Analysis: Hospital strain to test UK’s vaccine-based winter COVID plan

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British Prime Minister Boris Johnson is hoping to get through winter without any more coronavirus lockdowns, but doctors and scientists warn that relying largely on vaccines without other measures could put unsustainable pressure on hospitals.

Britain has recorded one of the highest COVID death tolls in the world for its population size and one of the deepest recessions of wealthy nations as a result of the pandemic, but also has one of the world’s highest vaccination rates.


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Leaning on that latter success, the plan Johnson announced on Tuesday involves booster vaccinations, shots for children and continuing a much-criticized test, trace and isolate system to avoid lockdowns during the tough winter months.

Measures such as mandatory mask wearing, a requirement to be vaccinated to attend mass events and a renewed order to work from home will only be brought in if data suggests the National Health Service (NHS) may become swamped, officials said.

But many doctors already feel overburdened, and their representatives say that if minor COVID restrictions are not brought in now, tougher restrictions may be needed later, noting lockdowns that were delayed last year had to be extended.

A woman paints on the National Covid Memorial wall beside St Thomas' hospital set as a memorial to all those who have died so far in the UK from the coronavirus disease (COVID-19), amid the coronavirus pandemic in London, Britain April 8, 2021. (Reuters)
A woman paints on the National Covid Memorial wall beside St Thomas' hospital set as a memorial to all those who have died so far in the UK from the coronavirus disease (COVID-19), amid the coronavirus pandemic in London, Britain April 8, 2021. (Reuters)

“Our hospitals and GP (doctor) practices are already overstretched,” Dr Chaand Nagpaul chair of the British Medical Association (BMA) council, told Reuters. “With high rates of infection, we need additional infection control measures if we’re to keep the health service afloat this winter.”

Asked why the government was not firming the rules now, health minister Sajid Javid told Sky News vaccination, including boosters and for children, was the first line of defense.

“There is no risk free decision but I think what we’ve announced in terms of this plan is well thought through,” he said.

A year ago Johnson was similarly determined to resist another lockdown, but the spread of the virus and high hospitalization levels forced him to lock down England for a second - and then a third - time for extended periods.

Britain is now averaging more than 30,000 new COVID-19 infections a day, behind only the United States, fueled by the highly transmissible Delta variant that has kept cases stubbornly high over the summer.

Johnson has stressed that vaccines have broken the link between cases and deaths, and that without them, he would not have been able to re-open England’s economy in July. His government sets health rules in England, with other nations setting their own policies.

But while 81.3% of people over 16 have received two vaccine doses, there are currently 8,340 COVID-19 patients in hospital in Britain, compared to just 1,066 a year ago.

The government’s scientific advisers say hospitalizations could rise further if the population begins to mix more, with one of their published scenarios showing more than 6,000 hospital admissions a day by mid-October.

“The earlier that interventions are brought in, the lower prevalence is kept, reducing the direct COVID-19 burden and reducing the risk of needing more stringent measures to quickly reduce transmission,” the advisers said.

Some business leaders and politicians in Johnson’s Conservative Party have argued forcefully against any restrictions, saying the damage they do to the economy far outweighs any benefits. The government says it will bring in the extra measures as soon as they are needed.

Public caution

Graham Medley, who chairs the group of modelers, said people had not mixed as much as expected since the July re-opening. Describing the current case load as an “exit wave”, he said the outlook was better than earlier in the year.

“It’s just not reaching the kind of peaks that any of the models suggested,” Medley told reporters, adding that if people became less cautious in the coming months “then we could well see the transmission rates pick up quite a lot”.

Government medical advisers and doctors have warned of a difficult few months for a health and care sector strained by 18 months of pandemic, in part because of an expected surge in other seasonal diseases like flu that lockdowns tamed last year.

One of those worried about a particularly bad flu season is Katharina Hauck, a health economist who is Deputy Director of the Jameel Institute at Imperial College London.

France and Italy both have COVID immunity passes that are needed to get into certain places, while both countries, along with Germany, have some form of mask mandate.

Hauck told Reuters such measures were a “no-brainer” as people spend more time indoors heading into the winter.

In Scotland, cases rose sharply when schools returned in August -- a few weeks earlier than England -- but have now begun to fall. Rowland Kao, an epidemiologist at the University of Edinburgh, said this may be a good sign for the rest of Britain.

“We are essentially at a cusp, certainly in Scotland, where that proportion of people who are immune protected is starting to have a big influence on transmission,” he told Reuters.

In Scotland, however, face masks are mandatory in public transport, shops, restaurants and other public buildings and the devolved government will require vaccine passports for entry to nightclubs and other big social gatherings from October.

“Government policies are slightly different in Scotland compared to England, and there’s some evidence that levels of face mask wearing are slightly different,” Kao said. “That may have an effect.”

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