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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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At least 13 people may have taken their own lives linked to Post Office scandal, public inquiry finds

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At least 13 people may have taken their own lives linked to Post Office scandal, public inquiry finds

At least 13 people may have taken their own lives after being accused of wrongdoing based on evidence from the Horizon IT system that the Post Office and developers Fujitsu knew could be false, the public inquiry has found.

A further 59 people told the inquiry they considered ending their lives, 10 of whom tried on at least one occasion, while other postmasters and family members recount suffering from alcoholism and mental health disorders including anorexia and depression, family breakup, divorce, bankruptcy and personal abuse.

Follow latest on public inquiry into Post Office scandal

Writing in the first volume of the Post Office Horizon IT Inquiry report, chairman Sir Wyn Williams concludes that this enormous personal toll came despite senior employees at the Post Office knowing the Horizon IT system could produce accounts “which were illusory rather than real” even before it was rolled out to branches.

Sir Wyn said: “I am satisfied from the evidence that I have heard that a number of senior, and not so senior, employees of the Post Office knew or, at the very least, should have known that Legacy Horizon was capable of error… Yet, for all practical purposes, throughout the lifetime of Legacy Horizon, the Post Office maintained the fiction that its data was always accurate.”

Referring to the updated version of Horizon, known as Horizon Online, which also had “bugs errors and defects” that could create illusory accounts, he said: “I am satisfied that a number of employees of Fujitsu and the Post Office knew that this was so.”

The first volume of the report focuses on what Sir Wyn calls the “disastrous” impact of false accusations made against at least 1,000 postmasters, and the various redress schemes the Post Office and government has established since miscarriages of justice were identified and proven.

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‘It stole a lot from me’

Recommendations regarding the conduct of senior management of the Post Office, Fujitsu and ministers will come in a subsequent report, but Sir Wyn is clear that unjust and flawed prosecutions were knowingly pursued.

“All of these people are properly to be regarded as victims of wholly unacceptable behaviour perpetrated by a number of individuals employed by and/or associated with the Post Office and Fujitsu from time to time and by the Post Office and Fujitsu as institutions,” he says.

What are the inquiry’s recommendations?

Calling for urgent action from government and the Post Office to ensure “full and fair compensation”, he makes 19 recommendations including:

• Government and the Post Office to agree a definition of “full and fair” compensation to be used when agreeing payouts
• Ending “unnecessarily adversarial attitude” to initial offers that have depressed the value of payouts, ⁠and ensuring consistency across all four compensation schemes
• The creation of a standing body to administer financial redress to people wronged by public bodies
• Compensation to be extended to close family members of those affected who have suffered “serious negative consequences”
• The Post Office, Fujitsu and government agreeing a programme for “restorative justice”, a process that brings together those that have suffered harm with those that have caused it

Regarding the human impact of the Post Office’s pursuit of postmasters, including its use of unique powers of prosecution, Sir Wyn writes: “I do not think it is easy to exaggerate the trauma which persons are likely to suffer when they are the subject of criminal investigation, prosecution, conviction and sentence.”

He says that even the process of being interviewed under caution by Post Office investigators “will have been troubling at best and harrowing at worst”.

Read more:
Post Office inquiry lays bare heart-breaking legacy – analysis

‘Hostile and abusive behaviour’

The report finds that those wrongfully convicted were “subject to hostile and abusive behaviour” in their local communities, felt shame and embarrassment, with some feeling forced to move.

Detailing the impact on close family members of those prosecuted, Sir Wyn writes: “Wives, husbands, children and parents endured very significant suffering in the form of distress, worry and disruption to home life, in employment and education.

“In a number of cases, relationships with spouses broke down and ended in divorce or separation.

“In the most egregious cases, family members themselves suffered psychiatric illnesses or psychological problems and very significant financial losses… their suffering has been acute.”

The report includes 17 case studies of those affected by the scandal including some who have never spoken publicly before. They include Millie Castleton, daughter of Lee Castleton, one of the first postmasters prosecuted.

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Three things you need to know about Post Office report

She told the inquiry how her family being “branded thieves and liars” affected her mental health, and contributed to a diagnosis of anorexia that forced her to drop out of university.

Her account concludes: “Even now as I go into my career, I still find it so incredibly hard to trust anyone, even subconsciously. I sabotage myself by not asking for help with anything.

“I’m trying hard to break this cycle but I’m 26 and am very conscious that I may never be able to fully commit to natural trust. But my family is still fighting. I’m still fighting, as are many hundreds involved in the Post Office trial.”

Business Secretary Jonathan Reynolds said the inquiry’s report “marks an important milestone for sub-postmasters and their families”.

He added that he was “committed to ensuring wronged sub-postmasters are given full, fair, and prompt redress”.

“The recommendations contained in Sir Wyn’s report require careful reflection, including on further action to complete the redress schemes,” Mr Reynolds said.

“Government will promptly respond to the recommendations in full in parliament.”

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Post Office scandal inquiry lays bare a second injustice

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Post Office scandal inquiry lays bare a second injustice

The long-awaited first report from the Post Office Horizon scandal inquiry lays bare not just the devastating personal toll of one of the greatest miscarriages of justice in British legal history, but also the slow-motion failure of the government and the Post Office to deliver meaningful redress.

Sir Wyn Williams’s first report documents with stark clarity how hundreds of sub-postmasters, wrongly accused of theft and fraud due to the faulty Horizon IT system, lost their livelihoods, homes, reputations – and in some cases, their lives.

Follow Post Office inquiry latest

Thirteen people are believed to have taken their lives as a result of the scandal.

Fifty-nine contemplated it.

It talks of alcohol addiction, serious mental illness, and bankruptcy – all tearing families apart and leaving behind a heartbreaking legacy.

But if the scandal was a failure of justice, the response to it has become a second injustice.

More on Post Office Scandal

Critical on a technical level

The report is critical, on a fairly technical level, about the complexity, delays, and bureaucracy of redress schemes that have left victims still waiting years for full compensation.

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‘It stole a lot from me’

Hundreds of whom have died before seeing “full and fair redress”.

While Sir Wyn is fair to the government and the Post Office in stating that he believes their commitment to delivering the above has been in “good faith”, he concludes this has not been achieved for every victim, describing “formidable” difficulties.

There are 19 recommendations – including a push to ensure consistency across all four redress schemes, with an agreed and public definition of “full and fair redress”.

Compensation

Among them, that family members of victims should be compensated, and a permanent public body established to manage future redress schemes in future.

Additionally, Fujitsu, the Post Office, and the government should engage in formal restorative justice programmes.

There was also a flavour of what is to come in the final report later this year or next.

The report has found that both Fujitsu and Post Office staff knew Horizon could produce false data but concealed this, maintaining a false narrative of accuracy.

One of the most important things now, though, is how and when the government, Post Office, and Fujitsu respond officially.

Sir Wyn has also set a deadline of 10 October 2025 for that.

The victims of this scandal have waited long enough.

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‘Wholesale failure’ to address risks posed by Southport attacker before murders, says public inquiry chairman

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'Wholesale failure' to address risks posed by Southport attacker before murders, says public inquiry chairman

There was a “wholesale and general failure” to address the risks posed by Axel Rudakubana before the Southport attack, the chairman of the public inquiry into the murders has said.

In his opening statement at Liverpool Town Hall, Sir Adrian Fulford said the teenager’s “known predilection for knife crime” suggests it was “far from an unforeseeable catastrophic event”.

The former vice president of the Court of Appeal said Rudakubana’s actions “impose the heaviest of burdens” to investigate how it was possible for him to cause “such devastation”.

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‘We need to understand what went wrong’

The 18-year-old murdered Elsie Dot Stancomb, seven, Bebe King, six, and Alice da Silva Aguiar, nine, at a Taylor Swift-themed class on 29 July last year.

He also injured eight other children and two adults at the Hart Space in the Merseyside seaside town, with Sir Adrian describing the attack as “one of the most egregious crimes in our country’s history”.

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‘We don’t want Elsie forgotten’

The public inquiry, announced by Home Secretary Yvette Cooper in January, will look into whether the attack could or should have been prevented, given what was known about the killer.

Rudakubana, who was born in Cardiff, had been referred to the government’s anti-extremism Prevent scheme three times before the murders, including over research into school shootings and the London Bridge terror attack.

He had also accessed online material about explosives, warfare, knives, assassination and an al Qaeda training manual.

A rapid review into his contact with Prevent found his case should have been kept open and that he should have been referred to Channel, another anti-terror scheme.

Read more:
‘She had a wonderful impact – we don’t want her to be forgotten’

What is the anti-terrorism programme Prevent?

Rudakubana was twice caught with a knife and managed to hoard other blades, as well as a bow and arrow, machetes, a sledgehammer and the deadly toxin ricin at his home.

He bought the 20cm chef’s knife used to carry out the attack using a Virtual Private Network (VPN).

Sir Adrian said he did not want to pre-judge the outcome of the inquiry.

But he added: “These factors, if correct and when taken together, tend to suggest that far from being an unforeseeable catastrophic event, the perpetrator posed a very serious and significant risk of violent harm, over a number of years, with a particular and known predilection for knife crime.

“Furthermore, his ability, unhindered, to access gravely violent material on the internet, to order knives online when underage, and then to leave home unsupervised to commit the present attack, speaks to a wholesale and general failure to intervene effectively, or indeed at all, to address the risks that he posed.”

Sir Adrian said the inquiry will examine decisions taken in light of Rudakubana’s “deteriorating and deeply troubling behaviour” to identify “without fear or favour” all of the relevant failings.

He said he aims to make recommendations to ensure the best chance of stopping others “who may be drawn to treating their fellow human beings in such a cruel and inhuman way”.

Rudakubana, 18, was jailed for a minimum of 52 years in January and is being investigated over an alleged attack on a prison officer at Belmarsh prison in May.

Sir Adrian said he would be referred to by his initials or as “the perpetrator” during the inquiry and asked the media not to show his “terrifying and singularly distressing” police mugshot to avoid causing distress to the survivors and their families, who have been granted anonymity.

The surviving children, many whom were under the age of 10, are “bravely trying to cope with school life in the face of what they have suffered,” he added.

Sir Adrian asked those in the room to stand for a minute’s silence for the victims.

Some of those whose children were injured will speak at a hearing on Wednesday before the inquiry is adjourned to 8 September, with the first phase expected to last until November.

It will then move on to a second phase next year to “consider the wider issues of children and young people being drawn into extreme violence”.

Rachael Wong, director at law firm Bond Turner, representing the three bereaved families, said: “We know that nothing the inquiry reveals or subsequently recommends will change the unimaginable loss felt by the families of Elsie, Alice and Bebe, but we all now have a responsibility to ensure that something like this never happens again.

“We will be doing all we can to assist the chair through the inquiry and uncover the truth.

“It is only through intense public scrutiny that real change can be effected.”

Sefton Council is asking people not to leave flowers near schools or the scene of the attack to mark the anniversary later this month, but to donate to local charitable causes instead.

There will be a three-minute silence and flags will be lowered to half-mast on public buildings around the Liverpool city region.

“We fully understand that many of us still need to grieve and to mark the day,” the council said in an open letter.

“Our colleagues have been working with faith and community leaders to identify local spaces where you can go, within your neighbourhood, to pay tribute, whether this be to say a prayer, light a candle, speak to someone or quietly reflect in a way that feels right for you.”

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