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Exactly four years ago today the UK’s first coronavirus cases were confirmed.

On 31 January 2020, Public Health England said a University of York student from China had tested positive for COVID-19, along with his mother.

Almost two months later, the UK locked down and it was another two years until the final legal restrictions were removed – with some arguing this happened prematurely.

Now in 2024, the virus is still affecting people in ways scientists are only just beginning to fully understand – and affecting the NHS. So how prevalent is COVID today and what have we learned?

How widespread are COVID infections now?

Unsurprisingly, COVID cases are much lower than they have been at various peaks over the past four years.

But the latest data, which covers up to 10 January, estimates that 2.3% of the population of England and Scotland had COVID in the community – the equivalent of around 1.2 million people.

As people no longer report their test results, the most reliable recent estimates on COVID prevalence come from the winter infection survey, carried out by the Office for National Statistics (ONS) and the UK Health Security Agency.

It is smaller than the original, regular ONS infection study that was discontinued in March 2023, and it doesn’t cover Wales or Northern Ireland.

Although the winter infection study uses lateral flow not PCR tests, the results are broadly comparable.

COVID infection graph winter 2023/24 for AN

It shows that following the spread of the JN.1 variant, which is a sub-lineage of the BA.2.86 version of Omicron, the virus last peaked before Christmas, with highs of 4.4% between 19 and 23 December – roughly one in 23 people.

Similarly to the height of the pandemic, the peak was felt most strongly in London, with 5.5% of the capital believed to have COVID by 19 December. The lowest peak was in the North East, with 3.2% of the region thought to have had the virus by 12 December.

Will we see more waves of cases?

The recent COVID peaks are only around half what they were in spring 2022, when 7.6% of England were estimated to have the virus and 9% of Scotland.

Stephen Griffin, professor of virology at the University of Leeds, warns that although the peaks look less dramatic, repeated waves mean they add up to a very high number of cases.

“We’re still seeing multiple waves of COVID every year because the virus is still evolving at an incredible rate,” he says.

The government often cites the initial vaccine rollout as the biggest success of its COVID response.

After they were offered to everybody aged 12 and over, 85% had two doses of a vaccine by mid-2022. But additional booster jabs are now only offered to the over-65s.

Booster uptake

And with new variants constantly emerging and most people’s vaccine protection waning, Prof Griffin says the UK is “not suppressing prevalence”, which means “we’ll continue to see those waves”.

How many people have to go to hospital for COVID now?

The pre-Christmas peak in cases didn’t result in as large numbers needing hospital treatment compared with the early days of the pandemic.

Professor Oliver Johnson, professor of information theory at the University of Bristol, says while there have been “many infections” recently, “they are much less severe on average since before we had vaccines”.

Fewer than 5,000 people with COVID have needed hospital treatment in England every week since early 2023. That number peaked at more than 25,000 in a single week in January 2021.

COVID patients in English hospitals

What impact has the anti-vax movement had?

Far fewer people are dying with COVID than before vaccines were offered to all over-18s in June 2021.

Despite the pandemic sparking a resurgence in the “anti-vax” movement, Greg Fell, Sheffield’s director of public health, says the overwhelming positive impact of vaccines on COVID mortality has undoubtedly been “good PR” for them.

“Anti-vax sentiment clearly got highlighted during COVID – but I think most people know that those vaccines really work and that in a world without them, it would be Christmas 2021 again.”

Monthly COVID deaths England

Asked whether the recent drop in MMR vaccines and the measles outbreak in the West Midlands are solely the result of anti-vax groups, he admits there has been “some outright anti-vax sentiment” around MMR that has had an impact, particularly on social media.

But he stresses that addressing “missed opportunities” to use community leaders to engage with disenfranchised groups is just as important in reversing the problem.

Prof Griffin says the delayed decision to vaccinate five to 11-year-olds in 2022 was bad for jab rates, alongside the then-health secretary Sajid Javid’s description of the programme as “non-urgent”. Data shows only around 10% of under-12s had a single dose.

“The dithering and indecision around the benefits for vaccinating children was pretty damaging in the sense that if you look at uptake in younger groups, it’s appalling,” Prof Griffin adds.

Primary courses of the vaccine are also no longer universally available for all age groups, aside from the clinically vulnerable and people who live with them.

“So children turning five after September 2022 have to wait until they’re in their 60s to have a vaccine, unless they become clinically vulnerable,” Prof Griffin says.

“The idea that repeated infections are a preferable means of generating population immunity to vaccines, especially in children, is a dangerous nonsense.”

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Doctor’s three-year struggle with long COVID

Concerns over ‘silent organ damage’ from COVID

Long COVID is defined by symptoms that persist for three months or more with no other explicable cause. Almost two million people in the UK had the condition at the time of the latest ONS survey in March 2023.

Studies have put the extra cost to UK GP and other primary care services at an estimated £23m a year – with annual losses to the workforce and greater economic cost thought to be as much as £1.5bn.

A Canadian study suggested that for people infected three times or more, long COVID rates were around 38%.

Dr Rae Duncan, a consultant cardiologist and long COVID research clinician at Newcastle Hospitals NHS Foundation Trust, warns that studies are beginning to suggest serious complications from COVID that could lie dormant for years.

“COVID is a spectrum and long COVID is only one end of that,” Dr Duncan says.

“It’s never been just a cold. The more times you’re infected, the higher your cardiovascular risk, neurological, and endocrine risk. These can all result in life-altering conditions.

“Some may have underlying silent organ damage, which is asymptomatic, meaning people are not aware of it. It needs more research but it’s very concerning.”

Read more:
How long COVID ruined my life

Hundreds of long COVID doctors suing NHS

A UK biobank study found increased risk of cardiovascular death up to a year-and-a-half after getting COVID in unvaccinated people. Others, including data pooled by scientists in Taiwan, show far greater COVID mortality in people with Alzheimer’s disease.

One piece of research suggested babies born to COVID-positive, unvaccinated mothers had a 20.3% risk of neurodevelopmental delay by age, compared to 5.9% of babies whose mothers did not catch COVID while pregnant.

Given emerging research the virus may carry cardiovascular risks for children, citing NHS guidance that children can go back to school three days after getting COVID, Dr Duncan adds: “We have published data showing it takes around seven days for 75% of children, and 10 days for 90% of children to become non-infectious.

“So we have largely chosen to ignore the impact of COVID on our kids and I think that’s a really bad decision.”

How many people are dying with COVID?

Last year excess deaths (how many more deaths occur than are expected) were still higher than the five-year average, but down on 2022 – from more than 30,000 in 2022 to nearly 27,000 in 2023.

COVID-related deaths almost halved from 32,300 in 2022 to 16,600 in 2023. But they still made up almost two-thirds (62%) of excess deaths last year.

Excess deaths 2023

Many argue that NHS backlogs are contributing to excess death numbers, and pressures are evident across all areas of services.

According to the latest data from November, 6.4 million patients were on the waiting list for treatment in England, 42% of whom were still waiting beyond the 18-week target.

The Royal College of Emergency Medicine attributed more than 23,000 excess deaths in England in 2022 to long waits in emergency departments – where the latest figures show nearly half (46%) are still waiting far longer than the four-hour target to be seen.

Prof Griffin says: “Excess mortality has got less attributable to COVID, but it’s still a problem.

“COVID did have a huge impact on NHS capacity to deal with the backlog, but we haven’t had those widespread restrictions for several years now, yet the NHS has been unable to catch up again and the year-long added pressure from COVID hospitalisations remains.”

NHS waits backlog

Prof Griffin says that as the years go by, one would expect COVID-related deaths to creep down, but not enough is being done to prevent COVID fatalities.

He adds: “We try and bring down excess deaths from non-communicable diseases like cancer and obesity, but we don’t seem to do it very well for infectious disease, even though that’s something we can do a lot more about.”

Dr Duncan says that we “urgently need multi-layered public health protections”, including seasonal vaccines and ventilation systems for cleaner indoor air to “stop people continuously re-infected with constantly evolving new variants”.

She adds that “already licenced medications” could help people with long-term COVID complications but the government needs to fund them.

What has COVID taught us?

Mr Fell says that as a nation we went into the pandemic in a poor state of health, with “deep inequalities” between ethnic and socioeconomic groups.

Risk factors for COVID

“The pandemic reminded us that inequalities in health outcomes are very real and matter enormously,” he says.

“There was more infection in some populations because of underlying health differences, but also things like occupational exposure and overcrowded housing in terms of chains of transmission.”

In those aged 65 and over, Alzheimer’s disease was the most common pre-existing health condition in people who died with COVID. Diabetes was the most common for those under 65.

Comorbities for COVID

Although COVID is still a factor driving excess deaths, Mr Fell highlights the mortality rate for age-old public health concerns like smoking, which according to the NHS, causes around 76,000 deaths a year in the UK.

“We still have all the other pandemics of death and illness day in day, out,” he adds. “We need to put as much effort into some of those things as we did in how we responded to COVID.”

From improved ventilation in schools and hospitals to investment in more antiviral drugs and vaccines, Prof Griffin adds: “If you think about the trillions of pounds that have been destroyed by COVID globally, surely the investment of however many million is worthwhile for this and future pandemics.”

Government guidance states that, based on evidence, the vaccine programme changed in 2023 to target higher-risk groups, and that vaccinating children outside of those groups is not recommended.

It also says that data at the end of 2022 suggested almost all older children and adults had coronavirus antibodies from either vaccines or infection.

Sky News has contacted the Department of Health and NHS England for comment.

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Man, 76, arrested on suspicion of administering poison at summer camp after eight children taken to hospital

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Man, 76, arrested on suspicion of administering poison at summer camp after eight children taken to hospital

A 76-year-old man has been arrested on suspicion of administering poison at a summer camp which led to eight children being taken to hospital, police said.

Police received reports of children feeling unwell at a summer camp in Canal Lane, Stathern, Leicestershire, on Monday.

Paramedics assessed eight children, who were taken to hospital as a precaution and have all now been discharged.

The suspect was arrested at the camp and remains in custody on suspicion of administering poison with intent to injure/aggrieve/annoy.

Detective Inspector Neil Holden said: “We understand the concern this incident will have caused to parents, guardians and the surrounding community.

“We are in contact with the parents and guardians of all children concerned.

“Please be reassured that we have several dedicated resources deployed and are working with partner agencies including children’s services to ensure full safeguarding is provided to the children involved.

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“We also remain at the scene to carry out enquiries into the circumstances of what has happened and to continue to provide advice and support in the area.

“This is a complex and sensitive investigation and we will continue to provide updates to both parents and guardians and the public as and when we can.”

The force said it has referred itself to the Independent Office for Police Conduct (IOPC) over what it said was the “circumstances of the initial police response”.

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‘No evidence’ malign activity caused Wednesday’s air traffic disruption, says transport secretary

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'No evidence' malign activity caused Wednesday's air traffic disruption, says transport secretary

There is no evidence that malign activity was responsible for yesterday’s outage of air traffic control systems, the transport secretary has said.

Heidi Alexander said she has spoken with the chief executive of National Air Traffic Service (NATS), Martin Rolfe, and added that what happened was an isolated incident.

NATS has apologised for the IT problems after thousands of passengers suffered extensive travel disruption during one of the busiest times of the year.

The technical glitch led to more than 150 flight cancellations, leaving airlines reacting furiously.

alexander
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Transport Secretary Heidi Alexander

Ms Alexander wrote on X: “I have spoken with NATS CEO Martin Rolfe who provided further detail on yesterday’s technical fault.

“This was an isolated event and there is no evidence of malign activity.

“I know that any disruption is frustrating for passengers.

“Flights are now resumed and I am grateful to airlines who are working hard to get people to where they need to be.

“I will continue to receive regular updates. Passengers should check with airlines before travelling.”

Read more: Flight delayed or cancelled? These are your rights

Officials said a “radar-related issue” caused the air traffic control failure.

A spokesperson for NATS said: “This was a radar-related issue which was resolved by quickly switching to the back-up system during which time we reduced traffic to ensure safety.

“There is no evidence that this was cyber related.”

The problem occurred at NATS’ control centre in Swanwick, Hampshire, and affected the vast majority of England and Wales.

Aviation analytics company Cirium said 84 departures and 71 arrivals were cancelled to or from UK airports up to 10pm on Wednesday, with several flights diverted to other European airports.

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Travel expert Paul Charles: This is a major outage

There was limited disruption on Thursday, with a handful of British Airways flights cancelled because aircraft and crew were out of position.

Heathrow and Gatwick airports said they had resumed normal operations.

Affected passengers are unlikely to be entitled to compensation as the disruption was outside of airlines’ control, but they will be able to claim expenses for a reasonable amount of food and drink, a means to communicate and overnight accommodation if required.

Martin Rolfe in 2023. Pic: PA
Image:
Martin Rolfe in 2023. Pic: PA

Ryanair has called on Mr Rolfe to resign, claiming “no lessons have been learnt” since a similar systems outage in August 2023.

The airline’s chief operating officer Neal McMahon said: “It is outrageous that passengers are once again being hit with delays and disruption due to Martin Rolfe’s continued mismanagement of Nats.”

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‘No lessons have been learned’: Airlines furious after another technical glitch cancels flights

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'No lessons have been learned': Airlines furious after another technical glitch cancels flights

Airlines have reacted furiously after a technical glitch in air traffic control systems led to more than 150 flight cancellations.

The National Air Traffic Service (NATS) has apologised for the IT problems – and said systems were back up and running 20 minutes after the “radar-related issue” was detected at 4.05pm.

But with thousands of passengers suffering extensive travel disruption, during one of the busiest times of the year, airline executives have warned this isn’t good enough.

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Departures resume after ATC problem

Ryanair’s chief operating officer Neal McMahon has called for NATS chief executive Martin Rolfe to resign – and claimed Wednesday’s incident was “utterly unacceptable”.

He said: “It is outrageous that passengers are once again being hit with delays and disruption due to Martin Rolfe’s continued mismanagement of NATS.

“It is clear that no lessons have been learnt since the August 2023 NATS system outage, and passengers continue to suffer as a result of Martin Rolfe’s incompetence.”

Mr McMahon was referring to a glitch that affected more than 700,000 passengers two years ago – and said that, if Mr Rolfe refuses to step down, the government should intervene.

“Heidi Alexander must act without delay to remove Martin Rolfe and deliver urgent reform of NATS’ shambolic ATC service, so that airlines and passengers are no longer forced to endure these preventable delays caused by persistent NATS failures,” he added.

The Department for Transport says Ms Alexander does not have any direct control over NATS – and no powers over staffing decisions at the service.

Martin Rolfe in 2023. Pic: PA
Image:
Martin Rolfe in 2023. Pic: PA

EasyJet’s chief operating officer David Morgan added: “It’s extremely disappointing to see an ATC failure once again causing disruption to our customers at this busy and important time of year for travel.

“While our priority today is supporting our customers, we will want to understand from NATS what steps they are taking to ensure issues don’t continue.”

NATS is yet to comment on the calls for Mr Rolfe’s resignation – but has stressed that the glitch is not believed to be “cyber related”.

“This was a radar-related issue which was resolved by quickly switching to the back-up system during which time we reduced traffic to ensure safety,” a spokesperson had said.

Departures at airports across the country have now resumed – but passengers are being urged to check with their airline before heading to terminals.

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Travel expert: This is a major outage

John Carr, from Stourbridge, was on his way from Heathrow to Norway to help arrange his brother’s wedding when he discovered his flight was cancelled after checking in.

“I’m pretty gutted,” he said. “We’ve got loads of stuff in the suitcases to set up the venue, because we’re obviously flying to Norway. We’ve got the wedding rehearsal to do. It’s quite stressful.”

Liberal Democrat leader Sir Ed Davey called for an urgent investigation and also referred to the “utterly unacceptable” disruption two years earlier.

“With thousands of families preparing to go on a well-earned break, this just isn’t good enough. The public deserve to have full confidence in such a vital piece of national infrastructure.”

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Flights departing or arriving at a UK airport, or aircraft operated by a UK airline arriving in the EU, are subject to rules concerning delays or cancellations.

Airlines may have to provide compensation, although there are exemptions for “extraordinary circumstances”, according to the UK’s Civil Aviation Authority.

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