Coronavirus: SAGE warns Britain’s next ‘wave’ will start after May 17 rule-change


Next Monday’s lockdown easing will trigger the start of another wave of Covid, SAGE has warned, but it won’t be anywhere near as bad as the ones in spring or winter 2020.

In more than 100 pages of files published tonight as Boris Johnson announced social distancing would become optional from May 17,  scientists said they were ‘more optimistic’ about the reopening than earlier in the year.

The better-than-expected vaccine rollout and warmer weather would have Covid on the back foot and keep hospital admissions and deaths much lower than in Britain’s first and second waves. Even the worst case scenario submitted by Warwick University experts suggests hospital occupancy might only reach half of its January high. 

But SPI-M, a sub-group of SAGE that contains disease modelling experts such as Neil Ferguson, Graham Medley, John Edmunds and Steven Riley, said ‘it is likely that Step 3 will lead to R greater than 1 in England’.

This means the rate of spread will be pushed into a continuously increasing state, with everyone catching the virus infecting one or more people. 

Due to widespread vaccination of the people most likely to get severely ill or die, however: ‘Any resurgence in hospital admissions and deaths following Step 3 of the Roadmap alone is highly unlikely to put unsustainable pressure on the NHS,’ they added.

Top-line estimates shown to the Government by SPI-M suggest that following the May 17 unlocking and then opening up society completely in June would likely lead to a maximum of 55,000 hospital admissions over the next year – compared to 464,000 since the start of the pandemic – and to 11,200 more people dying by September 2021.

Prime Minister Boris Johnson has already indicated that more disease and death is inevitable, saying in February there was ‘no credible route to zero Covid’ and adding: ‘Whenever we ease the lockdown – whether it’s today or in six or nine months – we’ve got to be realistic and accept that there will be more infections, more hospitalisations and therefore, sadly, more deaths, just as there are every year with flu.’

The PM tonight confirmed next Monday’s softening of the rules would go ahead as England announced zero new Covid deaths for the first time July 30, and there were another 2,357 coronavirus cases and four deaths across the UK. The Covid alert level was downgraded from four to three, suggesting the virus is ‘in general circulation’.

Top-line estimates presented to SAGE suggest that there are unlikely to be more than 5,000 people in hospital at any one time over the next five months – the purple worst-case is the only scenario in which this happens, and red is considered most likely. At the peak of the second wave there were almost 40,000 people in hospital in the UK. (This is a model by Warwick University and does not take into account a full lifting of lockdown in June)

Top-line estimates presented to SAGE suggest that there are unlikely to be more than 5,000 people in hospital at any one time over the next five months – the purple worst-case is the only scenario in which this happens, and red is considered most likely. At the peak of the second wave there were almost 40,000 people in hospital in the UK. (This is a model by Warwick University and does not take into account a full lifting of lockdown in June)

New daily hospital admissions for Covid were not expected to surpass 1,000 within eight weeks of the May 17 rule-change. The graph shows possible effects of different R rate values after lockdown is eased, with 0.9 – green; 1.2 – blue; 1.5 – yellow; 1.8 – red. SPI-M said it could not predict what the true number would be

New daily hospital admissions for Covid were not expected to surpass 1,000 within eight weeks of the May 17 rule-change. The graph shows possible effects of different R rate values after lockdown is eased, with 0.9 – green; 1.2 – blue; 1.5 – yellow; 1.8 – red. SPI-M said it could not predict what the true number would be

The PM tonight confirmed next Monday's softening of the rules would go ahead as England announced zero new Covid deaths for the first time July 30

The PM tonight confirmed next Monday’s softening of the rules would go ahead as England announced zero new Covid deaths for the first time July 30

SPI-M said in its report, presented to SAGE last Wednesday, May 5: ‘Modelling presented in these central scenarios is more optimistic than those in SPI-M’s previous Roadmap modelling. 

‘This is primarily due to recent evidence that vaccines significantly reduce onwards transmission from people who have been vaccinated but nevertheless become infected then symptomatic. 

‘This suggests that if baseline policies to reduce transmission are kept in place at the end of the Roadmap, behaviour does not return to pre-pandemic levels, and vaccine roll out progresses, there is an opportunity to keep the next resurgence very small.’

The report does not take into account the possibility of a new dominant variant that can escape vaccine immunity or spread faster than the Kent strain, and works off the basis that the situation in the UK is approximately as it is now while measures are released.

Scientists add that ‘seasonality’ could mean there are fewer cases over the summer – as was seen last year – and the next wave is pushed back to autumn and winter. They estimate transmission is around 10-20 per cent more likely in February than in August in the same outbreak situation.

This is because UV light is known to kill the virus and people spend more time outdoors, where transmission is significantly less common because people don’t breathe the same air as much. 

VACCINE ESCAPE VARIANT ‘COULD BE LIKE A NEW PANDEMIC’

A coronavirus variant that can escape immunity given from vaccines could be ‘akin to an entirely new pandemic’, SAGE sub-group SPI-M has warned.

Virus experts said in a report shown to the Government last week that ‘variants remain a major risk to the roadmap’.

The country is only able to start loosening lockdown now because so many people have been immunised, reducing the spread of the virus and making it significantly less likely that people will get severely ill or die.

Some variants have emerged that appear to be able to slip past some immune cells, making vaccines slightly less effective, but none appear to exist yet that will kill vaccinated people en masse. 

SPI-M warned: ‘A variant of concern with more substantial escape from immunity could be akin to an entirely new pandemic and would require the re-imposition of significant restrictions in order for NHS pressures to remain manageable. 

‘Even with rather moderate assumptions for variants of concern (some immune escape or with some immune escape but lower transmissibility), waves similar in magnitude to spring 2020 or January 2021 are possible.’

It added: ‘SPI-M-O considers slowing importation of new variants into the UK a very important priority to allow for the next generation of vaccines to be developed.’

They warned, however, that a new variant could ‘double or treble’ the size of the next resurgence, and that one that can completely or almost completely slip past vaccine immunity could be like an ‘entirely new pandemic’. 

The research was a summary of modelling done by teams at Warwick University, Imperial College London and the London School of Hygiene & Tropical Medicine, which have been advising officials throughout the crisis. 

It suggested that within the six weeks after the lockdown easing on Monday, the R value of the virus – the number of people infected by each person – could rise to between 1.2 and 1.8.

It said 1.8, in which every 10 people infected pass it on to another 18, was ‘highly unlikely but plausible’. 

An R of 1.5, meanwhile, would lead to a ‘substantial number of hospital admissions and deaths’ but this would slow down naturally towards the end of June because of herd immunity, even without more lockdowns.

Estimates of hospital admissions and deaths from the three teams varied widely. Step 3 alone would likely lead to between 9,100 and 12,700 hospital admissions, a peak of between 1,150 and 1,700 people in hospital, and between 1,160 and 2,600 more deaths, they suggested. It vaccine immunity wore off over time these numbers would be higher – there are not yet any signs this will happen.

If lockdown is lifted totally by the end of June the number of hospital admissions could be between 17,300 and 54,900; peak hospital occupancy could be 1,900 to 4,640; and there could be 4,000 to 9,000 more deaths.

The SPI-M team said they couldn’t predict exactly what might happen after restrictions are lifted next week and explained: ‘There is considerable uncertainty about behaviour, and therefore transmission, at each step of the Roadmap.’

The biggest risks that could push numbers up were people getting carried away and going back to pre-pandemic socialising, young people not getting vaccinated, and the emergence of a new, more dangerous variant. 

Monday’s relaxation will allow groups of six or two households to meet indoors, pubs to open inside, entertainment venues like cinemas and stadiums to reopen, holidays both at home and abroad in certain countries, indoor sports to start again and large outdoor events as well as smaller gatherings of up to 30 outside.

Boris Johnson today hailed it a ‘very considerable step on the road back to normality’ and said the signs were promising that the total reopening on June 21 would be able to go ahead.

But SPI-M has warned that the true effects of Step 3 – next week’s changes – will only be known in the middle of June at the earliest. It takes three weeks or more for people to start getting admitted to hospital and dying, especially when a resurgence starts at a level as low as the current one.

All the teams that sent reports to SPI-M – Warwick University (red), Imperial College London (purple) and the London School of Hygiene & Tropical Medicine (green) – estimated that the next surge of coronavirus will be much smaller than previous ones. For comparison, during the second wave daily infections peaked at 68,000; hospital occupancy peaked at 39,000; and daily deaths at 1,800 – none of the models for summer 2021 come anywhere close on hospitals and deaths, although infections do get close in the LSHTM model because so many children are likely to get infected

All the teams that sent reports to SPI-M – Warwick University (red), Imperial College London (purple) and the London School of Hygiene & Tropical Medicine (green) – estimated that the next surge of coronavirus will be much smaller than previous ones. For comparison, during the second wave daily infections peaked at 68,000; hospital occupancy peaked at 39,000; and daily deaths at 1,800 – none of the models for summer 2021 come anywhere close on hospitals and deaths, although infections do get close in the LSHTM model because so many children are likely to get infected

The effect of vaccines on reducing transmission of the virus will make the impact of the third wave less damaging, SPI-M predicted, but even if this doesn't happen and they only cut the risk of infection, serious disease and death, the next resurgence will still be significantly lower than at the peak in spring 2020 and over the winter

The effect of vaccines on reducing transmission of the virus will make the impact of the third wave less damaging, SPI-M predicted, but even if this doesn’t happen and they only cut the risk of infection, serious disease and death, the next resurgence will still be significantly lower than at the peak in spring 2020 and over the winter

Mr Johnson said in a Downing Street briefing: ‘The secret of the success that we’ve had so far is that we’ve been guided by the data and we’ve given time to see the effect of each successive stage on the road map.’ 

VACCINES GIVE UP TO 97% PROTECTION FROM DEATH IN REAL WORLD 

Britain’s vaccination drive was given another boost today as yet more real-world data revealed the jabs are saving thousands of lives. 

Public Health England analysis of 5,000 people showed that those vaccinated with a single dose of either vaccine had similar levels of protection against death after a single dose – at 44 per cent for AstraZeneca and 55 per cent for Pfizer, compared to the unvaccinated.

Combined with the protection vaccines offer against becoming infected in the first place, PHE said a single dose of either vaccine reduced deaths by about 80 per cent.

For the first time, the latest analysis included protection against mortality among people given both doses of the Pfizer vaccine.

It showed that people fully immmunised with the American firm’s jab have about 69 per cent protection against dying if they get infected with the disease. This rises to 97 per cent when combined with the estimated protection against becoming a case.

‘We think it’s prudent, we think we can do it, but it’s got to be done in a way that’s cautious and I think that we will want to have time to see the effects.

‘This unlocking amounts to a very considerable step on the road map back to normality and I am confident we will be able to go further.

‘Subject to the impact of step three on the data, we remain on track to move to step four on June 21.

‘And to give business more time to prepare we will be saying more later this month about exactly what the world will look like and what role there could be – if any – for certification and social distancing.’

Mr Johnson said new detailed guidance on social distancing for this roadmap step will be issued on Monday so people can make their own choices.

‘This doesn’t mean that we can suddenly throw caution to the winds. We all know that close contacts such as hugging is a direct way of transmitting this disease,’ he said. ‘So I urge you to think about the vulnerability of your loved ones.’

Although SPI-M’s report was optimistic, a summary of a SAGE meeting on May 5 warned: ‘It remains highly likely that there will be a further resurgence in hospitalisations and deaths at some point, however, the scale, shape, and timing remain highly uncertain.

‘The resurgence will be smaller if baseline measures and sustained changes in behaviour which reduce transmission are maintained beyond the end of the roadmap. 

‘The speed of vaccine rollout is also a key factor in the size of the resurgence. The two biggest risks ([without]new variants) are that either high contact patterns emerge early, or there is low vaccine rollout amongst younger adults. 

‘The combination of these two would lead to a larger resurgence. A variant which either substantially escapes immunity or is highly transmissible (more so than B.1.1.7) could lead to a very significant wave of infections, potentially larger than that seen in January 2021 if there were no interventions.’ 

What CAN you do from May 17? Britons will be able to hug ‘close friends and family’, drink a pint INSIDE a pub and finally go on holiday again as limit on mourners at funerals is lifted and cinemas, museums and hotels reopen 

Hugs with family and friends and indoor socialising will be allowed from next Monday after a further easing of Covid-19 rules in England was confirmed today.

The next stage of the roadmap out of lockdown will go ahead as planned on May 17, with up to six people or two different households allowed to meet indoors.

Most social contact rules outdoors will be lifted, although gatherings of more than 30 outdoors will stay illegal until at least June 21 – the final stage of the roadmap.

But indoor hospitality, entertainment venues such as cinemas, theatre and soft play areas and indoor adult group sports and exercise classes will all reopen.

The rest of the accommodation sector will also return, with people from different households now allowed to mix in hotels and self-catering properties.

The much-criticised cap on the number of mourners at funerals will be lifted, while up to 30 people will be allowed at weddings and other life events.

More than 50million vaccine doses have been administered in the UK as the Government said it is on track to offer all adults a first dose by the end of July. 

Here, MailOnline looks at what your newfound freedoms will be from May 17: 

Can people come over to my house again?

Yes. Up to six people from multiple households or an unlimited number of people from two households will be allowed to visit you inside your house again.

Can people stay over at my house again?

Yes. People from outside your household will be allowed to stay overnight, as long as you stick to within the rule of six or two households.

Can I still meet people outside?

Yes. You will now be able to meet in groups of up to 30 people outside. Bigger groups will be illegal. Until May 17, you can still only meet outside in groups of six.

A member of bar staff wearing a face masks serves drink in a pub in East London in July 2020

A member of bar staff wearing a face masks serves drink in a pub in East London in July 2020

Can I hug my friends and family again?

Yes. The Government has said you can hug ‘close friends and family’ from outside your own household – for the first time since the pandemic began in March 2020.

However, people are being urged to be ‘exercise their own personal judgement in line with the risks.’ There is no legal definition on who ‘close friends and family’ are.  

The Government also said wider social distancing rules will remain in place in adult social care, medical, retail, hospitality and business settings.

Can you sit inside a pub again?

Yes, indoor hospitality will resume – so you can sit inside a pub or restaurant with people from other households, as long as the rule of six (or two households) is met.

Will there be a substantial meal or curfew requirement for pubs?

No. As with step two on April 12, venues will not have to serve a substantial meal with alcoholic drinks; nor will there be a curfew.

An audience sit at the Pavilion theatre in Weymouth for a pantomime in December last year

An audience sit at the Pavilion theatre in Weymouth for a pantomime in December last year

Will you be able to stand at the bar?

No. Customers will still have to order, eat and drink while seated at a hospitality venue – even though they will now be allowed inside.

Will indoor entertainment venues now be allowed to reopen?

Yes. Cinemas, theatres, museums and indoor children’s play areas will all be allowed to reopen, but must follow guidelines on social distancing and face masks.

Concert halls, conference centres and sports stadia will also be allowed to reopen, with larger events in all venues able to resume with capacity limits (see below). 

Will venues face capacity limits?

Yes. Larger performances and sporting events will be capped in indoor venues with a capacity of 1,000 people or half-full, whichever is a lower number. For outdoor venues the cap will be 4,000 people or half-full – again, whichever is lower.

In the largest outdoor seated venues, where crowds can be spread out, up to 10,000 people will be able to attend – or a quarter-full, whichever is lower.

Football fans at Wembley Stadium at a pilot event for the FA Cup semi-final last month

Football fans at Wembley Stadium at a pilot event for the FA Cup semi-final last month 

Will social distancing and face masks rules remain for now?

Yes. The one-metre (3ft) rule remains in place in public settings such as pubs, shops and restaurants. You should wear a face mask when walking around these places.

What about children wearing masks in schools?

Secondary school children will no longer have to wear face masks in classrooms and corridors from May 17. However, those aged 11 and above will still be required to wear the masks in public settings such as shops, unless they have a medical exemption.

Ministers said infection rates among students and staff continue to decrease in line with wider community transmission, but twice weekly home testing will remain. 

Will students be able to attend university lectures in person again?

Yes. All university students in England can return to campus next week for in-person teaching. They will be expected to get tested for Covid-19 twice a week.

Most students, apart from those on critical courses, were told not to travel back to term-time accommodation as part of the third national lockdown in January.

Students on practical courses, who require specialist equipment and facilities, began returning to face-to-face teaching on March 8. But it is estimated that about half of university students have not been eligible to return to in-person lessons.

Cinema-goers in their seats for a film at the Odeon Leicester Square in London last August

Cinema-goers in their seats for a film at the Odeon Leicester Square in London last August

Can I go on holiday abroad again?

Yes, but with many restrictions. Last Friday, the UK Government cleared just 12 destinations for quarantine-free tourist trips for Britons from May 17.

However, many of the destinations are remote islands or have very strict entry measures or blanket bans on UK tourists, further reducing the list of options.

Portugal and Gibraltar are the only countries on the ‘green list‘ that most Britons will realistically be able to visit for a warm weather holiday this month (see below).

You can technically also go on holiday to ‘amber list’ and ‘red list’ countries again too, but you will need to complete a period of quarantine as follows:

For amber list, you must quarantine at home for ten days on your return and take a PCR test on days two and eight – as well as a lateral flow test before the return flight.

Or there is an alternative option that you could pay for an additional ‘Test to Release’ on day five to end self-isolation early. There is also a chance the country turns red.

Those returning from a red list country must stay in a government-approved quarantine hotel for 11 nights upon their return at a cost of £1,750.

Will there be a new limit on wedding numbers?

Yes. Up to 30 people will now be able to attend weddings. This limit will also apply to other types of significant life events including bar mitzvahs and christenings.

Will funerals also now be limited to 30 people?

No. There will now be no limit of the number of mourners at funerals, although the venue must operate in a socially distanced way and within capacity guidelines.

Travellers arrive at London Heathrow Airport on May 3. Non-essential travel is set to reopen

Travellers arrive at London Heathrow Airport on May 3. Non-essential travel is set to reopen

Can you stay overnight somewhere with people from another family?

Yes. The rest of the accommodation sector will now reopen, including hotels, hostels and B&Bs – and people from different households can share the same room.

Up until May 17, if you want to stay at a hotel or self-catering accommodation, you must only do so with members of your own household or support bubble.

Can I go to indoor sport classes now?

Yes. All indoor adult group sports and exercise classes will be allowed again, five weeks after gyms were allowed to reopen under step two on April 12.

Will closed parts of leisure centres now be allowed to reopen?

Yes. Saunas and steam rooms will now be allowed to reopen, following on from swimming pools and gyms on April 12.

There will be no more limits on mourners at funerals. Above: File picture of a funeral last July

There will be no more limits on mourners at funerals. Above: File picture of a funeral last July

Will there be limits on numbers in support groups?

Yes. The Government has said 30 people will now be able to attend a support group or parent and child group. The limit does not include children aged under five.

Will restrictions on care home visiting be changed?

Yes. Care home visiting will be eased further, with residents able to have up to five named visitors and more freedom to make ‘low risk visits’ out of the home.

Will the guidance on working from home change?

No. People are still being advised to ‘continue to work from home where they can’.

Hugs with family and friends will be allowed again from May 17 (file picture posed by models)

Hugs with family and friends will be allowed again from May 17 (file picture posed by models)

What is the exact time that the rules change on May 17?

Unconfirmed. This is not yet clear, but the April 12 rule change towards step two came in at midnight, so it is likely this will be the same for May 18.

Are there businesses that still cannot reopen?

Yes. Nightclubs are the only businesses that must remain shut until at least June 21.

Is there a confirmed date for when all Covid rules will cease?

Not yet. The Government hopes that on June 21 it will be able to drop all legal limits on social contact, but this will be confirmed nearer the time.

Before this date, the Government will complete a review of social distancing and other long-term measures such as face masks and guidance on working from home.

All university students in England can return to campus next week for in-person teaching (file)

All university students in England can return to campus next week for in-person teaching (file)

Why can we now move into Step 3 on May 17?

The Government has set four tests to further ease restrictions, which have now been met. These are that:

  • The vaccine deployment programme continues successfully;
  • Evidence shows vaccines are sufficiently effective in reducing hospitalisations and deaths in those vaccinated;
  • Infection rates do not risk a surge in hospitalisations which would put unsustainable pressure on the NHS;
  • Assessment of the risks is not fundamentally changed by new variants of concern.

It also comes after the UK Chief Medical Officers confirmed this morning that the UK Covid-19 alert level should move from level four to level three.

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