LONDON: In the middle of this year, all adults in Britain will be offered a Covid-19 vaccine in what will be the fastest inoculation release in a major western country. But recently, disease modelers who advised the UK government made a disturbing projection: 56,000 deaths from Covid-19 plus the summer of next year, even if the country closed on tiptoe 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 reintroduced periodically to control the spread of coronavirus.
The bottom line: Businesses and governments around the world need to prepare to live with Covid-19, accepting that the virus will not go away, but that blockages cannot continue forever once hospitalizations are reduced to levels manageable.
“We cannot escape the fact that lifting the closure will lead to more cases, more hospitalizations and sadly more deaths,” British Prime Minister Boris Johnson told Parliament on Monday as he charted a slow, conditional route out of the closure. “There is, therefore, no credible route to a Britain with a zero covid or, in fact, to a world with a zero covid.”
Future load
Disease modeling by scientists advising the UK government suggests that Covid-19 will likely still cause disease and death even after widespread vaccination once public health measures are relaxed.
Accumulated deaths (February 12, 2021 – June 30, 2022)
Accumulated hospital admissions (February 12, 2021 – June 30, 2022)
* All adults over the age of 50, health workers and other priority groups receive at least one dose of vaccine before April 21
† All over-70s and clinically vulnerable receive two doses before May 21st
Accumulated deaths (February 12, 2021 – June 30, 2022)
Accumulated hospital admissions (February 12, 2021 – June 30, 2022)
* All adults over the age of 50, health workers and other priority groups receive at least one dose of vaccine before April 21
† All over-70s and clinically vulnerable receive two doses before May 21st
Accumulated deaths (February 12, 2021 – June 30, 2022)
Accumulated hospital admissions (February 12, 2021 – June 30, 2022)
* All adults over the age of 50, health workers and other priority groups receive at least one dose of vaccine before April 21
† All over-70s and clinically vulnerable receive two doses before May 21st
Accumulated deaths
(February 12, 2021 – June 30, 2022)
Accumulated hospital admission
(February 12, 2021 – June 30, 2022)
* All adults over the age of 50, health workers and other priority groups receive at least one dose of vaccine before April 21
† All over-70s and clinically vulnerable receive two doses before May 21st
Caution does not undermine the value of a successful vaccine release. New data released on Monday showed that the British vaccination program, which has shot at least more than a third of the country’s 53 million adults, has significantly reduced infections and further reduced serious illnesses.
But while the program paves the way for a gradual unblocking of the country over the next four months, the government does not treat it like a silver bullet. “Vaccination will reduce rates downwards, but it will not be eliminated,” Chris Whitty, an English chief medical officer, said on Monday. He added that Covid-19 “is likely to be a problem for the coming winters.”
Epidemiologists have long warned that Covid-19 will likely circulate for years, or even decades, leaving society to deal in the same way it does with other endemic diseases such as the flu, measles and HIV.
No vaccine is 100% effective and no population will be completely inoculated. So a big 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 strategic advisory group of immunization experts. ‘World Health Organization
A Covid-19 patient who received care at London’s King’s College Hospital last month.
Photo:
kirsty wigglesworth / Agence France-Presse / Getty Images
“It’s a political and social issue about what’s acceptable,” he said.
The British government expects Covid-19 to be treated in the long run as a flu. In the last five years, between 4,000 and 22,000 people have died each year from the flu in England. In the last year, Covid-19 has killed 130,000 people in the UK
In the United States, Covid-19 has caused more than 500,000 lives. The flu is estimated to have killed between 22,000 and 61,000 people in the U.S. over the past five seasons, depending on the severity of the outbreak.
The entire adult population of England is expected to be offered a Covid-19 shot in late July. Currently, the government in England plans to ease almost all restrictions on June 21 in four graduated stages. But even with a good vaccination, the virus will still be present. Children will not be vaccinated, which will allow the virus to circulate freely among about one-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 variants of Covid-19 spread around the world, scientists are competing to understand why these new versions of the virus are spreading more rapidly and what it can mean for vaccination efforts. New research says the key may be the ear protein, which gives the coronavirus its unmistakable shape. Illustration: Nick Collingwood / WSJ
Modellers warn that it could translate into a jump in cases where restrictions are reduced. With a vaccine that is 85% effective and three-quarters of British adults inoculated, about half the population would be vulnerable to the virus, according to the model of Imperial College London, because children will not have been vaccinated.
A relaxation of restrictions during the summer would lead to an increase in infections in the fall. Even if the restrictions are not eased completely by August, Imperial College estimates that by June next year it could result in 56,000 deaths. The modeling of the University of Warwick that also informed UK government policy reached similar conclusions.
Marc Baguelin, an epidemiologist at Imperial College, says the model is a basic case and could underestimate both vaccine uptake and its effectiveness in slowing the transmission of the disease. Other reasons for optimism are improved treatments for people hospitalized with severe Covid-19, which especially reduce the risk of death for younger patients.
On the other hand, the virus could mutate to make vaccines much less effective. Some vaccines have already shown reduced effectiveness against variants identified in South Africa and Brazil, for example. “This makes the prospect of a third wave much bigger,” said Christopher Murray, director of the Institute for Health Metrics and Assessment at the University of Washington.
The long-term effects of Covid-19 infection in younger people are still being understood. If they are harmful, governments can be more cautious in allowing young people to resume life without getting vaccinated or socially distancing themselves.
Part of the problem is reflected in simple math. If 90% of the population gets a vaccine that is 90% effective, that leaves 19% unprotected, said David Sarphie, executive director of Bio Nano Consulting, which worked with Imperial College to develop Covid modeling tools. -19 for governments and companies. “19% of the UK population is 12.9 million,” he said.
A Covid-19 vaccination center in London this month.
Photo:
rain andy / Shutterstock
Successive waves of hospitalization and death in Western countries last year show that the disease can cause significant illness even when a relatively small number of people are exposed, said Martin Hibberd, a professor of emerging infectious diseases in London School of Hygiene and Tropical Medicine.
“Even with vaccines, there are still a considerable number of people who will still be vulnerable,” he said.
Disease experts say the possibility of substantial levels of serious and deadly disease, even in a population with widespread vaccine coverage, highlights the need for effective systems to test the virus and isolate those infected and their contacts. . Governments need to work hard to improve vaccine coverage and overcome misinformation and hesitation, they say.
In the UK, advisers to the British government say it may be necessary to reintroduce the use of masks or work from home in the winter to curb outbreaks. The government is reviewing whether the British will have to prove they are vaccinated or have no virus to resume activities such as going to the pub or the office.
Underlining the potentially rocky path to normalcy, the UK Treasury is likely to extend emergency financial support to the economy when the government budget is presented next week.
In general, the coronavirus “will be something we will 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 amplifications
With a vaccine that is 85% effective and three-quarters of British adults inoculated, about half of the British population would be vulnerable to the virus, according to the modeling. An earlier version of this article incorrectly stated that half of the adult population would be vulnerable. (Corrected on February 23)
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