Return to Office Working 'Could Lead to Rapid Increase in Hospital COVID Cases'

Jane Kirby & Richard Wheeler

September 15, 2021

Vaccine effectiveness against COVID begins to wane from 10 weeks after the second dose, public health experts have said, as Government scientists warned that a return to office working could lead to a "rapid increase" in hospital cases.

A paper from Public Health England (PHE), sent to the Scientific Advisory Group for Emergencies (SAGE) on Thursday, shows that the Pfizer and AstraZeneca vaccines begin to wane in effectiveness against symptomatic COVID from around 10 weeks after the second dose.

By around the 20-week mark, AstraZeneca is just over 50% effective while Pfizer is just over 70%.

However, the jabs are believed to still offer very good protection against hospital admission, in particular with the Pfizer vaccine, with effectiveness of around 95% beyond 20 weeks after vaccination.

With the AstraZeneca vaccine, there appears to be some waning to just under 80% effectiveness against hospital admission from more than 20 weeks.

The PHE document said the vaccines also appear to offer a high degree of protection against death.

It concluded: "Overall, the results indicate that there is waning of vaccine effectiveness against symptomatic disease with both the Pfizer and AstraZeneca vaccines from approximately 10 weeks after the second dose.

"This is most evident in older adults.

"There is some indication of waning against hospitalisation from 15 weeks after the second dose, in particular among recipients of the AstraZeneca vaccine, though this waning appears to be predominantly in clinical risk groups."

Hospitalisations

It comes as a consensus statement from the Scientific Pandemic Influenza Group on Modelling operational sub-group (SPI-M-O), released on Tuesday but dated September 8, said there is still "the potential for another large wave of hospitalisations" as the pandemic continues.

"While the relationship between cases and hospitalisations has changed due to vaccination, increasing cases remain the earliest warning sign that hospital admissions are likely to rise," it said.

SPI-M-O said the early use of measures to control spread, which could include continued homeworking, cut the need for tougher measures later on.

It added: "There is a clear consensus that continued high levels of homeworking has played a very important role in preventing sustained epidemic growth in recent months.

"It is highly likely that a significant decrease in homeworking in the next few months would result in a rapid increase in hospital admissions.

"As well as encouraging homeworking, more light-touch measures could include clear messaging that recommends people act cautiously, more widespread testing, a return to requiring all contacts of cases to isolate, and more mask-wearing."

The document also suggested that a peak of infections may occur in October to December instead of August to October.

But it added: "The large-scale outbreaks that were considered feasible after taking Step 4 (of the road map) have not been seen and the population has not reduced their cautious behaviours as dramatically as was considered possible.

"Given the large number of infections that have occurred in recent months and the additional vaccine doses delivered, it is unlikely that the highest levels seen in Step 4 road map scenarios from July will be reached without waning immunity or a novel variant emerging."

A separate document relating to a SAGE meeting from September 9 said the epidemic is "entering a period of uncertainty".

It added: "Key uncertainties include the potential impact of any waning of immunity and any significant changes in contact patterns associated with increased attendance at workplaces and reopening of education settings.

"It will take several weeks to be able to understand the full impact of any such changes."

SAGE stressed that "early, 'low-cost' interventions may reduce need for more disruptive measures" and avoid an "unacceptable" level of hospital admissions.

The group added: "Late action is likely to require harder measures."

Jabs 'Holding Up'

Sir Patrick Vallance echoed the concerns at a Downing Street press briefing on Tuesday, but said vaccines are still holding up "very well" against hospital admissions and death.


He said falling levels of immunity are most evident in those who are most vulnerable to COVID-19.

The chief scientific adviser said: "The waning of immunity is clear. It's greater for infection than it is for the waning against hospitalisations and deaths, so they're holding up very well.”

He added that “ waning is most evident in the people who are most at risk".

He was also confident booster shots would tackle the problem of declining resistance to COVID-19.

Sir Patrick said a round of third jabs for vulnerable people was expected to have a "very big knock-on effect for protection in terms of infection, hospitalisations and deaths".

Face-to-Face GP Appointments

Meanwhile, England's Health Secretary Sajid Javid told more GPs to open their doors and see their patients face-to-face.

He told MPs the Government "intends to do a lot more" to ensure this happens, although he did not give details of what action is planned.

Speaking in the Commons, Conservative MP Dean Russell raised concerns over some GP surgeries in his Watford constituency "still not opening their doors" to see patients.

He added: "Does he agree with me that we should encourage those GP surgeries to start opening up to help with the backlog and help see people face-to-face?"

Mr Javid replied: "Yes, I agree with (Mr Russell). He’s right to raise this.

"I think everyone can understand why during the height of the pandemic that GPs couldn’t provide access in the normal way.

"But we’re way past that now, life is starting to return almost back to completely normal and as that is happening it should be happening in our GP surgeries too, and more GPs should be offering face-to-face access.

"We intend to do a lot more about it."

Abuse

Mr Javid went on to "condemn" the abuse GPs have faced in recent weeks, and said the Department for Health can be contacted as a last resort if vulnerable people are having trouble getting in touch with their surgery.

Conservative MP Paul Holmes (Eastleigh) asked if Mr Javid could "instruct" GPs to hold in-person appointments.

He said: "Can I just emphasise to the Secretary of State the amount of anger there is in Eastleigh about not being able to get a face-to-face appointment with their GP.

"The Secretary of State stood at the despatch box and encouraged GPs to get back to work.

"If necessary and that uptake hasn’t happened, will he instruct them to get back to work so we have face-to-face appointments for my constituents?"

Mr Javid said patients should have a choice, noting that some prefer a virtual appointment.

He added: "The important thing is that for those who want to have a face-to-face appointment it should be made available.

"The department is looking at what measures can be taken."

Impractical

Dr Richard Vautrey, chair of the British Medical Association (BMA) GP committee, said in a statement: "Life is absolutely not back to normal – the number of COVID-related deaths and people in hospital continue to rise and there are now just 0.46 GPs per 1000 patients in England, down from 0.52 in 2015.

"To suggest a return to a pre-pandemic way of working is as impractical as it is unworkable for GPs.

"They need to see patients as safely as possible, often in premises unfit to do so and without anywhere near enough staff.

"They are also trying to see all those on the huge waiting lists who have not been able to get the care they needed in the past 18 months – a backlog that didn’t exist before the pandemic struck.

"GPs and their teams need so much more support and resource from this Government to be able to give patients the care they need and that doctors want to give."

This article contains information from PA Media.

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