Falling coronavirus cases and low death rates mean the NHS is close to being able to resume its normal services, experts say.
Daily deaths from the virus remain low, with 38 recorded in the UK yesterday, bringing the total to 41,736 as of 5pm on Sunday.
The declining numbers of cases meant that, as of yesterday, only 390 critical care beds were occupied by coronavirus patients across England.
Daily deaths from coronavirus remain low in the UK, with just 38 recorded on Monday meaning the total sits at 41,736
The falling rate of deaths and total cases could mean the NHS is able to return to normal service, according to experts
A study by Imperial College London calculates that all routine surgeries could be reintroduced once critical care occupancy by Covid-19 patients falls to 320.
It suggests the NHS could start to clear its waiting list – which stands at more than four million – within weeks.
The Imperial team cautioned that it would take a while to clear the backlog of operations cancelled in March, April and May.
And they said the NHS will need to keep in place some of the emergency measures used during the crisis in order to clear the backlog – such as using private hospitals, keeping on retired staff who returned to work and employing final-year medical and nursing students.
But this aside, hospitals are close to being in a position to resume full services, they said.
It would mean hospitals (pictured) are close to providing full services once again, but they will keep emergency measures in place
Researcher Dr Katharina Hauck, of Imperial College London, said: ‘It is impressive how the NHS adapted to provide life-saving treatment to Covid patients, but we have now many patients who are waiting for essential surgery.’
Ruth McCabe, also of Imperial, said it was ‘imperative’ that the emergency measures were ‘sustained to resume elective surgery while allowing for potential future surges in Covid-19 patients’.
Officials said the latest figure for Covid-19 deaths was further proof of a downward trend, though delays in processing fatalities over the weekend mean the daily totals are often lower on Sundays and Mondays.
Nevertheless, it is two thirds lower than a fortnight ago, when 111 deaths were recorded and at a similar level to March 21, two days before lockdown started.
Official figures show the number of those being put in hospital with the virus is also declining.
Some 430 were admitted on Saturday, down from 515 the week before, and a fraction of the peak of 3,432 on April 1.
The number being treated to hospital has also fallen by almost a fifth to 5,507, from 6,826 the same time last week, according to the Department of Health.
Those most severely ill, requiring ventilators, has fallen to 395 from 556 a week earlier and a peak of more than 3,000.
Has the virus burned itself out?
Analysis by John Naish
Nearly three months into Britain’s coronavirus pandemic and death and infection rates are falling steadily.
Elsewhere in the world, in countries that are some weeks ahead of us and where lockdown restrictions have been eased, there are as yet few signs of a dreaded ‘second wave’ – although it is early days.
Now some scientists are suggesting – tentatively to be sure – that this strain of the coronavirus may be following a path beaten by other pathogens, whereby the murderous intruder evolves into a house-guest that lives peaceably inside us.
Three months into lockdown in Britain (pictured) and the number of deaths and daily cases are beginning to fall
Early evidence for this positive development comes from northern Italy which suffered the full force of the pandemic weeks before it hit us.
Late last month, Professor Matteo Bassetti, the head of infectious diseases at San Martino hospital in Genoa, told journalists: ‘The strength the virus had two months ago is not the same strength it has today.
‘The majority of patients [seen] during March and April were very sick with acute respiratory distress syndrome, shock, multiple organ failure.
‘The majority died in the first days after admission. We no longer see these types of patients.
‘Is this because the virus lost some viral potency?’ he asked. ‘I don’t know.’
A positive sign in the European fight against coronavirus: Italian mayor of Gorizia (left) reopens the border with Slovenia in the north of Italy – one of the areas most devastated by the virus. It comes as Italian scientist say the virus is weakening
His observation is supported by an analysis of local death rates by Professor Lamberto Manzoli, an epidemiologist at northern Italy’s Ferrara University.
His results suggest that from March to April, mortality from Covid-19 across all ages fell by more than half.
Professor Manzoli’s paper has not yet been published in a reputable scientific journal and so has not been subject to peer review.
Scientists are still on a steep learning curve with this novel virus, but other observations feed into this theory.
In China, as far as we know, there have been localised spikes – including the current outbreak associated with a market in Beijing – but no widespread surge.
In France, Spain and Italy, where some semblance of normal life began two to three weeks ago, both new infections and deaths remain low.
In European countries such as France (pictured), a sense of normal life has returned with the number of cases and deaths remaining low
A similar apparent fall in lethality has been reported in America. Lee Riley, a professor of infectious diseases at the University of California, Berkeley, told the science publication Elemental that data from New York hints at an improvement in recoveries.
‘Every time a virus passes from one person to another it goes through mutations,’ he says.
‘These can accumulate and the virulence of the virus can ultimately lessen. It’s in the nature of these viruses to get tired after a while.’
While the world must hope and pray that the virulence is waning, there are some caveats, including two other possible explanations for the drop in deaths.
The first is that treatment has vastly improved as doctors have acquired experience of managing Covid-19.
Indeed, Prof Manzoli acknowledges that clinical protocols seem more effective now. In the early days, clinicians waited until the condition worsened before giving drugs and ventilation – the ‘Chinese protocol’. Now they start early, he says.
Alternatively, the virus might simply have infected and killed the most vulnerable first, with more resilient patients surviving.
UK experts are dubious, arguing that the genetics of the disease have not changed. Dr Oscar MacLean, a bioinformatician at Glasgow University’s Institute for Infection, Immunity, and Inflammation, argues: ‘We’ve seen no evidence of widespread [reduction in its lethality].’
UK scientists remain sceptical, however, with regards to the debate surrounding the reduction in the virus’ lethality
He adds: ‘The golden rule is that viruses tend to evolve over time to become less pathogenic, but that doesn’t happen over a matter of a few months. It’s more a matter of years.’
Viruses can evolve to a point where they can indeed help their hosts (human or animal), establishing a symbiotic relationship from which both species benefit.
This may be the optimum state for the pathogen which has one purpose – to reproduce itself and infect new individuals and it can better achieve this if it does not kill its host (one reason why the Ebola virus outbreaks, with a 50 per cent fatality rate, tend to burn out).
Dr Frank Ryan, a British evolutionary biologist and author of Virolution, about the powerful role of viruses in evolution, calls the beneficial relationship ‘aggressive symbiosis’.
The herpes virus, for example, has developed symbiosis with the squirrel monkey, passing harmlessly from mother to baby.
If a rival species such as marmosets invades squirrel-monkey territory, the virus infects the challenger to devastating effect.
It is in the squirrel monkeys’ interest not to purge the virus, so its immune system views it as friend rather than intruder.
Perhaps this type of ‘jungle immune system’ helps wild bats.
In fact, some ecologists have speculated on whether Covid-19 might be bats’ acquired defence against humans destroying their habitats and eating them.
Could we even ultimately develop a mutually beneficial relationship with coronavirus?
We know that nearly 10 per cent of the human genome comprises genetic material from viruses that invaded us in the past and this ‘borrowed’ viral DNA does vital work – ranging from enabling us to digest starchy foods to, ironically, helping us to fight infections.
Conversely, the Covid-19 virus might never bring anything useful to the human genetic table.
But three months on, even the slightest hint that it is in retreat – and for whatever reason – is something to hold on to.