Preparing for a challenging winter 2020/21

July and August must be a period of intense preparation for our reasonable worst-case scenario for health in the winter that we set out in this report, including a resurgence of COVID-19, which might be greater than that seen in the spring. The assumptions that we have made should be tested as new evidence emerges (including analysis of the evidence from the first wave) to enable prevention and mitigation strategies to be adapted and refined. Mitigation strategies should not pose further disadvantage to the most vulnerable in society or the highest risk patients or communities. To maximise their effectiveness (and to ensure they do not exacerbate inequalities), preparations for winter must be informed by engagement with patients, carers, public and healthcare professionals (as we have benefitted from in this report); and, whenever possible, be developed through co-production. Implementation of prevention and mitigation strategies requires enhanced coordination, collaboration and data sharing between central and local initiatives.

Overview of this report: At the request of the Government Office for Science, the Academy of Medical Sciences established in June 2020 an Expert Advisory Group chaired by Professor Stephen Holgate CBE FMedSci to inform:
- A clear understanding of what a challenging winter 2020/21 may look like – a likely mix of COVID-19, bad seasonal influenza and cold weather.
- An understanding of what this would mean for deaths, NHS capacity and social care.
- An understanding of what challenges this would present for surveillance; test, trace and isolate (TTI); and non-pharmaceutical interventions.
- Plans being developed by policy/operational colleagues to manage this.
The Expert Advisory Group completed this rapid review to define the extent of the challenges that might be faced this winter in terms of health, and health and social care delivery, as well as potential options to mitigate these. The deliberations of the Expert Advisory Group were informed by a Patient and Carer Reference Group, which provided guidance on priorities and concerns for winter 2020/21. [...]. The development of this report was also supported by early to mid-career researchers.
Expert Advisory Group (chair): Holgate S
Expert Advisory Group members: Barclay W, Bird W, Brayne C, Brightling C, Chalmers J, Clark T, Clarkson J, Corner J, Cubbon M, de Lusignan S, Dunning J, Field N, Grenfell B, Hayward A, Hort M, Hotopf M, Johnson A, Khunti K, Marteau T, Medley G, Murcia P, Noakes C, Openshaw P, Ramsay M, Riley S, Rudczenko M, Scott J, Shah S, Shallcross L, Sheikh A, Smyth R, Swanson L, Viner R, and Yardley L
Additional expertise (early to mid-career researchers): Amarnath S, Bailey H, Clarke G, Di Cesare M, Gentile E S, Gill U, Hargreaves S, Harling G, Hassan M, Makin S, Payne R, Sofat R, Tansley S, Wang Y
Patient and Carer Reference Group: Barrett K, Cole K, Laidlaw L, Liddle C, Malde-Shah N, Rudczenko M, Shah S, Wilkinson C