Nothing in this pandemic is easy, and on Friday Boris Johnson will face one of his toughest decisions yet – delay or advance Monday’s long-awaited reopening which will see the mix inside the pubs, restaurants and homes restart.
The problem is the Indian variant. It is making worrying progress in a series of hotspots across the country and, if left unchecked, could undo the huge progress made in recent months.
Despite the rapid rollout of vaccination in the UK, we remain vulnerable: over 40 percent of the population is unvaccinated and less than 30 percent have received both vaccines.
The prime minister’s decision will be informed by Sage, who met on Thursday to review the rapidly evolving situation. But this briefing, when it arrives, is likely to pose only tough choices.
The main piece of evidence Sage will examine is an article published on Monday by the Covid modeling group at the University of Warwick. Like Imperial, his projections for a third wave of infections – assuming the current Kent stain remains dominant – are now relatively benign.
It predicts only a moderate increase in new cases and hospital admissions between mid to late summer, assuming the lockdown is lifted as planned, resulting in some 7,250 additional deaths linked to Covid-19 .
But Warwick’s modelers also considered what might happen if a new variant of the virus is picked up – and here the math looks more worrying.
“England remains extremely vulnerable to new variants,” the newspaper said. “A variant which is 30 to 40% more transmissible than B.1.1.7 [Kent] is expected to generate more hospital admissions than the first wave. Variants that escape immunity (either from infection or vaccination) could generate larger outbreaks than wave two. “
So what do we know about the Indian variant? First, the good news. Vaccines seem to protect at least against serious diseases. There is laboratory evidence that it can reduce their effectiveness, but not catastrophically. In India, where most health workers were vaccinated early, only a few reports of hospitalizations and deaths have been reported.
The real concern is transmission. Public Health England believe it is “at least” as contagious as the Kent variant, and other data suggests it outperforms the Kent strain, here and around the world. The latest PHE data should show cases continue to climb rapidly, albeit from a very low base.
Warwick’s modeling looked specifically at the impact of a variant that vaccines continued to protect against but was between 10 and 50% more transmissible (see graphs below). For all degrees of transmissibility, he found that the peak in hospitalizations would be distinct but modest if the reopening on Monday was canceled.
But if the reopening continues and the new variant turns out to be 40% more transmissible, reopening on Monday would lead to an increase in hospitalizations close to that observed in the first wave. Stages three and four of the combined release plan (Monday’s changes, then the restrictions being lifted again on June 21) would have a similar impact with just a 30% increase in transmission.