Will Wales be going into another lockdown? That is the question that is on many people’s minds as winter approaches and Covid infection rates increase.

The Covid infection rate in Wales has now reached 716.9, the highest rate since the pandemic began. Blaenau Gwent has a case rate of 1,185 which makes it the area of the UK with the highest infection rate. In England there are daily calls for the government to begin re-introducing restrictions to prevent the overwhelming of its NHS. You can keep up with all the important coronavirus stories in Wales here.

It was in the second week in August that Wales lifted almost all restrictions. Fast forward 10 weeks and there are very real concerns around whether we could be facing another lockdown this winter. But how likely is it we will be going into a lockdown with all the associated misery and harms that come with that? We spoke to three experts in Covid to find out what the coming months have in store for us:

Ultimately the decision to go into a lockdown will be taken by the First Minister Mark Drakeford. He has indicated that he will only ever do this if it is needed to protect the NHS. Whether this happens or not will depend on several factors which are hard to predict (the virus has been full of unforeseeable twists and turns) but given the interest in the issue it is worth digging into to data to see what cautious predictions we can make.

Will Wales go into another lockdown?

Both Professor Michaelis and Dr Williams are sceptical about the need for further lockdowns.

Dr Williams said: “Lockdowns are a thing of the past. We won't see anything like what we had last year, where we had a stay at home order. I suspect the Covid pass may be extended into new venues — perhaps bars, restaurants etc, like in Denmark — at least that is the next step into the plan.

“Beyond that, if things really get bad, then we may see some of the alert level one measures come back, where there are limits imposed on the numbers of people being able to mix indoors and where social distancing is reintroduced. Hopefully it won't come to this but that is why minimising our mixing voluntarily and trying to keep wearing our masks where required is important. But also the government and employers need to support people to work from home and to self-isolate where needed.”

He added: “The days of lockdowns are thankfully behind us. I think it's important that governments are clear on this. Although you can never be 100% certain, I think it's important to communicate that if and when more restrictions are introduced they are going to be much more moderate than in past waves, because of vaccines. A recent survey, however, showed that half of people in the UK worry there will be another lockdown. This is important to be clear about because it will help build public buy-in to new measures if they know that they are going to be relatively 'low cost' - things like reintroducing masks in hospitality, or encouraging working from home.”

Professor Michalis agrees with these sentiments saying: “Lockdowns similar to those last year seem unlikely. The vaccine roll-out has reduced the number of individuals who develop severe Covid-19. Although there are so-called ‘breakthrough’ infections in fully vaccinated individuals, i.e. individuals who received their second jab at least 14 days ago, infections tend to be milder than in unvaccinated individuals.

“The roll-out of booster jabs to people over 50 should further increase immune protection and reduce both the levels of Covid-19 spread and the number of severe cases. Similarly, vaccinating the 12 to 17-year-olds should have an impact on Covid-19 transmission.

“Notably, Covid-19 is not the only respiratory disease expected to spread over the winter. We see a return of common colds, which are caused by more than 200 different viruses. Of concern is, for example, respiratory syncytial virus (RSV), for which no vaccination exists and that typically affects young children. Moreover, the flu, which is caused by influenza viruses, will add to the pressures caused by Covid-19. Hence, we expect another rough winter, but probably not the re-introduction of full-scale lockdowns.”

So ultimately a lockdown only becomes likely if there is a substantial increase in hospitalisations. The current hospital admissions rate is averaging around 41 a day, which is the same as we saw on September 10. This begs the question of why the case rates are skyrocketing but the hospitalisations are fairly stable (though slightly up)?

“Young and unvaccinated people are still dominating the cases.” explained Professor Gravenor. As young people are the least likely to be in hospital with Covid, this explains how the cases haven’t transmitted into hospitalisations.

He added: "Hospitalisations have been a lot less volatile than cases. I would say it's not super low. It's a concerning level. The experience we've had in the last few years is five ICU admissions can easily become 10 and 15. And then that's starting to have a really, really big impact."

Professor Michaelis says that if there ever was a lockdown it would be in the form of a firebreak and only then if there were upturns of other diseases.

He said: “Lockdowns are really a measure of last resort and politically there seems to be a very high reluctance to impose such sweeping measures again. Hence, I do not expect general lockdowns, as we had them in the past. If the situation becomes bad enough in some areas, I think that restrictions will be more localised or that shorter circuit breaker lockdowns may be applied.

“However, these are all just informed guesses in the end. If the combined impact of common cold viruses, the flu, and Covid-19 becomes so large that lockdowns are needed to ensure that there is a hospital bed for everyone who needs one, there will be no alternative."

When are cases going to start dropping?

In early September, modelling suggested that Covid would peak in Wales around the start of October and then fall.

There was an initial fall in the virus but it then came back with a vengeance. So why did it fall and then rise again?

According to Professor Gravenor, who carries out the modelling, there are two potential reasons. The first is that our behaviours have changed. If we reduce the actions which suppress the virus like mask wearing and self-isolating when we have symptoms, then the numbers of cases can rise.

However, we also need to take into account the errors in the Immensa testing lab in Wolverhampton which may have given at least 43,000 people an incorrect negative Covid test result.

This makes it very difficult to predict when cases will start to fall again (though the increase has already slowed down) for two reasons.

Firstly, the errors may have contributed to increasing the cases themselves. If thousands of people are walking around with Covid thinking they are safe it is likely that the virus will spread more than usual. There is still some provisional (but by no means conclusive) evidence that this may have happened.

“We know that some areas that didn't send tests to that lab are still seeing cases go down, “ said Professor Gravenor. “And we know that samples went there from areas that were going down and now going up. So it's clearly worth a lot of investigation. We would expect this subgroup of false negatives to have a larger R value. That would have led to maybe an R of 1.5-2 in the next generation.”

The other reason this lab error makes it harder for us to say when cases will peak in Wales is because it has made the previous data uncertain. So it is tough to fully understand how the virus is behaving. It may be that cases never actually dropped as much as we thought and instead the error in the lab made it seem like they had.

Right now the team at Swansea University are trying to estimate how many positive cases in Wales the labs missed. To do this they are looking at the positivity rates for other labs. If the Welsh average was 15% test positivity in other labs and only 10% in the Immensa then it may be possible to give an approximation of how many positive cases were missed.

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