Act now or NHS could be overwhelmed this winter, report warns

Report commissioned by chief scientific adviser says Covid, flu and RSV could push health service to breaking point

Covid and flu threaten to push the NHS to breaking point this winter unless major precautions are taken over the summer, according to a report commissioned by the government’s chief scientific adviser.

Sir Patrick Vallance asked the Academy of Medical Sciences to assess how the “triple whammy” of coronavirus, influenza and respiratory syncytial virus (RSV) might affect the NHS in the winter and to make recommendations on how best to protect the health service.

The report brought together by 29 experts, with input from a patient and care group, warned that hospitalisations and deaths from influenza and respiratory syncytial virus (RSV) could be double those seen in a normal year, leading to as many as 60,000 flu deaths and 40,000 children in hospital with RSV as the health service continues to battle Covid.

Cases of influenza and RSV are expected to bounce back hard in the winter because people’s immunity to the viruses is likely to have fallen under Covid restrictions that kept infections down over the past 16 months.

Prof Azra Ghani, a member of the expert advisory group for the academy’s report, Covid-19: Preparing for the Future, who studies infectious disease epidemiology at Imperial College London, said the modelling was uncertain and represented a worst-case scenario but added: “What is clear is that the triple whammy of these infections on top of the backlog of routine care is going to potentially disrupt services in the coming winter and is likely to put severe strain on the NHS.”

The warning came as new data from Imperial suggests people working in retail and hospitality, including personal trainers, beauticians and hairdressers, have been slow to get vaccinated. Scientists on the React-2 study found that between 12 and 25 May, vaccination rates were 20% lower among retail and hospitality staff than other people of the same age. It is unclear why, and the gap may have closed since May, but the researchers speculate that zero- hours contracts may be one reason staff find it harder to make vaccination appointments.

Prof Stephen Holgate, chair of the academy report and honorary consultant physician at the University of Southampton, said the NHS was unlikely to cope with the winter pressure because hospitals would be operating with fewer beds, due to infection control measures, and a shortage of staff. The NHS is facing a shortage of 84,000 staff and 2,500 GPs, the report said.

Prof Dame Anne Johnson, president of the Academy of Medical Sciences who studies infectious disease epidemiology at University College London, called for a “concerted effort” to ensure all adults are vaccinated by September while the NHS prepares for a double campaign of influenza jabs and Covid booster shots.

With the UK witnessing a sharp rise in cases, she urged people to exercise caution, adding that face masks in crowded indoor environments, physical distancing, working at home if possible, and socialising outdoors in the summer months are all “sensible measures” that will help to keep cases of respiratory viruses down.

“The key thing that reduces transmission is when sick, stay out of the way, get your test, and then if you’ve got Covid, continue with that careful self-isolation,” she said.

“We’re not saying we’re about to have the worst winter ever, we’re saying we have got a bunch of uncertain things that could hit us in the winter that we need to think about mitigating now,” she added.

The report calls on government to “supercharge” the NHS by bringing in new staff, increasing bed numbers, and improving infection control measures. The experts also recommend more financial support to help people self-isolate without losing earnings, and the use of tests that can rapidly distinguish between Covid, influenza and other respiratory viruses. This would help doctors identify influenza patients who could immediately be put on antivirals.

Dr Doug Brown, chief executive of the British Society for Immunology, said the report painted a concerning picture of the winter ahead and said efforts must be made to ensure high vaccine coverage going into the winter. “This means redoubling efforts to reach out to communities with lower vaccination rates, to engage with them to understand their concerns, and answer their questions as well as providing accessible vaccination services for all,” he said.

“We have never experienced this type of thing where society has really shut down and really reduced transmission to this extent,” Ghani said. “It’s very difficult to know what impact this will have. It’s really just a warning to say: we can do something about this, this isn’t an inevitable, we can put measures in place and reduce the impact.”


Ian Sample Science editor

The GuardianTramp

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