'Prepare now for winter COVID-19 peak', says Academy of Medical Sciences

Experts at the Academy of Medical Sciences (AMS) are warning that the UK must prepare now for a potential new wave of coronavirus infections that could be worse than the first.

The Preparing for a challenging winter 2020/21 report calls for ‘intense preparation’ throughout the rest of July and August to reduce the risk of the health service being overwhelmed by a second wave, as it already grapples with existing disruption caused by the virus and a backlog of patients awaiting medical attention.

These new pressures are in addition to challenges normally faced by the health service during the winter season, such as flu outbreaks, a rise in other infectious diseases, and worsening of common conditions such as asthma and chronic obstructive pulmonary disease.

To help prepare for this, the report stresses that urgent action is needed now to minimise transmission of coronavirus in the community, and reorganise health and social care staff and facilities to maintain COVID-19 and COVID-19-free zones.

It is also essential to ensure there is adequate PPE and testing and system-wide infection-control measures to minimise transmission in hospitals and care homes, it says.

The report also calls for increased capacity of the test, trace and isolate programme to cope with the overlapping symptoms of COVID-19, flu and other winter infections, and establishment of a comprehensive, near-real-time, population-wide surveillance system to monitor and manage a winter wave.

The AMS does note that there is 'a high degree of uncertainty' about how the COVID-19 epidemic will evolve in the UK over the coming months, but suggests a 'reasonable worst-case scenario' to prepare for is one where the average number of people that one infected person will pass the virus on to (Rt value) rises to 1.7 from September 2020 onwards.

Modelling of this scenario suggests there would be a peak in hospital admissions and deaths in January and February 2021, similar to or worse than the first wave in spring 2020, coinciding with a period of peak demand on the NHS.

This could result in up to 119,000 COVID-19 related hospital deaths between September 2020 and June 2021 if no action is taken (the figures also don't take into account recent trial results with the steroid dexamethasone, which could also reduce deaths).

“This is not a prediction, but it is a possibility. The modelling suggests that deaths could be higher with a new wave of COVID-19 this winter, but the risk of this happening could be reduced if we take action immediately,” said Professor Stephen Holgate FMedSci, a respiratory specialist from University Hospital Southampton NHS Foundation Trust, who chaired the report.

“With relatively low numbers of COVID-19 cases at the moment, this is a critical window of opportunity to help us prepare for the worst that winter can throw at us.”