Scientists warn public health at risk as leading Covid surveillance programme ends

Study shows 6.37 per cent of population in England infected with Covid between 8 and 31 March, the study’s highest figure on record

Samuel Lovett
Science Correspondent
,Rebecca Thomas,Chloe O'Connor
Wednesday 06 April 2022 00:22
Comments
<p>A medical worker talks to a member of the public waiting in their car to take a test for Covid</p>

A medical worker talks to a member of the public waiting in their car to take a test for Covid

Ministers will be left in the dark on Covid spikes just as case numbers reach unprecedented levels if a “world-beating” surveillance programme is scrapped, scientists have warned.

The React-1 study, which played a crucial role in detecting and tracking the spread of the Alpha variant in December 2020 ahead of the second lockdown, has been stopped as part of the government's plan to cut its Covid costs.

But in its last report, the study found 6.37 per cent of the population was infected between 8 and 31 March – the highest figure since it began in May 2020. More worryingly, the scientists behind the research said the prevalence rate has also reached new highs for people aged 55 and over, at 8.31 per cent.

The Royal Statistical Society (RSS) said dismantling the project while cases were at record levels damaged preparedness and put public health at risk.

On Tuesday, the number of UK patients in hospital with and because of Covid was back over 20,000 for the first time since February 2021, the latest NHS data show, while primary and incidental admissions have risen in recent weeks.

The spread of Covid within hospitals is also fuelling staff shortages, bed closures and delayed discharges in multiple regions of the country. This is coinciding with delays in ambulance handovers and response times, NHS sources say.

Information seen by The Independent revealed hundreds of beds are currently out of use at Newcastle upon Tyne Hospitals trust due to Covid outbreaks. A senior clinician said the “hospital is coming apart at the seams” and that, across the northeast, even “high” performing emergency departments were “crashing” and “stacking ambulances outside of hospital”.

Professor Christl Donnelly, one of the experts working on the React study, said the vaccination programme had been “hugely important” in protecting the population, especially older, more vulnerable people.

However, she warned that “it’s still the case” that the recent nationwide rise in infections would lead to “more severe outcomes”.

“We don’t yet know when we’ll see a peak in the in the oldest age group, the 55+, and because those people are at higher risk of severe outcomes, that is a particular worry,” Prof Donnelly said. “If the prevalence continues to go up, then you will see further increases in the severe outcome rates.”

In March, the prevalence of Covid was more than twice that in February, the latest and final React-1 study showed. The highest rates were seen in five to 11-year-olds, who have only just started to be vaccinated.

Rates are plateauing in 18 to 34-year-olds and 35 to 54-year-olds, but showing no signs of slowing down in the over-55s, the research said.

The React study also picked up five cases of the new XE variant, of which 763 have been identified in the UK so far, according to the UK Health Security Agency (UKHSA).

“Little is known about the clinical manifestations of XE and whether it may lead to more severe disease than BA.1 or BA.2, but early indications suggest a growth advantage compared with BA.2,” the scientists wrote.

Prof Donnelly suggested that the ability to detect new variants could be impacted by the decision to scale back the UK’s surveillance infrastructure. (The Office for National Statistics’ weekly Covid survey, deemed the gold standard, is due to be downsized, but not scrapped.)

“You reduce the amount of testing that you’re doing, that reduces capacity and it may take a bit longer to detect these [new variants],” she said.

“But the fact that there is still testing going on and that there is systematic sequencing of samples is important … There are lots of variants out there and it’s looking at the pattern that helps both nationally and internationally to identify these variants of concern and make sure that people see what’s coming.”

Professor Paul Elliott, the director of React-1, said he was “disappointed” that the programme had drawn to a close, having assessed 2.5 million samples since May 2020, but acknowledged that “things have moved on” with regards to Covid and the government’s response.

Christina Pagel, a professor of operational research at University College London (UCL), said: “React-1 has been an incredible study of community infection in England, complementing the ONS infection survey.

“Because it uses PCR tests, it is also a crucial window into ongoing evolution of the virus which we cannot get from lateral flow tests. Stopping funding now seems very unwise just as infection rates are the highest ever recorded and several new sub variants are emerging.”

Professor Sylvia Richardson, president of the RSS, said the study has “provided vital insights into the spread of the disease and new variants so that public health decisions could be made quickly.

“We are entering a new phase of the pandemic, with cases rising and testing considerably reduced. Dismantling the programme altogether without maintaining a scaled down version of React-1 damages preparedness and puts the public’s health at risk.”

It comes as several ambulance services warned of rising handover times at hospitals, causing severe delays in response times.

NHS sources working within the southwest claimed there had been an increase in police transporting ill patients to hospitals due to a lack of ambulance availability over recent months and had now become a “frequent” occurrence.

In Manchester, meanwhile, one senior doctor said they’d seen 30-hour waits for a bed within their hospital, while reports in the Health Service Journal revealed doctors at Lancashire Teaching Hospitals recently warned leaders that patients were waiting two days for a bed in A&E.

Ambulance leaders believe around eight in 10 patients in February may have suffered some degree of harm due to delays in handing over patients to busy A&E departments.

Dr Layla McCay, director of policy at the NHS Confederation, which represents all hospitals in England, said: “NHS leaders and their teams are increasing their Covid services and reopening coronavirus wards, but the government must take heed, combined with chronic staff shortages, and a waiting list backlog that now tops 6.1m, we really need a realistic conversation about the current situation in the health service.”

Commenting on the React-1 study, she said it was “particularly concerning to note the unprecedented and still rising levels in older people”.

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