Risk of substantial third wave, says Professor Neil Ferguson

·6-min read

Modelling submitted to the Government in recent days shows there remains a “risk of a substantial third wave” of Covid infection, a leading expert has said.

Professor Neil Ferguson, from Imperial College London, whose modelling was instrumental to the first lockdown in March 2020, suggested that delaying the road map for England could have benefits in ensuring more people have second vaccines.

It came as the UK recorded another 7,540 coronavirus cases – the highest daily total since February 26 – alongside six more deaths.

Prof Ferguson said work by the Scientific Pandemic Influenza Group on Modelling (Spi-M) is basically “saying there is a risk of a substantial third wave – we cannot be definitive about the scale of that, it could be substantially lower than the second wave, or it could be of the same order of magnitude”.

The size of the wave “critically depends” on how effective vaccines are at protecting people against admission to hospital and death, in the face of the variant first identified in India, as well as a few other issues, he said.

The professor told a media briefing that “in the next few weeks” experts hope to be able to see more clearly what the ratio is between hospital admissions and cases, though it was already known that “vaccination has fundamentally changed that ratio” for the better.

Prime Minister Boris Johnson is due to make a decision shortly on whether England can go ahead with full reopening on June 21.

Speaking during a visit to Cornwall, Mr Johnson said ministers would be “driven by the data”.

Coronavirus graphic
(PA Graphics)

“What everybody can see very clearly is that cases are going up and, in some places, hospitalisations are going up,” he said.

“What we need to assess is the extent to which the vaccine rollout, which has been phenomenal, has built up enough protection in the population in order for us to go ahead to the next stage.”

Asked if delaying the road map date would make a difference, Prof Ferguson said: “Yes, because it allows more people to get second doses.”

He said efficacy for the second dose against the variant first identified in India was higher than after one dose.

Coronavirus graphic
(PA Graphics)

A delay would also protect people and “have an effect on transmission, of getting more weeks of getting people vaccinated”, he said.

He said any third wave of cases “will translate, by definition, into some number of hospitalisations and deaths” but added that it is “harder to pin down quite how significant the latter will be at the current time”.

Prof Ferguson stressed that models sent to the Government examined what the “pluses and minuses” are of reopening, what additional data will be available at what point, and “what the scale of the potential risk is”.

He added: “I mean, fundamentally, it’s for policymakers to take that on board.

“Clearly you have to be more cautious if you want measures to be irreversibly changed and relaxed, but the Government will decide in the next few days.”

When asked whether a four-week delay in the road map could have a potential added advantage, due to schools being closed for summer holidays, Prof Ferguson said holidays would “reduce contacts in the population slightly and that will counterbalance any increase caused by going to step four (of the UK road map)”.

Earlier in the briefing, he said the the country has not yet seen a “huge surge in transmission from step three” of the road map for England, “but that may still be coming”.

Data on partial vaccine escape for the variant first identified in India was “turning up to some degree”, with “moderate” drops in vaccine efficacy.

(PA Graphics)
(PA Graphics)

He added that “we’re seeing growth (of the variant) in nearly all local authority areas”, with an estimate for the reproductive value (R number) of the variant put at 1.5-1.6.

The current doubling time for the variant is just under a week, which is “comparable with what we saw before Christmas”, he added.

“The key issue is how long will it keep on doubling, because we’re starting at a very low level and we have a lot of immunity in the population from vaccination and from people being infected in the past.”

Prof Ferguson said it was currently difficult to resolve how cases “will translate into hospitalisations, but it’s well within the possibility that we could see a third wave at least comparable in terms of hospitalisations, maybe not as severe, as the second wave.

“Almost certainly I think deaths probably will be lower – the vaccines are having a highly protective effect, cases in hospital now are milder – but it still could be quite worrying.”

(PA Graphics)
(PA Graphics)

It comes as data shows the number of people in hospital with Covid-19 in England is now a fifth higher than it was at the end of the second wave, with more regions reporting a rise in patients.

A total of 879 patients with Covid-19 were in hospital in England as of 8am on June 8, according to NHS England, up 13% from the 776 one week earlier.

It is also up 20% from a low of 730 patients on May 22.

But new Office for National Statistics (ONS) data shows an estimated eight in 10 (80%) adults in households in England were likely to have tested positive for Covid-19 antibodies in the week beginning May 17 – a marker of whether somebody had the infection in the past or has been vaccinated.

In Wales, the figure was 83%, while it was 73% in Scotland and 80% in Northern Ireland.

Coronavirus graphic
(PA Graphics)

On Wednesday, the chief executive of NHS Providers, Chris Hopson, said hospitals in Covid hotspots are seeing a “significantly” lower death rate among people admitted for treatment and are coping with current levels of infection.

He said there was a degree of confidence that vaccines have “broken” the link between infections and the “very high level of hospitalisations and mortality we’ve seen in previous waves”.

He told Times Radio: “And if, and it is a big if, if Bolton has gone through its complete cycle and if other areas follow Bolton, the view from the hospital there was that they were able to cope with the level of infections.

“It’s important not to just focus on the raw numbers here, you also do need to look at who’s being admitted into hospital and how clinically vulnerable and what level of acuity they’ve got.

“What chief executives are consistently telling us is that it is a much younger population that is coming in, they are less clinically vulnerable, they are less in need of critical care and therefore they’re seeing what they believe is a significantly lower mortality rate, which is, you know, borne out by the figures.”

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