Covid: What comes next in the fight against the virus after England's July 19 reopening?

ITV News Science Editor Tom Clarke hears what the government's leading advisor thinks will happen next

Forget what the government has said about so-called “Freedom Day” not being a gamble. There is still a huge amount of uncertainty about how the next few weeks and months might play out.

“It’s a calculated risk,” Professor Neil Ferguson, one of the government’s leading Covid advisors, told me on Monday.

Prof Ferguson sounds far more optimistic than he has done at any of the times we’ve spoken since the start of the pandemic.

But he’s the first to admit, he can’t reliably predict where we might be in even a few weeks time.

The impact of England's lockdown easing will take three or four weeks to show, says Prof Neil Ferguson

The risk is around three main uncertainties.

First, how effective vaccines prove to be at preventing people from dying of Covid-19.

There’s no doubt they’re highly effective: it's estimated they’re between 92% and 98% effective at preventing someone dying from the disease.

But at a population level, those few percentage points add up to a big difference. If the vaccines are 98% effective we may never see more than 100 deaths a day in the coming wave, but if they’re at the low of that estimate, the experts predict we could see 400 deaths a day.

Next, is how we all behave.

With a gradual return to pre-pandemic behaviours between now and the autumn, cases might peak at around 100,000 each day.

That’s way more than the January peak of 60,000 but due to vaccination, it will lead to around 1,000 hospitalisations and 100 deaths (or more-depending on vaccines — see above).

Whereas if we do, in the words of the Deputy Chief Medical Officer Jonathan Van-Tam, “tear the pants out of it”, cases could surge to 200,000 a day and hospitalisations and deaths to roughly 2,000 and 200 a day, respectively.

What is a reasonable worst case scenario? Prof Fergusion lays it out:

And then there’s schools.

They’ve been a major driver of infections since the Delta variant took off in the UK. But at the end of the week, they will close.

It’s expected they’ll take some of the heat out of the current explosion, perhaps, even cause cases to stall.

But by how much, and for how long, is about as uncertain as what we do, or don’t do, with those pants.

Hospitalisation rates are down, mortality rates are down - what next?

But if you look beyond Covid, the situation is less optimistic: “We’ve got a serious triple threat coming this winter,” according to intensive care specialists Dr Charlotte Summers.

She’s concerned about a huge backlog of NHS operations, combined with forecasts of a severe winter season due to the fact no one was exposed to flu or other respiratory viruses last winter meaning a very susceptible population.

'We've got a really serious triple threat this coming winter,' says Dr Charlotte Summers

While the government doesn’t describe its current policy as one of “herd immunity”, that is effectively what will result from the mantra of “learning to live with the virus”, coming out of the Department of Health.

And if vaccines work, and unvaccinated young people are left unharmed by Covid, that may be a reasonable policy. But we can’t ignore the fact Covid isn’t a typical respiratory disease.

It can cause damage to vital organs like the heart, kidneys and liver.

It can cause Long Covid.

While some of the worst-case predictions for Long Covid don’t appear to be materialising, it is still very early days.

Coronavirus: What you need to know - How can clinically vulnerable people be protected after 'Freedom Day'?

What’s more, letting the virus effectively run riot though a partly vaccinated population — which is precisely what could happen from Monday onwards — is the perfect way to select for new variants of Covid.

We’d like to think Covid hasn’t got much more to throw at us, but the short, grim history of this pandemic tells us otherwise.