Experts say the UK is practically "flying blind" when it comes to Covid this autumn, owing to a rise in cases. While the UK Health Security Agency (UKHSA) continues to monitor specific Covid indicators, such as hospitalization rates, many community surveillance studies tracking infection levels have concluded.

According to experts, the scenario has left the country in the dark about how Covid will play out in the next months.

Christina Pagel, a professor of operational research at University College London, said that a fresh wave of Covid appeared to begin, presumably driven by decreasing immunity, novel Omicron variations, and variables such as bad weather keeping people indoors.

Covid demands may rise as autumn approaches and people return to school and work, according to Pagel. “We might see the wave continue to grow, and grow faster, in September,” she said.

In addition to public health measures such as returning high-quality masks in healthcare settings, Pagel stated that she would support bringing back the Office for National Statistics' nationwide infection survey for autumn and winter, as well as expanding it to include flu and RSV.

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In the absence of that, she believes that wastewater monitoring, which is used in many countries to track Covid prevalence and variants, should be re-established across the UK. In England and Wales, such programs have recently been reduced. “What worries me most is if we get a repeat of the last winter NHS crisis this winter again, with Covid, flu, and RSV all hitting around the same time,” said Pagel, adding that “We are definitely flying near blind.”

Prof Rowland Kao, an epidemiologist at the University of Edinburgh, also highlighted the decline in surveillance. “With seasonal flu, we have of course a certain amount of predictability with the many years of data. However, with Covid, now that we don’t have those multiple data streams to rely on, it’s harder to say what is happening [in the general population],” he said.

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Kao went on to say that Covid's variant emergence patterns were mostly unknown and that Covid did not just follow seasonal cycles. As autumn approaches, experts are also concerned about the UK's immunization program.

Covid and immunity 

Prof Danny Altmann, an immunologist at Imperial College London, said that while Covid was on the rise, it had started at a low level and that the "mildness" of Covid currently was largely due to the fact that most people were still within a year or so of having received three vaccination doses.

“The immune-evasion mutations continue to emerge and cross-protection is looking ever more precarious. Meanwhile, immunity beyond one year wanes appreciably,” Altmann said, adding it was important to plan for another round of boosters and consider which specific vaccine it should involve.

Prof Adam Kucharski of the London School of Hygiene & Tropical Medicine stated that Covid exposure will also impact population immunity. However, he acknowledged that there was uncertainty regarding how Covid would play out, including if there would be many waves of Covid per year.

“I think we don’t really have enough data points to say confidently what normal looks like for Covid, other than the fact that normal is probably going to be significantly higher infection and disease burden layered on top of all the other things that are already causing us problems every year,” he said.

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However, Kucharski emphasized that the UK is no longer in the phase of a pandemic in which swift responses are taken - a period when extremely precise surveillance was critical - and that surveillance now is focused on studying vaccination effectiveness, fading immunity, and the factors that drive waves of infection.

“If we go into winter, and it isn’t a [unusual] variant and it isn’t an unusually large wave, then probably some of the surveillance we have will give us the sort of indications we need for a lot of that kind of management,” he said.

According to UKHSA, another vaccination program with eligibility based on health problems or age will be launched later this year, and according to the EPA, discussions regarding expanding testing are ongoing.

Prof Steven Riley, the UKHSA's director general of data, analytics, and surveillance, stated that protecting the public against Covid-19 remained a primary priority for the organization.