Predicting the Health Effects of the COVID-19 Epidemic in the UK to October 2023 Using a Dynamic Causal Model

Background – predicting the future UK Covid-19 epidemic provides a baseline of a vaccine only mitigation policy from which to judge additional public health interventions.Methods - a Dynamic Causal Model (DCM) is used to compare previous predictions with actual estimates over a 12-month period. It is also used to predict the future trends in infections, long-Covid, hospital admissions and deaths over the next 12 months.Findings – the October 2022 predictions made in October 2021underestimated cases by 43%, deaths by 24%, hospital admissions by 31% and overestimated post covid syndrome lasting more than 12 weeks by 94%. Plausible reasons for the disparities are the reduction in non-pharmaceutical interventions and the arrival of the Omicron variants. The predictions for October 2023 indicate a large wave of infections with significant health and economic consequences such as 120,000 additional Covid-19 related deaths, 800,000 hospital admissions and 3.5 million Post Covid-19 Syndrome lasting more than 12 weeks.Interpretation - the 12-month projection in 2021 underestimated the scale of the subsequent wave of infections. The 2023 projection could well underestimate the size of the next wave of Covid-19 infection. Vaccination alone will not control the epidemic. The Covid-19 epidemic is not over.Funding: KF is supported by Wellcome through core funding to the Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology [203147].Declaration of Interest: None to declare.