Wed. Oct 27th, 2021

Six weeks of stalemate between the UK and coronavirus, with little decisive movement in key indicators of infection and disease, is likely to end soon, experts predict. Cases, hospitalizations and deaths are generally expected to increase after the month returns to school, combined with more social mixing within the fall.

Scotland, where schools returned two weeks earlier than England and Wales, can give a taste of what’s to come. According to the Infection Survey of the Office for National Statistics, positive tests in Scotland rose to 2.2 per cent of those tested in the week to September 3 – just 0.7 per cent two weeks earlier.

However, case numbers indicate that Scottish infections have peaked. Over the past seven weeks, the equivalent rate in England has been around 1.5 per cent.

Chart showing that infections have risen sharply in Scotland over the past month, although there are signs that they could now reach a peak

“In many ways, the experience of Scotland can be seen as a foretaste of possible increases in cases that could occur in the next few weeks in England,” said Rowland Kao, professor of epidemiology at the University of Edinburgh.

John Edmunds, professor of epidemiology at the London School of Hygiene & Tropical Medicine and a member of the government’s advisory group Sage, agrees. “Transfer in schools [in England] “It probably happened this week and last, so I think we will see new cases from now on,” he said.

‘In the next month or two we’re going to have a lot of cases, and that’s going to result in hospitalizations, and unfortunately. . . deaths, ”Edmunds added. ‘I’m worried about the next few weeks. We will then find out what could be next with the twin pressure of Covid and winter flu. ”

Some scientists are more optimistic. “I do not think we will see a huge increase in cases after schools go back,” said Paul Hunter, a professor of medicine at the University of East Anglia.

The current vaccination levels, combined with the immunity provided by natural infection with the Sars-Cov-2 virus, are sufficient to prevent a Covid-19 crisis during the fall and winter, Hunter said. “At many international conferences I have attended, people have described infections as actions such as vaccine boosters, although you do not hear many British commentators talk like that,” he said.

A graph showing that if the UK saw another winter wave of Covid, it would start from a much higher level of hospital pressure than last year's wave

Hospital admissions and deaths have increased slowly in recent weeks in most of the UK – and faster in Scotland. ‘Scotland is close to the same number of hospitalizations as in January. . . although Scotland’s peak in January was lower than that of England, “said Edmunds.

The NHS is working hard ahead of the autumn rise in Covid cases, says Tom Wingfield, senior clinical lecturer at the Liverpool School of Tropical Medicine. “We are busier than I saw during the summer during my 18 years in the NHS,” he said, “and the chronic tension in the system is very high.”

“We are not overwhelmed because the vaccines work, but we have three wards in one Liverpool Hospital Trust, filled with Covid patients – wards that could otherwise be used for other treatments,” he said. “I’m very worried about what this winter is going to bring, as we will see flu and other respiratory infections that we have not seen this past winter, because people are not going out and mixing.”

Although the UK has set the early pace with its rapid rollout of vaccinations, it has recently been overtaken by several other European countries that have moved faster to vaccinate young people, especially in the 12-15 age group. Britain has now administered 138 doses per 100 inhabitants, compared to 150 in Portugal, 149 in Denmark and 144 in Spain.

Graph showing that the UK has been overtaken by countries that vaccinate young teenagers, and its early rollout in the elderly means more time for immunity to decline

Neil Ferguson, professor of epidemiology at Imperial College London, said some countries were in a better position than the UK because they had been vaccinated more recently, so that immunity had less time to decline and that they ‘ used a larger proportion of the mRNA vaccines “which provide better protection against infection.”

“I’m not sure if I would feel that comfortable, but I would definitely feel more comfortable in countries like Spain, Portugal and Denmark,” Ferguson added. “I do not want to exaggerate the situation we are in. I do not think we are currently in a crisis. I just think that at this stage we need to continue to promote immunity in the population. ”

However, few experts anticipate the need for another comprehensive lock-up this winter, even as flu and other respiratory illnesses increase Covid’s burden.

“In the worst case, we could probably reverse a wave of infections with more lenient measures,” such as telling people to work from home and wear masks in public places if possible, Edmunds said.

“We have a lot of immunity in the population, and it does what they have to do – which puts a limit on the number of reproductions,” he said. “So, we do not need such an extreme measure to prevent things from getting out of hand as in the past.”

The reassuring conclusion can be invalidated by the emergence of a new variant that is significantly more contagious than Delta and better equipped to overcome human immune defenses.

But Hunter said it is very unlikely. “I do not believe we will get another variant worse than Delta,” he said. “Once the virus best suits its human host, it’s in terms of major evolutionary steps.”

Ferguson said modeling done for Sage could yield a whole range of scenarios ranging from slow, steady rises to a high, sustained peak to very sharp increases in the demand for hospital beds. ‘

“The hardest thing to deal with is a big increase, because that’s where you put a lot of pressure on the NHS,” Ferguson said. “If we can avoid it, and it’s so far, that’s good news.”

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