England Covid update 7 March 2024: numbers are low but significant long term illness remains - a call for action.

Current Covid numbers

The current Covid situation in terms of acute illness in England is all going in the right direction. Last week’s ONS winter infection survey showed continued falls in new infections to 18 Feb 2024. The winter survey randomly tests a representative sample of people every week and the UKHSA then does some fancy statistical modelling to estimate the number of new people infected every day in England. This is as good an estimate for new infections (regardless of symptoms) as it is possible to get.

Overall, the modelled prevalence estimate is that just under 1% of the population was infected in mid February. We can compare this winter’s estimates of prevalence to the gold standard ONS Infection Survey which ran from the summer of 2020 to March 2023. The two survey estimates are not exactly comparable but are as good as we are going to get. Firstly, the large wave we had in December is very clear (even though it was not as large as I feared it would be). Secondly, current estimated levels of Covid are lower than they’ve been since the arrival of the Delta variant in April 2021. (NOTE: it’s possible we had lower levels last summer but we have no prevalence estimates for those months).

Hospital admissions with Covid are continuing to fall quite rapidly. We can’t compare directly to earlier in the pandemic as testing practices have changed, but the overall trend certainly matches what is seen in the infection survey and shows that cases have continued to fall at the end of February and are approaching the low levels we saw last June and July. There are no new variants immediately on the horizon that I am aware of and so I hope that a new Covid wave is not imminent.

Long term illness and economic impacts

However, the pandemic has cast a long shadow over our workforce. Bob Hawkins wrote a fantastic detailed piece on this yesterday - please do go and read it here! I’m just going to highlight a couple of the main points now.

Firstly, after years of falling, the number of people economically inactive has risen markedly since the start of the pandemic and is approaching the highs last seen after the financial crash of 2008. This is a combination of ill health, the slow economic recovery post Covid restrictions and the impacts of Brexit, the Russia-Ukraine war and other such destabilising events.

However, ill health now makes up a larger proportion of the people who are economically inactive in England (now over 30%) and the number dropping out of the labour market through ill health has increased sharply since the pandemic. Much of this increase since 2020 is likely due to Long Covid, but there is also an increasing contribution from people whose health is worsening as they struggle to access NHS care. Another driver (and one that could be fixed!), is a lack of safe working environments forcing clinically vulnerable people out of the workforce. Overall, Hawkins reports that the cost to the UK economy of ill health is estimated to be £148 billion per year.

The impact that Covid has had on the NHS can be seen by record waiting lists for treatments and the high number of surgeries cancelled in 2020 in England compared to European peer countries (see below).

We went into Covid with a weaker health system than most of our peers, and we (and NHS staff) are now paying the price - a system that was forced to cut routine services during the crisis and is now struggling to tackle the backlog in the context of a burnt out workforce, crumbling infrastructure and an aging and sicker population. Again, I encourage you to go and check out Bob’s full post.

Future proofing our health

So while the current Covid situation is getting better, we now have a significantly sicker population which is making economic recovery even harder. We have also done precious little to reduce the spread of airborne respiratory diseases (whether Covid, Flu, RSV or colds) or reduce environmental pollution indoors to support a healthier population. Just last November, the CBI released a report calling for cleaner indoor air, estimating that a 95% reduction in indoor pollution could boost London employees’ productivity by up to 15%.

A healthier population is a more productive and happier population. The acute phase of the pandemic is over, but that shouldn’t mean going backwards and stopping all efforts at preventing ill health. We should instead be taking the opportunities to future proof the health of our population through cleaner indoor and outdoor air, more green space, better housing, better sick pay provision, better nutrition, alongside focussing on all the myriad social determinants of health.