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http://www.theguardian.com/world/2022/may/31/as-uk-covid-cases-fall-to-lowest-level-for-a-year-what-could-the-future-look-like
Coronavirus
Now that normal life has resumed for most people, will the disease
continue to remain in the background?
Crowds of rail commuters
The UK has eased back towards normality, but testing habits have changed
and cases could rise as the weather changes. Photograph: Andy Rain/EPA
Ian Sample Science editor
@iansample
Tue 31 May 2022 01.00 EDT
After enduring record-breaking levels of Covid in the past six months,
Britain has seen cases fall to their lowest for a year. But as the
country eases back into a life more normal, will the disease remain in
the background – or is another resurgence on its way?
Science editor Ian Sample explains how the virus is changing – and why
one expert thinks infection rates “are not going to get down to very low numbers again in our lifetimes”.
Why have cases fallen so low?
Britain has weathered two major waves of coronavirus in the past six
months, driven by versions of the highly transmissible Omicron variant.
At the winter peak, official figures recorded hundreds of thousands of confirmed cases a day, although the true number of infections was
substantially higher. The surge in infections bolstered immunity to
Covid, particularly among the vaccinated, which in turn has helped to
push cases down.
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But there are other forces at work behind the dwindling numbers.
As with much older human coronaviruses that cause the common cold, cases
of Covid rise and fall with the seasons, with more transmission in the
winter and less in the summer months. We are now into a period where
cases should naturally subside. Another important factor at play is the dramatic shift in testing habits.
Since April, most people have had to pay for Covid tests, meaning far
fewer infections are being confirmed and logged as cases. Whereas
lateral flow and PCR tests in the community once detected perhaps half
of all Covid infections, they are now picking up less than one in 10,
according to Paul Hunter, professor of medicine at the University of
East Anglia. “The daily dashboard isn’t picking up anywhere near as many infections as it was,” he said.
According to the government’s Covid dashboard, daily cases in England
have fallen by 98% since the start of the year. They now sit below 5,000
cases a day for the first time since last June.
In contrast, the Office for National Statistics, which estimates
infection levels from swabs taken in random homes around the country,
has recorded only a 73% fall in prevalence in England, from more than 3
million people infected in the week ending 31 December to nearly 875,000
in the week ending 21 May.
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After the successive waves of infection and the UK’s mass vaccination programme, the proportion of people with antibodies against Covid is
extremely high. In England, about 99% of over-25s have Covid antibodies,
but levels are high even among pre-teens, with 89% or more of those aged
8 years and over carrying antibodies against the virus.
Will cases drop further over the summer?
They may fall a little more and remain low through the summer as people
spend more time outdoors, but another rise before the autumn is not out
of the question.
With the full relaxation of Covid rules, the steady filling of offices,
and people gradually reverting to pre-pandemic behaviour, there is
plenty of scope for the virus to spread. And as immunity wanes from vaccinations and past infections, protection against infection will be
the first line of defence to fail.
Because protection against severe illness wanes more slowly, any rise in
cases should not translate into high rates of hospitalisations and
deaths unless another variant intervenes.
… but Covid maybe spreading differently
Over the past few weeks, scientists have noticed a shift in the Scottish
data, with a higher proportion of lateral flow tests coming up positive
in more affluent than deprived areas.
“It’s not clear if this is a long-term effect yet,” said Prof Rowland Kao, who studies infectious disease dynamics at the University of
Edinburgh, “but if it holds it’s very unusual.”
The way Covid is circulating appears to have changed.
In summer 2020, daily cases fell to the low hundreds, but they may not
get as low this summer, Hunter said. “It won’t continue falling for
ever. Covid is undoubtedly becoming endemic. We are not going to get
down to very low numbers again in our lifetimes.”
Despite huge uncertainties about the trajectory of the pandemic, the
Joint Committee on Vaccination and Immunisation has proposed an autumn
booster programme for people aged 65 and over, the clinically
vulnerable, frontline health and social care workers and the staff and residents of care homes.
… And it is still evolving
Britain’s spring surge of Covid was driven by an Omicron variant called
BA.2. Its dominance in the UK is now being challenged by two recent descendants, namely BA.4 and BA.5, which are driving a new wave of Covid
in South Africa.
The UK Health Security Agency declared BA.4 and BA.5 “variants of
concern” last week, as new data revealed they had a growth advantage
over BA.2.
Another descendant causing concern is BA.2.12.1, which spreads faster
still, and last week became the dominant variant in the US. So far,
there is no evidence that any of them cause more severe disease, but as
the original Omicron demonstrated in December, the danger comes from
reaching more people. “Any increased spread without a decrease in
severity could be a bad thing,” Kao said, adding that with plenty of
virus in circulation around the world, we should expect more variants to
come.
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