After two winters of Covid angst, one would be forgiven for watching the shortening of days with a sense of dread. It wouldn’t be entirely out of place.
According to data from the Office for National Statistics (ONS), about one in 70 people in the community in England, roughly 766,500 people, had Covid in the week ending September 14, up from 705,800 people, or one in 75, the week before.
This is the first time since the end of July that an increase has been seen in England. There was also an increase in Wales, although infection levels have fallen slightly in Northern Ireland and Scotland in the most recent week, after the latter showed an increase the previous week.
An increase in cases has also been seen in UK data compiled by the Zoe Health Studywhile the latest NHS figures show a 17% rise in the number of Covid patients admitted to hospitals in England, from 3,434 in the week ending 12 September to 4,015 in the week ending 19 September , with larger percentage increases in some regions.
If Covid takes off again, the prospect is for a bumpy ride. “With cases on the rise, it looks like we’re in for a bad October and it’s likely to be worse than the last wave,” said Professor Tim Spector, scientific co-founder of Zoe.
A wave of covid was expected this fall. Decreased immunity from previous vaccinations and infections, increased indoor mixing, decreased testing, children returning to school and students to college, and other changes in behaviors may increase infection rates.
There are also new variants. While Omicron has dominated the UK since last winter, there are numerous sub-lineages. The BA.5 subvariant is the most common, but experts keep an eye out for others such as BA4.6, BF.7, BA.2.75.2, and BQ.1.1.
As Dr Thomas Peacock of Imperial College London points out, recent data suggests the latter two each account for less than 0.5% of UK Covid genetic sequences, but they are growing rapidly. “It’s very possible that a fall/winter wave will be driven by a mix of variants,” Peacock said.
Professor Tom Wenseleers, an evolutionary biologist at the Université Catholique de Leuven in Belgium, said BA.2.75.2 and BQ1.1 have mutations in their spike protein that help them partly escape BA.5-induced immunity.
“Combined with the fact that Covid hospitalizations have already started to rise again in the UK, and the full effect of these variants is yet to be felt, I’d say it’s not great news,” he said.
What is not known is the impact these variants may have on disease severity, although Peacock noted that there is currently no evidence that they cause worse disease. And Covid-related deaths remain low.
Wenseleers said: “Most scientists believe that our high population immunity will cause the death rate from infection to continue to decline. But any new wave of infection will of course add to the toll of the pandemic.”
But deaths are not the only concern. Peacock said: “Even a small wave will put massive additional pressure on the health service, particularly if combined with other respiratory viruses making a comeback this winter,” such as the flu.
Experts agree that vaccines are crucial in dealing with Covid. “I can only recommend everyone who is offered a booster to go and get one – this is the best way to protect yourself from serious illness and limit the impact of any new waves,” Wenseleers said.
Dr Emma Hodcroft, a molecular epidemiologist at the University of Bern and the University of Geneva, said studies suggest the new dual-variant Covid booster vaccines available in the UK and other countries may increase protection against Covid, while that Dr. David Strain, from the University of Exeter medical school, said vaccination could also reduce the chance of developing prolonged covid.
But there are concerns about acceptance. “We’re getting a lot of vaccine fatigue — people are just getting tired of being told to go get vaccinated,” Strain said.
A new wave of covid also poses the potential to disrupt education, transportation, deliveries and other infrastructure, Hodcroft said, raising the question of whether more measures, such as wearing masks or working from home, may also be needed. .
“Overall, I think the most important thing right now is to take a hard look at our plans for the fall and make sure we have a plan,” he said.