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Covid Testing To Be Scaled Up In England As Winter Pressure On NHS Draws Near

Coronavirus testing and monitoring are set to be scaled up for the winter, the UK’s public health agency has said, as pressures on the health service are expected to rise in the coming months.

Scientists warned last month that the UK was nearly “flying blind” when it comes to Covid, because many of the surveillance programmes that were in place at the height of the pandemic have been wound down.

Now the UK Health Security Agency (UKHSA) has confirmed that it is planning to boost testing and surveillance as winter approaches.

The announcement has been made as schools and universities prepare for the return of students this week after the summer break, employees head back to work and indoor gatherings become more common – factors that are known to increase the risk of respiratory infections, including Covid, spreading.

Prof Steven Riley, the director general of data, analytics and surveillance at the UKHSA, said: “Planned scaling up of testing and community surveillance for the winter season, when health pressures usually rise, is in progress and UKHSA will make a further announcement regarding community surveillance plans for this winter shortly.

“Protecting the public from Covid-19 remains one of our top priorities. We continue to monitor the threat posed by Covid-19 through our range of surveillance systems and genomics capabilities, which report on infection rates, hospitalisations and the risks posed by new variants.’’

The UKHSA announced last week that the autumn Covid and flu vaccination programme in England was being brought forward to September to ensure that the most vulnerable are protected as the winter draws near.

A new variant, BA.2.86, which has been detected in a number of countries around the world including the UK, the US and Denmark, is probably behind the shift. The variant is being closely monitored because it contains a large number of mutations that might help it to evade immune defences – although experts say little is currently known about how big an impact it may have.

Prof John Edmunds of the London School of Hygiene & Tropical Medicine, said the discovery of the variant in a number of countries in a short space of time was one reason for concern. Another is the large number of genetic differences compared with other Omicron subvariants.

“It is definitely concerning, there’s no question about that,” he said. “The good news is we haven’t seen it suddenly take off anywhere.”.

Edmunds said there were still many unknowns about the variant, making it difficult to assess how much of a risk it posed – including whether it would cause more severe disease than other variants in circulation.

One reason for that, he said, is that there was less data available.

“Our surveillance has been much reduced so we are slightly blinded compared to where we have been in the past,” he said. “If you compare it to where we were with Omicron, it’s really very different in terms of just the quality of our surveillance.”

Dr Emma Hodcroft, a molecular epidemiologist at the University of Berne and the University of Geneva, agreed, adding that time was needed to see how the situation progresses.

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“If the ‘slow start’ is real, it may eventually fade away, could linger on at a low frequency, or further mutations could enhance transmission and lead to faster spread,” she said.

Hodcroft said at the moment there was no cause for undue worry about the coming months. But she added:“We should be realistic that we often see waves and that for many people, immunity has waned as they haven’t been boosted or infected in a while.

“At the same time, we have the return from holidays, restart of schools, and resumption of a lot of business travel and meetings – all things we know contribute to respiratory viruses being able to get around.”

Edmunds said Covid had yet to follow seasonal patterns, with cases rising rather than falling over the summer. A key driver in waves so far had been changes to the virus itself, he said.

According to the latest data from UKHSA, largely covering the period between 21 August and 27 August, both the increase in Covid case rates, picked up through testing in hospitals, and the recent rise in Covid hospital admissions in England have stabilised.

Restrictions have been lifted as part of the government’s “living with Covid” strategy, but Dr Mary Ramsay, the head of immunisation at the UKHSA, said people with any symptoms of respiratory illness should avoid mixing with others.

Edmunds agreed. “I doubt whether we’ll see much of a return to a mask-wearing and hand-washing, but those things can help reduce spread as well,” he said.

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