The Academy is launching a new position paper on what we need to do to prepare, both for COVID-19 and to address wider health challenges, as we proceed into winter and beyond. Here we share a summary of the most important points.
Our position has been informed by a series of roundtables held in April and May 2022 with the experts, including patients and carers, involved in the development of our previous COVID-19 reports.
The Academy of Medical Sciences has provided evidence and advice to Government throughout the COVID-19 pandemic, most notably through our 2020 and 2021 policy reports. While there has been tremendous progress to address COVID-19 and its impacts, the virus still disrupts the lives of many in the UK and globally.
“I welcome the Academy’s updated messages around COVID-19 which contains a number of practical suggestions, some which are achievable now and others aspirational, to ensure everyone has the ability to live with COVID-19 and no one is left behind.” -Lynn Laidlaw, a patient involved in the patient and carer group consulted for this position paper.
Prepare for a challenging winter
The COVID-19 pandemic put huge pressures on health and care services, and the measures to address the virus have greatly impacted the economy, as well as individuals. In the coming months, the UK will still experience waves of COVID-19 alongside further challenges, such as delayed care provision and increases in the cost of living.
To minimise the wider impacts of COVID-19 on society this winter we propose the following:
- The UK Health Security Agency (UKHSA) should undertake or commission modelling of COVID-19, influenza and RSV infections, hospitalisations and deaths ahead of winter. Modelling of respiratory infections including COVID-19, influenza and RSV is necessary to determine the scale of the challenges facing health and social care services ahead of winter. This should happen every year.
- Governments and the NHS in all UK nations should prepare for another vaccination campaign for COVID-19 and influenza. There is evidence of waning immunity to COVID-19, with cases increasing again in the UK and Europe, as well as increases in cases of influenza in the Southern hemisphere. Prioritisation of the most vulnerable populations for vaccination is necessary ahead of the winter period to minimise hospital admissions, deaths, and incidences of long-Covid. Efforts should focus on strategies to improve vaccine uptake in groups with low coverage.
- Continue surveillance effort to identify new variants quickly. UKHSA, the Office for National Statistics (ONS), COVID-19 Genomics UK Consortium (COG-UK), the NHS and others should continue with robust COVID-19 surveillance efforts. SARS-CoV-2 has demonstrated the ability to mutate throughout the pandemic creating public health problems as it has done so.
- Evaluation of the efficacy of behavioural and environmental interventions should be prioritised. Several interventions to minimise the impact of COVID-19 were introduced during the pandemic, such as the wearing of face masks, self-isolation, school closures, care home restrictions and physical distancing. It will be necessary to understand the success and trade-offs of these measures both individually and collectively in case we need to use them again in the future.
- Governments in all UK nations should provide adequate resource for the NHS to tackle the backlog of care while adhering to infection, prevention and control measures. Operating at a maximum of 85% occupancy is considered appropriate for hospitals to deliver care while minimising the risk of infections originating from hospitals. Hospitals and care homes can respond better to infection outbreaks and use their bed base more efficiently by increasing the number and proportion of side rooms and improving ventilation. In addition, reporting of COVID-19 infections from hospitals, similar to that for MRSA, may help to improve infection rates by keeping health and care organisations accountable.
- Support for the health and care workforce to minimise burnout and improve staff conditions is essential. This will require addressing vacancy rates, exploring the transfer or sharing of duties, re-employ and accelerated training. Pressures on primary care are again expected to intensify as we approach winter, particularly with vaccination efforts and increased requests for both antivirals and support for those with long-Covid.
- Governments in all UK nations should provide clear guidance on the importance of ventilation in households, care homes, schools, workplaces and public spaces. Adequate ventilation can reduce the transmission of SARS-CoV-2 and other airborne viruses without placing significant restrictions on individuals or business activities. This is especially important throughout the winter as people socialise more indoors.
- Governments and the NHS in all UK nations should communicate timely, transparent and tailored information to enable patients and the public to assess risks. The removal of all legal measures to limit the spread of COVID-19 has left some patients and carers feeling vulnerable, putting strain on their physical and mental health. Without such precautions, many are faced with difficult decisions to return to socialising the way they did before the pandemic, or risk developing severe disease. Any communication efforts require working with patients and the public to make sure the messaging is framed in the right way.
Prepare for the future
As the UK and other nations cycle through waves of COVID-19, there is a need to look beyond the one disease and identify ways of building resilience in the health and care system to tackle future health crises.
- Prepare for future pandemic(s). The UK rapidly developed the infrastructure and processes necessary to research, diagnose, treat and vaccinate against COVID-19. Many of these successes were due to well-funded research prior to the pandemic, as well as coordination of resources and services around COVID-19. Research into viruses that pose greatest pandemic risk is essential. Also, the systems and processes implemented to tackle COVID-19 need to be evaluated and adjusted to address infectious diseases more broadly, not just for pandemic response.
- Build a health and care system that is resilient to future shocks. This includes investing in the NHS, social care and public health structures at both a national and local level. While the UK’s response to the COVID-19 pandemic had many successes, the lack of resources available to public health structures prior to the pandemic may have limited the resilience of local public health teams. The new systems for health, social care and public health, and remote or digital medicine present opportunities but need further evidence as well as support for patient and carer use.
- Embed research in the health and care system. The COVID-19 pandemic has showcased the NHS’s ability to conduct complex trials and recruit large numbers of patients. Now more than ever the value of research has been demonstrated to the public and the willingness of patients to get involved in research should be capitalised on. Providing research opportunities has also shown to decrease the rate of burnout for health and care staff.
To maximise the success of these interventions, policymakers should seek to reduce inequalities; be informed by meaningful public engagement; ensure the timely access and sharing of data; and collaborate globally where possible.
The pandemic has had a disproportionate impact on certain groups, including children, older people, individuals from poorer and disadvantaged backgrounds and ethnic minority groups. The economic impact of the pandemic and repeated lockdowns is likely to have longer-term negative health impacts for groups already experiencing structural inequalities. The needs of these groups must be prioritised when developing future policies related to health and care.