Covid: Third wave could see up to 200 deaths and 2,000 hospitalisations each day as rules are eased

Carl Dinnen reports on what 'freedom day' means for the country and the NHS

Up to 200 people could die every day and up to 2,000 could be hospitalised every 24 hours under a third wave of Covid-19 as restrictions are eased across the country, experts have warned.

The government confirmed their plans to press ahead with lifting restrictions on July 19 in England despite the rise in coronavirus cases on Monday arguing it was the best date out of all possible options.

Lockdown rules in England: What's changing from July 19

What has happened to social distancing and the rule of six?

The 'one metre plus' rule has been scrapped entirely, as of July 19 in England. However, some guidance to maintain social distancing in certain situations will remain in place of the legal restrictions.

Social distancing guidance will continue if someone is Covid positive and self-isolating, or in airports, or other ports of entry, to avoid travellers arriving from amber or red-list countries mixing with those from green list areas.

Limits on social contact in England have disappeared, meaning the end of the rule of six indoors and the limit of 30 people for outdoor gatherings.

Do I still need to wear a face mask?

There is now no legal requirements to wear face coverings - but guidance still encourages using masks in some settings, including hospitals, healthcare settings and in crowded enclosed public spaces.

Has the working from home guidance changed?

The guidance on working from home has gone. It's ultimately down to employers to decide whether to keep staff at home or in the office, but the government say employers are able to plan the return of staff to the workplace.

What about weddings and funerals?

The current limits on numbers of people who can attend weddings, funerals and other life events has ended.

What's happening in Wales, Scotland and Northern Ireland?

The changes to Covid rules announced by Boris Johnson, only impact England and will not change regulations in Northern Ireland, Wales or Scotland.

The Welsh Government “would like to move together” with other parts of the UK in lifting coronavirus restrictions but will only do so if it is “right for Wales”, health minister Eluned Morgan said on Monday 5 July.

As of July 19, restrictions in Scotland have eased, with all areas of the country moving to level 0. The government is aiming to lift all major restrictions in Scotland by August 9.

In Northern Ireland, some significant restrictions have already been eased including allowing the resumption of live music and the lifting of caps on organised outdoor gatherings.

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Experts and the government have urged the public to "go slow" once restrictions are lifted in a bid to curb the "exit wave" and cut the number of people who will go on to die from Covid-19.

Boris Johnson said in a press conference on Monday that the government believed it was right to proceed "with caution", adding that life will not "simply revert" to the pre-pandemic normal on July 19.

Advisors to the government recommended that workers do not all head back to the office from mid-July, continue to wear masks in crowded spaces and stay at home when infected or contacted by the NHS app or NHS Test and Trace.

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Central estimates from scientific modellers advising the government show that step 4 of the road map for England and the wave of infection that follows could be associated with 1,000 to 2,000 more hospital admissions per day at the peak, which is expected around mid-August.

Deaths are expected to be between 100 and 200 per day at around the same time, although there is a large amount of uncertainty in the modelling.

The UK recorded 34,371 new cases of Covid-19 on Tuesday with cases up 30% in the past seven days when compared to the previous week.

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Most of the modelling presented to the government has a lower expected peak of infection than that seen in January this year.

Scientists argue that if people revert to normal pre-pandemic behaviour all at once on July 19, then there will be a big wave of infection and larger numbers admitted to hospital.

Instead, if behaviour reverts to normal over several months, the impact will be lower.

Government scientists say that while the link between cases and hospital admissions is weakened due to vaccines, it has not been broken.

In papers newly released by the government on Monday, a document dated July 7 from the Scientific Advisory Group for Emergencies (Sage) concluded "all modelled scenarios show a period of extremely high prevalence of infection lasting until at least the end of August".

"There is high uncertainty around both the scale of the peak in prevalence and in the number of confirmed cases that this would correspond to."

(PA Graphics) Credit: PA Graphics

Under pessimistic assumptions, some modelling scenarios presented to ministers show a resurgence of cases on the same scale or larger than the peak seen in January.

Sage concluded, "it is almost certain that the peak in deaths will be well below the levels seen in January 2021 due to the impact of vaccination (assuming that no new dominant variant emerges)".

The government said on Monday that July 19 was the best option available but admitted it was not perfect.

They pointed to the fact that school holidays and warmer weather over the summer will help keep infections down and any restriction lifting later would coincide with term time and the coming winter.

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Experts are worried that pushing the peak of the wave into cooler months would hit the NHS at a time when it is already under pressure.

Modelling by the Scientific Pandemic Influenza Group on Modelling (SPI-M) from earlier this month shows that, taking into account current studies on vaccine effectiveness, peak daily hospital admissions range from about 500 to 950 when there is a slow return to pre-pandemic behaviour.

But this rises to about 1,300 to 4,800 for the most rapid return to pre-pandemic behaviour.

Scientists informing government also expect half of all deaths to occur in vaccinated individuals, predominantly in those aged 75 and over.

(PA Graphics) Credit: PA Graphics

However, a substantial number of deaths are also projected to occur in fully vaccinated adults aged 50 to 74.

Researchers from the University of Warwick argued there could be a "heavy burden" on the NHS as a result of restrictions loosening.

The researchers said daily hospital admissions could peak at 6,970 daily if people immediately begin to act normally again once restrictions have eased off completely, and if the vaccines are not as effective as once believed.

But if people return to normal life slowly over several months, a smaller wave is generated, with a projected peak in daily hospital admissions of 668.