If we loosen restrictions too early, there is a real risk of a third wave in the UK | Devi Sridhar

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Just when it felt like we could begin to relax again, Covid-19 has thrown us yet another curveball. While we’ve been debating in the UK where to go for a holiday and booking long-overdue nights out with friends, the virus has been causing havoc across the world.

The Kent variant, B.1.1.7, found its way into countries such as Taiwan and Singapore; P.1 is causing another wave in Brazil; and most devastatingly, the highly transmissible variant B.1.617 (which has three subtypes) is causing a public health crisis in India. The country has seen cases surging with estimated deaths to be several times greater than that being reported by the government, which continues to downplay the epidemic.

The UK has done well, largely through strong public compliance, in bringing its case numbers down, but Boris Johnson has repeated his mistake from last summer and left the borders open. The Sunday Times estimates that at least 20,000 passengers from India were allowed to enter the UK while Johnson delayed imposing a travel ban because he didn’t want to upset the Indian prime minister, Narendra Modi, while negotiating a trade deal. This is at a time when other countries such as New Zealand and Hong Kong completely stopped all flights.

This puts us now in a precarious situation. The World Health Organization has identified B.1.617 as a “variant of concern” because it is at least as transmissible as the Kent variant, potentially even more so. This means that the virus can jump faster among those susceptible and accelerate out of control. The UK has not fully vaccinated enough of the population to avoid a third wave among younger people that could still strain the NHS.

We’re now in a race between the spread of the virus (especially as we begin to mix more freely) and getting jabs into arms. Open up too quickly and we face a third wave like Chile and the Seychelles did, and yet another period of lockdown. Open up too slowly and we face continued economic costs and a frustrated public. Such decisions are incredibly difficult, and taken with considerable scientific uncertainty.

There is still not enough data to know whether the Indian variant could undermine vaccine effectiveness; initial reports are encouraging that vaccines will offer protection, but nothing conclusive yet. Still, it is far better to have full or partial protection from a vaccine than to get Covid-19 and gamble with your health. The vaccines even seem to reduce transmission, as a study in Scotland among healthcare workers indicated, and reduce long-term health effects associated with long Covid.

What is absolutely clear is that we have it in our power to prevent another lockdown by speeding up vaccinations, and in particular targeting areas in which an outbreak is occurring. Surge testing (both PCR and lateral flow rapid tests) can locate infectious individuals and support them to isolate. Up to a third of cases may show no symptoms, which means relying purely on signs such as fever or cough, or feeling unwell, just isn’t enough.

Those who are unvaccinated are still susceptible and should continue to meet people outdoors, wear masks indoors and wait until getting vaccinated before engaging in riskier indoor activities. The plan is still for all adults in the UK to be offered their first dose by mid-July, so the end is in sight, but patience is needed for the coming weeks. Vaccines will eventually do the heavy lifting and allow us to stop using face coverings, end physical distancing and get back to somewhat normal life.

Instead of an incoherent travel traffic light system, the UK should align with the US and EU to only allow visitors who have proof of full vaccination and a negative PCR test prior to arriving. This is a much safer way to open up international travel, and a system that has been used for other diseases such as yellow fever. The virus (including variants) moves when infectious people move; vaccines reduce the likelihood of someone being infectious. Finally, richer countries through the G7 need to continue to offer vaccines and support low- and middle-income countries that are struggling. This is a global problem requiring a global solution.

If the right policy steps are taken, and the public are provided with a clear message about the current state of the pandemic, the UK could avoid a third wave and another national lockdown.

No one wants longer restrictions, especially given the massive harms including unemployment, loneliness and increased poverty. But the solution required needs to contain the spread of the virus and hospitalisations until the bulk of the population is fully vaccinated. The finish line is in sight, let’s not put obstacles in our way.

Devi Sridhar is chair of global public health at the University of Edinburgh

Hafta Ichi
Source: The Guardian
Keyword: If we loosen restrictions too early, there is a real risk of a third wave in the UK | Devi Sridhar

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