Vaccines are reducing COVID-19 hospital admissions but 21 June decision still carries major risk

06 June 2021

The chief executive of NHS Providers, Chris Hopson, has posted a Twitter thread on the COVID-19 pandemic and current pressures on the trust sector. Please find a summary comment below:

"Trust leaders are increasingly confident that vaccines are breaking the chain between COVID-19 infections and the high levels of hospital admissions and death rates we've seen in previous COVID-19 waves.

"In places where community infections rates are increasing, hospital COVID-19 admission rates are rising too, but not at an alarming rate. Admissions rates are a lot lower than in previous waves. The admitted patients are generally younger and less likely to need critical care or be at risk of dying. Very few of these patients have had two vaccination doses.  In 'front of wave' hotspot areas like Bolton, admissions are now declining and trust leaders feel they have coped well with this latest surge.

But there are still risks here – the Delta variant appears to have significantly higher transmissibility.

Chris Hopson    Chief Executive

"But there are still risks here – the Delta variant appears to have significantly higher transmissibility. There are still many people, including some from the clinically vulnerable groups, who have yet to have a double vaccination dose and the required time to build up full protection. And trust leaders report their trusts as very busy.

"In heading towards a decision for 21 June, trust leaders want a more sophisticated debate than the current black and white 'full steam ahead' or 'delay everything'. They want the government to consider five critical questions:

 

  1. Do we need more evidence on hospitalisation and mortality rates – both in 'front of wave' areas and to check 'middle of wave' areas will behave in same way? If so, what evidence and how much more of it do we need? And how long will that take?
  2. If greater vaccine protection requires a double dose and two-to-three weeks to build up immunity, how much, and which sections, of the population do we want to have passed this milestone before we ease restrictions?
  3. Given the underlying dynamics of this virus, relaxing restrictions will lead to higher levels of mortality, albeit lower than in previous waves. What level of risk are we prepared to accept here, recognising this is a deeply uncomfortable debate and one that we are totally unused, as a society, to having?
  4. Given current pressures on the NHS, increased COVID-19 hospital admissions will likely lead to delays in treatment for other patients, for example slowing down work to recover the care backlog. Are we ready to accept this trade off and how do we measure whether it is the right one?
  5. How do we balance the risks and benefits here, and if we need to strike a balance between two extremes of 'full steam ahead' or 'delay everything', which lockdown easing measures carry more risk and which less?


There are difficult decisions to make in the days ahead with important trade offs. It's essential we have a full and transparent debate that explores these issues properly."

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