(Image credit: VHS/Commons)

On August 16, Covid-19 self-isolation rules changed in England, causing fewer people to need to self-isolate if they come in contact with someone who has tested positive for Covid.

These changes have already come into force in Scotland and Wales. Under the new guidelines, fully vaccinated adults and children under the age of 18 will no longer have to quarantine for 10 days if they have been in contact with a person who has had a positive Covid test.

It is hoped this will reduce the disruption caused by self-isolation, which in the last two months saw a so-called ‘ping-demic’, reaching its peak in July when over 600,000 people were told to self-isolate in just one week, badly affecting the end of the school term and many workplaces. It is hoped the new rules will mean businesses can get back to more normal working practices, and that the new school term will not see pupils’ education disrupted by constant rounds of staff and students isolating for 10 days — especially as most isolating students did not develop Covid.

Health Secretary, Sajid Javid, said the changes to the self-isolation rules were part of a cautious “step back towards normality”, thanks to the vaccine rollout. People who are pinged via the NHS App or are a known contact of a person who tests positive for Covid are urged to get a PCR test (free on the NHS) but will not need to self-isolate whilst waiting for the results.

However, it is advised that even vaccinated people can still contract Covid; they take precautions whilst waiting for results such as wearing a face mask, limiting close contact with other people, especially those who may be more clinically vulnerable. If the PCR test is positive, they will then have to self-isolate for 10 days.

Those who have not been fully vaccinated will still be required to isolate for 10 days following contact with a Covid-positive person.

So, does this mean that the Covid pandemic is mostly over for the UK? Following the easing of most restrictions on July 19, there were concerns that Covid cases would start rising significantly, but so far there has not been the huge spike in infections that had been predicted by some — including Javid, citing numbers potentially up to 100,000 cases a day.

However, whilst Covid cases seem to have steadied over the past few weeks, at around 25,000 to 30,000 per day, the high number of cases show the pandemic is far from over. There are currently around 6,000 people in hospital with Covid, and deaths have seen a rise in recent weeks.

The average age of patients in hospital with Covid is younger than in previous phases of the pandemic, reflecting the fact that the older generation is now mostly fully vaccinated, but it is a reminder that all age groups can become seriously ill with the virus.

There has also been a drive to encourage pregnant women to get vaccinated following several cases of pregnant women becoming seriously ill with the virus. It is not fully clear why cases seem to have plateaued, but several factors are thought to have helped prevent a summer spike – the end of the school term, better weather, so people are meeting outdoors more and ventilating rooms, and, of course, the high number of adults who are now vaccinated.

In addition, there is mounting evidence that vaccinated people are not only less likely to contract the virus but are also less likely to pass it on to others due to having a smaller viral load —helping to break the chains of infection.

Whilst the vaccine rollout has undoubtedly reduced deaths and the number of people getting seriously ill and requiring hospitalisation, there are still many cases in hospitals of people who have been fully vaccinated, a reminder that the vaccines are not 100 per cent effective.

Data from Public Health England (PHE) revealed that of all the people who died within 28 days of testing positive for the Delta [Indian] variant between February 1 and July 19, 49 per cent (224) had two vaccine doses, of whom 220 were aged 50 or older. Hospitals across the country are reporting cases of doubly vaccinated people requiring hospitalisation and being admitted to the ICU.

The Delta strain, which is more infectious than previous strains of the virus, emerged as the vaccine rollout was underway, and how effective the vaccines are against this new strain is not fully clear. Raising the prospect that there is always the potential for new variants to arise that might be more virulent even among the vaccinated.

Data up to August 4 from Imperial College London’s React study found that people who said they had received two vaccine doses were 50 per cent less likely to test positive for Covid-19. The researchers estimated a 50-60 per cent lower risk of infection from the Delta virus if a person was double vaccinated.

However, data from the UK and other countries suggests that vaccinated people are likely to experience some symptoms, such as cold and flu-like symptoms, with the Delta variant compared with earlier strains. So, whilst the vaccine lessens the severity of the disease, people are still getting ill and, in some cases, becoming seriously ill. In addition, it is also unclear how long vaccine-immunity lasts. If immunity wanes, then booster shots may be needed in the autumn – but this could create an opportunity to adjust the vaccines to reflect the predominant circulating virus strains – as happens with the flu jab each year.

As we head to autumn and the return of schools, universities, and office workers, there are fears we could see a rise in Covid cases again. Professor Neil Ferguson, an infectious disease modeller and epidemiologist from Imperial College London and former Government adviser, said higher numbers were still possible in autumn, but deaths would remain low compared to January. Speaking on BBC Radio 4’s Today programme, he said, “We’ll be reopening schools, people will go back to the office, so we’ve still got the potential of quite a large wave of infections in September, October.”

There are also concerns for flu season, as there were restrictions in place last winter, meaning the flu was also curtailed, but now restrictions have been lifted, and the flu and other seasonal respiratory viruses will circulate again. Health officials are concerned about how this will affect the NHS, which has so far been coping with Covid cases whilst trying to address the backlog of operations and treatment from the past year.

For now, we can enjoy our freedom and wait to see if this Covid pandemic peters out or has more to come.

Rachel Kayani