Specialists explain if we should expect to see soaring infections and lockdown debates every autumn.
As Covid cases rise again, people are once again asking if the UK should lockdown
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As Covid cases rise again, people are once again asking if the UK should lockdown

Rising Covid cases mean the UK has become one of the world’s hotspots for the virus, despite having a trailblazing vaccine rollout.

Although 79% of those aged 12 and over are fully vaccinated against Covid, the NHS is warning that rising cases will overwhelm the health service across the winter, prompting calls for restrictions to be re-introduced.

The UK has seen more than 50,000 new Covid infections in one day for the first time since lockdown this week and Britain appears to be struggling especially when compared to western Europe.

Some have argued that the UK death rate is much lower than that compared to any of the previous infection peaks, and that is the real metric which matters.

Prime minister Boris Johnson is facing growing calls to implement “plan B” or stricter measures to curb the virus ahead of the colder months.

Johnson has not yet ruled out a winter lockdown, but said “we see absolutely nothing to indicate that that’s on the cards”.

Downing Street is currently relying on voluntary mask-wearing in crowded areas, the booster vaccine scheme, testing and the upcoming arrival of two new antiviral drugs to combat Covid.

Is this the most protected we can ever expect to be in the fight against Covid – or will we need to be more cautious every winter?

Covid-19 case rates in UK nations
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Covid-19 case rates in UK nations

Will we ever be able to eradicate Covid?

“I believe the opportunity for global eradication was gone very, very early in the pandemic,” Francois Balloux from the UCL Genetics Institute explained, according to the magazine Wired.

He said: “You can eliminate it locally but as long as there’s a focus somewhere in the world, whether that’s Iran, Afghanistan, Somalia, it will eventually come back.

“As of February 2020, it was clear that elimination would be impossible.”

Jeremy Farrar, director of the Wellcome Trust also tweeted in August that Covid is now endemic, meaning it is a virus which will circulate among the population for an indefinite amount of time regardless of any attempts to contain it.

This prediction has become more prevalent in recent months, especially after New Zealand renounced its “Zero-Covid” strategy once the Delta variant struck in August – the country had been a virus-free nation for most of the pandemic.

Why is Covid so hard to eradicate?

The widespread nature of Covid means that a range of variants have been able to crop up since it was first detected. More mutations reduce the likelihood of herd immunity.

Animal populations can also become a hotbed for viruses which makes it even more difficult to erase Covid.

President of the Asia-Pacific Society of Clinical Microbiology and Infection Paul Tambyah also told Wired: “We probably have no alternative to living with the virus, protecting the vulnerable, and ensuring the smooth running of the healthcare system.”

People getting vaccinated against Covid
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People getting vaccinated against Covid

But Covid vaccines make a difference, right?

Professor of vaccine epidemiology at the London School of Hygiene and Tropical Diseases, Mark Jit told HuffPost UK: “Vaccines have been a game changer.”

Vaccine have reduced the fatality of the disease although everyone vaccinated can still catch it and pass it on, and it can still cause a serious illness.

Yet even if everyone in the UK was vaccinated, many have pointed out that until the less developed nations are vaccinated Covid-19 will continue to be deadly.

According to Our World in Data, only 48.3% of the global population have received at least one dose of a Covid vaccine.

Without vaccine equity, Covid is even more likely to continue mutating and infecting.

The director-general of WHO, Tedros Adhanom Ghebreyesus condemned vaccine nationalism among world leaders earlier this year and said: “Even as they speak the language of equitable access, some countries continue to prioritise bilateral deals, going around Covax, driving up prices and attempting to jump to the front of the queue.”

The lesser developed countries themselves provide another hurdle. Some don’t have the infrastructure to roll out a mass vaccination programme.

Covid-19 vaccine doses in the UK as of October 20
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Covid-19 vaccine doses in the UK as of October 20

Vaccine also can’t work alone

Jit also pointed out that “the vaccines aren’t perfect” and none of them offer 100% protection – meaning other restrictions are still needed.

“With no other control measures in place, we’re seeing over a hundred people dying and tens of thousands of people getting Covid every day,” he continued.

“Over the course of a year, this will be a good deal more deaths than we typically see from flu, for instance. Having this much transmission also raises the risk of new variants emerging.”

Prioritising vaccinations and dropping all restrictions has been a problem outside of the UK, too.

Israel experienced the world’s highest per capital infection rate back in September despite being the first country in the world to fully vaccinate the majority of its population against Covid. The nation is now looking to administer just the third and fourth shots among the elderly.

Alternatively Singapore has completely opened up and is using surveillance of symptomatic people and contact tracing to keep the virus at bay.

Prime minister Boris Johnson will a dose of the Pfizer vaccine
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Prime minister Boris Johnson will a dose of the Pfizer vaccine

Will there be more lockdowns?

Jit told HuffPost UK: “We all hope never to go back into full lockdown again.

“However, milder control measures may be inconvenient but not massively disrupt our lives and economy.

“These hard choices are what learning to live with Covid means”

- Professor Mark Jit

“For instance, mandating mask wearing in some public spaces, working from home a few days a week for those who can do so easily, getting fully vaccinated and tested before we attend a big gathering.

“Such measures combined with vaccination will hopefully keep Covid spread to a low level.”

Yet the government is still refusing to put any new restrictions into law.

Health secretary Sajid Javid has just pushed for people to choose to wear masks. Many believe until the slower we are to bring in restrictions, the more likely a winter lockdown lies ahead.

Future lockdowns are likely to depends on how the NHS copes, hospitalisations, the backlog from patients who need attention from other medical conditions and the impact of flu over the winter.

Fewer patients with Covid are being hospitalised in the third wave compared to the second wave
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Fewer patients with Covid are being hospitalised in the third wave compared to the second wave

How many Covid deaths should we expect?

Accepting Covid will never leave sadly also means accepting a certain number of deaths from the virus every year.

Farrar estimated that 30,000 deaths a year could be considered “acceptable” as 29,000 people died from flu in 2018 in the UK.

For context, approximately 69,000 Covid-related deaths were recorded in 2020.

Balloux predicted that in a few years Covid will cause a lower death toll than flu among the immunised population.

Professor Jit explained that the UK will have to decide when the death rate is at an acceptable level – and if we can cope with the impacts of long Covid.

He said: “We have to make hard decisions about how many cases and deaths we want to see every year and what level of restrictions we can live with in order to keep those numbers low.”

What will the UK do?

The government has been inconsistent with its recent messaging around whether a “plan B” exists and whether it could be implemented any time soon.

Jit explained: “Science alone can’t tell us that we ‘should’ do anything.

“Whether we put up with these measures to prevent some of the extra cases and deaths depends on our values as a society. In the long term, we might eventually find even better vaccines and treatments that make even these measures unnecessary.

“Until then, these hard choices are what learning to live with Covid means.”