June 21 isn’t just the longest day of the year. In 2021, it could mark an even more momentous occasion: the day England’s lockdown lifts completely.
This would mean all limits on social contact are removed and any venues that have had to remain shut could reopen – nightclubs, we’re looking at you. Restrictions would also be expected to be eased on mass gatherings, meaning festivals and gigs could go ahead, as well as larger weddings.
However, a scientist advising the government has said the UK is in the “early stages of a third wave of coronavirus infections” already. Prof Ravi Gupta, from the University of Cambridge, said new cases were “relatively low”, but the Indian variant had fuelled “exponential growth”. Ending Covid restrictions in England on 21 June should be postponed, he said.
As the date looms closer, it seems like the world of politics and health aren’t quite aligned on whether this final easing of restrictions is the best course of action with a new – and seemingly more contagious – variant on the cards.
What’s the government saying?
On May 21, Boris Johnson said he doesn’t see any signs that he would need to “deviate” from plans to lift lockdown completely and he intends to let people know by the end of May whether the June 21 lifting will go ahead. However, it has since emerged a review of the social distancing rules is delayed due to the new variant’s spread, which could mean the June 21 deadline is pushed back.
Health secretary Matt Hancock said he’s “increasingly confident” England is on track to continue along its roadmap. And Dr Jenny Harries, chief executive of the UK Health Security Agency (UKHSA), told the BBC the easing of restrictions is “looking good” as long as people continue to observe all the safety signals.
But others aren’t so sure easing everything in less than a month’s time is the right move – namely because of the new variant: B1617.2.
There were originally four variants of concern (VOCs) in England – the so-called Kent, South Africa, Brazil and Bristol variants. More recently, B1617.2, which originated in India, was swiftly upgraded to a VOC due to rising cases.
A member of the Scientific Advisory Group for Emergencies (Sage) warned the UK could be at the start of a third wave right now due to this particular variant’s ability to spread quickly. Professor Andrew Hayward told BBC Breakfast: “I think what we can see is that this strain can circulate very effectively. Although it was originally imported through travel to India, it’s spread fairly effectively within households and now more broadly within communities. I don’t really see why it wouldn’t continue to spread in other parts of the country.
“Obviously we’re doing everything we can to contain the spread of that, but it’s likely that more generalised measures may start to be needed to control it.”
But, people are getting vaccinated...
A report released by Public Health England (PHE) on May 22 found that two doses of either vaccine are considered effective against the new variant – encouraging news, on the surface.
But other data released at the same time wasn’t as positive. PHE found the secondary attack rate (the rate at which it spreads to close contacts) is higher for the B1617.2 variant compared to the B117 variant. It appears to be either as transmissible, or even more transmissible, than B117, too.
Many experts are breathing a sign of relief over the vaccines showing signs of working against newer variants. “It’s good news the AstraZeneca and Pfizer vaccines, which have been most used in the UK, are efficacious against the Indian B1617.2 variant,” says Dr Julian Tang, associate professor and clinical virologist at the University of Leicester, “it is not 100% efficacious, though it may well be close to this to protect us against severe disease and death.”
He points out the protection is only 33% after one dose of either vaccine, which isn’t great news for those who are partially vaccinated. In the UK, more than 38m people have been given their first dose of the jab, while almost 29m have received two doses and are therefore fully vaccinated and better protected.
Was a rise in Covid cases expected as restrictions eased?
It’s hard to tell whether the variant is spreading more efficiently, or if the easing of lockdown measures has impacted the rise in cases. Dr Eleanor Gaunt, a research fellow and expert in respiratory viruses at the University of Edinburgh, says people can now travel across the country, attend hospitality venues and see friends and family members indoors, and children no longer have to wear masks in schools. On top of that, for the first time in a year, people were given the go ahead to break social distancing guidelines for a ‘cautious cuddle’.
So it’s perhaps no wonder, then, we’re also seeing case numbers start to increase – although on the whole, the total number of cases per day is still considered to be low, says Dr Gaunt. The UK government’s Covid dashboard suggests around 2,400 people are testing positive for the virus daily – this is up 17% week on week. Some areas are far more impacted than others.
What’s being done about it?
In Bolton, one of the areas impacted by the new variant, it’s been reported that hospitalisations have tripled. This is one of the areas where the government quietly updated Covid guidance where the variant is spreading more rapidly. People in Bedford, Blackburn, Bolton, Burnley, Kirklees, Leicester, Hounslow and North Tyneside have been urged to meet outside rather than inside where possible, keep two metres apart from those they don’t live with, and avoid travelling in and out of affected areas unless it is essential.
As part of the government’s strategy to deal with the situation, vaccinations are being more intensively rolled out in regions experiencing a surge in cases, in addition to surge and community testing, and enhanced tracking and tracing. But Dr Gaunt warns this is not predicted to be sufficient to prevent the UK from experiencing a third epidemic wave.
“The final easing scheduled for June 21 is therefore only likely to go ahead if the cost of several thousands of lives is accepted,” she says.
So, is lifting lockdown on June 21 the right call?
Dr Tang believes it’s still too early to say whether the June 21 relaxations should still go ahead as planned. “With a return to indoor activities from May 17, just a week ago, we’re still waiting to see what the true impact of this latest relaxations will be on the Covid-19 case numbers going into June,” he explains.
The good news is he doubts we will see much increase in hospitalisations and deaths – “though there will be some,” he adds. “The main burden, I suspect, is the number of younger, unvaccinated – or even singly-vaccinated – people getting mild/moderate Covid-19 that does not require hospital admission, but which may leave 10-20% of them with long Covid symptoms.”
The impact of long Covid shouldn’t be underestimated. The issue has been estimated to affect over one million people in the UK already, points out Dr Nisreen Alwan, an associate professor in public health at the University of Southampton, who experienced long Covid herself. Many of these people have ended up with “significant functional disability”, she says – some have been unable to return to work months after first testing positive for the virus.
“It’s vital that the timing of further easing restrictions is not only decided based on the outcomes of deaths and hospital admissions – it must take into account the outcome of long Covid,” she says. “The long term consequences of the infection in groups not classed as ‘vulnerable’ must be at the forefront of decision-making.”
It’s believed we’ll know more about whether a total ‘unlockdown’ will happen by the end of May – until then, scientists and politicians will be monitoring the data closely on how a partially-vaccinated nation fares against the newest variant.