Covid-19 peak ‘could lead to 1,000 to 2,000 hospital admissions per day’

Experts are urging the public to “go slow” once restrictions lift on July 19, to curb infections and cut the number of people who will go on to die from Covid-19.

They recommend that workers do not all head back to the office from mid-July, continue to wear masks in crowded spaces and stay at home when infected or contacted by the NHS app or NHS Test and Trace.

Central estimates from modellers advising Government show that step 4 of the road map for England and the wave of infection could be associated with 1,000 or more hospital admissions per day at the peak (with an estimate of 1,000 to 2,000 per day).

Deaths are expected to be between 100 and 200 per day at the peak of the wave, though there is a large amount of uncertainty in the modelling.

Most of the modelling presented to the Government has a lower expected peak of infection than that seen in January this year.

Scientists argue that if people revert to normal pre-pandemic behaviour all at once on July 19, then there will be a big wave of infection and larger numbers admitted to hospital.

Instead, if behaviour reverts to normal over several months, the impact will be lower.

Government scientists say that while the link between cases and hospital admissions is weakened due to vaccines, it has not been broken.

In papers newly released by the Government on Monday, a document dated July 7 from the Scientific Advisory Group for Emergencies (Sage) concluded “all modelled scenarios show a period of extremely high prevalence of infection lasting until at least the end of August”.

“There is high uncertainty around both the scale of the peak in prevalence and in the number of confirmed cases that this would correspond to.”

Sage recommends that the Government looks at the impact of hospital admissions on NHS function, and at which point the admissions become a big concern.

The Government should then work back from that and introduce measures to stop infections when hospital admissions are half the number that the NHS can tolerate.

Sage argued this is because: “Given the time between infection and hospitalisation, at any point that cases are still increasing exponentially, admissions can be expected to at least double once more regardless of any measures put in place at that point.”

Sage also said rising cases mean the level of Covid-19 testing across the country “may become limited by uptake or capacity”.

It added: “If PCR testing and genomic sequencing capacity are overwhelmed, it may not be possible to rapidly identify a new variant.”

The experts said the likelihood of a variant emerging that can escape vaccine immunity “is unknown, but such a variant would present a significant risk both in the UK and internationally”.

Under pessimistic assumptions, some modelling scenarios presented to ministers show a resurgence of cases on the same scale or larger than the peak seen in January.

However, Sage has concluded “it is almost certain that the peak in deaths will be well below the levels seen in January 2021 due to the impact of vaccination (assuming that no new dominant variant emerges)”.

It said that while introducing further delays to the road map “could have some additional positive impact by allowing more people to be vaccinated”, the “effect of this would be much smaller than the effect of the current delay and it would push the wave further towards the autumn and winter”.

Experts are worried that pushing the peak of the wave into cooler months would hit the NHS at a time when it is already under pressure.

Modelling by the Scientific Pandemic Influenza Group on Modelling (SPI-M) from earlier this month shows that, taking into account current studies on vaccine effectiveness, peak daily hospital admissions range from about 500 to 950 when there is a slow return to pre-pandemic behaviour.

But this rises to about 1,300 to 4,800 for the most rapid return to pre-pandemic behaviour.

Scientists informing Government also expect half of all deaths to occur in vaccinated individuals, predominantly in those aged 75 and over.

However, a substantial number of deaths are also projected to occur in fully vaccinated adults aged 50 to 74.

Researchers from the University of Warwick argue there could be a “heavy burden” on the NHS as a result of restrictions loosening.

The researchers said daily hospital admissions could peak at 6,970 daily if people immediately begin to act normally again once restrictions have eased off completely, and if the vaccines are not as effective as once believed.

But if people return to normal life slowly over several months, a smaller wave is generated, with a projected peak in daily hospital admissions of 668.

In its research, the London School of Hygiene & Tropical Medicine also said it expects a peak of cases next month.

It predicts about half of the hospital admissions are likely to be in vaccinated people aged 45 to 75 and older, with deaths concentrated in those aged 75 and over.