Covid: How worried should we be?

By James Gallagher
Health and science correspondent

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Mural of NHS workerImage source, Getty Images
Image caption,
A mural in Manchester where cases are rising

Winter looks like it is going to be tough. Cases are rising across the whole of the UK, the restrictions on our lives are already tightening, there are fears some hospitals are starting to fill up and there are ongoing political and scientific rows.

It feels like there is a constant stream of information and you would be forgiven for getting lost in the whirlwind of headlines.

So - let's keep this really straight and really simple. Where are we, is this a repeat of spring and how worried should we be?

Covid is still mostly mild

Don't forget the overwhelming majority of people do recover from Covid and it is often a mild disease.

The main symptoms are a cough, fever and a loss of sense of smell and most will recuperate at home.

It is estimated that 1% to 3% of people who catch the virus require hospital treatment.

But it is more deadly than flu

The number of people that die after catching the virus, known as the infection fatality rate, is about 0.5%. Or one death in every 200 people infected.

That is five to 25 times more deadly than a seasonal flu infection, despite ongoing myths that Covid is just like flu.

Influenza kills between 0.02% and 0.1% of people who are infected.

Some people are at higher risk

People of any age can die from Covid, but the risks are higher the older you are.

Only a tiny fraction of people under the age of 45 die after catching the virus and the risk really picks up after the age of 65.

People with other health problems - such as type 2 diabetes and heart problems - are also at higher risk.

As are people from certain ethnic backgrounds.

The numbers are all going up

The statistics tell a grim tale.

The number of daily cases - up. The number of people being admitted to hospital - up. The number of people dying - up.

We are not at the same level we were at the peak, when 3,000 people were being admitted to hospital with Covid each day. It is currently below 1,000.

So this is a problem of trajectory.

The worry is rising cases could eventually overwhelm the NHS. If that happens then more people will die, from Covid and other causes, because there won't be enough beds and doctors to go round.

But the virus is spreading more slowly than before

The things we are now doing in our day-to-day lives are making a difference to the spread of the virus.

At the beginning of the pandemic, the number of people being infected was doubling every three-to-four days. The doubling time is now closer to every fortnight.

The reproduction or R number - the number of people each infected person passes the virus onto on average - was about 3.0 across the UK early March. It is now about half that (between 1.3 and 1.5).

We are making a difference, but any growth is still growth and unless the R number comes below 1.0, the number of cases, and in turn pressure on hospitals, will continue to rise.

We are better at treating Covid

The chance of dying if you are admitted to hospital has fallen since the start of the pandemic.

Getting a precise estimate is hard, but the death rate in hospitals seems to have fallen by between a third and a half.

Doctors have a better understanding of what happens to severe Covid patients, such as developing unusually sticky clot-prone blood. That means care has improved.

And we have the first life-saving drug, a steroid called dexamethasone that calms the immune system when it becomes overactive and attacks the body.

But we must not ignore 'long Covid'

However, there is rising recognition that a coronavirus infection can take a lasting toll on the body.

We don't know how long or exactly how many people are affected, but long-term fatigue and a whole host of other health problems have been reported.

These symptoms appear to affect young and old, as well as those who had even mild infections.

You're probably not immune

Most people have not been infected with the virus. About nine in 10 of us in the UK are thought to still be vulnerable.

Getting Covid twice is rare. However, nobody is quite sure how long any immunity from fighting off the virus might last.

We're still waiting for a vaccine

An effective vaccine would either stop people getting infected or at least make the disease less severe.

Progress is being made, but none has yet been proven to work.

A vaccine remains one of the key tools for getting our lives back, until then the government's strategy is relying on slowing the spread of the virus and that means restrictions on all our lives.

Test-and-trace is struggling

The other measure that was supposed to help suppress the virus was the government's test-and-trace programme.

Testing capacity has increased dramatically since the beginning of the pandemic and there are now more than 300,000 tests a day being performed.

However, the programme works best when levels of the virus are low and the government's own science advisers, Sage, say test-and-trace is having a "marginal impact on transmission".

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