LONDON – By mid-year, all adults in Britain will be offered a Covid-19 vaccine in what is on track to become the fastest rollout of vaccinations in a major Western country. But disease models advised by the UK government recently made a sobering projection: 56,000 more Covid-19 deaths by the summer of next year, even as the country tiptoes out of lockup and the vaccines work.
The study points to the uncomfortable prospect that even with an effective vaccine, the virus will continue to take its toll on society and that some restrictions may need to be periodically reintroduced to contain the spread of the coronavirus.
The bottom line: Businesses and governments around the world must prepare to live with Covid-19, accepting that the virus will not go away, but also that lockdowns cannot go on forever once hospitalizations are reduced to manageable levels.
“We cannot escape the fact that lifting the lockdown will result in more cases, more hospitalizations and unfortunately more deaths,” British Prime Minister Boris Johnson told parliament on Monday as he charted a slow and conditional route to get out of the lockdown. come. “There is therefore no credible route to a zero-Covid Britain or even a zero-Covid world.”
Future burden
Disease modeling by scientists advising the UK government suggests that Covid-19 is likely to still cause illness and death, even after widespread vaccination once public health measures are relaxed.
Cumulative deaths (February 12, 2021 – June 30, 2022)
Cumulative hospital admissions (February 12, 2021 – June 30, 2022)
* All adults over 50, health professionals and other priority groups will receive at least one dose of vaccine by April 21
† All over 70s and clinically vulnerable individuals will receive two doses by May 21
Cumulative deaths (February 12, 2021 – June 30, 2022)
Cumulative hospital admissions (February 12, 2021 – June 30, 2022)
* All adults over 50, health professionals and other priority groups will receive at least one dose of vaccine by April 21
† All over 70s and clinically vulnerable individuals will receive two doses by May 21
Cumulative deaths (February 12, 2021 – June 30, 2022)
Cumulative hospital admissions (February 12, 2021 – June 30, 2022)
* All adults over 50, health professionals and other priority groups will receive at least one dose of vaccine by April 21
† All over 70s and clinically vulnerable individuals will receive two doses by May 21
Cumulative Deaths
(February 12, 2021 – June 30, 2022)
Cumulative hospital admissions
(February 12, 2021 – June 30, 2022)
* All adults over 50, health professionals and other priority groups will receive at least one dose of vaccine by April 21
† All over 70s and clinically vulnerable individuals will receive two doses by May 21
The caution does not undermine the value of a successful vaccine rollout. New data released Monday showed that the UK’s vaccination program – which has given at least one injection to more than a third of the country’s 53 million adults – has significantly reduced infections and cut serious illness by even more.
But while the program paves the way for gradual opening up of the country over the next four months, the government is not treating it as a panacea. “Vaccination will bring rates down, but it won’t get rid of this,” Chris Whitty, England’s chief medical officer, said Monday. He added that Covid-19 “is likely to be a problem for the coming winters.”
Epidemiologists have long warned that Covid-19 is likely to circulate for years or even decades, causing society just as much to deal with as it does with other endemic illnesses such as influenza, measles and HIV.
No vaccine is 100% effective and no population will be fully vaccinated. So a great unknown in a vaccinated society is what levels of infection governments will be willing to live with before introducing restrictions, said David Salisbury, who previously chaired the World Health Organization’s Strategic Advisory Group of Experts on Immunization.
A Covid-19 patient who received care at King’s College Hospital in London last month.
Photo:
kirsty wigglesworth / Agence France-Presse / Getty Images
“It’s a political and social issue about what is acceptable,” he said.
The British government hopes that Covid-19 will eventually be treated like the flu. Over the past five years, between 4,000 and 22,000 people died from influenza in England every year. In the past year, Covid-19 has killed 130,000 people in the UK
In the US, Covid-19 has claimed more than 500,000 lives. Influenza is estimated to have killed between 22,000 and 61,000 people in the US in the past five seasons, depending on the severity of the outbreak.
The entire adult population in England is expected to be offered a Covid-19 injection by the end of July. The government in England is currently planning to ease almost all restrictions in four stages by June 21. However, even if the vaccine is properly absorbed, the virus will still be present. Children are not immunized, allowing the virus to circulate freely among about a fifth of the population. Not everyone will accept the vaccine.
To make matters worse, infection rates start from a very high base in the UK
As highly transmissible Covid-19 variants fly around the world, scientists are rushing to understand why these new versions of the virus are spreading faster and what this could mean for vaccination efforts. New research says the key may be the spike protein, which gives the coronavirus its unmistakable shape. Illustration: Nick Collingwood / WSJ
Modelers warn that this can lead to a jump in cases where restrictions are relaxed. With a vaccine that is 85% effective and vaccinated three-quarters of adult Britons, about half of the population would become vulnerable to the virus, models from Imperial College London, suggest, because children have not been vaccinated.
Relaxing restrictions during the summer would increase infections in the fall. Even if restrictions are not fully relaxed until August, Imperial College estimates that it could lead to 56,000 deaths by June next year. Modeling by the University of Warwick, which was also the basis of UK government policy, led to similar conclusions.
Marc Baguelin, an epidemiologist at Imperial College, says the model is a baseline scenario and could underestimate both vaccine uptake and their effectiveness in curbing the transmission of the disease. Other reasons for optimism include improving treatments for those hospitalized with severe Covid-19, lowering the risk of death especially for younger patients.
On the other hand, the virus could mutate to make the vaccines much less effective. Some vaccines have already shown reduced effectiveness against variants identified in South Africa and Brazil, for example. “That makes the prospect of a third wave much greater,” said Christopher Murray, director of the Institute for Health Metrics and Evaluation at the University of Washington.
The long-term effects of a Covid-19 infection on younger people are still understood. When they are harmful, governments can be more wary of allowing younger people to resume life without vaccination or social distance.
Part of the problem is expressed in simple math. If 90% of the population takes a vaccine that is 90% effective, 19% will go unprotected, said David Sarphie, CEO of Bio Nano Consulting, which partnered with Imperial College to develop Covid-19 modeling tools for governments and businesses. “Nineteen percent of the UK population is 12.9 million,” he said.
A vaccination center for Covid-19 in London this month.
Photo:
andy rain / Shutterstock
Successive waves of hospitalizations and deaths in Western countries last year show that the disease can cause significant illness, even when relatively small numbers of people are exposed, said Martin Hibberd, professor of emerging infectious diseases at the London School of Hygiene and Tropical Medicine.
“Even with the vaccines, there is still a significant number of people who will still be vulnerable,” he said.
Disease experts say the prospect of significant levels of serious illness and death, even in a population with widespread vaccination coverage, highlights the need for effective systems to test the virus and isolate those infected and their contacts. Governments must work hard to improve vaccination coverage and overcome misinformation and hesitation, they say.
In the UK, UK government advisers say wearing a mask or working from home may need to be reintroduced in winter to curb outbreaks. The government is looking into whether Britons need to prove they are vaccinated or virus-free to resume activities such as going to the pub or to the office.
To underscore the potentially rocky road to normalcy, the UK Treasury is likely to provide emergency aid to the economy when the government budget is presented next week.
Overall, the coronavirus will be “something we’ll live with,” said Roy Anderson, an epidemiologist and professor at Imperial College.
Write to Max Colchester at [email protected] and Jason Douglas at [email protected]
Corrections and reinforcements
With a vaccine that is 85% effective and vaccinated three-quarters of adult Britons, about half of the UK population would become vulnerable to the virus, models suggest. An earlier version of this article incorrectly stated that half of the adult population would remain vulnerable. (Corrected on February 23)
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