On Monday, the UK government will confirm whether the data allows us to lift the remaining COVID restrictions in England on 19 July.
If it does, then rules around face masks and social distancing will be dropped, as will limits on hospitality and guidance on working from home.
This is expected to accelerate the rapid spread of Delta, which is already causing a noticeable uptick in infections. On 1 July, case rates in the North East were almost three times higher than they were on the original date for lifting restrictions at the end of June.
The government decided to delay the last stage of its lockdown roadmap on 21 June because insufficient progress had been made against the four tests it set for lifting restrictions. The four-week delay has allowed scientists more time to study the impact of the Delta variant and increased population immunity from the vaccines.
So, what does the data show us about the performance against these four tests now?
1. ‘The vaccine deployment programme continues successfully’
The government set a target for two-thirds of adults to be double vaccinated by 19 July and hopes that all over-18s will be by mid-September.
It has already nearly met this target, with almost 65% of over-18s, or 34 million people, having had both doses, including the majority of people in the most vulnerable groups. More than 86% having had at least one jab.
But as a single dose is 14 percentage points less effective against symptomatic disease from Delta as Alpha, many experts are still worried that not enough of the population has been double vaccinated.
This is of particular concern as low uptake is concentrated in areas that are more deprived and have a higher proportion of ethnic minorities, which are populations that are known to be more severely affected by COVID.
2. ‘Evidence shows vaccines are sufficiently effective in reducing hospitalisations and deaths in those vaccinated’
One of the main reasons for increased optimism is that rising case rates have not led to a surge in hospitalisations and deaths.
In January, when infections were at a similar level, the number of patients admitted to hospital was more than double the number we are currently seeing. COVID-related deaths were around 10 times higher than they are now.
Chief scientific adviser Sir Patrick Vallance said that vaccines have “weakened” the link between infections and hospitalisations, although cautions that it is “not a completely broken link”.
3. ‘Infection rates do not risk a surge in hospitalisations which would put unsustainable pressure on the NHS’
Throughout the pandemic, one of the government’s main concerns has been whether the NHS can cope with increasing infections.
Despite the rapid spread of COVID in recent weeks, the weakened link between infections and hospitalisations has helped to keep admissions down.
At the peak in January, there were almost 80 beds occupied by COVID patients for every empty critical care bed in the South East. By comparison, in June, the number of critical care beds in the region outnumbered hospitalised COVID patients.
But the NHS is also under significant pressure from a backlog of non-COVID patients. A record 5.3 million people were waiting for an operation in May, according to the latest data from NHS England.
If cases surge into the hundreds of thousands, a small percentage causing severe illness could still create hospitalisation numbers that put the NHS under considerable strain.
4. ‘Our assessment of the risks is not fundamentally changed by new Variants of Concern’
The Delta variant has spread rapidly since the first case was discovered at the end of March. Its faster rate of transmission means it is now the dominant strain in England.
Currently, there are no other variants spreading as rapidly through the population. Public Health England is investigating eight COVID strains at present, but has not designated any more variants of concern since the decision was taken to delay lifting restrictions in mid-June.
The race between the vaccine and the variant was one of the main reasons that the government delayed easing restrictions at the end of June.
Analysis by Thomas Moore, science correspondent
But experts still feel that insufficient progress has been made. More than 100 scientists condemned the government’s plans, suggesting that more of the younger population needed to be vaccinated and warning about the creation of a vaccine-resistant variant.
Steven Paterson, professor of genetics at the University of Liverpool, said: “The concern to me is that you now have a lot of single-vaccinated people with some but incomplete immunity.
“Evolving to this partial immunity is easier than the virus having to evolve to the high levels of immunity from complete vaccination; indeed, this may give a stepping stone to that.”
So, should we be concerned about lifting restrictions with surging infections?
Overall, while the data paints a more positive picture, there are still concerns about lifting restrictions given the rapid spread of COVID at the moment.
The potential for rising case numbers to translate into hospitalisations and deaths is one of the reasons why Boris Johnson will not commit to an irreversible lifting of restrictions.
Dr Stephen Griffin, a virologist at the University of Leeds, said: “Taken together, the collective loss of restrictions we are due to see in July will no doubt lead to a sharp increase in transmission. Already increasing hospitalisations will accelerate, deaths will follow and many will develop long-COVID.”
To some extent this will be subdued by the vaccine, which is estimated to reduce transmission by between 60% and 80%, according to Karl Friston, a University College London professor and Independent SAGE advisor. But he says that COVID remains significantly more transmissible than seasonal flu, with a likely increase in the basic R number as we head into winter.
He said: “The key question now is whether the excess new cases incur a morbidity cost – e.g., long COVID and other systemic complications – that would justify delaying relaxation to vaccinate more younger people.”
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