100,000 cases a day by late summer: Is now the right time to lift nearly all Covid restrictions?

The health secretary, Sajid Javid, has confirmed that England will move into the final stage of the lockdown roadmap on 19th July, meaning nearly all Covid restrictions will be lifted. He has warned, however, that cases could reach 100,00 a day by late summer.

Cases are already rapidly rising across the country, currently sitting at around 30,000 a day ‐ the highest levels seen since mid-January 2021. With this is mind, many are asking whether now is the right time to re-open the country.

“If not now, when?”

In a statement, Javid said: “To those who say: why take this step now? I say: if not now, when? There will never be a perfect time to take this step, because we simply cannot eradicate this virus.”

The government have based their decision on the success of the vaccine programme, which has seen one of the highest uptakes internationally and has significantly reduced the number of hospitalisations and deaths.

At the time of writing, nearly 46 million people (87% of the adult population) have had their first dose of the Covid vaccine, while nearly 35 million (66%) are now fully vaccinated.

While hospital admissions remain fairly low, they have more than doubled (56.6%) in the last week data is available for, with 563 people admitted to hospital on 6th July and 3,081 in the week to that date. Deaths also remain low, with the latest data from 12th July reporting six deaths within 28 days of a positive test result.

The Prime Minister, Boris Johnson, has said the majority of those admitted to hospital are unvaccinated, with scientists confirming that vaccinations have weakened the link between infections and deaths. However, it has not been completely broken and Johnson has urged caution, saying: “We must all take responsibility so we don’t undo our progress, ensuring we continue to protect our NHS.”

Some believe the government is moving too quickly, deeming their actions “dangerous” and “premature”. In a letter published in the Lancet, 122 scientists condemned the government’s plans to abandon restrictions, warning that any strategy that tolerates high levels of infection is both “unethical and illogical”.

They describe the plan as an “unethical experiment” warning that the growth and spread of the virus will “likely continue until millions more are infected, leaving hundreds of thousands with long-term illness and disability”.

The scientists fear that the strategy will provide fertile ground for the emergence of vaccine-resistant variants and warn that only half (50.7%) of the population are fully vaccinated when accounting for children.

This is of particular concern after scientists recently discovered that it is possible to catch two Covid variants at the same time. The news comes as a 90-year-old woman died after contracting both the Alpha and Beta variant simultaneously.

Scientists now fear that the virus has an increasing ability to replicate or dodge some of our existing immunity from past infection or vaccination, however, it is not yet clear whether dual infections compromise the efficacy of vaccination.

A sudden rise in cases will create more Long Covid

There is also growing concern that a sudden rise in cases will create more cases of Long Covid and put further pressure on the NHS which is already struggling to cope with the huge backlog of patients with unmet healthcare needs.

Professor Eric Topol, a prominent scientist and founder and director of the Scripps Research Translational Institute, said: “The abrupt rise in UK Delta variant cases will not only engender more Long Covid, but has also already resulted in more severe illness, with hospitalisations and deaths. Taking more time to further improve vaccination rates should help reduce the toll of this superspreader disease.”

This is particularly concerning considering that Javid recently announced that NHS waiting lists in England could more than double in the coming months. Currently, some 5.3 million people are waiting for routine operations and procedures in England. However, health officials warn that the backlog could soon reach 13 million patients.

Javid has said addressing this backlog will be one of his “top priorities”. He has proposed various solutions including paying private healthcare providers to continue treating NHS patients and keeping virtual doctors’ appointments. However, services are already strained due to high numbers of staff self-isolating or unwell, a problem which will only worsen as restrictions are eased.

British statistician Professor Sir David Spiegelhalter warns that abandoning social distancing rules could lead to hospital admissions reaching 2,500 a day. He emphasised however that although this figure is “very high”, it is “considerably lower” than the peak of the second wave.

For some, this is simply not acceptable. In a Tweet, Christina Pagel, Professor of operational research at University College London, wrote: “There seems to be a narrative that as long as things don’t get as bad as January for hospitals we’re ok. January was a massive public health failure to contain a new variant which resulted in a devastating wave and traumatised the NHS. That should not be our benchmark for “ok”!”

In an article published in the Guardian, Professor Pagel wrote that both of the Prime Minister’s reasons for further easing of lockdown restrictions are “wrong”. She says allowing mass infection will not only put unprecedented pressure on the NHS, but also “risk[s] burdening a generation with long-term ill health.”

She explains that infections will mainly fall on unvaccinated children and young people which will in-turn lead to thousands of people in this age group living with Long Covid.

The Office for National Statistics estimates that 1 million people, including 33,000 children, currently live with Long Covid in the UK, with 385,000 having symptoms for more than a year and over 600,000 saying it adversely impacts their daily life. As the country opens up, there is bound to be hundreds of thousands more cases within a relatively short space of time.

Hope for diagnostic tests for Long Covid

There is some good news, however. Earlier this week, scientists announced they have discovered irregularities in the blood of Long Covid patients that could one day pave the way for a test for the condition.

The researchers hope that a simple blood test (that would be administered in a doctor’s surgery) could be developed within six to 18 months.

It is important to note that the research is in its early stages and is yet to be scaled up. Professor Danny Altmann, the lead researcher of the team at Imperial College London, warned that the findings cannot yet be described as a breakthrough, but said they were “a very exciting advancement”.

Meanwhile, the government has promised to set up 89 Long Covid clinics to help patients suffering with the conditions. NHS England said they have invested more than £134 million in Long Covid services, highlighting the extent of crisis the country is facing.

According to reports, the government is already planning for a fourth wave this autumn due to the colder weather, questions surrounding vaccine efficacy over time, and a return to schools and universities. As Professor Pagel writes: “The question then is how much millions more cases matter, given the economic and mental health benefits of further opening.”