As covid restrictions are relaxed in the UK, we look at how these new policies could play out
25 January 2022
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The big news in the UK is the easing of covid-19 restrictions, including England stopping the advice to work from home where possible and this week ending mandatory face masks in indoor public spaces. The rule that people must self-isolate if they test positive for the coronavirus also looks set to go, from 24 March or sooner.
There is, naturally, a wide spectrum of opinion on these moves. The debate over how we should respond to covid-19 has long been polarised, with each new wave of cases seeing the more cautious arguing for stricter rules and earlier implementation of them, while their opponents argue for less and later.
But whatever our personal opinions, it looks like England, possibly to be followed by the rest of the UK, will soon have a policy more akin to “let it rip” than ever before. So, what is likely to happen next?
To get one thing out of the way, some believe covid-19 will naturally evolve to be less virulent. But this is wrong – pathogens evolve to be more transmissible. The coronavirus doesn’t “care” if it kills people or not because it generally spreads long before it kills. “Diseases don’t always evolve to become less virulent,” says Paul Hunter at the University of East Anglia. “Sometimes they do, sometimes they don’t. And you can’t predict that.”
A virus’s inherent virulence isn’t the only thing that matters, though. Over the course of the pandemic, the coronavirus has gradually caused less serious illness because of a build-up of immunity in populations, from both natural infections and vaccines. National figures show that while immunity against catching the virus – from either source – wanes quite quickly, there is longer-lasting immunity against severe illness.
The delta variant, which surged in mid-2021, seems to have been intrinsically more virulent than the original version of the coronavirus, although it took less of a toll in many countries because there was some population immunity. Omicron seems to be both intrinsically less virulent than delta and is causing less illness because of greater immunity.
One encouraging sign is that another coronavirus called OC43 seems to have evolved to become much less virulent. This virus may have crossed to people from animals, and is thought to have caused a pandemic in 1889 that was dubbed “Russian flu”. It is now one cause of the common cold.
Cold-causing coronaviruses like OC43 seem to reinfect people every three to six years. As with covid-19, immunity to reinfections doesn’t last long, but immunity to serious illness does. After all, catching a cold is a byword for something that happens a lot, but is trivial for most people. Many scientists believe this will eventually happen with covid-19 too.
In the shorter term, it seems likely that we will get further waves of covid-19 caused by new variants – if not this year, then the next. The big question is whether the next variant will cause more of a toll than omicron, less or about the same.
As well as any changes to inherent virulence, that depends on two opposing forces: waning immunity to severe illness due to the passage of time and increasing population immunity from a steady patter of natural infections, plus more and more people topping up their vaccine doses.
I don’t think anyone can predict how the next variant will go.
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That’s all for this week, but take a look at our next online event, on “Nutrition and mental health”. It’s on Thursday 27 January at 6.00pm GMT.
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