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As the incidence of COVID-19 reduces in some parts of the world, countries like the UK are turning their attention to winter. The UK Government Office for Science commissioned a rapid review by the Academy of Medical Sciences (AMS). The report (‘Preparing for a challenging winter 2020/21’) 1 published on the 14th July presents a reasonable worst case scenario of a second wave, substantially worse than the first, occurring against the backdrop of the seasonal influenza epidemic, and examines the wider impacts on health, healthcare delivery and inequalities.

The report presents four main challenges arising from the usual winter pressures compounded by a possible increase in COVID-19 cases. Firstly, it describes estimates, based on an increase in Rt to 1.7 from September 2020, of hospital admissions and deaths. The modelled data suggests a peak at the height of NHS winter demand in January/February 2021 with double the number of in-hospital deaths compared to the first wave. Secondly, the ensuing disruption to non-COVID health and social care delivery. Thirdly, the mounting backlog of delayed access to care the pandemic has caused, including poor management of long-term conditions, long waiting lists for elective surgery, and late presentations to healthcare leading to worse outcomes. The final challenge is the additional damage of a major seasonal influenza epidemic.