What will the pandemic be like this winter?

Winter is always a tough time for the NHS. In addition to providing routine health care, additional requests seasonal diseases such as the flu. Also a big savings Health care postponed this year due to the pandemic.

If COVID-19 hospitalizations increase, the NHS is likely to be overwhelmed once again. Therefore, the UK government outlined It plans to contain COVID-19 this winter. He divided his tactics into two.

Revolves around primary strategy spreading more vaccines to key groups. A third dose will be offered this fall to all clinically vulnerable people over 50, their caregivers and frontline medical personnel. At the same time, the standard vaccination schedule will be expanded to include more schoolchildren.

The test, monitoring and isolation system will also continue to be used. People are also advised to minimize the risk of spreading the virus by socializing outdoors as much as possible, ventilating indoor spaces, and wearing masks in crowded places.

If cases and hospitalizations still rise too much, plan B will be initiated. Working from home and wearing masks will return, and vaccination passports will be needed to access some public places. The government stated that a new curfew would be an absolute last resort.

Does this plan make sense?

So far, the UK’s vaccine strategy is working. vaccines estimated It prevented more than 24 million infections and 143,600 hospitalizations. But one big uncertainty is how long immunity to COVID-19 lasts. Based on studies on other human coronaviruses, immunity preventing infection may be short-lived.

There is also emerging evidence United Kingdom, Israel and Train (still in preprint, so yet to be reviewed by other scientists) that vaccine-induced COVID-19 immunity declines over time, especially in the elderly.

An elderly woman who is vaccinated for COVID-19
Supplements for those most at risk will be given from the end of September.
David Pereiras/Shutterstock

Given that the risk of severe illness and death from COVID-19 increases with age, and older people are more likely to be vaccinated first and therefore have weakened protection, it makes sense to prioritize supplementation. This will increase the protection of people at risk of serious illness at a time when indoor mixing (and risk of transmission) is set to increase. This should reduce hospitalizations.

It was also decided to offer the COVID-19 vaccine to children aged 12-15. But this is not actually part of the government’s winter plan.

At this time, infections have intensified. youth and youthwhere vaccine coverage is lower. However, their infections tend to be mild and the risks of serious illness and death are low – meaning the health benefit of vaccinating young people therefore likely to be small. there is also some evidence that children are less likely to transmit the virus to others. Therefore, vaccination of this age group is unlikely to have a large impact on hospitalization rates – but why?

Vaccinating 12- to 15-year-olds can reduce their chances of infecting other vulnerable children and adults, some of whom may not be vaccinated. It will also reduce the likelihood of COVID-19 outbreaks in schools, thereby minimizing further disruption to education.

It is well known that the missing school resultssuch as harming children’s mental health and educational achievements. It also makes sense to provide more protection to younger people through vaccines. other public health measures for schools – like face overlays and bubbles – it’s been relaxed. While not directly beneficial for the NHS, it is a good thing to expand vaccine coverage to this group.

However, school resumed after the summer break. More infections could potentially have been prevented in the coming months if the vaccination of 12- to 15-year-olds had started sooner.

What about the rest of plans A and B?

The other big uncertainty is whether the proposed control measures (wearing masks in some cases, socializing outside and, if things go wrong, mandatory masks and working from home) will be sufficient in conjunction with the vaccine booster programme.

Duration vaccines are very effective, them Does not provide full protection. Even among those who are double-vaccinated, there will be more breakthrough infections over time. Even if there is a risk of infection reduced by vaccineIf large numbers of people are infected, this will lead to hospitalizations.

We are already seeing this happen. cases high and hospitalizations rising. It is reasonable to assume that as winter comes and more time is spent indoors, there will be more infections. Therefore, some public health measures probably necessary To prevent a further wave of infections, hospitalizations and deaths from COVID-19. The government is right not to rely solely on vaccines.

A man working on a laptop at home
Stronger control measures such as forced work from home are not here yet – but the public needs to be ready for them.

The Prime Minister has signaled that he is ready for lockdowns. They are disliked by the public and will become increasingly difficult to implement. But whether it will be needed will depend on how things unfold. If a dangerous new variant emerges that is more infectious or may evade vaccine immunity, robust containment measures may be needed. The government should be flexible and possibly not completely rule out re-isolation.

On the plus side, ongoing genomic surveillance The number of viral variants that are key to detecting such a threat is being increased as part of the winter plan.

The next few months period of uncertainty as people return to school and their workplace. Pressures on the NHS will increase. For now, more contentious measures such as vaccination passports, mandatory face coverings and work-from-home orders not deployed. However, it looks like they will be needed to avoid using even more destructive measures in the future should the situation worsen. It’s a good idea to prepare the public for their return.

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