England may have just three weeks to avoid coronavirus restrictions being reimposed after Sage scientists urged ministers to take action if hospital admissions soar above expected levels.
By Jane MerrickPolicy Editor inews.co.uk
Scientific advisers have warned that Boris Johnson should be prepared to act in the first week of August to prevent the NHS becoming overwhelmed by the end of that month.
Modelling has suggested that the central case for UK daily hospitalisations at the peak of the third wave – expected at the end of August – could be between 1,000 and 2,000, with deaths predicted to be between 100 and 200 per day.
Yet latest figures show that in the middle of July, six weeks before the expected peak, there were 745 patients admitted to hospital in the UK in a day, and that figure continued to rise even before the 19 July relaxation of all restrictions on so-called “freedom day”.
Last week chief medical officer Professor Chris Whitty said hospitalisations were doubling roughly every three weeks.
This would suggest close to 1,500 admissions by the end of the first week of August, well above the trajectory for the central case scenario for the third wave. It would point to 3,000 at the peak by the end of that month, which would match the peak of the first wave in April 2020.
Insiders stressed there is a lot of uncertainty in the modelling, and the picture will change all the time depending on vaccine take-up and people’s behaviour after 19 July.
But if admissions are outstripping the central estimates, Sage scientists have advised that some non-pharmaceutical measures should be reintroduced, such as mandatory face masks and advice to work from home, in early August, halfway between the19 July unlocking and the predicted peak at the end of August.
This early intervention, they argue, would prevent the NHS becoming swamped in a late summer crisis.
On Tuesday there were 46,558 new coronavirus cases in the UK, while a further 96 people have died, the highest daily reported fatality rate since the middle of March.
Experts warned against predicting hospital admission rates two to three weeks in advance, but stressed that contingency plans should be in place to reintroduce measures at short notice.
Last week, when the Prime Minister gave the go-ahead for the fourth and final stage of the roadmap in England, he accepted that some restrictions may have to be reimposed if the situation worsened.
A source said what was needed was “less of an emergency brake and more of a gear change” in readiness to keep the third wave “under control”.
While mandatory face masks would be the “easiest” route to curb transmission, with minimal impact on the economy if it were kept to public transport and essential settings like supermarkets, this would have to be weighed against the “totemic” impact it would have on the public if they were ordered to cover up once again.
But others are arguing that the government should be prepared to take tougher action.
Professor Dominic Harrison, director of public health for Blackburn, said: “Any return to non pharmaceutical interventions (NPIs) to control spread would have to focus on those that give the biggest suppression effect.
“Essentially we might expect a reverse through the lockdown lifting steps with each ‘reverse step’ being introduced to match the scale of the surge in cases.”
Prof Harrison added that the rise in hospitalisations may be because the bar for admission is lower now, when there is less pressure on the NHS, than during the first wave in April 2020 and second wave in January this year.
He said: “The current rise in hospital cases is difficult to interpret clearly. It is likely some cases now hospitalised might not have met the threshold for hospital admissions in the last wave in January as the system is ‘adaptive’.
“Some cases now hospitalised may have been managed by care at home on ‘virtual COVID wards’ when the system was under highest pressure of cases in the last wave.
“However for anyone with significant symptoms, hospitalisation will give the best chance of high quality care and close monitoring of risk – so a lower (current) threshold of admission may be keeping mortality rates as low as possible.”