Relaxing all restrictions by the end of April, a scenario demanded by some Tory MPs, could lead to a massive fourth wave of infections higher than the January peak and risk almost doubling the UK’s death toll, government documents have revealed. Lockdown-sceptic Tories have campaigned for the full lifting of all restrictions by the end of April. More than 60 MPs from the Covid Recovery Group (CRG) wrote to Boris Johnson calling on him to commit to a complete end to controls by 30 April. The government’s Scientific Advisory Group for Emergencies (Sage) released documents on Monday including five different models for easing lockdown in England. They suggest that under even the most optimistic scenarios modelled by teams at Imperial College London and Warwick University, tens of thousands more people can be expected to die from Covid because vaccines will not provide complete protection against the disease, and not everyone will have the jabs. The five scenarios differed in the speed at which restrictions were lifted, roughly between two and five months, with baseline measures such as mask-wearing and test-and-trace in place at the end. All scenarios led to a resurgence of cases because so many vulnerable people remained unprotected, even with high vaccine coverage.
Scenario 1 would entail ending restrictions by 26 April, in line with demands of Tory MPs, with others seeing a progressively more cautious timetable. The modelling of scenario 1 says: “Unless vaccine efficacy is significantly better than assumed here, it is highly likely that hospital occupancy would be higher than that seen in January 2021, if all restrictions are lifted by the start of May.” It says that in scenario 1, even under the most optimistic modelling, there would be “another wave comparable in size to January 2021, resulting in a further 62,000 to 107,000 deaths in England”. The document warns that a fourth wave would occur even under the optimistic vaccine rollout scenario of 4m doses a week from the end of March 2021. The outlook is far brighter if restrictions are lifted with case rates low, vaccination rates high, and changes being made gradually. However, even under the most optimistic vaccine scenario and with cautious unlocking, models suggest there could be tens of thousands of additional Covid-related deaths by summer next year. In Warwick’s submission, the scientists say that “relaxing too quickly (scenario 1) will result in peak hospital occupancy considerably higher than the current wave and substantial additional deaths. This holds regardless of vaccine efficacy, rollout, adherence to baseline NPIs [non-pharmaceutical interventions, such as testing and isolating positive cases, hand-washing and mask-wearing], and impact of seasonality.” The government has said it hopes to vaccinate all priority groups – which will include all over-50s and vulnerable adults – by 15 April and all adults in the UK by 31 July.
It will hope that the data released by Sage may avert a collision with MPs when they vote on the regulations in the coming weeks. The CRG chair and deputy chair, Mark Harper and Steve Baker, said in a letter to the prime minister that restrictions should end when all the government’s top nine priority groups, including all over-50s, have been offered a vaccine. After that, they said, there would be “no justification” for any legislative restrictions to remain at all. Labour’s deputy leader, Angela Rayner, said it was time for Johnson to face down attempts to undermine lockdown. “It is deeply concerning that a group of Conservative MPs is actively campaigning for a policy that the government’s own scientific advisers warn could lead to a deadly fourth wave, a 50% spike in the death toll and up to 100,000 more deaths,” she said. “If we are to ensure this is our last lockdown, he must now face down those Conservative MPs who have throughout this crisis undermined the national effort to defeat the virus.” The government’s roadmap, which anticipates gradual easing in four stages starting from 8 March until 21 June, is a bespoke model that does not directly correlate to the scenarios modelled by Sage. However, its closest scenario – scenario 3 – projects that the UK is likely to see a resurgence of the virus around September. In more pessimistic scenarios where the vaccine is not found to be as effective, then another fourth wave could occur similar to that in January. Speaking at a press briefing on Monday, the government’s chief scientific adviser, Sir Patrick Vallance, said infections would probably increase as the country emerged from lockdown, but reopening fast would drive a much bigger wave of infections than releasing gradually and allowing scientists to gauge the impact of each step on the epidemic. “The sooner you open up everything, the higher the risk of a bigger resurgence,” Vallance said. “The slower you do it, the better.” He said: “Vaccines are predicted – as you’d expect and hope – to make a big difference.” But even with high levels of vaccine efficacy and uptake, he added, “it is important to remember that a large number of people in the population remain unprotected”. If all adults received an 80% protective vaccine, roughly half of the population would still be at risk from disease, he said. Given the uncertainties, Vallance said it was important to lift restrictions step by step, with enough time – four to five weeks – between each to monitor the impact. “You will be flying blind on this if you don’t wait,” he said. In a further paper on reopening schools, the modellers estimate that reopening primary and secondary schools will drive the R number up by 10-50%, and point out that a limited and cautious reopening, perhaps of primary schools only at first, would allow scientists to assess the impact on community infections.