Published 5 January 2021
No one wanted to start 2021 with a national lockdown, but it was necessary to reduce the pressure mounting on the NHS.
Rapidly increasing cases of Covid-19 - not as far off the levels from March, despite a huge change in social distancing - can be seen in the chart below. This chart shows estimated actual cases for England over the whole pandemic - not just those picked up through testing.
Aside from increased case numbers driving increased mortality rates (despite some improvements through treatments), there is an immediate and building pressure on the NHS - the chart below shows admissions over the full pandemic.
While admissions are, not yet, as high as they were in March and April, they pose a greater risk to the NHS. During the first wave of Covid-19, demand for normal hospital activity (including cancer diagnosis and treatment) plummeted at the same time as people were discharged relatively quickly - no one really knows how extensive the pressure on the NHS would be from an unknown disease. Since the Spring, pressure has grown on the NHS to manage the backlog of activity (I have shared projections of this previously). There are also greater constraints on how patients that test positive with Covid-19 are discharged into care homes and the community more generally.
In short, a similar number of hospital admissions means more occupied beds now than in the Spring from Covid-19, and that is before accounting for the normal activity. In most places, the workforce is exhausted and stretched.
It is not an understatement to say that all of the metrics are currently going in the wrong direction - see below (read more on how to interpret here). The increases are highest in London and the South East.
Unfortunately, the relaxation of the rules (and likely reduced compliance) around Christmas combined with a more spreadable variant of Covid-19 ("up to 70% more transmissible") led to the levels of concern (and NHS pressure) only previously seen in March and April (as shown in our modelling with The Telegraph here).
The vaccines have been touted as providing the exit route from the current lockdown, but it is still early days, and there are lots of questions: will they stop people spreading the virus (as well as not getting sick); will they work as well as estimated from the trials; will they continue to be effective as Covid-19 variants emerge; will it be possible to vaccinate enough people quickly enough; etc.
I find it particularly interesting to note that in China, they are not yet planning mass vaccination. A friend in China that works in the health sector told me:
"Honestly I wasn’t paying much attention to the vaccine, my friends who work at international airports or to be posted at overseas construction projects get shots, but I am not going to get one since I’ve been wearing masks and we have zero local cases in Xian. No hard feelings but we didn’t care for one since we basically don’t need it."
Another told me:
"They have got the virus pretty under control I think, there ability to track and trace and then quarantine anyone with it is second to none"
Relying on the vaccine as the sole way out of this pandemic and to end future lockdowns may be foolish. In this context, building testing capacity and improving contact tracing should remain a core focus for 2021. -------------- If you are keen to explore more of our Covid-19 tracking research, have a look here - https://www.edgehealth.co.uk/covidtracking --------------