Major setback as shock analysis shows coronavirus transmission levels rising in England

Nicolas Cecil

England's battle against coronavirus appears to have suffered a major setback in recent days as transmission levels rise probably due to more travelling and mixing between households, a shock analysis warned today.

The research by a Cambridge University/Public Health England joint modelling team suggested the disease may now be spreading very slightly in the North West, is at a stand-still level in the South West, and is declining in other regions, but far more slowly in London than previously.

Even in the capital and other regions a small increase in the R transmission rate would see the number of new cases, which they put at a worryingly high 17,000 a day at the moment, starting to rise again.

Dr Yvonne Doyle, PHE medical director, said: “Our estimates show that the regional R numbers have increased although they remain below one for most of England - this is to be expected as we gradually move out of lockdown.

“It is vital that everyone continues with social distancing, practising good hand hygiene and must remain at home and order a test if they have symptoms.”

The study is not the official R rate from the Government which was being announced this afternoon and comes after an ONS report suggesting the epidemic certainly at the end of May was under more control.

The new analysis will inevitably raise fresh questions over whether the Government started easing Covid-19 restrictions too quickly and if the Dominic Cummings Durham trip furore damaged the lockdown.

It emerged shortly before the Department of Health said 40,261 people had died in hospitals, care homes and the wider community after testing positive for coronavirus in the UK as of 5pm on Thursday, up by 357 from 39,904 the previous day.

The figures suggested the number of Covid-19 fatalities may now no longer be falling on a sustained and consistent basis, which is one of the Government’s five tests for easing the lockdown.

In a series of alarming findings, the Cambridge University/PHE experts said:

  • We estimate that across England there are 17,000 new infections a day (though there could be as many as 25,000 or as few as 11,000).
  • There is some evidence that R (the infection rate) has risen in all regions and we believe this is probably due to increasing mobility and mixing between households and in public and workplace settings
  • We estimate that the number of deaths each day is likely to fall to between 100–250 by mid-June. An increase in R will lead to a slowdown in the decrease in new infections and deaths
  • There is evidence, from the forecast of deaths, that the increases in the regional reproductive numbers may result in the decline in the national death rate being stopped by mid-June.

If the R rate is above one it means that the disease is on the increase, and on the decline if it is below one.

For London, R is believed to have been as low as 0.4 or 0.5 but is now 0.95, according to the research.

For the North West it is 1.01, the South West one though on a relatively small number of cases, the South East 0.97, East of England, 0.94, Midlands 0.9, and North East and Yorkshire 0.89.

The grim figures emerged just hours after a study led by the Office for National Statistics suggested the disease was coming under control.

It estimated the number of people with Covid-19 in England was 53,000, outside hospitals and care homes, at any given time between May 17 and 30.

This is less than half last week’s figure of 133,000, for the period between May 11-24, and was by far the biggest fall so far.

There were still believed to be 39,000 new infections on average a week, between 26 April and 30 May 2020, though again a drop from 54,000 from a week earlier.

Professor Jeremy Farrar, director of the Wellcome Trust and a member of the Government’s Scientific Advisory Group for Emergencies (SAGE), welcomed the ONS figures as “very good news” and stressed they were “falling as a result of respecting the restrictions in place since March”.

He tweeted further: “If physical distancing & other measures continue these numbers will probably fall within June to levels that a fully functional, locally responsive community Test-Trace-Isolate system, infection control in Hospitals/Care homes/others could cope with.”

The study, done in conjunction with Oxford University, Manchester University, and Public Health England, also raised hopes that the lockdown could be eased more quickly and people might be able to get away on summer holidays abroad.

But the more up-to-date figures from the Cambridge University and Public Health England experts suggested relaxation of restrictions have already pushed the transmission rate close to a level which could be the start of the epidemic growing again, with the death toll, including suspected Covid fatalities without a positive test, already above 50,000.

The stark difference with the ONS figures also raised questions over reliability of estimates on coronavirus.

Professor Sheila Bird, former Programme Leader, MRC Biostatistics Unit, University of Cambridge, said: “The findings are the opposite of reassuring.

“First, in no region of England is the effective reproduction number assuredly below 1 with regions’ median estimates ranging from 0.89 to 1.01. No wonder members of SAGE are worried.

“Secondly, the estimated daily number of new infections is 16,700 (uncertainty interval: 11,000 to 25,000). That is three times this morning’s estimate from the ONS Infection Survey of 5,600 new infections daily for persons who reside in households (95 per cent CI: 3,700 to 7,900).”

The lockdown has been gradually eased since May 10 when Boris Johnson unveiled his “conditional plan” to reopen society by urging people who could not work from home to return to the workplace - but avoid public transport.

That Wednesday, May 13, people were allowed to meet with one other person from outside their household, providing they maintained a two-metre distance.

On June 1 lockdown measures were eased to allow more pupils to return to school and people were urged to return to work.

Since Monday, individuals have been allowed to meet with up to five people from separate households outdoors and more than two million clinically vulnerable people who have been shielding also be allowed to go outside.

The Prime Minister announced the rules last Thursday.

But due to the hot weather over the weekend it is thought many people saw the announcement as a green light to break lockdown prematurely to meet friends and family while thousands flocked to beaches.

A number of scientists and public health experts raised concerns about lifting the lockdown too quickly and the risk of a second spike.

However, ministers are caught in a fraught dilemma between sticking to measures to suppress the disease or relaxing them to ease the economic, social and health harm being caused by the lockdown.

If they act too quickly, the epidemic may return, but if they are too slow, more people will continue suffering unnecessarily from economic woes, being out of work, even if furloughed, and mental health problems linked to social restrictions.

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