Category: Medical

Tens of thousands of deaths are now inevitable in a second wave of coronavirus infections sweeping across England because of the failure to contain the virus, a government scientific adviser has warned.

John Edmunds, a professor at the London School of Hygiene & Tropical Medicine, told MPs on Wednesday that without further measures England’s tiered Covid-19 strategy would lead to high numbers of new infections every day, putting the NHS under strain and driving up the death toll.

“If you look at where we are, there is no way we come out of this wave now without counting our deaths in the tens of thousands,” Edmunds, an epidemiologist, told the joint hearing of the Commons science and technology committee, and the health and social care committee.

He added: “We are already at the point, or getting close to the point, where the health service will be under strain in the next few weeks. And even if we stop things now, cases and hospitalisations will continue to go up for the next 10 days, two weeks, because they are already baked into the system.”

Edmunds, who sits on the government’s Sage (advisory) committee, warned that if nothing more were done the virus would peak in north-west England in the coming four to six weeks; and the remainder of the country would face “very severe numbers of cases” around Christmas and New Year.

Since the prime minister, Boris Johnson, acknowledged the second wave of coronavirus infections, on 18 September, the government’s Covid-19 dashboard has recorded 2,191 deaths in the UK, with 1,903 in England.

The hearing, the second in an inquiry focusing on lessons to be learned from the pandemic, highlighted the failure of the UK’s test and trace system to take control of the epidemic by containing outbreaks early on.

Max Roser, a doctor and director of the Oxford Martin programme on global development, told the committee that several countries in Asia had recorded fewer than 10 deaths per million population, compared with the UK’s 644 deaths per million.

One aspect that stood out as important, Roser said, was the ability to test people and to scale up testing when outbreaks demanded it. “It’s really only when people are aware they’re sick that they can self isolate,” he told MPs.

David Heymann, professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine, said countries that were now opening up successfully were able to do so because they had started contact tracing early and could stem outbreaks. “You can’t do contact tracing from a central point, it must be done with full involvement of the communities,” he said.

Public Health England abandoned its routine test and trace strategy in mid-March, before the spring lockdown, because it was unable to keep up with the outbreak.

In a fractious exchange, Jeremy Hunt, chair of the Commons health and social care committee, asked Edmunds about the government’s decision in March to shift from containing the virus to mitigating the impact of the outbreak. He asked why Sage scientists had not modelled and then proposed test and trace as a strategy. Edmunds said it had been modelled, but that, by March, England had too many cases for test and trace to keep up.

Asked about the government’s three-tier local Covid alert levels, Edmunds said it was not a strategy he would follow. The restrictions in tier 3 might at best bring the R value (the average number of infections caused by someone infected with Sars-CoV-2) close to 1, he said, but that meant regions that were placed in the top tier when their cases soared would continue to have high levels of new infections, increased pressure on hospitals, and high death rates.

“What that means is we all end up at a high level of incidence where hospitals are really overstretched and we have large numbers of deaths. That for me is the logical conclusion of the strategy we are following – and I would not follow that strategy,” he said.

Edmunds argued that if regions imposed a strict two-week circuit breaker first, they could potentially halve the rate of new infections and hold cases at a lower level where the NHS was under less strain. Alternatively, he said, the entire country could move to tier 3 to prevent places with low levels of infection reaching the situation in Liverpool now and elsewhere in the north of England.

In a press briefing on Tuesday, Johnson referred to graphs showing infection rates falling in those aged 10 to 29 in many regions, but continuing to rise for older people. Jonathan Van-Tam, a professor and England’s deputy chief medical officer, said the apparent decline could be to the rate at which people were coming forward for testing.