England's new wave of coronavirus could put 2,000 people in hospital every day for six weeks, the government’s chief scientific modeller has said.
Professor Graham Medley, chairman of the Sage modelling subgroup Spi-M, said that the latest spike in cases threatened to place a “considerable burden” on the NHS. The so-called exit wave will not be constrained by lockdown rules, meaning that the hospital admission rate may be stubbornly high for some time, he said.
Yesterday Boris Johnson approved lifting the last remaining lockdown restrictions from next Monday while warning the country not to rush back to normality. The prime minister said that there was considerable uncertainty about how it would affect the spread of serious cases; the worst-case scenario under goverment modelling is 4,800 admissions a day, more than the winter peak.
Spi-M’s central forecast is for between 1,000 and 2,000 admissions a day but Medley said that this could continue for a significant time.
“We’ve never seen a peak before that hasn’t been controlled,” he told Today on BBC Radio 4. “The intention is not to introduce a lockdown for this peak. Then we are going to see a natural peak and that may well be long and disseminated. So even if we don’t get up to very high numbers, the numbers that we get up to might last for several weeks, six weeks or so, in which case there’s still a considerable burden on healthcare.
“So, although we might not get over 2,000 admissions a day, if that lasts six weeks then that’s a lot of people.”
Medley questioned the government’s decision to remove the legal requirement to wear facemasks in enclosed public spaces. “Without the mandation, then we end up with a situation where even if the majority of people, let’s say 70 per cent of people wear a mask, will that actually do any good because of the 30 per cent who don’t? I think that is something which still needs to be determined and discussed,” he said. “I understand the government’s reluctance to actually mandate it. On the other hand, if it’s not mandated it probably won’t do any good.”
Professor Calum Semple, another member of the goverment’s Scientific Advisory Group for Emergencies (Sage), said the “winter bump” would be a mixture of Covid-19 cases and other respiratory conditions that have receded during the pandemic.
He told BBC Breakfast: “That’s why I’m saying, ‘we’re going to have a miserable winter. I’m sorry, we’re going to have a rough winter’.”
Asked whether restrictions would come back, he said: “Possibly, and it may just be about reinforcing some common sense. It may be bringing back some mask-wearing in certain environments but I don’t foresee the lockdowns or the school suspensions that we’ve seen.”
Johnson has given increasingly cautious remarks about the reopening and stressed that the country could not “revert instantly to life as was before Covid”.
He said: “For this to be irreversible, it’s got to be cautious. We must rule nothing out and I’ve been very, very clear about that. We must protect the public and we will not hesitate to use the means that we have at our disposal.”
Quoting Jonathan Van-Tam, the deputy chief medical officer for England, he urged people not to “tear the pants out of” the final stage of reopening, saying it “should not be taken as an invitation by everybody simply to have a great jubilee and freedom from any kind of caution or restraint”.
Jeremy Hunt, the former health secretary, told Times Radio Breakfast that he welcomed the change in tone from Johnson.
“Six months ago we didn’t even know about a Delta variant. Now it is dominating the new infections,” he said. “I don’t have a problem with moving to encouraging people rather than mandating people to do sensible things. But I think we also have to be honest with people that it might change . . . If the modelling turns out to be wrong again, we may unfortunately have to go backwards, so I think we have to be honest with people we are not through this pandemic yet.”
All remaining legal limits on social contact will end on Monday in England, but under new government guidance to try to control the virus the use of masks in crowded areas and on public transport will be “expected and recommended”.
Covid-19 certification checks will be advised for large events where strangers mix at close quarters, potentially including theatres, concerts, sports events and nightclubs. The government said it “reserves the right to mandate certification in certain venues at a later date if necessary”.
While guidance on working from home will be lifted, ministers made clear they did not want to see a mass return to the office from next week. Instead, employees should be brought back “gradually” over the summer.
“We don’t expect that the whole country will return to their desk as one from Monday,” Johnson said.
Chris Whitty, chief medical officer for England, urged people to “avoid unnecessary meetings” and avoid crowded areas if possible. He added: “The fact that we can move from working at home doesn’t mean that we should rush it.”
Johnson is facing questions about why he is easing restrictions when cases are increasing. He said now was “about as good a time as any”, adding that it was becoming less clear how best to proceed.
“We’ve come to a stage in the pandemic when there is no easy answer and no obvious date for unlocking,” he said, adding that if he had delayed until “September, or later, then we will be reopening as the weather gets colder and as the virus acquires a greater natural advantage and when schools are back”.
Whitty agreed, saying there was “no such thing as an ideal date”, with all options leading to “broadly similar outcomes”. He said: “There is no clear evidence that a delay now is going to make a difference. What is going to make a difference is going slowly.”
Sir Patrick Vallance, the chief scientific adviser, said: “The message is very simple: the slower this goes, the better.”
Covid passports
Nightclubs and other venues will be urged to restrict entry to people with Covid passports to slow the spread of the virus.
Johnson said that it was a “matter of social responsibility” for them to use the NHS Covid pass, which shows proof of vaccination, a recent negative test, or natural immunity as a result of having had the virus. This was a change from last week, when ministers said that they would not press ahead with Covid passports but would leave it up to businesses to make use of them if they wished.
Guidance published last night said that the passports should be used “in large crowded settings where people are likely to be in close proximity to others outside their household”. It warned that the government reserved the right to make such checks mandatory in the future.
Test and trace
Pubs and restaurants will be encouraged to take customers’ details for NHS Test and Trace, which will maintain an “important ongoing role”.
In another change from last week, ministers said that businesses would be encouraged to ask customers to check in using QR codes, although it will no longer be a legal requirement. The expectation is that the test and trace system will “remain necessary through the autumn and winter”, according to government documents.
Free lateral flow tests for asymptomatic people have been extended until at least the end of September, and will be focused in particular on those who are not fully vaccinated, those in education and those in high-risk settings including the NHS, social care and prisons. In settings where the spread of the virus has become “acute”, the government will advise that social distancing measures be reimposed in a “targeted, time limited” way.
The fully vaccinated will no longer be required to self-isolate after coming into contact with an infected person after August 16.
Future restrictions
Johnson said he would “rule nothing out” and that restrictions could be reimposed in “very exceptional circumstances”. If a dangerous new variant of the virus emerged, he said, ministers would “not hesitate to use the means that we have at our disposal”. He added: “But the way things are working at the moment, we do think that if we are cautious and we go slowly . . . we can continue with the road map as it stands. That is our hope.”
There will be a review in September to assess preparedness for autumn and winter. Whitty said that “sensible precautions” would be needed but restrictions were not inevitable. Documents said that ministers would “as far as possible prioritise strengthened guidance and seek to avoid imposing restrictions that have significant economic, social and health costs”.
