Government ‘must determine whether testing can control a third wave’

The Government will need to decide whether it can manage further rises in Covid-19 infection with testing or full-scale controls, an expert has said, as scientists predict a third wave will hit the UK.

Dr Mike Tildesley, from the University of Warwick and a member of the Scientific Pandemic Influenza Group on Modelling (Spi-M) group, said “there may well be” a third wave of cases across the country but probably not as high as some have predicted.

He expects a rise in infections as more social mixing is permitted over the summer, with all legal limits on social contact due to lift in England on June 21, but scientists are divided on the scale of the expected wave.

The Government has published Spi-M documents dated the end of March showing an increase in hospital admissions and deaths is “highly likely” during the later stages of the UK’s road map out of lockdown.

Spi-M assessed three separate modelling documents, with one paper from the London School of Hygiene and Tropical Medicine suggesting that lifting restrictions completely in June could “lead to a larger surge of cases and deaths comparable to that seen during the first wave”.

The researchers cautioned their findings were “preliminary” and made “pessimistic assumptions” about the later stages of the road map.

But scientists at the University of Warwick also shared a similar conclusion that a “distinct third wave of infection” would arise due to the current rate of planned unlocking, with hospital admissions peaking between late July and mid-August.

Other modelling by Imperial College London also predicts a third wave.

In a round-up of the findings, Spi-M concluded that a resurgence in infections, hospital admissions and deaths will occur but point to a lot of uncertainty in the predictions.

“The scale, shape, and timing of any resurgence remain highly uncertain,” it said, adding that “in most scenarios modelled, any peak is smaller than the wave seen in January 2021”, though could reach a similar scale if there is little reduction in virus transmission by June.

It said: “Maintaining baseline measures to reduce transmission once restrictions are lifted is almost certain to save many lives and minimise the threat to hospital capacity.

“Even accounting for some seasonal variation in transmission, the peak could occur in either summer or late summer/autumn. It is possible that seasonality could delay or flatten the resurgence but is highly unlikely to prevent it altogether.”

Spi-M said the resurgence in both hospital admissions and deaths “is dominated by those that have received two doses of the vaccine, comprising around 60% and 70% of the wave respectively”.

It said these will be in the most at-risk age groups, “such that immunisation failures account for more serious illness than unvaccinated  individuals”.

While the current vaccines offer a high level of protection, they do not work perfectly for everyone.

However, AstraZeneca has said its results so far show the jab is 100% effective at preventing severe disease and admission to hospital – higher than that suggested by the modelling papers.

Spi-M also predicts deaths among the unvaccinated, with some experts having said previously they are the most at-risk group.

The team of experts also predicted that outbreaks are “will still happen in some communities” that have shunned vaccination.

Dr Tildesley told LBC radio: “I think we do have very high levels of vaccination now, we do need to remember this, we are protecting our vulnerable.

“But the vaccines are not 100% protective so when we switch from an R number less than 1 that we have at the moment, to a lot of mixing later on, we may get a resurgence.

“I don’t expect we will have a resurgence of the same scale that we saw in January.

“So then there needs to be some very serious questions asked. If we do see a rise in cases, if we do start to see hospital occupancy go up a little bit, are we going to put in controls or is it something that we’re just going to try to manage with local testing and so forth?

“I think that’s the question the Government are going to potentially have to answer as we get towards the summer.”

However, Dr Tildesley also said that he was “pleasantly surprised” about the levels of cases as schools reopened and said that if cases continued to stay low, there could be some arguments for lifting restrictions in the road map sooner.

TV doctor Dr Rosemary Leonard took to Twitter to condemn some of the modelling, saying: “Am fed up with lack of balance in the modelling predictions of #covid.

“All very negative – with suggestions vaccine not very effective. How about some realistic, positive predictions based on current excellent outcomes from our vaccine programme.”

Professor Graham Medley, from the London School of Hygiene & Tropical Medicine and chairman of Spi-M, told BBC Radio 4’s Today programme a third wave could result in more deaths.

He said all three independent models published by Sage “show that, as we open up, as the virus starts to transmit some more, and because the vaccine isn’t 100% safe, then it’s almost inevitable that we will see some increase in infections, and potentially hospitalisations and deaths”.

Asked why the third wave predictions are so pessimistic when vaccine uptake is high, Prof Medley said: “It really just depends upon the impact of vaccination, particularly on transmission, so whether or not people can get infected and pass the virus on.

“And we just don’t know that. The vaccine hasn’t been around in people in the real world… only in December it started… so we don’t know what effect it’s going to have in three, four months’ time and that’s the real unknown.

“So it’s a question of genuine uncertainty.

“The only thing we can be sure of is that we don’t know exactly what is going to happen but we do know that because the vaccine isn’t 100% effective, there will be some transmission, and there will be some breakthrough of immunity.”

Meanwhile, Professor Sir Mark Walport, former chief scientific adviser to the Government, said “very good progress” was being made on the road map.

“But we’re a long way from taking the brakes off completely,” he told BBC Breakfast.

“The vaccine rollout is going incredibly well… we’ve seen deaths fall fairly precipitously… all very good news, but we’ve only got to look across the Channel and see that France currently has over 39,000 new cases a day, so the virus is still very much around and if we take all the brakes off, then it’s quite clear that there is a very substantial risk of a further wave of infection.”