• Stuart McDonald

When to take the next step?

Jeremy Vine asks a perfectly reasonable question. We know the vaccines work, and the UK vaccination effort has been incredible. So why then do so many people - including me - feel that unlocking on June 21 is just too much of a risk right now?

With the Delta (India) variant now prevalent in the UK, cases are rising exponentially, doubling around every 9 days. I like the way Oliver Johnson presents the case data... follow the line to see where the current trajectory takes us.

As Jeremy Vine notes, vaccines have dramatically reduced the proportion of cases that turn into hospital admissions and deaths. The reduction appears consistent with our modelling from January, though of course take-up is not 100% and vaccine-efficacy against the delta variant is lower than our assumption at the time (which was based on the Alpha, or UK variant).


Whilst I’m mindful of concerns around Long COVID, it’s these more immediate outcomes (pressure on the NHS and deaths) that underlie the roadmap.


Hospital admissions are now clearly rising, as we highlighted yesterday.

To date, admissions growth is much slower than for cases. We need to watch this closely over the next couple of weeks to see where it goes. We just won’t have enough data in time for the 21 June decision.


The UK’s vaccination push has been incredible, and all involved should be proud. Nonetheless, 3 out of 5 people remain either unvaccinated or only partially vaccinated (just one dose, or received second very recently). A short delay allows millions more people to be fully vaccinated.

The vaccines are great but they are not perfect, particularly against the Delta variant. Even if, as the latest data suggests, there is 70% protection from one dose and 95% protection from two that has the potential to result in another large wave of hospital admissions and deaths.

How bad could things get? James Ward provides regular updates using a well-explained model in the public domain. The scenario shows below is one of the most troubling that his model shows to currently be plausible. Others scenarios in his latest update show a much smaller wave. The variation between the scenarios shows just how uncertain the current situation is. A huge exit wave of hospitalisations is by no means certain, but in my view the risk is currently too high.

So what can we do? With exponential growth apparent the national policy discussion should consider:

  • more restrictions

  • stay as we are

  • relax restrictions as planned.

Based on the data and modelling available today I would favour staying as we are for a couple more weeks.


Of course more local measures should be discussed given the clear difference between the North West and other parts of the country, but we shouldn’t kid ourselves that the NW situation is unique - they are just ahead of the curve.


Equally, consideration could be given to relaxing some but not all measures. For me though this sends the wrong signal to the public, at a time when even the current measures might not be strong enough.


The roadmap out of lockdown has, in my view been a great success. The "data not dates" approach has brought us to a position where hospital numbers and deaths are low, despite the delta variant. We need to be true to that approach and hit the pause button for a couple of weeks.


As individuals we need to continue to follow the guidance and keep numbers meeting indoors low. Crucially, we need to get both jabs as soon as we can. Over 25s can book first jab and over 40s waiting 11-12 weeks for their second AstraZeneca jab can bring the date forward here (click on "Manage my appointment").


https://www.nhs.uk/conditions/coronavirus-covid-19/coronavirus-vaccination/book-coronavirus-vaccination/


In summary then:

  • The vaccines are working and are saving lives - do get both jabs as soon as you can.

  • I don’t think more national restrictions are currently needed, but we can’t risk opening on 21 June. Tests 3 and 4 are currently questionable.

  • The hospital data should be clearer in a couple of weeks. So it makes sense to push the decision on re-opening back slightly. The delay also allows millions more people to be fully vaccinated.

Stay safe!

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