We know the date is 19 July – here's what we still don't know about the data

·6 min read
Prime Minister Boris Johnson (left) and Chief Medical Officer Professor Chris Whitty during a media briefing in Downing Street, London, on coronavirus (Covid-19). Picture date: Monday July 5, 2021.
Boris Johnson has outlined his plans for stage 4 of the coronavirus lockdown easing roadmap, tearing up existing regulations. (PA)

Boris Johnson has confirmed he plans to lift all England's remaining coronavirus regulations at the next stage of the road map, currently planned for 19 July.

Mask wearing will become voluntary, social distancing in pubs and bars will end and work from home guidance will be scrapped, the prime minister said.

A decision on whether to press ahead on 19 July will be made on 12 July.

When he first outlined his roadmap to easing lockdown restrictions in February, the PM insisted that all the government's decision would be led by "data not dates".

It was concerning data about the spread of the Delta variant, first identified in India, that led Johnson to delay the final stage of lockdown easing for four weeks. 

However, experts warn existing data does not paint a full picture of the risks posed by doing away with all restrictions.

Here are four things the data so far doesn't tell us.

How much have vaccines broken the link between cases, hospitalisations and deaths?

Vaccines have saved the lives of tens of thousands of people in England, according to Public Health England (PHE).

It is clear that the vaccine rollout has vastly improved the shape of the pandemic, protecting the vulnerable and making coronavirus less deadly.

The graph below shows COVID cases and hospital admissions in the UK since September 2020.

The vaccine rollout has altered the relationship between cases and hospitalisations for the better (Yahoo News UK/Flourish/Government data)
The vaccine rollout has altered the relationship between cases and hospitalisations for the better (Yahoo News UK/Flourish/Government data)

During the second wave last winter, the increase in hospital admissions mirrored the increase in cases.

However as cases begin to trend upwards in May 2021, the increase in hospitalisations is far less steep.

Speaking on 1 July, the prime minister said it was "ever clearer" that jabs had "broken that link between infection and mortality".

However experts warn the link has been weakened, but not completely severed. 

Some 14% of the adult population is yet to receive a vaccine, and more than a third have not received a second jab, leaving them vulnerable to the Delta variant.

Consequently it is not yet clear what the impact of the current exponential growth in cases will be in terms of hospitalisations and deaths.

Watch: England primed to ‘return to normality’ on 19 July

Doctor Duncan Robertson, an analytics expert at the University of Loughborough, warned that the rate of people being hospitalised is accelerating.

He told BBC Politics Live: "Hospitalisations are always going to follow cases. We've seen cases go up around 70% this week and we've seen hospitalisations jump around 25%. I think the really concerning thing is that the rate of hospitalisations is increasing."

Earlier this week, the unofficial Independent Scientific Advisory Group for Emergencies (Sage) warned in a joint letter: "Cases are surging in school aged children, and spreading into the community, particularly amongst those yet to be fully vaccinated. 

"It is clear that the link between infection and hospitalisation has not yet been fully broken."

How many people suffer from long COVID, and how bad is it?

There is no universal definition of long COVID, but the Office For National Statistics (ONS) defines it as symptoms persisting for more than four weeks after the first suspected coronavirus infection that cannot be explained by something else.

The ONS estimates that 962,000 people experienced self-reported long COVID in the four weeks to 6 June, and that 40% of people reporting long COVID experience symptoms for more than a year.

Chief scientific adviser Sir Patrick Vallance speaking during a media briefing in Downing Street, London, on coronavirus (Covid-19). Picture date: Monday July 5, 2021.
Chief scientific adviser Sir Patrick Vallance presents the latest COVID data, showing rising infections in the UK. (PA Media)

A study by Imperial College London in July estimated that more than two million adults in England may have had long COVID.

Professor Christina Pagel, director of operational research at University College London, said on Twitter: "While final numbers are uncertain, we do know that they are big and that very many are finding their daily lives much harder.

"... We should be routinely monitoring long COVID and reporting it alongside hospitalisations & deaths.

"Otherwise, it's far too easy for people (inc govt) to ignore it and argue that infections don't matter if they don't lead to deaths."

There is specific concern about the impact of coronavirus on children.

Dr Peter English, retired consultant in communicable disease control, said: “It seems that about 1% of children who are infected are ill enough to require hospital admission; and many children and young people suffer 'long COVID'.

"We know that the infection can damage the lungs, brain, and other organs; and such damage may cause long-term or permanent impairment.

"Young people may carry such impairment for the rest of their lives. 

"This harms them directly, and there is a substantial cost to society if people require more care, and are less able to contribute (through work and taxes, volunteering, informal caring and so on) for the rest of their lives.

"It is far too soon to be sure of the extent of the long-term harms; and this should require a degree of caution."

How long does immunity against coronavirus last?

The data does not yet paint a clear picture of how long immunity against COVID – both through prior infection and through vaccination – lasts.

The outlook is still less clear when it comes to new and emerging variants.

Dr Julian Tang, clinical virologist at the University of Leicester, said: "We are not sure how effective and how long natural and vaccine-induced immunity lasts against the different variants."

This raises the question of whether the current vaccine rollout will provide sufficient protection in the future. 

What new variants will we face in the future?

The world's portfolio of COVID vaccines is currently highly effective, including against the Delta variant of coronavirus.

However, high levels of infections in the population increase the risk of a new variant emerging that evades vaccine protection.

A pedestrian wearing a face covering due to Covid-19, walks near a 'social distancing' sign in Penrith in Cumbria, north west England on June 21, 2021, following an outbreak of a coronavirus variant of concern. (Photo by Oli SCARFF / AFP) (Photo by OLI SCARFF/AFP via Getty Images)
New variants that evade vaccine protection are more likely to emerge if infections run wild, experts have warned. (Getty Images)

Prof Susan Michie, a member of the Scientific Advisory Group for Emergencies (Sage), tweeted: “Allowing community transmission to surge is like building new ‘variant factories’ at a very fast rate."

Dr Julian Tang said: "Ongoing replication that does not lead to hospitalisations and deaths, still allows the virus to mutate and generate new variants in the community – even without the international importation of new variants.

"Vaccine escape variants are more likely to arise in a partially immune population as some people lose their vaccine-induced immunity over time as their antibody levels fall – though T cell immunity may blunt this to some degree. Third dose boosters will help with this."

Watch: Keir Starmer criticises Boris Johnson's 'reckless' COVID plan

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