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Things to consider when COVID restrictions end

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No restrictions doesn't mean no COVID

With coronavirus restrictions ending in England on 19 July, what does this mean for the decisions we need to make about how we live our lives? asks Dr Elizabeth Webb

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The Prime Minister has announced that coronavirus restrictions in England will end on 19 July. Along with his scientific advisors, he acknowledged that when restrictions are lifted the number of cases of COVID-19 will rise, along with the numbers of hospitalisations and deaths. This news will worry many, says Dr Elizabeth Webb.

COVID cases in the rise

Cases of coronavirus have been rising for several weeks, with the Office for National Statistics’ most recent estimates suggesting that 1 in 260 people in England have coronavirus. When restrictions are lifted further the number of cases will continue to rise, with models predicting that this coronavirus wave may peak with around 100,000 new infections each day. If this were to happen, it would be the highest number of infections each day that we have seen in the pandemic.

However, whilst cases of coronavirus are rising steeply, the numbers of people who are being admitted to hospital and dying due to coronavirus are rising much less steeply than in previous waves. With more than 38 million people in England having had a vaccination, and more than 28 million of those people having had both doses, the vaccination campaign is protecting many of the people who would otherwise have been most vulnerable to the worst outcomes from coronavirus.

The impact vaccines have had

The vaccination campaign has weakened, but not broken, the link between coronavirus infections and hospitalisations and deaths. Recent estimates suggest that fewer than 1 in 1000 coronavirus infections now leads to a death, while earlier in the pandemic this was around 1 in 100. Throughout the pandemic, the Government has had to judge how high infections should be allowed to rise in relation to the NHS’s ability to accommodate people with coronavirus. If hospitalisations continue to rise less steeply, it follows that cases can be allowed to rise higher before the ability of the NHS to cope is threatened.

However, despite the success of the vaccination programme there are still large numbers of the population who do not have immunity and are therefore still susceptible to catching coronavirus. The latest estimates suggest that 1 in 10 adults don’t have coronavirus antibodies and an unknown, but likely higher, proportion of children don’t have immunity.

The majority of adults who aren’t immune are in younger age groups which have only recently become eligible for vaccination, and are less likely to become seriously ill if they catch coronavirus. However, this group also includes about 1 in 20 people aged 65+ who have not yet been vaccinated and adults who have conditions or are on treatments that mean that their immune system doesn’t respond well to vaccination.

Things to remember

It’s important to understand that if coronavirus cases rise higher than they have previously, people who are not yet immune may be more at risk of catching it during the peak of this third wave of infections than they have been during the pandemic to date. It is also important to remember that, despite the vaccines offering excellent protection for most people, those who have been vaccinated may still catch and become ill with coronavirus. The chances of serious illness are enormously reduced, thankfully. However, the risk of developing so-called ‘long Covid’ remains, even if someone does not become seriously ill with the virus itself.

What does this mean for us all as individuals and the choices and decisions we need to make about how we live our lives? During the next few months, it will be important to take the precautions that we personally feel most comfortable with. For instance, if we haven’t already done so it is a very good idea to take up the offer of vaccination and the second dose too, to maximise our protection against coronavirus. In the autumn, if we are aged 50 and above we may be offered a booster vaccination to ensure our immunity remains high over the winter, and it will be wise to accept it.

We may also want to continue to wear a mask, even when it is no longer a legal requirement; to stay outdoors where possible; and to keep indoor spaces well ventilated. And importantly, as we adjust to the removal of restrictions as a country, we should all take care to respect the precautions that others around us want to take.

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Last updated: Jul 09 2021

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