COVID-19: WHAT CAN BE EASED ON 21 JUNE?

Recent cases in Oxford

It’s just a few days to go until the Government needs to announce whether the remaining restrictions in England can be eased from 21 June.

As discussed in the previous blogpost, it’s fundamentally a decision between:

• Easing all restrictions, but risking a further lockdown
• Delay some or all easings until more people are vaccinated

WHAT'S SUGGESTING DELAY?

The problem is that the ‘Delta’ variant is now the dominant variant in new cases, which are growing dramatically.  Today the official estimate is some 91% of all cases.

Here in Oxford, the estimate of new cases is rising sharply, with some other areas of the country in a far worse state.  According to the Kings College ZOE study, the 2-week average shows a rapid rise in recent days:

The vaccine roll-out has reduced hospitalisations, but these are also rising across the country.  The issue is that the existing vaccines are not as effective against the Delta variant as against the earlier Alpha (Kent) variant.  According to Public Health England’s study published in late May:

• Both AstraZeneca and Pfizer vaccines are only 33% effective against symptomatic disease for Delta three weeks after one dose, compared to 50% for Alpha

• Two weeks after two doses:

• AstraZeneca down from 66% for Alpha to 60% for Delta
• Pfizer down from 93% to 88%

These statistics were based on observations in April and early May.  The Government will now have access to more recent data, which may improve the picture.  The good news is that early indications are that the vaccines prevent serious disease, and therefore reduce the level of hospitalisations compared to previous waves.  But as hospitalisation and deaths lag new cases by a couple of weeks, it is still rather too early to get a reliable view of potential levels.

But assuming these statistics are broadly correct:

• Even fully vaccinated people, mostly with AstraZeneca, will have far lower protection than previously expected.  1 in 3 double-dosed could still catch the disease
  
• Younger adults 25-29 are only just starting to be vaccinated.  By 21 June they will have little protection. Very few younger adults and teenagers will have any protection.

That creates three problems:

• Younger people can easily transmit the virus to more vulnerable people
• The more people who catch the disease, the more are likely to suffer LongCOVID.  As Delta is more transmissible, it is potentially more likely that the virus will spread around the body and cause LongCOVID problems in other organs such as heart and brain. This would not only affect tens of thousands of individuals, but also then put enormous strain on NHS primary care and specialist services
• High case rates provide greater opportunity for the virus to mutate into more troublesome variants
  

A third wave has clearly started.  Easing restrictions further will only tend to accelerate it.  Until many more people are vaccinated, that will likely mean:

• More hospitalisations, and more deaths
• Significant increases in people suffering from LongCOVID
• Higher risk of troublesome variants
  

Against this needs to be balanced the economy, mental health and other drawbacks of continuing lockdown.

But risking going back to lockdown, especially if tighter than currently, is not desirable.  Indeed people are increasingly saying it will be better to delay some or all easings until after 21 June to minimise that risk.  That includes some businesses, as it can cost a business a lot to have to close and reopen again.

WHAT CAN BE EASED ON 21 JUNE? 

Much of the additional easings would be for gatherings, often involving younger people. Nightclubs for example.  Much of these would probably be too risky given that few participants will have been vaccinated, and easings should be delayed.

Conversely, many venues are saying they can keep people socially distanced at up to say 50% of capacity.  That would allow events such as many wedding receptions to be larger than the current limit of 30.

Other remaining restrictions will need individual consideration, in conjunction with practicality of testing people on or before entrance.  It is probably appropriate to place remaining easings into three phases:

• On or shortly after 21 June
• Two or three weeks after at least say 80% of each age group has been vaccinated once
• Two or three weeks after at least say 80% of each age group has been vaccinated twice

The Government have been right to wait to see the latest data, which could be more positive than set out above.  Hopefully that means some easings on 21 June, but it looks too risky to ease all restrictions.  We’ll find out the decisions by next Monday 14th.