increased restrictions in the UK seem inevitable as winter approaches – .

increased restrictions in the UK seem inevitable as winter approaches – .

COVID-19 cases, hospitalizations and deaths have increased in the UK, putting pressure on an already hard-working health service to deal with the backlog of non-COVID patients that has built up since March 2020.

While some modelers suggest cases have peaked and are now expected to drop, the total number of new infections isn’t the only trend worth paying attention to. The increase in the number of cases in the older age groups and the increase in hospitalizations are concerning, both possibly due to two other worrying trends: the decrease in immunity and the vaccine booster program running too far. slowly.

The government is taking note and holding a COVID press conference in response to the recent increase in cases, but has yet to change course. Its COVID control strategy is still based mainly on vaccination today.

He is resisting calls for the stricter ‘Plan B’ control measures outlined in his COVID winter plan to be implemented now. These measures include, in certain situations, the introduction of vaccination certificates and the reintroduction of the compulsory face covering, as well as the suggestion to work from home.

But looking closely at the current data, Plan B measures – or even other more effective measures – seem inevitable in the weeks and months to come.

Vulnerable people contract COVID

In the second half of October, new reported COVID cases exceeded 50,000 per day for the first time since July. However, the current situation is much more worrying than in July. At the time, cases were only high in young people. Today, cases have dramatically increased in the older half of the population.

The case rate among those over 60 is the highest since the end of January. We know this is especially important because although they make up less than a quarter of the population, those over 60 make up more than half of all COVID hospital admissions. The increase in cases in this age group is disproportionately leading to people falling seriously ill with COVID and pressure on hospitals.

COVID cases in England in people over 60, October 2020-October 2021.
Author provided

The number of COVID patients hospitalized in England reached 6,801 on October 25, the highest figure since mid-March. It should be noted that a year ago, in October 2020, the government called for a nationwide lockdown when hospital occupancy rates hit around 10,000. At the current trajectory, it seems likely that we will reach this. milestone sooner or later this winter. If we are to avoid it, we not only need the cases to go down, but the cases in the older age groups to go down in particular.

Hospitalized patients with COVID in England, October 2020-October 2021.
Author provided

Boosters, Passports – and more?

Due to vaccination, we will not see hospital occupancy rates increase as quickly as in October 2020. So even if we reach 10,000 COVID patients in hospital, a lockdown is unlikely. Slower growing admissions mean there is much less chance of the NHS suddenly being overwhelmed, which in the past has necessitated the introduction of drastic lockdowns. However, it is likely that we will see the pressure on the NHS increase to a level that warrants more action.

The pressures on the NHS are already very serious, particularly in emergency care, where A&E wait times are the worst since records began. About 25% of people going to A&E are not seen within the target four-hour timeframe, and people routinely wait 45 minutes for an emergency ambulance. This pressure is not primarily due to COVID, but the return to normal levels of A&E attendance, as well as increased patient severity, staff issues and infection control measures making life more difficult in the city. A&E services.

The government is therefore right to pursue a policy of vaccination reminders for those over 50 years of age. Older groups of the population are heavily vaccinated – over 90% of 60-69 year olds are doubly vaccinated and over 95% of over 70s – but the fact that we are seeing an increase in cases and hospitalizations in this cohort older suggests immunity based on vaccination is waning. Emerging research also suggests this is the case (although its findings have yet to be formally reviewed by other scientists).

Rapid deployment of these additional vaccines is expected to significantly reduce cases and hospitalizations. Data released by Pfizer – whose vaccine is the booster of choice in the UK – suggests that a third dose restores immunity to highly protective levels (although those results are also pending review).

The problem is that the callback program seems to be late in administering the third dose to individuals when they become eligible six months after the second. We also don’t know if the boosters will be as high as the first two doses. If not, many people could find themselves vulnerable to hospitalization and death from COVID this winter.

Health Secretary Sajid Javid has admitted that the government’s Plan B may be necessary if the pressures on the NHS become unsustainable, but the components of this plan appear quite weak compared to the restrictions that were used earlier this year . Would these measures reduce transmission and reduce cases – and therefore hospitalizations – in older and more vulnerable age groups? Maybe not. The Cabinet Office COVID-19 Working Group estimates that the impact of these measures on transmission may be only “moderate.”

Some experts have reported less invasive measures that could also be introduced. Improving test targeting by revising the list of symptoms that allow people to reserve a PCR test, or even moving away from large-scale PCR tests in favor of cheaper rapid lateral flow tests, could speed up research and isolation. cases. However, such changes remain unlikely at this time. This means that Plan B, if implemented, may struggle to meet its goals of relieving pressure on the NHS.

Still, new measures to limit the spread of the virus, such as those in Plan B, seem inevitable unless progress can be made to reduce cases in older groups. While cases among these groups remain high, more drastic restrictions – such as imposing social distancing at reception facilities at some point this winter – remain a strong possibility.


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