LONDON – By the middle of this year, all adults in Britain will receive a Covid-19 vaccine in what is about to be the fastest inoculation launch in a major western country. But the disease modelers who advised the UK government recently made a worrying projection: 56,000 more Covid-19 deaths in the summer of next year, even if the country comes out of the blockade and the vaccines work.
The study points to the uncomfortable prospect that even with an effective vaccine, the virus will continue to harm society and that some restrictions may have to be reintroduced periodically to control the spread of the 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 also that blockages cannot last forever after hospitalizations are reduced to manageable levels.
“We cannot escape the fact that lifting the blockade will result in more cases, more hospitalizations and, unfortunately, more deaths,” British Prime Minister Boris Johnson told Parliament on Monday as he plotted a slow and conditional route to leave. of the lock. “So there is no credible route to a Britain with zero Covid or even a world with zero Covid.”
Future Load
The modeling of disease by scientists advising the UK government suggests that Covid-19 is likely to still cause illness and death, even after widespread vaccination, once public health measures are relaxed.
Cumulative deaths (February 12, 2021 – June 30, 2022)
Cumulative hospital admissions (February 12, 2021 – June 30, 2022)
* All adults over 50, health professionals and other priority groups receive at least one dose of the vaccine by April 21
† All over 70 and clinically vulnerable receive two doses by May 21
Cumulative deaths (February 12, 2021 – June 30, 2022)
Cumulative hospital admissions (February 12, 2021 – June 30, 2022)
* All adults over 50, health professionals and other priority groups receive at least one dose of the vaccine by April 21
† All over 70 and clinically vulnerable receive two doses by May 21
Cumulative deaths (February 12, 2021 – June 30, 2022)
Cumulative hospital admissions (February 12, 2021 – June 30, 2022)
* All adults over 50, health professionals and other priority groups receive at least one dose of the vaccine by April 21
† All over 70 and clinically vulnerable receive two doses by May 21
Cumulative deaths
(February 12, 2021 – June 30, 2022)
Cumulative hospital admissions
(February 12, 2021 – June 30, 2022)
* All adults over 50, health professionals and other priority groups receive at least one dose of the vaccine by April 21
† All over 70 and clinically vulnerable receive two doses by May 21
Care does not detract from the value of a successful vaccine implementation. New data released on Monday showed that Britain’s vaccination program – which gave at least one injection to more than a third of the country’s 53 million adults – significantly reduced infections and further reduced serious illnesses.
But while the program is paving 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, but it will not eliminate that,” said Chris Whitty, England’s medical director, on Monday. He added that Covid-19 “is likely to be a problem in the coming winters”.
Epidemiologists have long warned that Covid-19 is likely to circulate for years, or even decades, leaving society to deal with other endemic diseases like flu, measles and HIV.
No vaccine is 100% effective and no population will be fully 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 has chaired the World Health Organization’s Strategic Advisory Group on Immunization Specialists.
A Covid-19 patient receiving care at King’s College Hospital in London last month.
Photograph:
kirsty wigglesworth / Agence France-Presse / Getty Images
“It is a political and social issue about what is acceptable,” he said.
The British government expects Covid-19 to be treated like flu in the long run. In the past five years, between 4,000 and 22,000 people have died of influenza every year in England. Last year, Covid-19 killed 130,000 people in the UK
In the USA, Covid-19 has claimed more than 500,000 lives. Influenza is estimated to have killed between 22,000 and 61,000 people in the United States over the past five seasons, depending on the severity of the outbreak.
The entire adult population of England is expected to receive an injection of Covid-19 by the end of July. The government of England is planning to ease almost all restrictions by June 21 in four gradual steps. But even with good acceptance of the vaccine, the virus will still be present. Children will not be immunized, allowing the virus to circulate freely among about a fifth of the population. Not everyone will accept the vaccine.
To make matters worse, infection rates start on a very high basis in the UK
As Covid-19’s highly transmissible variants spread across the world, scientists are racing to understand why these new versions of the virus are spreading more quickly and what this could mean for vaccine efforts. New research says the key may be the peak protein, which gives coronavirus its unmistakable shape. Illustration: Nick Collingwood / WSJ
Modelers warn that this could translate into a jump in cases where restrictions are eased. With a vaccine that is 85% effective and three quarters of British adults inoculated, about half the population would be vulnerable to the virus, suggests a model from Imperial College London, because the children would not have been vaccinated.
A relaxation of restrictions during the summer would cause infections to increase in the fall. Even though the restrictions are not fully eased until August, Imperial College estimates that this could result in 56,000 deaths by June next year. The modeling of the University of Warwick that also informed the UK government policy came to similar conclusions.
Marc Baguelin, an epidemiologist at Imperial College, says the model is a basic case and may underestimate both the absorption of the vaccine and its effectiveness in reducing disease transmission. Other reasons for optimism include improving treatments for those hospitalized with severe Covid-19, which is reducing the risk of death for younger patients, especially.
On the other hand, the virus can mutate to make vaccines much less effective. Some vaccines have already shown reduced effectiveness against variants identified in South Africa and Brazil, for example. “It makes the prospect of a third wave much bigger,” said Christopher Murray, director of the Institute of Metrics and Health 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 about allowing younger people to resume life without vaccination or social detachment.
Part of the problem is reflected in simple mathematics. If 90% of the population gets a vaccine that is 90% effective, that leaves 19% unprotected, said David Sarphie, chief executive of Bio Nano Consulting, who worked with Imperial College to develop Covid-19 modeling tools for governments and businesses . “Nineteen percent of the UK’s population is 12.9 million,” he said.
A Covid-19 vaccination center in London this month.
Photograph:
andy rain / Shutterstock
Successive waves of hospitalization and death in Western countries over the past year show that the disease can cause significant illness, even when a relatively small number of people are exposed, said Martin Hibberd, professor of emerging infectious diseases at London School of Hygiene and Tropical Medicine .
“Even with vaccines, there are still a considerable number of people who are still vulnerable,” he said.
Disease experts say the prospect of substantial levels of serious illness and death, even in a population with broad vaccine coverage, highlights the need for effective systems to test the virus and isolate infected people and their contacts. Governments need to work hard to improve vaccination coverage and overcome misinformation and hesitation, they say.
In the UK, British government aides say that wearing a mask or working at home may have to be reintroduced in the winter to contain the outbreaks. The government is analyzing whether the British will have to prove that they are vaccinated or virus-free to resume activities like going to the bar or the office.
Highlighting the potentially rocky path to normality, the UK Treasury is likely to extend emergency financial support to the economy when the government budget is presented next week.
Overall, 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 UK’s population would be vulnerable to the virus, the modeling suggests. An earlier version of this article incorrectly said that half the adult population would be vulnerable. (Corrected on February 23)
Copyright © 2020 Dow Jones & Company, Inc. All rights reserved. 87990cbe856818d5eddac44c7b1cdeb8