18 July 2020 | New Scientist | 7A PARTICULARLY challenging
winter in the UK could bring
a second wave of coronavirus
infections that results in around
120,000 hospital deaths – twice as
many as the first wave – according
to an estimate of a reasonable
worst-case scenario.
Assuming lockdown
restrictions continue to ease, the
average number of people one
person with the virus goes on to
infect, known as the R number,
could rise in the UK from the
current estimate of between
0.7 and 0.9 to 1.7 by September,
say the scientists behind a report.
This would lead to a second wave
peaking in January and February
next year.
“A peak of coronavirus infection
in the winter could be more
serious than the one we’ve just
been through,” report chairStephen Holgate at the University
of Southampton, UK, told a press
briefing. “We’re anticipating the
worst, which is the best we can do.”
The report, requested by the
UK government’s chief scientific
officer, was by the UK Academy
of Medical Sciences. It considered
what might happen if people
went back to a typical way of life
and didn’t factor in the use of
new medicines or a vaccine.
The team considered the known
impact of covid-19 on healthcare
resources, combined with that of
flu and other seasonal infections.
In any given year, deaths in the
UK rise in winter, due to the effects
of cold weather and the impact of
seasonal viruses like the one thatcauses flu. People tend to stay
indoors with their windows
closed, providing ideal conditions
for infections to spread.
A worst-case scenario would
involve an unusually cold winter
and a flu epidemic, on top of
the backlog of routine care and
elective surgery that has already
been postponed as a result of the
coronavirus outbreak.
If it were to happen, around
119,900 hospital deaths related
to covid-19 could be recorded in
the UK over the winter – more
than double the number seen
in the spring, according to the
report. The figure is an estimate,
and could lie somewhere between
24,500 and 251,000, according toThe UK has just three months to get ready for a covid-19 second
wave that could be deadlier than the first, reports Jessica HamzelouPrepare now for winter
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newscientist.com/coronavirus-latestthe authors. It also doesn’t include
deaths outside hospitals, such as
in care homes.
The figure isn’t a prediction and
the UK has a crucial three-month
window to avoid this scenario,
the authors say.
One important approach will
be limiting the impact of seasonal
flu. “We don’t know how covid-
will interact with flu,” says reportco-author Anne Johnson at
University College London. An
adequate supply of the flu vaccine
will be vital in the autumn, she
says. Those who are vulnerable to
flu, people working in healthcare
and schoolchildren should all
have the vaccine, she says.
Test, trace and isolate schemes
will need to be scaled up,
according to the report, which
also recommends widespread
flu testing, so people know
which virus they have.
With this in place, the UK might
be able to treat many flu infections
with antiviral drugs. This hasn’t
previously been possible due to
a lack of testing, says Johnson.
The authors also advise using
facilities set up to deal with the
coronavirus outbreak, such as
the Nightingale hospitals, to
help clear the backlog of hospital
procedures that have accumulated
since the spring.
Any attempts to limit the
impact of coronavirus should
prioritise those at the greatest
risk of severe illness and death,
including people who are from
black, Asian and minority ethnic
groups, and those living in
crowded housing, the authors say.
If measures successfully limited
the R number to 1.1, the outcome
would be very different. “There’s
a lot to do and we don’t have a
lot of time to do it,” says Johnson.
“The window for action is now.” ❚A sign outside a doctor’s
surgery in the UK. Flu injections
could be vital this winter“ A peak of coronavirus
infection in the winter
could be more serious than
the one we’ve just had”