Chances of further easing restrictions explored by experts amid variant spike
ON June 4, the First Minister is due to announce the results of Wales’ next three-week review of Covid restrictions.
A few weeks ago there was much hope that Wales would be able to move to alert level one on this date – opening the door for further restrictions being lifted. However, the rise of the Indian variant has thrown this up in the air.
It is too early to tell if the new variant will lead to a halting, and perhaps a reversal of lockdown rules, however there are some really important things to consider.
We have spoken to experts in virology and immunology to look at the chances of being able to continue lifting restrictions in Wales as well as the dilemmas Mark Drakeford will face.
THE VACCINES WORK, BUT NOT STRAIGHT AWAY
Professor of operational research Christina Pagel at University College London (UCL) explained some of the challenges the Indian variant poses on Twitter. She explained that though the vaccine is effective against the variant, it is far more effective after the second dose.
“The study estimates that both vaccines are 33% at preventing symptomatic B.1.617.2 disease [Indian variant] after one dose (vs 51% against B117 “Kent”) and 81% effective after 2 doses (vs 87% for B117),” she wrote.
“Essentially, yes, two doses work almost as well against B.1.617.2 as they do against B.1.1.7. And in a country that had three weeks between doses, this would be less of an issue. But we are not that country.
“We are doing 10-12 weeks between doses – now being reduced to eight weeks for over 50s. In the context of a rapidly growing variant against which vax is only 33% after one dose, eight weeks is a long time. We currently have 43% of adults who have received two doses of vaccine. Only 33% of those are two weeks out from their second dose. Adding in kids, and it’s only 30% of population who are fully vaccinated.”
According to Professor Pagel (who was mainly writing with an English focus but Wales and England are so interlinked much of this is applicable), the decline in the Kent variant is masking the spike of the Indian.
She wrote: “People have been saying we’ve not seeing big increases in overall numbers of cases. But that’s cos (sic) we’ve had two epidemics – one declining (Kent) and one growing (Indian). While Kent remained dominant, it masked the growth of the Indian variant and kept case numbers down.”
THE DATA WE HAVE HASN’T YET RESPONDED TO THE LATEST LIFTING OF RESTRICTIONS
IT IS HARD TO JUDGE THE STATE OF THE PANDEMIC BECAUSE CASES ARE STILL FALLING IN MANY PLACES
Wales has just made two steps in lifting lockdown which are likely to have
some impact on the Covid figures – increasing household bubbles and reopening indoor hospitality.
Because it takes several weeks for a change in the reopening times to be seen in the daily stats, we don’t know what impact they have had yet.
Professor Pagel wrote: “All of the B.1.617.2 [Indian variant] growth in the data so far is under step 2 of the roadmap – i.e. before May 17. The additional impact of Monday’s opening will become clear over next few weeks. SAGE obviously worried in their docs (documents) from May 13.”
Again this is referring to England – but it applies to Wales. Professor Pagel thinks there needs to be some urgent action taken to combat this rise.
She said: “Right now, we should reintroduce masks in schools, accelerate vax and make vax more accessible to communities, support people to isolate and support businesses andschools to improve ventilation. If B.1.617.2 does not start looking less scary, we must wait until we have fully vaxxed more people. If cases keep going up next week – consistent with continued rapid growth of B.1.617.2 – we should consider rolling back step 3 of roadmap.”
This fear is echoed by professor of molecular medicine, University of Kent, Martin Michaelis.
He said: “There are still enough unvaccinated people for an outbreak that will put the NHS under pressure and result in tens of thousands of deaths. We should also not forget that this is not only about the direct Covid-19 deaths but also about collateral damage. The NHS is suffering from a huge backlog of postponed treatments and procedures, which will cost many additional lives. If the NHS comes under pressure again, people will not only die from Covid19. There will be additional deaths from other causes that could have been avoided, if the system had not been busy dealing with Covid-19.”
IT ISN’T JUST ABOUT COVID DEATHS
Though the most at-risk people have had both vaccinations, there are still risks for younger people.
Dr Julian Tang, honorary associate professor and clinical virologist at the University of Leicester said there were also risks of long Covid that needed to be considered.
He said: “My concern is less about severe disease, hospitalisations and death in the younger population, with the older population now vaccinated – but there may be a significant rise in long Covid in those not yet vaccinated that get infected – even mildly or asymptomatically with Covid-19.
“We need to monitor the case numbers and balance the risk of spread and long Covid complications vs. economical impacts of delaying the removal of restrictions – not easy. But the economical impact/ healthcare burden of long Covid cases could be significant if too many people get infected – of which 10-20% may develop.”
WILL THE LIFTING OF THE RULES ON JUNE 7 GO AHEAD OR WILL SOME RESTRICTIONS BE REIMPOSED?
The study estimates that both vaccines are 33% at preventing symptomatic B.1.617.2 disease [Indian variant] after one dose (vs 51% against B117 “Kent”) and 81% effective after 2 doses (vs 87% for B117) - Professor of operational research Christina Pagel at University College London (UCL)
“I think this is a gamble,” said Professor Martin Michaelis. “Nobody can really predict what will be happening, because there is chance involved. It is like predicting a football match.
“Hence, I would play it safe and only open up when the transmission numbers are very low, about one per 100,000 residents per week. This is a number at which we should sustainably be able to avoid sweeping restrictions and general lockdowns by identifying transmission chains and isolating infected individuals, even when novel variants emerge or are imported.”