19 July 2021 is “freedom day” – the day when the UK government has relaxed the last Covid restrictions in England. But does it mark a return to normality (whatever that is), or is it, as some have suggested, a dangerous British experiment?
For many of us, the relaxing of restrictions is a welcome relief. The cost in economic and social terms has been high. Many businesses in the hospitality sector have really struggled to survive the restrictions. That’s not to mention the impact on our social lives. Covid has left some people feeling incredibly isolated and others struggling on reduced incomes.
Most of us are keen to see life return to normality. After all, we cannot go on like this forever. Sooner or later, we must find a way to live with Covid.
However, some experts have dubbed “freedom day” as a dangerous British experiment.
In an article in the Lancet, on 7 July 2021, the idea of relaxing restrictions on 19th was branded as dangerous and premature in a letter signed by 100 experts that has since been endorsed by many scientists around the world.
These experts highlighted five of key risks:
- A significant proportion of the population are still unvaccinated (especially younger adults and children). This will lead to high levels of infection running the risk of leaving many people with long term health problems.
- It risks high levels of infection amongst children that will accelerate when they return to school. This will lead to further significant disruption of children’s education.
- Such high levels of infection represent fertile ground for dangerous new strains of Covid to emerge. This includes the risk of a vaccine resistant strain emerging.
- It will lead to more hospitalisations which will place significant pressure on the NHS.
- Deprived and vulnerable communities are the most at risk and likely to be hardest hit by rising infection rates.
The experts recommended delaying easing restrictions further until the vaccination program has covered most of the population. This would imply a delay until late August or possibly early September.
As it stands, on 19 July 2021, the government statistics show that nearly 88% of the population had had their first jab and 68% had received both jabs. These are high numbers and positions our vaccination roll out well ahead of other countries. However, it is nevertheless the case that one in three of us are not yet fully covered.
Infections are rising
Infections have risen significantly since the beginning of June, as restrictions have been eased and we have had to deal with the impact of the more infectious Delta variant.
The number of cases is fast climbing towards 60,000 and could easily hit 100,000 by the end of the month. There seems little doubt now that case numbers will exceed the peak we saw back in January 2021.
The link between cases and hospitalisation: weakened but not gone
It has been claimed that new cases are not leading to new hospitalisations.
A few weeks ago, we wrote a blog in which we created a Covid Index to allow us to view trends in cases, hospitalisations and deaths in parallel. So now seems like a good time to revisit this to see how well the data supports this claim.
Unfortunately, if we look at the data, we can see that this claim is not entirely true.
It is now clear that we are seeing a gradual but distinct uptick in hospital admissions. More cases does mean more hospital admissions, even if the link is now a lot weaker than before.
The good news is that the level of increase is not tracking new cases anywhere near as closely as was the case back in January. At that time rising cases led to a similar rise in both hospitalisations and deaths. These followed on fairly quickly behind case reporting.
Now, the immediate impact is much reduced and instead we are seeing a more gradual but nevertheless notable increase in hospitalisation.
Clearly, the fact that so many people are now vaccinated (especially amongst the most vulnerable groups) means that a much higher proportion of infections are now mild or asymptomatic.
A modest increase in deaths
A closer look at trends over the past month also show that as yet we are not seeing any major uplift in deaths. However, the figures do show a slight overall increase.
Overall case numbers have grown to be around four times higher than the average for the past 12 months.
Hospitalisations are rising at a slower rate but rising, nonetheless. The current levels of hospital admissions sit are around 75% of the average number recorded over the past 12 months. At the current rate of increase it is likely that hospital admissions will exceed that average before the end of the month.
Deaths, at present, show only a relatively modest increase since the start of June. We’d have to say that at present it is too early to fully judge the likely medium-term impacts on death rates. Death rates are still low at around 10%-15% the average of the rate we have seen in the past 12 months. However, this is still up from a rate of under 5% recorded during late May and early June.
As vaccination continues to roll out, it will inevitably have an increasingly depressive impact on infections. However, the relaxing of restrictions will serve as an accelerant – especially amongst young adults who are the least protected and the most likely to wish to congregate together in large social gatherings at pubs and nightclubs.
It is always difficult to predict numbers given the changing nature of the pandemic and the ongoing rolling impact of vaccinations. However, it seems that by the middle of August we are likely to see:
- Infection rates; will probably exceed 100,000 cases.
- Hospital admissions; likely to be c.1,300 per day.
- Deaths; likely to be c.50-70 per day.
This would mean that hospitalisations would be around the levels we were seeing in mid to late February and deaths at around the levels we were seeing in mid-to-late March.
With infection rates about 100,000, many people would be forced to self-isolate based on current test and trace rules, which could be very disruptive. Although the government plans to modify rules of self-isolation for fully vaccinated people, this will not happen until mid-August.
A race to roll out
We are now in a race between a virus that has been given significant freedom to spread on the one hand and a vaccination programme that is fast progressing to a point where the population will be fully vaccinated on the other. These two factors combine to push the numbers in different directions.
Of course, we have to re-open society and adapt to live with this virus at some point. Let’s just hope we have not made that step a month or two too soon.
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