Worst-case scenario sees 200,000 hospital deaths in second wave

The UK must prepare now for another potential wave of Covid-19 this winter that could be more serious than the first and in a worst case scenario will lead to almost 200,000 hospital deaths, according to the Academy of Medical Sciences.

worst-case scenario sees 200,000 hospital deaths in second wave of Covid-19 epidemic.

The Academy say that combined with the disruption already created in the health service by the virus a backlog of patients needing NHS assessment and treatment, and the possibility of a flu epidemic, this poses a severe risk to health.

These new pressures are in addition to the challenge winter usually presents to the NHS, when other infectious diseases are more common and conditions such as asthma, heart attack, chronic obstructive pulmonary disease and stroke tend to worsen.

The ‘Preparing for a challenging winter 2020/21’ report stresses that ‘intense preparation’ is urgently needed throughout the rest of July and August to reduce the risk of the health service being overwhelmed and to save lives this winter.

This includes - reorganising health and social care staff and facilities to maintain Covid-19 and Covid-19-free zones, and ensure there is adequate PPE, testing and infection-control measures to minimise transmission in hospitals and care homes.

Increasing capacity of the test, trace and isolate programme to cope with the overlapping symptoms of Covid-19, flu and other winter infections.

And guarding against the worst effects of flu with a concerted effort to get people at risk, and health and care workers safely vaccinated.

Research suggests Covid-19 is more likely to spread in winter with people spending more time indoors and the virus able to survive longer in winter conditions.

The report notes there is a high degree of uncertainty about how the epidemic will evolve over coming months, but suggests a ‘reasonable worst-case scenario’ to prepare for is 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 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.

It estimates the number of hospital deaths (excluding care homes) between September 2020 and June 2021 could be as high as 119,900.

However, these figures do not take account of the fact Government would act to reduce the transmission rate, or the recent results from a trial to treat patients in intensive care with the steroid dexamethasone, which could substantially reduce death rates.

Professor Stephen Holgate FMedSci, a respiratory specialist from University Hospital Southampton NHS Foundation Trust, who chaired the report, said: “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.

“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.”

An advisory group of 37 experts were rapidly assembled to create the report following a request by the Government’s Chief Scientific Advisor.

The report was guided by a patient and carer reference group that provided information and advice on the key issues for those who would be most affected by a bad winter.

The Academy also commissioned Ipsos MORI to run online workshops with the general public, people who have been advised to ‘shield’ and those from black, Asian and minority ethnic backgrounds to understand how they think and feel about the problems expected this winter.

Scottish Conservative Health Spokesperson, Miles Briggs, said: “A second wave of Covid-19 would be catastrophic for Scotland’s health service and our economy.

“The Scottish Government must plan for the worst and hope for the best as we enter into the winter months.

“My biggest concern is the lack of commitment to testing by SNP Ministers.

“Outbreaks of Covid-19 are going to be inevitable, but to keep them under control they will need to be located early, which requires widespread and regular testing.

“Test, trace and isolate is the best way to prevent a second wave, but without testing being comprehensive it will fail in Scotland.”

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