After two winters of Covid fear, one would be forgiven for feeling some trepidation at the shortening of the days. It wouldn’t be entirely out of place.
According to the Office for National Statistics (ONS), around one in 70 people in the community in England – an estimated 766,500 people – had Covid in the week ending September 14, up from 705,800 people or one in 75 the week before.
It is the first time since late July there has been an increase in England. There has also been a surge in Wales, although infection numbers in Northern Ireland and Scotland have both fallen slightly in the last week after the latter saw a spike the week before.
An increase in cases has also been noted in UK data collected by the Zoe Health Study, while the latest NHS figures show a 17% rise in the number of Covid patients hospitalized in England – from 3,434 in the week to March 12 September to 4,015 for the week ending September 19 – with larger percentage increases in some regions.
Should Covid take off again, the prospect is for a bumpy ride. “With cases already rising, it looks like we’re in for a bad October, and it’s likely to get worse than the last wave,” said Prof Tim Spector, a scientific co-founder of Zoe.
A wave of Covid this fall had been expected. Declining immunity to vaccination and previous infections, increased indoor mixing, a decrease in testing, children returning to school and students returning to university, and other behavioral changes can increase infection rates.
There are also new variants. While Omicron has been dominant in the UK since last winter, it has numerous ‘daughter’ forms. The BA.5 subvariant is the most common, but experts keep an eye on others including BA4.6, BF.7, BA.2.75.2, and BQ.1.1.
like dr Imperial College London’s Thomas Peacock points out that recent data suggest the latter two each account for less than 0.5% of the UK’s Covid genetic sequences – but they are growing fast. “It’s entirely possible for a fall/winter wave to be fueled by a mix of variants,” Peacock said.
Prof Tom Wenseleers, an evolutionary biologist at the Catholic University of Leuven in Belgium, said BA.2.75.2 and BQ1.1 have mutations in their spike protein that help them partially escape BA.5-induced immunity.
“Combined with the fact that Covid hospitalizations are already picking up again in the UK and that the full impact of these variants is still not being felt, I would say this is not such good news,” he said.
What isn’t known is the impact these variants might have on the severity of the condition, although Peacock noted that there’s currently no evidence they cause a worse condition. And Covid-related deaths remain low.
Wenseleers said: “Most scientists believe that our high level of immunity among the population will mean that the death rate from infections will continue to fall. But each new wave of infections will of course increase the toll of the pandemic.”
But deaths are not the only concern. Peacock said: “Even a small wave will add a massive burden to healthcare, especially when paired with other respiratory viruses making a comeback this winter,” such as the flu.
Experts agree vaccines are vital in fighting Covid. “I highly recommend anyone who is offered a booster shot to get one: it’s the best way to protect against serious illness and limit the impact of a new wave,” Wenseleers said.
dr Emma Hodcroft, molecular epidemiologist at the University of Bern and the University of Geneva, said studies suggest the new two-variant Covid booster shots available in the UK and other countries could increase protection against Covid, while Dr. David Strain, of the University of Exeter Medical School, said getting vaccinated could also reduce the chance of catching Covid for a long time.
But there are concerns about the inclusion. “We get a whole lot of vaccine fatigue — people are just fed up with being told to go and get their vaccine,” Strain said.
A new wave of Covid also has the potential to disrupt education, transport, supplies and other infrastructure, Hodcroft said, questioning whether further measures such as masking or working from home might be needed.
“In general, I think the most important thing right now is to carefully review our plans for the fall and make sure we have a plan,” she said.