All the Covid indicators in the UK are going in the wrong direction. They have been for a while now. Cases are surging upwards; hospitals are feeling the strain of increasing numbers of Covid patients, and daily death tolls are rising. At the same time, vaccination delivery is slowing down. On Monday we saw almost 50,000 cases reported. Only on 16 days throughout the whole pandemic have we seen higher numbers. On Wednesday we saw similar numbers. Our seven-day average is more than 45,000 cases a day, and the ONS estimates that one in 60 people are infected – the highest level since January. For comparison, Germany is seeing 165 daily cases per million of its population. In France, the figure is just 71, and in Spain 35. The corresponding rate for the UK is more than 650 per million. The continued rise in cases since mid-September has been driven in large part by unmitigated transmission in schools. Cases in secondary school students are at unprecedented levels. The recent uncovering of false negative testing at the Immensa laboratory in Wolverhampton is also starting to have an effect on the numbers. The south-west, the region most affected by the scandal, and which appeared to be bucking the trend of the rest of the country, with (artificially) low case rates early in October, is now at the centre of the UK’s epidemic. Unsurprisingly, the impact of telling thousands of people they were not infectious and could go about their daily business has been devastating. This will lead to tens of thousands of unnecessary illnesses, further increasing pressure on hospitals in the region and ultimately costing lives. The Immensa debacle will raise an already high nationwide death rate higher still. Currently we are averaging more than 130 deaths a day, with 223 reported on Tuesday alone – the highest figure since 9 March. At 1.8 daily deaths per million, our rate is more than double that of Germany and three times that of France and Spain. The UK’s death figures are all the more startling in light of the fact that current numbers reflect case rates about three weeks earlier. Three weeks ago, we were averaging 35,000 cases a day. In the short term, death figures are only going one way. The most frustrating aspect of our poor Covid performance is that, with relatively little effort, it could have been so different. R is hovering just above one. It wouldn’t have taken that much to bring the transmission number back below one, reversing our upwards trends. Looking green-eyed to our comparable continental neighbours highlights the alternative reality we could have been living in had we continued with masks in indoor public spaces, begun to vaccinate our children over the summer, and taken measures to improve ventilation in our schools and workplaces. Instead, in England, masks – which come with no economic detriment, only a public health benefit – were removed for purely ideological reasons. The Joint Committee on Vaccination and Immunisation pontificated for weeks before recommending against vaccinating 12– to 15-year-olds, despite finding an overall benefit of the vaccines in this age group, using calculations that it has not published. It took the intervention of the UK’s chief medical officers to give the green light to protect our secondary school pupils against this disease. Even then, the rollout has been catastrophically slow. Only 17% of 12- to 15-year-olds in England have been vaccinated since the programme was announced, over a month ago. In the absence of vaccination we should have been implementing mitigations in schools. Masks, ventilation and locally led contact tracing would have helped keep children safer. Instead, the 300,000 promised CO2 monitors – not even a mitigation in themselves, but the first step to determining when there is a problem – have not arrived. Last week it was reported that only 2% of the promised monitors had been delivered. There is still no mention of filters or mechanical ventilation to actually address the core problem. We have left our children, who have suffered and sacrificed so much throughout the pandemic, to face Covid on their own. The other factor that could account for some of the difference between the UK and European neighbours is vaccination in the adult population. Last spring, the UK was genuinely “world-beating” when it came to vaccination, rolling out jabs faster than almost any other country. But since the summer we have found our vaccine coverage lagging behind many EU countries’. Five million adults in the UK remain unvaccinated. As well as the overall coverage, the type of vaccine delivered influences the quality of the protection provided. The most vulnerable people in our society were given the AstraZeneca jab, which provides worse protection and is less effective at reducing transmission than the mRNA vaccines that were the staple of much of mainland Europe. To add to our problems, the recent scientific consensus is that vaccine-mediated immunity wanes over time. Six months down the line from our peak vaccination rate and heading into winter, it is clear that our rapid rollout, which made such a difference early on, is now acting to our disadvantage. The booster programme was supposed to rectify the problem, but its rollout has been unable to keep pace with the rapid first and second doses we delivered last spring. More and more people are falling six months beyond their first dose, becoming increasingly vulnerable all the time. In a country employing a vaccine-only strategy, boosters are crucial for protecting our most vulnerable. The single most important lesson the government should have learned from its mistakes in the handling of the pandemic thus far is that decisive early action is always better than watching and waiting. In short, it’s time for “plan B”. Introducing masks, vaccination passes and increased working from home now may allow us to bring the situation under control in a relatively pain-free manner. It’s important, however, that we activate plan B as soon as possible, because if we don’t, we may need to jump straight to plan C. And at the moment there is no plan C. Kit Yates is director of the Centre for Mathematical Biology at the University of Bath and author of The Maths of Life and Death