The UK is flying almost blind when it comes to Covid this autumn, experts have said, amid a rise in cases.
While the UK Health Security Agency (UKHSA) continues to track certain Covid metrics, including the number of hospitalizations, many community surveillance studies of infection levels have been completed.
Now experts have said the situation has left the country in the dark about how Covid may unfold in the months to come.
Christina Pagel, professor of operations research at University College London, said a new wave of Covid appeared to be underway – possibly driven by waning immunity, new Omicron variants and factors such as the bad weather that keeps people indoors.
With fall approaching and people returning to school and work, Covid pressures could increase, Pagel added.
“We could see the wave continue to grow, and grow faster, in September,” she said.
Along with public health measures, including the reintroduction of high-quality masks in healthcare settings, Pagel said she would support the return of the National Infections Survey released by the Office for National Statistics for the fall. and winter, as well as its extension to cover influenza and RSV.
Failing that, she said, sewage monitoring should be reinstated across the UK as a cheaper alternative used in many countries to track the prevalence and variants of Covid. Such programs have recently been scrapped in England and Wales.
“What worries me most is if we get a repeat of the last NHS winter crisis this winter, with Covid, flu and RSV all hitting around the same time,” Pagel said. “We are definitely flying almost blind.”
Professor Rowland Kao, an epidemiologist at the University of Edinburgh, also pointed to the decline in surveillance.
“With seasonal flu, of course we have some predictability with the many years of data. However, with Covid, now that we don’t have these multiple streams of data to rely on, it’s harder to tell what’s going on [in the general population],” he said.
Kao added that the patterns of variant emergence for Covid were largely unknown and that Covid did not simply follow seasonal patterns.
Experts have also raised concerns about the UK’s vaccination program heading into autumn.
Professor Danny Altmann, an immunologist at Imperial College London, said that while Covid was on the rise it had started quite low and the ‘softness’ of Covid was now largely because most of the people were still about a year away from having had three doses of the vaccine.
“Immune evasion mutations continue to emerge and cross-protection looks increasingly precarious. During this time, immunity beyond a year declines noticeably,” Altmann said, adding that it was important to plan another round of boosters and figure out what specific vaccine that should involve.
Professor Adam Kucharski, from the London School of Hygiene & Tropical Medicine, said exposure to Covid will also affect the level of immunity in the population. But he agreed there were uncertainties about how Covid might unfold, including whether there will be multiple waves of Covid a year.
“I think we don’t really have enough data points to say with confidence what normal looks like for Covid, other than the fact that normal is probably going to be a much higher burden of infection and disease superimposed on all the other things that are already causing us problems every year,” he said.
However, Kucharski noted that the UK is no longer in the pandemic phase where rapid action is taken – a time when very detailed monitoring was crucial – adding that monitoring is now more about understanding the effectiveness of vaccines , diminished immunity and pressures that lead to waves of infection.
“If we go into winter, and it’s not a [unusual] variant and it’s not an unusually large wave, so probably some of the monitoring that we have will give us the kind of guidance that we need for a lot of this type 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 going forward,” Kucharski said.
Another vaccination campaign, with eligibility based on health status or age, is due to launch later this year, according to the UKHSA. The agency says it understands the conversations about ramping up testing are ongoing.
Professor Steven Riley, chief executive of data, analytics and surveillance at 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 genomic capabilities, which report on infection rates, hospitalizations and risks posed by new variants.”