‘We don’t have very much headroom’: UK more vulnerable to winter Covid surge than European neighbours

Amid high infection rates and flagging vaccination coverage, expert warns: ‘This is not a good way to start the winter’

The UK is more vulnerable to a Covid winter surge than its European neighbours, one of the country’s leading epidemiologists has warned, adding that “we don’t have very much headroom” for an increase in cases in the months ahead.

Professor Neil Ferguson, a member of the Scientific Advisory Group for Emergencies (Sage) from Imperial College London, said that Germany, France, Spain, Italy and Portugal have much lower levels of Covid-19 than Britain and can therefore “afford to see something of a surge in transmission” without “unduly stressing” their health systems.

The UK, in contrast, has a higher prevalence of infection and is “much closer to the limit of what the NHS can cope with”, he told MPs during an all-party group session on coronavirus.

Dr Jonathan Cylus, a research fellow at the European Observatory on Health Systems and Policies, also told politicians during Tuesday’s meeting that “this is not a good way to start the winter”, adding that Britain was the “canary in the coal mine” for the rest of Europe.

Despite the early success in rolling out the Covid vaccines, the rate of coverage in the UK has slowed compared to the continent.

According to Our World in Data, the UK has fully vaccinated 65.9 per cent of its adult population. For France, Italy, Ireland, Spain and Portugal, this figure stands at 66.1 per cent, 68.3 per cent, 74.1 per cent, 78.6 per cent and 85.2 per cent respectively.

Alongside a handful of Baltic state nations, Britain also has one of the highest infection rates in Europe, with an average of 32,000 new Covid cases being recorded every day.

Martin McKee, a professor of European public health at the London School of Hygiene and Tropical Medicine, told MPs that the UK is “not quite as bad” for daily deaths compared to other European countries, “but we’re still in the bottom third”.

The political decision to "live with Covid" is behind the UK's current levels of transmission, said Prof Ferguson, adding that the government's Plan B for tacking Covid could be triggered if hospital admissions doubled to reach 1,200 a day. This would see the return of mandatory face masks, the introduction of Covid passports in certain settings and new guidance on working from home.

"We are starting with quite a high incidence and so we don't have very much headroom for increases,” Prof Ferguson said. “We will come on to plan B, I think that is what is exercising Whitehall and policymakers, is that limited headroom.”

He said there was a high level of unpredictability in the modelling, but added: "We could see continued flat incidence, even slow decline if we get boosters out quickly.

"So it's not guaranteed we will see a large winter surge by any means, but we can't afford, at the current time, to have too much of a winter surge before really the NHS is very heavily stressed."

Asked about whether the UK wants to keep case rates down, Prof Ferguson said: "The government clearly has said, it's not really science here, it's a political judgment, they want to live with Covid.

"Their prime criteria for acting is additional pressure on the NHS."

While the UK chose to lift all Covid restrictions during the summer, other countries in Europe have continued to enforce mandates on indoor mask wearing or implemented Covid passports for access to restaurants and bars. As a result, Britain is “a couple of months ahead of some European countries”, said Dr Cylus. “We're the canary in the coal mine.”

“Why we've gotten here? I think it has got everything to do with the fact the we lifted all restrictions at about 50 per cent of the population vaccinated, and really no-one else in Europe has been doing this.”

Prof Ferguson said the key determinants of what is going to happen in the next few months, given that most countries have relaxed most social distancing, "is the level of population immunity traded off against the level of contact rates in the population".

He said the UK was now behind Spain, Portugal and "probably even France and Netherlands" in terms of population immunity.

However, people in the UK were not seeing each other and having the same level of contact as before the pandemic, which was helping the situation.

"I don't think we're in a position where we can make reliable predictions of what the next few months will hold, (but) the key uncertainties are: what will happen to population immunity - we know that it wanes over time; what will happen to contact rates in the population; and then layered on top of that, the effect of seasonality in transmission due to climate - which we still don't fully understand either."

Prof Ferguson added: "I personally think it's unlikely we'll see a very large wave comparable to what we saw in the second wave last year, but we could still see quite a substantial wave of transmission, and the real challenge will be the extent to which that stresses the NHS, where capacity is limited."