UK almost ‘flying blind’ on Covid this autumn, experts say

The UK is nearly “flying blind” when it comes to Covid this autumn, experts have said, amid an increase in cases.

While the UK Health Security Agency (UKHSA) continues to track some metrics of Covid, including hospitalisation numbers, many of the community surveillance studies tracking infection levels have finished.

Now experts have said the situation is leaving the country in the dark about how Covid may play out in the months ahead.

Christina Pagel, a professor of operational research at University College London, said a new wave of Covid appeared to be under way – possibly driven by waning immunity, new variants of Omicron, and factors including poor weather keeping people inside.

With the autumn coming on and people returning to school and work, Covid pressures may increase, Pagel added.

“We might see the wave continue to grow, and grow faster, in September,” she said.

As well as public health measures including reintroducing high-quality masks within healthcare settings, Pagel said she would support bringing back the nationwide infection survey published by the Office for National Statistics for autumn and winter, as well as expanding it to cover flu and RSV.

Failing that, she said, wastewater monitoring should be reinstated across the UK as a cheaper alternative that is used in many countries to track Covid prevalence and variants. Such schemes have recently been cut in England and Wales.

“What worries me most is if we get a repeat of the last winter NHS crisis this winter again, with Covid, flu and RSV all hitting around the same time,” said Pagel. “We are definitely flying near blind.”

Prof Rowland Kao, an epidemiologist at the University of Edinburgh, also highlighted the decline in surveillance.

“With seasonal flu, we have of course a certain amount of predictability with the many years of data. However, with Covid, now that we don’t have those multiple data streams to rely on, it’s harder to say what is happening [in the general population],” he said.

Kao added that the variant emergence patterns for Covid were largely unknown and Covid was not simply following seasonal patterns.

Experts have also raised concerns about the UK’s vaccination programme as the autumn approaches.

Prof Danny Altmann, an immunologist at Imperial College London, said while Covid was on the rise, it had started from quite a low level and the “mildness” of Covid now was largely because most people were still within a year or so of having had three vaccine doses.

“The immune-evasion mutations continue to emerge and cross-protection is looking ever more precarious. Meanwhile, immunity beyond one year wanes appreciably,” Altmann said, adding it was important to plan for another round of boosters and consider which specific vaccine it should involve.

Prof Adam Kucharski, of the London School of Hygiene & Tropical Medicine, said exposure to Covid would also affect the level of population immunity. But he agreed there were uncertainties about how Covid may play out, including whether there will be multiple waves of Covid a year.

“I think we don’t really have enough data points to say confidently what normal looks like for Covid, other than the fact that normal is probably going to be significantly higher infection and disease burden layered on top of all the other things that are already causing us problems every year,” he said.

However Kucharski noted the UK is no longer in the phase of pandemic where rapid actions are being taken – a period when very detailed surveillance was crucial – adding surveillance now is more about understanding vaccine effectiveness, waning immunity, and pressures that drive waves of infection.

“If we go into winter, and it isn’t an [unusual] variant and it isn’t an unusually large wave, then probably some of the surveillance we have will give us the sort of indications we need for a lot of that kind of management,” he said.

“We’re still in that kind of period of uncertainty where we might want the ability to deploy something that can give us more insight in future,” said Kucharski.

Another vaccination campaign, with eligibility based on health conditions or age, is expected to be launched later this year, according to UKHSA. The agency says it understands conversations about scaling up testing are continuing.

Prof Steven Riley, the director general of data, analytics and surveillance at the UKHSA, said protecting the public from Covid-19 remained one of the agency’s top priorities.

“We continue to monitor the threat posed by Covid-19 through our range of surveillance systems and genomics capabilities, which report on infection rates, hospitalisations and the risks posed by new variants.”