A winter resurgence of Covid-19 in the UK could result in more cases and deaths than the recent peak unless action is taken now to prepare the health system, according to a government-commissioned report.
In the worst-case scenario, where very limited action is taken, the number of coronavirus-related hospital deaths could hit 120,000 between September and June 2021, more than double the tally so far this year, according to the study by the Academy of Medical Sciences, requested by Patrick Vallance, the chief scientific adviser.
“The window for action is now, between July and October — the infection rates are low and that’s the time to think, breathe and get on top of things,” said Professor Dame Anne Johnson, professor of infectious disease epidemiology at University College London and vice-president of the Academy. The report’s authors list measures to mitigate the risks of a severe resurgence, including an extensive public information campaign, significant expansion of the test, trace and isolate system and the launch of a widespread influenza vaccination programme for the vulnerable.
“We don’t have a vaccine yet for coronavirus but we do have one for influenza,” said Prof Johnson. “We must help as many people as possible get that vaccine.” A “reasonable worst-case scenario” would see the reproduction value rise from about 0.7-0.9 today to 1.7 in September, causing a peak in hospital admissions and deaths in January and February 2021 similar to or worse than the first wave this year, according to the report.
The report’s estimates on deaths do not take into account the recent positive findings about the use of a cheap and widely available steroid, dexamethasone, which has been found to reduce mortality substantially. In a less severe scenario, the reproduction rate would reach 1.5, causing roughly 74,800 deaths between September and next June. And in the base case scenario, in which local outbreaks are dealt with effectively and population surveillance is strong, the reproduction rate would rise to 1.1, causing closer to 1,300 deaths in the same 10-month period.
At its peak in March, the Covid-19 reproduction rate in the UK was 3. Experts believe winter will be particularly severe for transmission as the virus thrives in colder conditions, with less humidity and sunlight, and is much more easily transmitted indoors where there is poorer ventilation.
The NHS also typically comes under significant strain in winter, operating at near maximum capacity with bed occupancy regularly topping 95 per cent. The spectre of a backlog of non-Covid care presents a further challenge to the health system.