‘The way it’s playing out is unexpected’: UK faces up to changing waves of Covid

Beer gardens are filled with people. The third wave of Covid infections will cause a lot of people in the UK to be in their bedrooms in July.

This will be an unpleasant experience for most people. With a fourth wave expected in the autumn, and experts saying that Covid may never settle into a seasonal cycle, some are questioning if this steady grind of illness is sustainable.

Covid became less deadly than seasonal flu for all age groups when a threshold was crossed in the spring. This was positive. The impact of an illness on society depends on a number of factors.

We might be heading towards a more regular pattern of infections with Covid in which we would endure a few tough months during the winter and forget about it for the rest of the year, according to many people. The reverse seems to be happening.

Dr Stephen Kissler, an Epidemiologist at Harvard, said that the way the Pandemic has played out is surprising.

In April 2020 Kissler and colleagues published a paper that predicted seasonal resurgences of Covid. For many in the scientific community, this was a coin-drop moment that provided a glimpse of what lay beyond the first few months of catastrophe and crisis.

Kissler said that they had expected strong seasonal wintertime patterns. Respiratory viruses have an advantage in the winter when people are indoors and our immune systems are not as strong. Once a winter wave has passed, people are able to suppress infections for a long period of time.

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Kissler has a different view two years later. He said that we are in a new landscape. The fact that we are having such a rapid succession of variant is the most surprising thing.

He thought it would reach a steady state by now. The opposite appears to be the case.

Others have been surprised by the pattern. Prof Peter Openshaw, an immunologist at Imperial College London, said that it looks like the waves are getting closer together. One is piling in on top of the other.

In the first year of the Pandemic, new waves were driven by the emergence of more transmissible variant, such as Alpha and Delta. The ability to transmit the disease to people who have been vaccine-vaccinated is one of the reasons why the latest variant, dubbed Centaurus, is being driven.

The Australian Health Protection Principal Committee advised this week that infections of the BA.4/BA.5 variant could occur as soon as 28 days after a previous Covid-19 infection.

The rate of replacement seems to have accelerated. There is a change in the way evolution is being driven.

The death toll from each Covid wave is not as high as it used to be. School attendance in England fell to the lowest level since January, with almost one in five secondary pupils absent and 8% of teachers off work.

Hospitals, already trying to process massive surgery delays, are coming under immense strain due to staff absences.

A paramedic described the ambulance service as being on the fringe of collapse in a recent report. The number of people affected by long Covid are growing.

According to Prof Tim Cook, a consultant in anaesthesia and intensive care medicine, Covid still has a significant impact on healthcare.

Infections are an ongoing burden for hospitals and staff absences are putting pressure on the system. Cook said it was a fairly fragile eco- system. Primary healthcare is difficult to access, a lot of staff exhaustion, and it remains a system under a lot of stress. The swine flu is not over.

There isn't a single way to stop the tide of infections.

The vaccine has been a huge success, but it has limitations in managing this phase. They do not provide protection against infections. Protection against mild illness fades very fast. When it comes to boosting the population, this creates a zone of diminishing returns.

Adam Finn is a professor of paediatrics at the University of Bristol and a member of the UK's Joint Committee on Vaccination and Immunisation.

There is a tool that can stop old people from dying. We have given up on the idea of mass vaccinations to control infections. It's not possible to vaccinate everyone every three months.

He said that special cases could be made for healthcare workers who were not up to date on their vaccinations. He said that giving them all a vaccine in November would be helpful.

Next- generation vaccines could improve this situation. Major programmes are under way to develop variant-proof vaccines or even pan-coronaviruses that would work against other endemic coronaviruses, and some believe that these vaccines could produce more enduring immunity.

Efforts are being made to develop a vaccine similar to the flu vaccine given to primary school children that would be more likely to protect against infections and illness.

Prof Danny Altmann is an immunology professor at Imperial College London. He said that in early 2020 they had a unified purpose on vaccines. We stopped working and lost interest. It is not finished, it is unfinished. We need to up our game now that we are in a stage in the arms race.

Lower-tech approaches to pandemic management are well known. New Zealand announced this week that it would bring back free masks and Covid tests, as other countries continued to have stricter guidance on mask-wearing and self-isolating.

There isn't much enthusiasm for more active management in the UK. We will reach some sort of equilibrium if we allow nature to follow its course. It is possible that it means coexisting at a lower level of health.