Home quarantine for travellers “doesn’t work” while long Covid has not featured in government decisions around how to tackle the pandemic in the UK, experts have said.
Cases of the Delta variant are rising rapidly in the UK, with 11,007 new infections reported on Thursday – the highest figure since 19 February.
The variant now accounts for more than 90% of new Covid cases while early data has suggested it is somewhat more resistant to Covid jabs than the Alpha variant, particularly after one dose, and might be linked to a greater risk of being admitted to hospital with Covid.
Speaking at a Royal Society of Medicine webinar, Prof Graham Medley, chair of the Scientific Pandemic Influenza Group on Modelling (Spi-M), which advises the government, suggested limiting travel from India to the UK earlier that 23 April would likely have delayed but not prevented the Delta variant becoming established in the UK.
Prof Neil Ferguson, an epidemiologist at Imperial College London, agreed. “I think the lessons are that if you take the policy of Australia and New Zealand [which have very tight border controls], then it can be effective, but anything much less than that is at best slowing things down,” he said.
“One of the things this last experience with Delta in the UK has highlighted is that home quarantine for travellers just doesn’t work. I mean, everybody coming in from India in April of this year was meant to quarantine at home [for 10 days], but it has still established itself.”
Ferguson went on to suggest the border controls were more about appearances than impact.
“I think we need to think carefully about the extent to which travel restrictions are really intended to be effective, in which case they have to be quite stringent. Or we adopt a different strategy,” he said.
While concerns have been growing about long Covid, with recent figures suggesting more than 376,000 people in the UK have been living with symptoms for more than a year, Medley revealed it had not featured in expert modelling.
“That’s mainly because the government’s focus is on the healthcare burden in terms of tertiary health care [hospitals],” he said, adding that this needs “careful thought” as the burden of Covid is now being shared more between primary care and hospitals.
“I think long Covid is a significant issue. But at the moment hasn’t really played into government decisions,” he said.
Ferguson said the Delta variant appeared to be about 60% more transmissible than the Alpha variant, and that a new wave of infections had already begun.
“The million dollar question is we are going to see lots of cases in the next few weeks, I am sure of that, but how is that going to translate into hospitalisations and of course into deaths? There is greater uncertainty around the answer to that,” he said.
The comments came as England’s chief medical officer, Prof Chris Whitty, also warned of a rise in case rates in the next few weeks because of the Delta variant being “significantly more transmissible” than the Alpha variant
Speaking to an NHS conference, he added: “In terms of the medium term, my expectation is that we will get a further winter surge, late autumn/winter surge, and that is because we know that winter and autumn favour respiratory viruses,” he said.
However Ferguson noted there were some “encouraging signals” including that Covid vaccines offer around 90% protection against hospitalisation with the Delta variant.
Ferguson also said Covid patients may be spending less time in hospital once admitted, meaning hospitals might be able to cope with a higher level of admissions.
However, speaking to the Commons science and technology committee on Wednesday, Dr Susan Hopkins, chief medical adviser for NHS test and trace, and deputy director of Public Health England’s National Infection Service, said the reduction was only small, not least because certain treatments such as remdesivir required a hospital stay of a number of days.
“We are seeing a younger population coming into hospital and we are seeing the median length of stay is slightly less, not significantly less, but more time is required for us to give fuller figures on that,” she said.
Ferguson added the relaxation of restrictions in Britain last month probably contributed to the rise in infections – a situation further relaxations would amplify – but both he and Medley said they thought it was unlikely such restrictions would be reapplied.