The handling of the UK coronavirus crisis has provided a few moments to celebrate, but the day we reach zero deaths from the disease will clearly be a toast. That day may not be far off. The UK reported four deaths from Covid within 28 days of testing positive on Tuesday. Monday, it was only one. Months of painful blockage in the face of more transmissible variants and the rapid deployment of effective vaccines have proven their worth. We have good reason to be optimistic for the months to come.
No one will have forgotten the brutal winter. In January alone, the UK reported nearly 32,000 Covid deaths, an appalling number directly linked to the too late lockdown. In April, the death toll fell to 753. This month, scientists informing the government expect deaths to decline further. It should be remembered that it has been over nine months since the UK last reported any deaths from Covid. We may see more in May, although people will continue to die from Covid, and the numbers may well rise again when restrictions are lifted on the mixture indoors.
One day is not a milestone. The most important thing is to achieve consistently low daily death rates, a goal achieved through a combination of factors. Earlier this year, the lockdown broke the chains of transmission and reduced the R – the number of people to whom an infected person transmits the disease, on average. Once R fell below 1, the epidemic started to decrease. For example, when R reached 0.8, every 100 cases transmitted the virus to only 80 more people, and so the numbers dropped. Fewer infections inevitably lead to fewer deaths.
But as the immunization program kicked in, it took on an increasing share of the heavy lifting. First and foremost, these first vaccines gave the most vulnerable, and therefore those most likely to die from Covid, the immune system to repel the virus. Second, the gunfire hampered the spread of the disease, pushing R even further. Even though people who are vaccinated are infected, and some can, the amount of the virus in the respiratory system is lower, so they are less likely to pass it on.
The NHS vaccination program was designed to protect those most at risk as quickly as possible. This decision was essential, especially for its simplicity. The Jabs went first to those in the top nine priority groups established by the Joint Committee on Vaccination and Immunization. These included those who were clinically extremely vulnerable – people on drugs to suppress their immune systems, or those with underlying health problems, for example – as well as anyone aged 50 and over. Together, these 32 million people account for 99% of Covid deaths.
Before the vaccine was deployed, public health authorities only had clinical trial data in their hands. They weren’t sure how effective the fire was in the real world. The answer has now become clear thanks to a recent burst of data. The first good news came in the form of vaccination rates. At least 95% of people aged 50 and over have received at least one injection, much better than many scientists are hoping.
Then come the discoveries about the impressive impact of vaccines. The ONS found that only a fraction of people hospitalized with Covid were admitted more than three weeks after being vaccinated. It takes two to three weeks for the body to get a good immune response. The results came after work from Public Health Scotland showed hospital admission rates dropped sharply one month after a single dose. Further positive news came from Public Health England about the vaccine’s ability to curb the spread of the disease. While unvaccinated people infect around 10% of people in their households, the agency estimates that the risk is almost halved when the original case is vaccinated.
Outbreak modeling submitted to the Scientific Advisory Group for Emergencies (Sage) in March shows that daily Covid deaths could be close to zero for much of May and June, but increase again in July and August. How much is up for grabs. The art is to suppress the increase in infections as the restrictions ease, by further vaccinating the population. So far, this balancing act seems to have worked: Steps one and two of the roadmap seem to have caused cases to be capped rather than restarted.
The urgent question now is what happens after Steps Three and Four of the roadmap, scheduled for May 17 and June 21, respectively. Mass vaccination of the elderly and more vulnerable will reduce the number of deaths, but not all will be protected because vaccines are never 100% effective. Many young people will not be fully immunized until later in the year, but achieving high coverage in these age groups is critical, not only to reduce the risk of infections affecting more vulnerable people, but to save money. the risk of serious illness or debilitating impact of the long Covid.