England faces the sternest test of its vaccination strategy

England is the first country to end covid-19 restrictions with infections so high. It is the most robust test of a vaccine programme yet

7/25/2021 4:16:00 PM

England is the first country to end covid-19 restrictions with infections so high. It is the most robust test of a vaccine programme yet

The country has ended covid-19 restrictions in the midst of rapidly rising infections. Will the “wall” of inoculations hold? | Graphic detail

ENGLAND IS embarking on a brave—critics say reckless—epidemiological experiment. It is seeking to end all social restrictions despite a large new wave of covid-19 infections. The British government certainly thinks it is possible to do so without incurring myriad deaths and overwhelming the National Health Service. From July 19th England ended all restrictions on its citizens, including the legal requirement to wear masks in enclosed public places. (Other nations of the United Kingdom set their own policy and are being more cautious.)

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The Economist TodayHand-picked stories, in your inboxA daily email with the best of our journalismSign upThe decision is controversial. England recorded 289,000 cases in the seven days to July 18th, the highest number since January. That is just 27% fewer than the whole of the European Union combined. Official cases per head of population are the third-highest in the world and infections are doubling every six days.

As with many other countries, England has been wallopped by the more infectious Delta variant of the coronavirus—it now accounts for nearly all new cases there. But vaccines have so far kept deaths low. Fully 68% of adults in England are fully vaccinated and a further 20% have had the first of two doses. As a result, just 229 covid-19 deaths have been registered in the country over the past seven days. That compares with 2,400 deaths during a week in November 2020 when cases were at similar levels but vaccinations had not yet begun. headtopics.com

Indeed, an analysis byThe Economistfinds that in recent months the link between covid-19 cases and subsequent hospitalisation and death has been weakened—but not entirely broken. Between August 2020 and March 2021 every one thousand cases resulted in an average of 81 hospital admissions and 18 deaths. Since April 2021 every one thousand cases has been associated with 43 hospital admissions and four deaths (see chart below). As more people have been innoculated those figures have further reduced.

Nonetheless, England’s unlocking on July 19th does not come without risks. As cases rise exponentially—the government has warned that they might surpass 100,000 a day in August—more people will need treatment in hospital and more will die. At current rates of hospitalisation, official cases would need to rise to about 175,000 a day—three times their winter peak—for hospital admissions to approach the levels experienced in January. That could occur in about four weeks.

Rates of hospital admission will be highest among the unvaccinated. As in America, whose vaccine programme has slowed markedly in recent weeks, England’s government still needs to persuade more people to get jabbed. Covid-19 cases tend to be clustered in places that have the lowest vaccination rates. That suggests two things. First, most infections are taking place among the young people who are still waiting in line to be vaccinated (or among those who are too young to be jabbed). Second, vaccine hesitancy in pockets of England will continue to harbour high rates of infection.

Mr Johnson insists that the country must learn to live with coronavirus. His scientists say that delaying the ending of restrictions would simply defer rather than avert the deaths that will inevitably occur. They say that it is better to end restrictions now, when schools are closed for summer and flu cases are low. But other scientists worry about the burden of long covid among those, such as the young, that are still awaiting vaccination: just 27% of 18- to 39-year-olds have had both shots of a vaccine. In response, the government says that it is investing £50m into research on the chronic effects of the disease. headtopics.com

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In January England broke with international convention when it decided to lengthen the time between covid-19 vaccine doses from the recommended three weeks to 12. That allowed a larger number of people to obtain a single dose more quickly. It was a gamble that initially paid off as it allowed more of the most vulnerable to gain partial protection sooner, and the early evidence supported a longer dosing strategy as more efficacious. The government has since shortened its dosing strategy in response to the Delta variant because two doses offer most protection against it.

Meanwhile the Delta variant has spread to other countries with high rates of vaccination. It is now dominant in America, Denmark, Germany and Portugal. But England will be the first country to end covid-19 restrictions with infections so high. It will be the most robust test of a vaccine programme yet.

Read more: The Economist »

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