THEOn Monday, Boris Johnson announced his roadmap for lifting all Covid restrictions by June 21, but was criticized by some Tory MPs for failing to plan for a faster return to normal life. Here is some of the evidence the government and its science advisers have reviewed, highlighting the risks of lifting the restrictions too soon.
Based on modeling from the University of Warwick and Imperial College London, the Scientific Pandemic Influenza Group on Modeling (SPI-M), a subgroup of the Scientific Advisory Group on Emergencies (Sage), warned a quick relaxation [of restrictions] causes a huge wave of hospitalizations and deaths.
He said if all restrictions were lifted by April 26 (scenario 1), even under the most optimistic assumptions, including 4 million doses of vaccine per week from March 22, there would be another wave of comparable in size to January 2021, resulting in an additional 62,000 to 107,000 deaths in England. More pessimistic vaccine efficacy led to a forecast of 102,000 to 176,000 additional deaths.
Explaining the likely resurgence if restrictions were lifted sooner, SPI-M says: There are still a lot of people in vulnerable groups who have no protection; neither directly (either because they were not vaccinated or because their vaccination did not prevent them from becoming infected and then sick) nor indirectly from the immunity of a wider population (because many age groups younger people have not yet been vaccinated or infected).
Admission to hospital
With warnings that the NHS is on its knees after three waves of the pandemic, making sure it isn’t overwhelmed by a fourth wave is one of the key factors in the decision to lift the restrictions.
For its article, discussed by Sage on February 4, the SPI-M asked the University of Warwick and Imperial College to model four scenarios, with the first scenario considering the fastest return to minimum measures (April 26) and the fourth most recent scenario (August 2). SPI-M said: The four modeled scenarios lead to a substantial resurgence in hospitalizations and deaths. He found that the models from the two universities were in remarkable quantitative agreement on hospital admissions.
Daily admissions for Covid peaked at 4,134 on January 12, but on Monday stood at 904. The most optimistic interpretation of Scenario 1 in Warwicks’ modeling suggested a resurgence in admissions later this year, reaching between 4 000 and 6500 admissions per day.
In the same document, SPI-M said: Unless the efficacy of the vaccine is significantly better than what is assumed here, it is highly likely that the occupancy rate of hospitals would be higher than observed. in January 2021, if all restrictions are lifted by early May, even under the optimistic vaccine deployment scenario modeled here of 4 million doses per week from the end of March.
The number of beds occupied by Covid patients in England peaked on January 18 at 34,336. That figure has since fallen (the figure was 14,137 on Monday) but modeling has warned of a reversal if restrictions are lifted too early. According to the most optimistic interpretation of the first scenario, the Warwicks modeling suggested an occupancy of approximately 20,000 to 50,000 beds.
SPI-M wrote: The easing of the current restrictions would be all the more safe as the prevalence and occupancy rate of the hospital decreases before the relaxations begin. This would give a longer window of time to react should it become clear that the easing of measures is leading to an unsustainable increase in hospital admissions. A lower prevalence of infection will also reduce the risk of developing new variants.
The occupancy rate of hospitals is still very high and will remain so for a long time. SPI-M-Os [the operational subgroups] the medium-term projection of the occupation of hospitals in England on March 8 is between 5,600 and 12,1001.
Avoid another lock
There is universal agreement on all sides of the argument that avoiding another lockdown is vital, whether it’s to preserve people’s sanity or to prevent businesses from being forced to shut down or fire employees. . SPI-M says lifting restrictions in a hurry would risk triggering a fourth national modeling-based lockdown.
He says: As restrictions are relaxed, transmission of the virus will increase. The slower the restrictions are relaxed, the greater the number of hospitalizations and vaccine-averted deaths, and so the restrictions would be less likely to need to be reimposed later to avoid extreme pressure on hospitals. Rapid relaxation leads to a huge wave of hospitalizations and deaths.
Johnson left a minimum of five weeks between each step in lifting the restrictions and this, again, is supported by the evidence presented by SPI-M. He says: It’s much less likely that restrictions would have to be reimposed if an approach were taken in which every step was followed by careful evaluation of the data before any further unlocks were allowed. It takes several weeks between stages to determine if this change significantly increased transmission.
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