In February, Prime Minister Boris Johnson said the public should get used to “living with COVID” and announced the phasing out of all COVID-related restrictions over the following months. For many people, life has since started to return to something resembling normal.
Of course, there are notable differences from the pre-pandemic period, with a huge increase in working from home and, worryingly, many people are still suffering from long COVIDs. But in many ways, you could be forgiven for thinking the pandemic was over.
Yet over the past few weeks there have been indications that a new wave of COVID is coming. The latest Infections Survey data from the Office for National Statistics (ONS) suggests around 1.7 million people in the UK had COVID in the week ending June 18 – a increase of more than 80% over the previous three weeks. Given that infection survey data is released with a delay of at least a week, these figures almost certainly underestimate the number of cases today.
COVID cases across the UK are rising
A significant change in recent months has been the end of free mass testing, which stopped in April. Although this was unavoidable at one point due to the significant costs involved, it removed one of the UK’s main early warning systems.
In the past, an increase in positive tests in the community has been among the first signs that a new wave is coming. Without it, we may not realize the seriousness of a new variant until it is already well established and people start showing up in increasing numbers at hospitals.
BA.4 and BA.5
Two new omicron variants, BA.4 and BA.5, make up most infections in the current wave. Both are more transmissible than BA.2, the previously dominant variant. Evidence is still unclear whether these variants are more or less serious than earlier forms of omicron, but the UK Health Safety Agency (UKHSA) has classified them as “variants of concern”.
The latest hospital data shows that the number of new COVID patients (a combination of new admissions and people who catch COVID in hospital) in England is on the rise. In the most vulnerable age groups (65 and over), these numbers are almost two-thirds of the January peak seen during the first omicron wave.
Rate of new COVID hospital admissions in England by age
The situation is most acute in the North West of England, where there are currently around 200 new COVID admissions every day. The North West was also one of the most affected regions in the country in terms of hospital admissions during waves BA.1 and BA.2.
The key question at this point is how long this increase will continue. Without the mass testing early warning system, it’s hard to know. Eventually, this wave will begin to subside as the growth advantage of new variants comes up against the wall of immunity erected by previous vaccinations and infections.
While we’ve done a great job getting initial doses of COVID vaccines into arms in this country, a combination of diminishing immunity over time and the fact that newer variants are generally better at overcoming that immunity means that this wall is not as strong as it once was.
There are, however, a few reasons to be cautiously optimistic. South Africa, which has often been an indicator of new variants, and where BA.4 and BA.5 were first identified, saw a much smaller surge following these variants, with relatively few hospitalizations and deaths compared to previous waves. Portugal was one of the first European countries to experience a BA.4/5 wave and, although it has seen a significant increase in hospital admissions, the number of cases now seems to have started to fall without reaching the same gravity as the previous waves.
A few areas of concern
Even though wave BA.4/5 is not as big as previous waves, there are two major concerns. The first is the pressure already on the NHS, which has been taken to an extreme by the events of the past two years. Ambulance wait times are at record lows, as are A&E wait times, with more than a quarter of patients waiting more than four hours to be seen. This comes with a huge backlog of operations and other types of medical care that have been delayed during the pandemic. Even a modest BA.4/5 wave will only add to these pressures.
The second problem is the growing number of people with long COVID. As many as 1.4 million people in the UK report symptoms which affect their daily life. And those numbers are from May, before infections started to rise again.
Long COVID: Female gender, older age and existing health conditions increase risk – new research
So what can we do? If you were taking precautions earlier in the year that you have since abandoned, it would be wise to consider resuming them. These include wearing a mask in crowded places, not meeting people if you have symptoms, and testing if possible if you are not feeling well or are going to be spending time with a vulnerable person. The UKHSA also suggests meeting other people outdoors or in well-ventilated places.
To help bolster our protection against these new (and future) variants, it may help to bring forward the fall recall campaign, which will offer a fourth dose to people over 65 and other more vulnerable groups. . It may also be worth considering offering a fourth dose soon to younger age groups and additional boosters to more vulnerable groups.
The tide of the pandemic is receding. But as with any ebb tide, there will always be a bigger wave that can surprise you if you’re not careful. The end of mass testing and threats to the future of the ONS’ valuable COVID infection survey make it more likely that these waves will catch us unawares. The alarming state of the NHS and the threat of a long COVID means we should not be complacent about the potential threat of this wave or subsequent waves, even if the tide continues to recede.
Colin Angus does not work for, consult, own stock, or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond his academic appointment.