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So what’s really going on with Covid in the capital?

Covid cases are rising as winter hits, and experts predicting a ‘twindemic’ of the virus and flu are encouraging extra vigilance. Katie Strick reports on how Londoners are tackling the situation

NICOLE ABEL, 29, assumed it was just a sore throat, the first symptom she always gets at the start of a cold. The Claphambased marketing executive decided to plough on and go ahead with her weekend plans, telling friends she was probably just run-down after a busy work trip in Canada.

It was only four days into her return that Abel decided to take a Covid test, “just in case”, because she’d been on a plane and had some free tests lying around. “It really shocked me,” she says, when she tested positive. “I hadn’t even realised a sore throat was a symptom.”

Abel’s story is a common one across the capital at the moment — though many of us might not have realised it yet. While official guidelines are yet to be updated, a sore throat is currently the most common Covid symptom, with fever and loss of smell much rarer, according to health experts warning of a “twindemic” of Covid and flu this winter. The latest data shows Covid infections have increased by 14 per cent in the last week — the biggest rise since the summer — with a sore throat affecting two-thirds of the UK’s current million or so cases of the virus.

“Fever and loss of smell are really rare now. So many old people may not think they’ve got Covid. They’d say it’s a cold and not be tested,” professor Tim Spector, co-founder of the Covid ZOE app, said this week as health bosses warned of a “perfect storm” for an autumn wave. So why haven’t official guidelines caught up? How high could actual Covid rates be at the moment, if so many of us don’t even realise we have it? And are rising cases just an inevitability, as the UK faces its first winter in three years with no restrictions?

For most experts, it’s too early to say. Scaremongering headlines about “devastating” new Covid waves, “perfect storm” conditions for new variants and a “double threat” of low immunity and widely circulating winter viruses are unhelpful and often overly-dramatic, but not entirely without basis. Comments like US President Joe Biden’s recent declaration that the pandemic is “over” was also wrong and even more unhelpful. “We’ve got [Covid] forever: it’ll continue to put pressure on the NHS forever more,” says John Edmunds, a professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine.

Predictions for the coming months are difficult and varied but most experts agree that rising figures should at least be a “wake-up call” as Britain finds itself facing several new crises since the last wave: the NHS expecting its toughest winter yet; our immune systems being weaker than ever thanks to three years without the flu; and the worst cost-of-living crisis in a generation, limiting the ability of thousands to afford tests and take time off work.

The latest surge in cases is already being called “a very heavy straw on the camel’s back” for UK hospitals, with 7,000 people hospitalised with Covid in England last week alone — a 37 per cent rise on the week before and the equivalent of seven per cent of hospital beds in the UK. Despite cases rising most sharply in secondary-school age children returning to schools after the summer holidays, most of those hospitalised have been vulnerable and elderly patients. Nevertheless, “the fact that there are people getting so seriously ill they need to go into hospital is a wake-up call to us all that Covid is still here,” Dr Thomas Waite, deputy chief medical officer for England, said this week.

Indeed, patients like Abel are among the lucky ones, relatively speaking. She

I can’t afford to take time off but I also can’t afford to stay at home for a week because of the electricity bills

had a stash of free tests at home, she’ll receive sick pay if she has to take time off work, and — so far — her symptoms are yet to worsen into a full-on fever. Many are not so fortunate. “It feels like razor blades in my throat and like I’ve been hit by a bus,” says Georgia Lewis, 46, a writer from Morden. She is worried about her husband, who is clinically vulnerable and just tested positive.

Zoe Watson, a GP in Walthamstow, points out that infections don’t just mean an increase in patients for the NHS but fewer staff. “When staff sickness happens to an already struggling NHS workforce, this has a huge ripple effect,” she says. “We all know an economic crisis mean cuts. Given that the NHS is already operating on a tight budget, many people fear that this could be the final nail in the coffin.”

OTHERS are equally concerned about the financial implications of catching the virus on individuals. “I’m terrified about this winter, to be honest,” says PhD student Sarah Montgomery*, 27, who had Covid last week. As a part-time teaching associate, she is paid by the hour and only just manages to make ends meet when she’s healthy — a week off work would mean losing £200 of pay and a new pack of tests (just under £10 for five) would mean not being able to afford public transport for a week. “I can’t afford to take time off but I also can’t afford to stay at home for a week because of the electricity bills.”

So is Britain facing its third Covid Christmas — or worse, a “twindemic” Christmas? Dr. Hana Patel, a GP in Dulwich, believes the answer depends on how the Government and the public handle the virus over the next few months — particularly the flu. Dr Charles Levinson, CEO of urgent GP service Doctorcall, agrees. “We’re all aware of the dangers of Covid, but influenza is horrific and can kill thousands,” he says, pointing to the situation Down Under. “Australia [which is experiencing its worst flu season in five years] is usually seen as a precursor for our winter and it has had a tough time.” He and Patel believe the answer to making sure the UK doesn’t follow suit is getting high-risk members of the public vaccinated, fast. “We are encouraging everyone who is eligible for a free flu vaccine and a Covid booster to take up the offer as soon as possible, particularly younger children at risk of flu as they have not built up a natural immunity to it,” says Patel. Among the millions eligible for the Covid booster are the over-50s, care home residents, front line health and social care staff and the clinically at-risk — so will it then be opened up to the rest of the population? Edmunds says it’s “not a given”: rolling out boosters is expensive and disruptive, so it might become a winter routine for the high-risk. Levinson and Edmunds believe future lockdowns should be avoidable if vaccines are delivered quickly — but what if new variants emerge? Recent weeks have seen reports of a “downscaling” of testing laboratories since the unveiling of the Government’s Living with Covid plan. Among recent warnings are that the UK is “blind” to the behaviour of potential new variants.

Levinson admits that new variants are indeed a fear — improved testing will be needed to help detect them. Free tests stopped being made available to the public in April and they now cost upwards of £1.70 per test, which has lowered the number of people using them. “We’ve taken our eye off the ball with Covid tests.”, says virologist Professor Lawrence Young.

Indeed, £1.70 might not sound like much but for many people it’s the difference between being able to eat lunch or not. “I’m going to struggle to pay for more tests,” says Montgomery. She will test, because she couldn’t face infecting others, but “it’s become a case of: what do I not buy instead?”

Montgomery is among increasing swathes of the public calling for tests to be made free again, and many believe additional support is needed. For people at the lower end of the income spectrum, it’s not just the cost of testing that worries them this winter, but taking time off work. Montgomery will isolate if she tests positive again, but she’ll lose at least £200 per week, which will affect whether she can afford to turn on her heating.

So will masks and social distancing become mandatory again? Levinson says while masks “should not become mandatory and they are not part of the future we all want”, they can play a role. “Public advice to wear masks in crowded places such as Tube trains may be appropriate,” he says. “But we must rule out social measures beyond that.”

Adeem Azhar, co-founder of healthcare organisation Core Prescribing Solutions, says a mandatory mask situation is unlikely — and even if it did happen, he thinks the public mood has moved on so much that people don’t have the patience for restrictions.

Experts suggest we won’t see a repeat of the last two Christmasses this December. Last Christmas already saw much “lighter restrictions” than in 2020, Edmunds points out, while Azhar says he expects 2022 to be “quite different, probably more like back to reality... But that’ll be based on the numbers: is the recent rise in hospitalisations an acute problem, or will it persevere?”

The outlook for this winter will be determined by Covid case rates and how pro-actively the Government tackles them. Many of us might be able to live relatively normally, and restrictions like we saw in 2020 and 2021 might not return, but “[Covid] will be a constant drain on NHS resources forever more, so the NHS will need more resources. It’s a whole new disease we didn’t have before, so something has to give.”

• For the full article, see standard.co.uk

Masks in crowded places may be appropriate but we must rule out social measures beyond that

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