The tide of the COVID pandemic is going out – but that doesn’t mean the big waves can’t hold us still


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In February, Prime Minister Boris Johnson said the public would have to “get used to living with Covid”, and announced a phased easing of all COVID-related restrictions over the following months. For many people, life has since returned to normal.

Of course, there are some notable differences in pre-pandemic times, with a huge increase in working from home, and the worrying fact that many people are still suffering from chronic COVID-19. But in most cases, you could be forgiven for thinking the pandemic is over.

Still, over the past few weeks there have been signs that a new wave of COVID is approaching. The latest data from the Office for National Statistics (ONS) infection survey shows that around 1.7 million people in the UK had COVID in the week ending 18 June – an increase of more than 80% over the past three weeks. Given that infection survey data are published at least a week late, these figures almost certainly underestimate the number of cases today.

COVID cases rising across the UK

A significant change over the past few months has been the end of free mass testing, which kicked off in April. While this was at some stage unavoidable due to the significant costs involved, it has superseded one of the UK’s leading early warning systems.

In the past, an increase in positive tests in the community has been one of the first signs that a new wave was coming. Without it, we may not realize the seriousness of a new variant until it is already well established and people start coming to hospitals in increasing numbers.

BA.4 and BA.5

Two new Omicron variants, BA.4 and BA.5, are making up most of the transition in the current wave. Both of these are more permeable than the earlier major version BA.2,. The evidence is still unclear whether these variants are more or less severe than the earlier forms of Omicron, but the UK Health Protection Agency (UKHSA) has classified them as “anxiety types”.

The latest hospital data shows that the number of new COVID patients (a combination of new admissions and people catching COVID in hospital) is increasing in England. These figures in the most vulnerable age groups (65 and over) are at about two-thirds of the January peak seen during the early Omicron wave.

Rates of new COVID hospital admissions by age in England

A line chart showing the rate of new COVID admissions by age in England, showing recent increases across all age groups.

The situation is most dire in the north-west of England, where there are currently around 200 new COVID admissions every day. The North-West was also one of the worst affected parts of the country in terms of hospitalizations during the BA.1 and BA.2 waves.

The key question at this stage is how long this increase will continue. Without the early warning system of mass testing, it’s hard to know. Eventually, this wave will begin to subside when the developmental advantage of new variants mounts against the wall of immunity imposed by vaccination and previous infections.

Although we have done an excellent job of getting the initial doses of COVID vaccines into arms in this country, over time there is a combination of diminishing immunity and the fact that newer versions are generally better at overcoming this immunity. This means that this wall is not as strong as it once was.

However, there are some reasons to be cautiously optimistic. South Africa, which has often been a bellwether for new variants, and where BA.4 and BA.5 were first identified, resulted in these variants with relatively low hospitalizations and deaths compared to previous waves. A small wave was observed. Portugal was one of the first European countries to see a BA.4/5 wave and, while it saw a significant increase in hospital admissions, case numbers have now begun to fall without reaching the same severity as previous waves.

some cause for concern

Even though the BA.4/5 wave may not be as big as the previous wave, there are two major concerns. The first is the pressure already placed on the NHS, which has been exacerbated by the events of the past two years. Ambulance wait times are at record levels, as are A&E wait times, with more than one-quarter of patients waiting longer than four hours. This comes with a huge backlog of operations and other types of medical care that were delayed during the pandemic. Even a slight BA.4/5 wave is only going to add to these pressures.

The second issue is the increasing number of people with chronic COVID-19. At least 1.4 million people in the UK report symptoms that affect their daily lives. And these figures are from May, before infections started rising again.

Read more: Longer COVID: Female sex, older age and existing health problems increase risk – new research

So what can we do? If you were taking precautions at the beginning of the year that you left, it would be wise to think about taking them again. These include wearing a mask in crowded places, not meeting people if you have any symptoms, and if possible getting tested if you are feeling unwell or going to spend time with someone who is vulnerable. The UKHSA also recommends meeting other people outside or in well-ventilated places.

To help strengthen our defenses against these new (and future) forms, it may merit to bring an autumn booster campaign, which will provide a fourth dose to people over 65 and other vulnerable groups. It may also be worthwhile to consider giving a fourth dose sooner to younger groups and an additional booster to the most vulnerable groups.

The tide of the pandemic is going out. But as with any receding tide, there will always be an oddly big wave that can catch you if you’re not careful. The end of mass testing and the threat to the future of the invaluable ONS COVID Infection Survey make it more likely that these waves will catch us unprepared. The poor state of the NHS and the protracted COVID threat mean we should not be complacent about its potential threat, or subsequent waves, even if the tide continues to go out.

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