Blizard Institute - Barts and The London

Blizard researcher helps draft report calling for intense preparation for winter COVID-19 peak

A new report from the Academy of Medical Sciences released on Tuesday 14 July warns that the UK must prepare now for a potential new wave of coronavirus infections this winter, which could be even more deadly than the first.

16 July 2020

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Members of the public wearing face masks on the street. Photo by Gustavo Fring.

A more deadly second wave

According to the ‘Preparing for a challenging winter 2020/21’ report, a potential second wave of COVD-19 infections in the winter poses a serious risk to health in the UK. Dr Upkar Gill (Uppy), Clinical Lecturer within the Centre for Immunobiology at the Blizard Institute, was selected by the Academy of Medical Sciences as one of the early/mid-career researchers to aid the Expert Advisory Group in drafting the report, led by Professor Stephen Holgate, Medical Research Council Clinical Professor of Immunopharmacology at the University of Southampton.

With his expertise in viral immunology, Uppy was given the role of providing input regarding reinfection along with the interaction and interference of different viruses. This forms part of the report indicating ‘What is not known about seasonal variation in COVID-19 transmission’ and the further research that is required to tackle this.

Research suggests that the virus can survive longer in colder, darker conditions when people tend to spend more time indoors in enclosed spaces, and in closer proximity to each other. Winter also tends to bring about a worsening of other conditions such as asthma, heart attacks, chronic obstructive pulmonary disease (COPD) and stroke. Match this with an increase in other infectious diseases such as a seasonal flu epidemic and a backlog of patients needing NHS treatment, it is easy to see how a second wave in winter could be more damaging.

Dr Upkar Gill (Uppy)
Dr Upkar Gill (Uppy)

Uppy, who also holds a starter grant from the Academy of Medical Sciences and was recently appointed as an Early Career Researcher at the Medical Research Foundation, said: “It is critical to determine the seasonal variation in COVID-19, and how immunity to COVID-19 can be enhanced. The impact of other respiratory infections, more common in winter, also needs to be considered as this is likely to impact COVID-19 in the winter months. There are now experimental studies being published highlighting the differential immune responses in COVID-19, but more research in this area is still required to learn more about long-term immunity and augment vaccine development”.

Preparing for the winter

The report makes the following recommendations to minimise the severity of a second wave in winter:

  • Develop a public information campaign and advice tailored to individuals and high-risk communities to minimise the transmission of coronavirus in the community.
  • Minimise transmission in hospitals and care homes by reorganising staff and facilities to maintain separated zones for COVID-19 and COVID-19-free patients, ensuring adequate PPE, testing and system-wide infection-control measures.
  • Increase the capacity of the test, trace and isolate programme to ensure that it can cope with the overlapping symptoms of COVID-19, flu and other winter infections.
  • Monitor and manage a winter wave by establishing a comprehensive, near-real-time, population-wide surveillance system.
  • Encourage health and care workers and people at risk to get safely vaccinated against flu.

The ‘Peoples perspective’ report, released by The Academy and written by patients and carers, also calls for engagement with patients, carers an the public around any actions developed around these recommendations. This is to ensure services, guidelines and communications work for people, rather than focusing plans on individual medical conditions.

Uppy added: “Working with such a diverse group of experts was truly an excellent experience, in fact a ‘tour de force’ to produce a document of this magnitude in the space of a few weeks. More importantly, an extra dimension is provided to this report by the involving of patients, carers, public and healthcare professionals”.

‘Reasonable worst-case scenario’

Although it notes a high degree of uncertainty about how the epidemic will evolve in the UK over the coming months, the report suggests that we currently have a ‘critical window of opportunity’ for intense preparation to deal with a ‘reasonable worst-case scenario’ of a rise in the Rt value to 1.7 from September 2020 onwards.

The modelling suggests a peak in hospital admissions and deaths in January and February 2021 similar to or worse than the first wave in Spring 2020, and this would coincide with the period of peak demand usually experienced by the NHS during these months.

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