Looking for the peak: the cautious optimism over stalling UK Covid cases

The Covid pandemic has been a story of twists and turns, with the situation often developing quickly.

For much of October, confirmed cases in the UK have risen daily – largely driven by increases in England and Wales.

The situation has provoked consternation, with voices ranging from the head of the NHS confederation to the British Medical Association and a number of leading scientists urging the government to implement its “plan B” – a series of “light touch” measures such as advice to work from home if possible, mandatory use of face coverings in some settings and the introduction of vaccine passports.

But, at least on the surface, it seems that the rise in cases may have stalled, while modellers who contribute to the Scientific Advisory Group for Emergencies (Sage) have suggested cases may decline in the coming weeks even without extra measures.

Speaking on BBC Radio 4’s Today programme on Wednesday, Prof John Edmunds, an epidemiologist at the London School of Hygiene & Tropical Medicine, said work by three groups of researchers who have modelled potential scenarios pointed in a similar direction.

“If you take the consensus, we all feel that we might see cases either levelling off or falling in the next few weeks,” said Edmunds, who sits on Sage.

One reason for that is the expected decline of cases in children – the group where infection levels are highest. “The epidemic in the last few months has been really driven by huge numbers of cases in children … and that will eventually lead to high levels of immunity,” Edmunds said.

But while the models offer cause for optimism, there is also a need for caution. Reported new Covid cases in the UK reached a recent daily high of 52,009 on 21 October before falling for four consecutive days. But in the past two days they have risen again, reaching 43,941 on Wednesday.

And that may just be the tip of the iceberg. According to the latest Zoe Covid study figures – based on PCR and lateral flow test data from up to five days ago – there are 92,953 new daily symptomatic cases of Covid in the UK on average, with about 1 in 56 people in the UK having the virus with symptoms.

As Prof Neil Ferguson of Imperial College London notes, while the models point in a similar direction, there is uncertainty about when a peak would be seen.

Another consideration is that many schools in England are closed for the half-term holiday. Half-terms have previously led to a fall in infections among children, although that would not be expected to be seen immediately. But experts say the break can also lead to a drop in testing.

Speaking to the Guardian this week, Edmunds said it was too early to say whether cases had reached a peak.

“After half-term we will have to evaluate where we are; do cases start to go up again or not?” he said.

That situation may not be the same across all regions. London, for example, has had some of the lowest Covid case rates in the country during the autumn despite relatively low rates of vaccination, possibly because the capital was hit hard by previous waves, meaning a high proportion of the population has some level of protection. Meanwhile, parts of the south-west have seen large increases in case rates over the same period.

That means cases could pick up again after half-term in some areas, but not others.

It will take another couple of weeks before it becomes clear whether cases in the UK are really declining.

If a peak in cases has been reached, it would suggest that Covid hospitalisations will soon peak too. However, with concerns that this winter could bring higher than normal levels of flu and other respiratory infections, and the NHS already loaded with an enormous backlog of routine treatments, the question remains as to whether a levelling or even a decline in Covid cases – and hospitalisations – will be enough to prevent “unsustainable pressure” on the NHS.


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