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The snag, worry in rising COVID-19 cases for households

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IT’S now clear we’re heading into another COVID wave. For the fourth week in a row the Office for National Statistics’ household infection survey has shown a rise in cases.

  According to the data, an estimated 1.7 million people in the UK would have tested positive for COVID last week, up from an estimated 1.3 million the week before.

This is the highest total since late July, but it’s still lower than the 3.8 million weekly infections seen at the peak of the summer wave in early July.

With the exception of Scotland, where there’s no clear rise in cases, the trends are similar in all other parts of the UK. But while they’re rising, the current uptick in cases isn’t as steep as we saw with other recent waves of infection.

Despite the fact cases are rising a bit more slowly than before, it’s who is getting infected that’s more relevant to the NHS. A potentially good sign is that cases in secondary school children in England appear to have peaked.

More concerning, is that infections are rising fastest in the oldest, and therefore most vulnerable, age group.

The thing to remember of course, is that older people in the UK are very well vaccinated, nearly 94% of over 80s in England have had at least three vaccine doses. More than half have so far taken up the offer of a booster dose this autumn. From today, anyone over 50 is being invited to book a booster shot.

Commenting on the figures, Mary Ramsay, head of immunisations at the UK Health Security Agency (UKHSA) said: “I think it is to be expected.”

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“This is the first year where people are going to be mixing normally so I’m expecting that there is going to be more infection going around.

“The big difference obviously is that most people have been vaccinated. And, certainly the older age group, is very, very highly vaccinated so that should protect against more severe forms of disease.”

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What’s behind the current surge in cases? It’s likely a combination of factors. Immunity from the spring booster vaccine campaign is waning and colder temperatures mean more people are mixing indoors.

There are also a number of new Omicron-related variants evolving in response to our vaccines. The chart below is based on the genetic sequences of viruses sampled from people testing positive.

All the variants shown are forms of Omicron. BA.1 (in blue) caused the original Omicron wave around Christmas, its descendant, BA.2 (in beige) caused another wave in March, before BA.5 (in brown) came along in July and caused a corresponding wave.

“This is the first year where people are going to be mixing normally so I’m expecting that there is going to be more infection going around.

“The big difference obviously is that most people have been vaccinated. And, certainly the older age group, is very, very highly vaccinated so that should protect against more severe forms of disease.”

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What’s interesting now, are the three relatives of BA.5 (down in the bottom right-hand corner) that are rising rapidly and could be on course to become dominant by dodging the immune protection we’ve been getting from vaccines or previous infection, just like their ancestors did over the course of the year.

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But significantly, for the time being at least, is that the current wave isn’t being driven by a new variant.

And as with all things COVID, the past is not necessarily a good predictor of the future. The boosters now being offered to people are the first use of “bivalent” vaccines. These include both the original COVID strain, as well as an Omicron specific vaccine. It’s hoped these jabs might be better matched to combat the Omicron-related variants that are emerging.

When it comes to the emerging variants, “we’re keeping a close eye”, says the UKHSA’s Mary Ramsay, “But that’s not probably the main reason for what we’re seeing at the moment. The main reason is probably just the fact that we’re going back to normal and mixing more.”

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