Covid is back — but how worried should we be?

With the “best summer ever” well under way — Glastonbury’s back, Wimbledon’s back, masks are off! — it feels anathema to most of us to even acknowledge the fragile ground we might be on when it comes to the pandemic. In fact, due to two “immune-escaping” variants of Omicron, the population’s waning protection from the virus, and our super-sociable summer so far, the UK is in the midst of a big surge in infections.

Cases are the highest they have been since April with a total of 2.3 million people estimated to have had the virus last week — up 32 per cent from the week before. While it’s not as high as the 4.9 million seen at the peak of the Omicron BA.2 wave at the end of March, it does mean that an estimated 3.35 per cent of the population has Covid. That figure was 0.1 per cent in the summer of 2020.

This wave, however, is markedly different to the previous ones. The successful vaccine programme meant the end of restrictions, so for the first time we are truly living with Covid. But as cases continue to climb and pressure mounts on the NHS, experts are questioning whether we will reach a crunch point, with some tentatively suggesting that if the situation worsens perhaps isolation requirements will need to be reconsidered.

Two Omicron variants, BA.4 and BA.5 are behind the UK’s current rise in cases. They are highly transmissible and able to evade immunity from previous infection or the vaccine — meaning that even if you had the first strain of Omicron, you could still catch this one. “It’s easy for these strains to punch through the wall of immunity,” explains Simon Clarke, associate professor in cellular microbiology at Reading University. “This is coupled with the fact that immunity is waning all the time. It’s like constantly trying to top up a bath that leaks. With new variants appearing this will keep happening.”

Luckily there is currently no evidence to suggest the variants cause more severe illness (the most common reported symptom of the new variants is a headache), says the UK Health Security Agency but hospitalisations are on the rise. Professor Denis Kinane, founding scientist of Cignpost Diagnostics and leading immunologist, is concerned. “It is clear that the virus is not about to disappear,” he says. “There are some extremely worrying trends in the rising number of infections, particularly compared with the levels from a year ago, and already these are leading to a gradual rise in hospitalisations. The concern now is that as these new strains spread, pressure on the NHS will intensify —with an increasing number of patients requiring medical attention and rising staff absences because of infections.”

He thinks our summer of freedom with “super spreader” events such as Glastonbury, jubilee celebrations and Wimbledon have been crucial in the quick transmission of the variants.

Also, the end of free testing means many people who have it are walking around none the wiser. Anecdotally, Professor Clarke has heard of incidents of employers telling staff to ignore positive tests and come into work anyway. “We should be aware that this could get out of control quicker than we would like,” he says.

“We may have to rein ourselves in a bit. It’s not unreasonable for people to want to live their lives normally and I’m not for one moment suggesting another lockdown but mask-wearing could be a reasonable measure.”

In fact, several NHS trusts have already brought them back after having dropped them in June. Dr Lara Alloway, chief medical officer at Hampshire Hospitals NHS Trust, said: “We have taken the hard decision to require that surgical masks be worn by all staff, visitors and patients. In addition we strongly encourage social distancing of at least one metre in our hospitals. These measures have been brought in due to a significant increase in the number of Covid-positive patients in our hospitals, very high rates in the community and increasing levels of staff sickness.”

“People are being admitted to hospital with Covid, not because of it but it’s still causing a problem,” says Professor Clarke. “It’s like throwing a stone in a pond, it causes ripples.”

The ripples are a major cause of concern for the already stretched NHS. “Trust leaders are concerned about the level of pressure we’re seeing at this time of year,” says Miriam Deakin, director of policy and strategy at NHS Providers. “It’s been unrelenting. Historically you might expect a breather in the summer months but there has been sustained pressure.”

With the rise in Covid cases affecting the ability of the NHS to deal with care backlogs and exacerbating staff shortages there’s increasing concern about what autumn and winter might look like, especially if flu outbreaks arise earlier this year.

“All in all the next few months are looking very challenging for the NHS,” says Ms Deakin. “As Dr Jenny Harries (CEO, UK Health Security Agency), has recently said, it makes sense for the public to consider appropriate precautions such as wearing masks in enclosed spaces. We all want to live with Covid but the fact is this remains a dangerous disease if you are vulnerable or have underlying health conditions.”

With the end of free testing it’s hard to accurately establish how many people actually have Covid.

Professor Kinane thinks that this is an error on the Government’s part. “We must understand that the UK’s globally lauded testing regime allowed us a high degree of visibility as to the virus’s behaviour, and often allowed us to deploy tactics that effectively contained the spread of newer variants, most prominently the supercharged roll-out of the booster vaccination. The ending of universal free testing and the resultant draw-down in publishing data has severely diminished our capabilities to identify, analyse, and control the spread of future variants.”

While it’s hard to accurately measure the extent of Covid in the community, it’s being felt by the hospitality industry. Restaurateur, James Chiavarini, who runs the popular Italian Il Portico in Kensington High Street said the last couple of weeks had been very quiet.

“There’s been a noticeable drop in customers and footfall,” he says. “Things are more dicey than ever. Especially now working from home is so entrenched.”

In France, where virus-related hospitalisations are rising quickly, the government is “inviting” people to return to using face masks. Dr Quinton Fivelman, the chief scientific officer at London Medical Laboratory, thinks that this should happen here.

“There should be a government drive to encourage people to wear masks on transport and in crowded places. I don’t see a lockdown occurring. People wouldn’t take it seriously and it would be so unpopular but masks are something we can do.

“It would also be good if the government brought back free testing and self-reporting. The number of people I know who returned from Glasto with Covid but I doubt have been a registered case.”

The hope of herd immunity hasn’t been realised because the virus keeps adapting — just like the flu, he explains. “The best thing we can do is try to be cautious and keep our immune systems up with healthy habits.”

But Professor Kinane warns: “While vaccines have provided us with substantial protection against the virus, if cases continue to climb and the infection rate grows rapidly, changes to restrictions including mandatory use of face coverings, work from home guidance, and perhaps changes to the isolation requirements might be options that could be considered.”

In the Autumn Covid booster jabs will be offered but only to over-65s. Some experts, including Prof Kinane think they should be rolled out further. “With immunity waning over time, it is vital that if a further vaccination dose is offered, uptake should be swift and across the board for maximum protection.” Meanwhile experts watch nervously as the situation unfolds.