Why this winter won’t be as bleak as the last

Oct 30, 2021 News

Why this winter won’t be as bleak as the last

“There is no alternative. From Thursday until the start of December, you must stay at home.”

These words were uttered on national television a year ago today by Boris Johnson as he stood at his Downing Street podium – flanked by his trusty academic lieutenants Prof Chris Whitty and Sir Patrick Vallance – plunging the country into a month-long lockdown. 

The Prime Minister’s somber words were accompanied by terrifying graphs presented by the poe-faced scientists which showed cases, hospitalisations and deaths soaring unchecked. SAGE modelling was wheeled out for good measure which claimed it was feasible England could see 4,000 deaths a day if no action was taken. 

With a vaccine still a pipedream, the only thing to be done, in the eyes of Mr Johnson, was the reimposition of draconian restrictions to confine people to their homes. 

The lockdown worked, to an extent, and curtailed the pandemic for a few weeks. But come December, the second wave erupted as a new strain of coronavirus, the so-called Kent variant – later rebadged as “alpha” – tore through the UK and cancelled Christmas.

More than 75,000 Britons died of coronavirus between Hallowee’n 2020 and March 2021, with the winter dwarfing the spring wave of March 2020. 

And now, with record levels of virus prevalence in the community once more, some are calling for Plan B measures.

One year ago, there were around 20,000 new cases a day, almost half the current figure. Data from the Office for National Statistics show 1.1 million people are likely currently infected with the virus, around one in 50 people, twice the figure for the same time last year. 

So, it is beyond doubt that there are more new infections every day now than at the same point in 2020, and there is more of the virus around in total. 

However, comparing 2020 and now is the same as comparing apples and pears; the coronavirus is not as potent as it once was as a result of various factors, not least of which is the vaccine programme. 

Vaccination has altered the entire complexion of the country’s ongoing arm wrestle with SARS-CoV-2, weakening the link between infection, hospitalisation and death.

Evidence now suggests a double-jabbed individual is around 80 per cent less at-risk of infection, and they are around 97 per cent less at risk of hospitalisation or death. 

Figures from the UK Health Security Agency, the replacement for Public Health England, show that people who are double-jabbed are far less likely to be admitted to hospital. 

The current hospitalisation rate in vaccinated 70-somethings is 25 per 100,000 people, but for those who are unvaccinated, the risk is almost thrice as high, at 68 per 100,000. A similar relationship exists for all age groups. 

And so, if cases no longer provide an early indicator of the pandemic’s trajectory, what metric is used to inform policy decisions? For that, we must look at hospitalisations, the number of occupied hospital beds, and the number of deaths.

In 2020, the level of Covid hospital admissions was higher than it is currently (1,225 a day versus 839). But back then, they were on a steep climb, rising uninhibited. Now, they are fairly stable, and perhaps even showing signs of dropping. We have not hit 1,000 admissions a day in England since February. 

The rate of increase in hospitalisations at the moment is 1.6 per cent. In 2020, it was increasing at a rate four times this. 

The rate of increase – the steepness of the lines on the graphs we are inundated with – was four times greater a year ago for the number of Covid patients on ventilators; and 13 times higher for the rate of increase in deaths. 

In summary, deaths and hospitalisations are creeping up slowly compared to this time last year. 

The current state of play is optimistic when compared to 2020, but it also looks promising going forward. 

SAGE’s sub-committee SPI-M have created models throughout the pandemic showing what will likely happen under a specific set of circumstances. 

In October 2020, they said it is possible 4,000 people could die a day, in reality, the peak was around 1,200. 

In September of this year, they said it was possible 7,000 people could be admitted to hospital a day by mid-October. This, again, was wildly out, with the real figure a shade under 1,000. 

But the notoriously pessimistic group on Friday released a new set of medium-term projections and, for once, the image is rosy. 

They believe the trajectory of hospital admissions and deaths will remain under control and that instead of a recurrence of the fearsome spikes of yester-waves, this winter will likely be a gentle knoll. 

Modelling from Imperial College London was also released on Friday showing that, assuming the booster programme rolls out well and confers good protection for the next five months – which prevailing evidence shows it should, then it is possible there are just 5,300 deaths by March 31 – 14 times less than for the same timeframe in 2020. 

Even in the most pessimistic scenario, there will be less than 10,000 deaths.

But there are other tools in the Covid armoury now that were absent in the dark days of the winter wave.

Against the backdrop of vaccination, we now also have antivirals, monoclonal antibodies and dexamethasone. 

As effective treatments continue to be discovered, the patients who do become critically ill with Covid are recovering better than they were a year ago.

Data from Icnarc, the intensive care national audit and research centre, also published on Friday, show that fewer critical cases are dying; survivors are recovering quicker; the number of people needing advanced respiratory or cardiovascular support is dropping; and even when these chronically ill patients do need such interventions, they spend less time on organ support.

Most experts believe that barring an unexpected hiccup – such as a new variant which can dodge the vaccine or a catastrophic failure with the booster campaign – it seems increasingly unlikely that the NHS will be overwhelmed by Covid cases this winter.

Last year, Mr Johnson concluded his press conference by saying: “I can tell you tonight that the scientists may be unanimously gloomy about the immediate options, but they are unanimously optimistic about the medium- and the long-term future.”

On this, at least, it seems he and his scientific advisors were correct. 

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