England’s Covid-susceptible population among lowest in Europe

The number of people in England who are susceptible to Covid is one of the lowest in Europe, analysis has shown.

Modellers at the London School of Hygiene and Tropical Medicine (LHSTM) ran a hypothesis in which everyone was exposed to the virus at the same time to determine how many people in different countries are at risk of hospitalisation or death.

Figures for 19 nations were available, allowing for comparable analysis that factored in vaccination levels and infection rates.

In the research – carried out before the emergence of the omicron variant – academics found England has around 73,000 people at risk of hospitalisation and roughly 15,000 at risk of dying, equivalent to 130 hospitalisations and 27 deaths per 100,000 people.

Only Hungary, at 106, has a smaller proportion of people at risk of hospitalisation, while just Denmark, at 24 per 100,000, has a smaller ratio of people vulnerable to death from Covid.

Romania has the highest number in danger of hospitalisation because of its low vaccination rates, while France (149 per 100,000), Germany (322) and Italy (163) all have a bigger proportion than England.

Germany has more than twice as big a population at risk of dying than England (65 per 100,000). France (33), Spain (29) and Italy (36) also have bigger susceptible populations.

The study was published as a pre-print on the medRxiv website and reviewed by Sage scientists on Nov 24.

Dr Lloyd Chapman, an expert in infectious disease modelling at LSHTM, warned that omicron's ability to evade prior immunity means the numbers of vulnerable people may now be higher, but said the relative positions of countries remained valid.

"We used data on deaths over time to estimate the level of prior exposure to Covid-19, allowing us to account for the impact of undetected infections on the remaining risk of hospitalisations and deaths," he told The Telegraph.

"Our findings suggest there is still a high potential burden of hospitalisations and deaths from Covid-19 in all 19 countries despite reasonably high vaccine coverage, since the absolute number of people who have not been vaccinated or exposed to the virus remains high.

"However, there is a lot of variation between countries. The data suggests that countries with lower vaccine coverage among the elderly have the highest potential remaining hospitalisation and death burdens.

"The analysis does not account for waning of immunity, potential new variants emerging or the booster rollout, so cannot be used to predict the effect of restrictions being lifted or when the pandemic will end.

"We need to understand how epidemics might evolve over the coming months. This pre-print is just one piece of the puzzle when looking at the bigger picture of Covid-19 risk in Europe."

The research was presented to experts at SPI-M, the Sage sub-group advising the Government on the spread of the virus.

"The estimate for England is significantly lower than for other countries assessed," SPI-M said. "This is a consequence of widespread vaccination and high prevalence of infection over the course of the epidemic, but specifically since July 2021.

"They estimate that this low number of susceptible individuals, coupled with fast rollout of booster vaccinations in the most vulnerable, implies a smaller potential for further hospitalisation in England in the short term compared to many countries across Europe.

"SPI-M-O views this hypothesis as plausible, with observed patterns of infection and vaccination consistent with a smaller susceptible population in the UK compared with other parts of Europe."