previous coronavirus, the “Mers” disease which broke out in the Middle East in 2012.

The Oxford vaccine is a “viral vector”: it uses a modified monkey-flu virus to imitate Covid-19 in a non-dangerous way, so the human body can develop immunity without experiencing the terrible symptoms of coronavirus. Sarah Gilbert, one of the scientists who led the creation of the Oxford vaccine – and really one of the heroes of this story – made clear that without years of support from public-sector institutions this would not have happened. She said: “Long-term funding through UKRI (UK Research and Innovation) adding up to more than a decade of investment, has been key to developing the viral vector vaccine platform and optimising our manufacturing methods. This meant that all the pieces were in place for us to be able to develop a novel coronavirus vaccine at speed.”

UKRI is the public-sector board which funds largely university-based research. As Professor Gilbert makes clear, this long-term work meant the Oxford team could both design the vaccine and work out “manufacturing methods,” as scaling up production is as important as design.

Sarah Gilbert also said the “UK Vaccines Network” was vital because it funded development of the anti-Mers vaccine which underpins the new vaccine.

As Professor Gilbert says, the UK Vaccines Network is “a partnership between the Department of Health and Social Care and UKRI’s Medical Research Council and Biotechnology and Bioscience Research Council” – that is, a partnership of established public institutions.

The UK Vaccines Network was set up because of “market failure,” because the “Big Pharma” firms don’t invest enough in vaccines.

The UK Vaccines Network’s founding statement runs: “Vaccines are widely recognised as an important mechanism in controlling infectious disease outbreaks. However, outbreaks of some of the world’s deadliest diseases only occur intermittently, and often in the world’s poorest countries, meaning that there may not be a strong market incentive to for the pharmaceutical industry to develop vaccines for such diseases.”

Big Pharma doesn’t invest in vaccines because they find it easier to make profit from high-cost medicines that need regular repeat doses.

Vaccines mean single or double doses of low cost drugs for many, often poor people, so are not seen as profitable. The UK Vaccines Network was set up as “concerted and co-ordinated action to address this market failure.”

It is important to remember this is not the AstraZeneca vaccine, it is the Oxford vaccine. AstraZeneca are now manufacturing the vaccine, but both the vaccine and the manufacturing process were created by the Oxford scientists. (IPA Service)