England is about to take a huge gamble.
On Monday, July 19, the country is ditching all of its remaining pandemic-related restrictions. People will be able to go to nightclubs, or gather in groups as large as they like. They will not be legally compelled to wear masks at all, and can stop social distancing. The government, with an eye on media coverage, has dubbed it “Freedom Day,” and said the lifting of safety measures will be irreversible.
At the same time, coronavirus cases are rapidly rising in the UK. It recorded over 50,000 new cases on Friday, and its health minister says that the daily figure of new infections could climb to over 100,000 over the summer.
In theory, a full reopening during a surge in cases sounds like a combustible mix. But the UK government is betting that this time won’t be like the others because of its vaccination program.
Researchers say it’s extremely difficult to predict what will happen next, with multiple overlapping, complex factors at play. So let’s examine what we know, what we don’t know, and what we need to keep an eye on over the coming weeks.
What we know: the vaccines are working
The UK’s vaccination program is still under way, but it has been broadly successful so far. In all, 52% of the adult population is fully vaccinated, and about 87% of adults have received their first dose (this includes the 52% who have had both doses). Just 6% of Brits are hesitant about getting a shot, according to the Office for National Statistics.
There is still plenty of cause to be nervous, however. The country is months away from fully inoculating the entire adult population. Young people are particularly vulnerable; the over-18s have only just started to receive their first doses, and only a quarter of 18- to 39-year-olds have had both shots. And unlike the US and much of Europe, the UK has not started vaccinating children.
“That’s dangerous,” says evolutionary virologist Emilia Skirmuntt. “We need to vaccinate teenagers urgently, especially before they return to school in September.”
This matters because the overwhelmingly dominant strain of covid-19 in the UK right now is the delta variant. While fully vaccinated people have relatively little reason to worry about delta—with both Pfizer and AstraZeneca vaccines offering over 90% efficacy against hospitalization, according to data from Public Health England—the variant is bad news for those who have only had one shot or are unvaccinated.
It’s about 60% more transmissible than the alpha variant, which was previously dominant in the UK, and almost twice as likely to lead to hospitalization, according to Scotland’s public health body. A single dose of either the AstraZeneca or the Pfizer vaccine is just 33% effective against the delta variant, versus 50% for alpha, says data from Public Health England.
“This reopening is going to lead to a lot of avoidable damage,” says Deepti Gurdasani, a clinical epidemiologist at Queen Mary, University of London. “We should be halting easing up until all adults and adolescents have been offered both doses of the vaccine.”
What we don’t know: when cases will peak
It’s clear that the UK is experiencing yet another wave of the pandemic. What we don’t know is just how bad it’s going to get—or how lifting restrictions will change that. Even the top experts in the field can’t say for sure.
“It is very hard to know what is going to happen after July 19,” says Graham Medley, professor of infectious disease modelling at the London School of Hygiene & Tropical Medicine and chair of SPI-M, a group of scientists that advises the UK government on pandemic modeling.
A lot depends on public behavior, and that is notoriously very tricky to predict. While some will enjoy their newfound freedoms with gusto (a tendency that was on full display last weekend during the final of the European soccer championships), others will be far more cautious.
Many people are frustrated at the ditching of masks, one of the most basic and effective public health measures. An Ipsos Mori poll found that a sizable majority of British people plan to continue to wear masks in stores, and on public transport. If people follow through on this, it may help curb the spread somewhat: Israel, which also has high vaccination rates, had to reimpose mask-wearing indoors last month due to a steep rise in cases.
Regardless, it is very likely that cases will continue to rise for 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 gets.
In a webinar on Thursday, Dr Chris Whitty, the chief medical officer for England, said that the country could see “quite scary numbers again” and “get into trouble again surprisingly fast.”
But the government seems to be betting that not all numbers are equally scary. It hopes that hospitalizations will stay low enough to stop the National Health Service from being completely overwhelmed. It is making the assumption that the link between cases and hospitalization rates has been weakened, if not broken.
“This wave is very different to previous ones,” says Oliver Geffen Obregon, an epidemiologist based in the UK, who has worked with the World Health Organization. “The proportion of hospitalization is way 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 in The Lancet arguing that Britain should care about the huge rise in infections, regardless of the rates of deaths and hospitalizations.
Gurdasani, the epidemiologist, is one of them.
“Cases matter,” she says, pointing to two main dangers: the increased chance that large numbers of people will develop long covid, and the risk of new, vaccine-dodging variants.
What we know: more people will get long covid
The UK already has a significant long covid problem. More than two million adults may already have—or have had—complications which persist for 12 weeks or more, according to a major study from Imperial College London. But long covid is poorly understood, with over 200 symptoms ranging from fatigue to shortness of breath to memory issues, according to the largest study of it yet, recently published in The Lancet.
About one in 10 of those who catch covid-19 go on to develop long covid, according to the WHO. That means if another million people in the UK catch covid during this wave—a feasible scenario by most estimates—there could be another 100,000 people with long-term issues.
Whitty is worried. “I think we will get a significant amount more long covid, particularly in the younger ages where the vaccination rates are currently much lower,” he said on July 6.
That could place huge pressure on the NHS, businesses, and society in general, let alone cause untold misery for vast numbers of individuals.
“Some symptoms may persist for years, and there’s a chance we’re exposing a whole generation to very bad health for the rest of their lives,” says Skirmuntt.
What we don’t know: if this could all spawn another dangerous variant
The big fear for many experts is that this approach by the government is creating an ideal breeding ground for the emergence of a vaccine-resistant variant.
On July 5, Steve Peterson, co-director of the Centre for Genomic Research at the University of Liverpool, summed up the concerns in a tweet: “Letting a virus rip through a partially vaccinated population is exactly the experiment I’d do to evolve a virus able to evade immunity.”
These robots know when to ask for help
A new training model, dubbed “KnowNo,” aims to address this problem by teaching robots to ask for our help when orders are unclear. At the same time, it ensures they seek clarification only when necessary, minimizing needless back-and-forth. The result is a smart assistant that tries to make sure it understands what you want without bothering you too much.
Andy Zeng, a research scientist at Google DeepMind who helped develop the new technique, says that while robots can be powerful in many specific scenarios, they are often bad at generalized tasks that require common sense.
For example, when asked to bring you a Coke, the robot needs to first understand that it needs to go into the kitchen, look for the refrigerator, and open the fridge door. Conventionally, these smaller substeps had to be manually programmed, because otherwise the robot would not know that people usually keep their drinks in the kitchen.
That’s something large language models (LLMs) could help to fix, because they have a lot of common-sense knowledge baked in, says Zeng.
Now when the robot is asked to bring a Coke, an LLM, which has a generalized understanding of the world, can generate a step-by-step guide for the robot to follow.
The problem with LLMs, though, is that there’s no way to guarantee that their instructions are possible for the robot to execute. Maybe the person doesn’t have a refrigerator in the kitchen, or the fridge door handle is broken. In these situations, robots need to ask humans for help.
KnowNo makes that possible by combining large language models with statistical tools that quantify confidence levels.
When given an ambiguous instruction like “Put the bowl in the microwave,” KnowNo first generates multiple possible next actions using the language model. Then it creates a confidence score predicting the likelihood that each potential choice is the best one.
The Download: inside the first CRISPR treatment, and smarter robots
The news: A new robot training model, dubbed “KnowNo,” aims to teach robots to ask for our help when orders are unclear. At the same time, it ensures they seek clarification only when necessary, minimizing needless back-and-forth. The result is a smart assistant that tries to make sure it understands what you want without bothering you too much.
Why it matters: While robots can be powerful in many specific scenarios, they are often bad at generalized tasks that require common sense. That’s something large language models could help to fix, because they have a lot of common-sense knowledge baked in. Read the full story.
Medical microrobots that travel inside the body are (still) on their way
The human body is a labyrinth of vessels and tubing, full of barriers that are difficult to break through. That poses a serious hurdle for doctors. Illness is often caused by problems that are hard to visualize and difficult to access. But imagine if we could deploy armies of tiny robots into the body to do the job for us. They could break up hard-to-reach clots, deliver drugs to even the most inaccessible tumors, and even help guide embryos toward implantation.
We’ve been hearing about the use of tiny robots in medicine for years, maybe even decades. And they’re still not here. But experts are adamant that medical microbots are finally coming, and that they could be a game changer for a number of serious diseases. Read the full story.
5 things we didn’t put on our 2024 list of 10 Breakthrough Technologies
We haven’t always been right (RIP, Baxter), but we’ve often been early to spot important areas of progress (we put natural-language processing on our very first list in 2001; today this technology underpins large language models and generative AI tools like ChatGPT).
Every year, our reporters and editors nominate technologies that they think deserve a spot, and we spend weeks debating which ones should make the cut. Here are some of the technologies we didn’t pick this time—and why we’ve left them off, for now.
New drugs for Alzheimer’s disease
Alzmeiher’s patients have long lacked treatment options. Several new drugs have now been proved to slow cognitive decline, albeit modestly, by clearing out harmful plaques in the brain. In July, the FDA approved Leqembi by Eisai and Biogen, and Eli Lilly’s donanemab could soon be next. But the drugs come with serious side effects, including brain swelling and bleeding, which can be fatal in some cases. Plus, they’re hard to administer—patients receive doses via an IV and must receive regular MRIs to check for brain swelling. These drawbacks gave us pause.
Sustainable aviation fuel
Alternative jet fuels made from cooking oil, leftover animal fats, or agricultural waste could reduce emissions from flying. They have been in development for years, and scientists are making steady progress, with several recent demonstration flights. But production and use will need to ramp up significantly for these fuels to make a meaningful climate impact. While they do look promising, there wasn’t a key moment or “breakthrough” that merited a spot for sustainable aviation fuels on this year’s list.
One way to counteract global warming could be to release particles into the stratosphere that reflect the sun’s energy and cool the planet. That idea is highly controversial within the scientific community, but a few researchers and companies have begun exploring whether it’s possible by launching a series of small-scale high-flying tests. One such launch prompted Mexico to ban solar geoengineering experiments earlier this year. It’s not really clear where geoengineering will go from here or whether these early efforts will stall out. Amid that uncertainty, we decided to hold off for now.