England is going to take a huge gamble.

On Monday, July 19, the country is eating up all its epidemic-related sanctions. People can go to nightclubs, or gather in large groups as they like. They will not be legally forced to wear masks, and can prevent social distance. Keeping an eye on media coverage, the government has called it “Freedom Day” and said taking security measures would be reversible.

At the same time, cases of coronavirus are increasing rapidly in the UK. It reported more than 20,000,000 new cases on Friday, and its health minister says the number of new infections could reach 100,000 every day in the summer.

In theory, reopening completely during a boom in cases seems like a composite mix. But the UK government is betting that this time will not come like others because of its vaccination program.

Researchers say it is extremely difficult to predict what will happen next, with multiple overlapping and complex factors in the game. So let’s look at what we know, what we don’t know, and what we need to pay attention to in the coming weeks.

What we know: Vaccines are working

The UK’s vaccination program is still ongoing, but it has been widely successful so far. Overall, 52% of the adult population has been fully vaccinated, and about 87% of adults have received their first dose (this includes 52% who have both doses). According to the Office for National Statistics, only 6% of Brits are reluctant to get a shot.

However, there are still plenty of reasons to be nervous. The country is months away from fully inoculating the entire adult population. Young people are particularly vulnerable; People over the age of 18 have just started receiving their first dose, and only 18- to 39-year-olds have had both shots in the quarter. And U.S. And unlike many Europeans, the UK has not started vaccinating children.

“It’s dangerous,” says evolutionary virologist Emilia Schirmont. “Adolescents need to be vaccinated immediately, especially before they return to school in September.”

This is important because the UK right now has a hugely impressive strain Delta variant of the Covid-19. While fully vaccinated people have relatively little reason to worry about Delta – both Pfizer and AstraZeneca provide over 90% efficacy against hospitalization with the vaccine, according to data from Public Health England – the only bad news for those who have Only one shot was or is. unvaccinated.

It is about 60% more transmissible than the Alpha variant, which was previously prevalent in the UK, and is almost twice as likely to be hospitalized, according to the Scottish Public Health Institute. Against the Delta variant says a single dose of the Strazeneca or Pfizer vaccine is only 33% effective, compared to 50% for alpha, according to data from Public Health England.

Dipti Gurdasani, a clinical epidemiologist at Queen Mary University in London, says: “We should get easier until all adults and adolescents are offered both doses of the vaccine.”

What we don’t know: When the case comes up high

It is clear that the UK is experiencing another wave of epidemics. What we don’t know is how bad it will get – or how. Even the top experts in the field cannot say for sure.

“It is very difficult to know what will happen after July 19,” said Professor Daling, a professor of infectious disease at the London School of Hygiene and Tropical Medicine and chairman of SPI-M, a UK advisory group. Government on epidemic modeling.

Much is based on public behavior, and it is notorious for making predictions. While some will enjoy their new freedoms (the trend that was on full display last week during the European Soccer Championship finals), others will be more cautious.

Many people get frustrated at the digging of masks, which is one of the most basic and effective public health remedies. The Ipsos Mori poll found that most British people plan to continue wearing masks in stores and on public transport. If people follow this, it could help curb the spread to some extent: Israel, which also has a low vaccination rate, had to increase the number of masked cases indoors last month.

Regardless, it is very likely that the case will continue to grow in at least a few days if not a few weeks. And that means more hospitalizations and deaths are inevitable, according to Medley. The big question is how high this wave is.

In a webinar on Thursday, England’s chief medical officer Chris Whitty said the country could see “horrendous numbers again” and “surprisingly quickly get back into trouble”.

But the government seems to be betting that not all numbers are equally scary. He hopes hospitalization will be low enough to prevent the National Health Service from being completely overwhelmed. He is assuming that if the link between cases and hospital admissions is weakened, it is not broken.

“This wave is very different than before,” says Oliver Geffen Obregon, a UK-based epidemiologist who has worked with the World Health Organization. “Hospital admissions are lower compared to similar points on the epidemic curve before the vaccination program.”

But not everyone agrees. NHS bosses are already sounding the alarm over capacity, and more than 1,200 scientists have signed a letter to The Lancet arguing that Britain should take care of the huge increase in infections regardless of death and hospitalization rates.

One of them is Gurdasani, an epidemiologist.

“The case does matter,” he says, pointing to two main risks: the possibility that large numbers of people will develop long covid, and the risk of new, vaccine-dodging variants.

What we do know: More people will get long covid

The UK already has a significant problem with long covid. According to a large study from Imperial College Ledge London, two million adults may already have – or – have difficulties that last for 12 weeks or more. But the long covid is poorly understood, with more than 200 symptoms ranging from fatigue to shortness of breath and memory issues, according to the largest study to date, recently published in The Lancet.

According to the WHO, Covid-19 develops a long covid, one in 10 of those caught. That means if another million people in the UK fall ill during this wave – a speculative scenario by most estimates – there could be another 100,000 people with long-term issues.

Whitey is concerned. “I think we’ll get a longer covid, especially in youth, where vaccination rates are currently much lower.” He said on July 6.

It can put tremendous pressure on the NHS, businesses and people in society in general, not to mention that a large number of individuals suffer unwanted suffering.

“Some symptoms persist for years, and there’s a chance we’ll bring the entire pay generation up against very poor health for the rest of their lives,” says Schirmont.

What we don’t know: Can all this lead to other dangerous types?

The big fear for many experts is that the government’s approach is creating an ideal breeding ground for the emergence of a vaccine-resistant variant.

In July, Steve Peters, co-director of the Center for Genomic Research at the University of Liverpool, summed up these concerns in a tweet: Viruses capable of avoiding the immune system. “