How London is avoiding a second Covid wave

At the Government’s Covid data briefing this week, alarming graphs revealed rapidly growing infection rates nationwide, from one in 2,200 people in August to one in 85 now. 

The number of people in hospital with Covid in England over the same period reflected that dramatic rise, going from a few hundred to more than 14,300.

But a closer look, by region, showed something else. As might be expected, the South was faring far better than the North. Fewer people were going to hospital across the South-East, South-West and east of England combined than in Yorkshire, where 376 people were admitted on Sunday.

One region, above all, appeared to be thriving – London, where new ONS figures showed that, in contrast to every other part of the country, there are currently no "excess deaths" at all compared to previous years. 

The percentage of those testing positive in the capital, at 0.71 per cent, is lower than any other region bar the East. Not only that, the infection rate in London is trending noticeably down from its peak of 0.85 per cent about three weeks ago.

Our most prosperous, populous city appears to be ducking the second wave. Intensive care units that were jammed almost exclusively with Covid patients in March are ticking along as normal. Two weeks into lockdown, doctors say case numbers show few signs of spinning out of control.

What’s going on? Is the second wave merely waiting to break across the capital, or might Covid be having a tougher time this time around? Here are five theories doing the rounds in the medical profession:

Fewer people

There are simply not as many people in London as usual, with a complete absence of tourists having changed the face of the city. 

Covent Garden in central London, normally a tourist destination, is all but deserted

Credit: Justin Tallis/ AFP

In 2019, there were 21 million tourist trips to London – 10 times the number to Edinburgh, in second place. National tourism agency VisitBritain noted that "from mid-March to mid-July, Covid-19 triggered a near-total shutdown in international tourism".

Things then picked up a little, but full year estimates are desperate. "Our central scenario forecast for inbound tourism to the UK in 2020 is for a decline of 74 per cent," said VisitBriain – and that was before the second national lockdown.

Behaviour changes

Those left in the city are doing different things – no more clubbing, massive concerts, sporting events, gigs. 

Packed commuter trains and Tube carriages are also a thing of the past. There were just 36.3 million Tube journeys in the last month for which figures are available.

The equivalent last year was 99.4 million – meaning there has been a fall of two-thirds. 

A quiet main concourse at London's Waterloo Station shortly before the start of the second lockdown

Credit: Niklas Hallen/AFP

The same is true of the rest of the country, of course. But such restrictions leave "general mixing" of households as the principal driver of infection. 

"Although everyone goes on about illegal raves or parties, the general mixing of people in London has changed," said Nicky Longley, associate professor at the London School of Hygiene and Tropical Medicine. "All that has gone away." 

In contrast, household mixing has been a problem in other regions. Andy Street, the West Midlands Mayor, said lockdown measures imposed in September were "to emphasise… about mixing between households".

Even a few breaches can be critical – some studies suggest that just 10 per cent of people might be responsible for 80 per cent of infections.

Second time lucky

London was badly hit by the first wave. Over the summer, React, the huge Imperial College study tracking Covid, reported a national average of six per cent of us had antibodies to the virus, showing that we had been infected. 

London – at 13 per cent – was more than twice that, and the highest in the country. In a separate nationwide study of children between two and 15 years old, 11.6 per cent in London had antibodies – "significantly higher than all other sites". 

Safer, a study of frontline healthcare workers at UCLH, showed that a whopping 45 per cent had been infected. "Obviously that is bigger than the general population [in London] but indicates that rates were likely to have been higher here than in the country as a whole," said Ms Longley, who also works at UCLH. 

Even this is not "herd immunity" level, but protection in London is almost certain to be higher than elsewhere.

Covid-19 antibody prevalence by region

Jobs and wealth

Of course there is deprivation in London. Of course there are multi-generational households in which vulnerable older people can easily be exposed to the virus. But the city is richer than other parts of the country. In 2018, disposable income per head stood at £29,362. In Yorkshire, it was £17,665. 

That is a consequence of the kinds of jobs people do. Close contact is the overwhelming route of infection. A study found that, in Sweden, the job carrying the greatest risk was taxi driver – 4.8 times higher than the average for all professions. 

In London, workers are more likely to be part of the "knowledge economy" and to more easily work from home. An ONS survey in the summer showed that 57 per cent of Londoners worked from home, 11 per cent above the national average and 20 per cent above Yorkshire, now so badly hit.

The Government favours London

This is the controversial one. But it is hard to escape the conclusion that the Government is, at the very least, dazzled by the fortunes of London and its nine million residents. 

Take the first lockdown. Many regions were forced indoors when infection rates, high in London, were low with them. When lockdown was first imposed, hospitalisation figures were the inverse of those now – London was way out in front. 

On March 23, when Boris Johnson told us all to stay indoors (see video below), some 1,515 were admitted in the capital, half the national total. In Yorkshire and the North-East, by comparison, there were just 190 admissions. 

When lockdown measures were eased, London had dramatically reversed the trend. On the last day of May, just 748 people were in hospital – fewer than half the total at the beginning of lockdown, and an 84 per cent decline from the capital’s peak of 4,813.

But everywhere else, the story was very different. In every other region, the numbers in hospital at the end of lockdown were higher than at the beginning. The Midlands, with 1,113, had almost three times as many people in hospital at the end of lockdown as at the beginning, and was only 64 per cent down from its own peak of 3,092. 

Yorkshire had almost five times as many, just 66 per cent down. The North-West, too, had five times as many people in hospital at the end as the beginning, and was just 57 per cent down on its peak.

It’s hard to escape the conclusion that the first lockdown was timed to suit London and that, this time around, the second national lockdown was imposed in time to protect the capital. 

"Last time our London figures dropped off and they released lockdown, but it hadn’t done the same in the North and they never really had a chance to catch up," said Ms Longley. "It’s possible that the second lockdown has also been timed in a London-centric way."