Come the end of March, the lights will dim on the UK’s Covid epidemic. Despite infection levels rising, cases will plummet, as free lateral flow and PCR tests are stopped for the majority of people in England, with other countries in the UK also set to reduce free testing in the coming weeks and months.

But while the government has argued it is time to manage Covid as we do other infectious diseases such as flu, scientists have warned ending community testing could put vulnerable people at risk and undermine efforts to understand the virus.

From 1 April, symptomatic testing will be free only for certain groups, such as hospital patients and social care staff. However, the Department of Health and Social Care has yet to give details on which other groups will be eligible.

After a winter of “flow before you go”, the change in policy seems dramatic.

Tackling Covid has undoubtedly been expensive: free testing, contact tracing and research studies do not come cheap. And, as the government points out, there is a high level of immunity across the country and the Omicron variant is less severe – the threat to most people is very different now to what it was at the start of the pandemic.

However, the end of free community testing means most individuals will be in the dark as to whether they have the virus, unless they are able to pay for a test, meaning they may go into public places while infected, passing the virus on to those they would otherwise have tried to protect. The situation is likely to be worse in more deprived communities.

While the success of vaccines and other approaches in tackling the severity of Covid, as well as less severe variants, may suggest that is not the problem it once was, rising infections have once again put significant pressure on the NHS. Experts warn even hospitalisations with Covid, rather than because of it, can cause logistical difficulties, exacerbate existing health problems and put vulnerable people at risk.

Researchers at the University of Southampton have explored how the pandemic has impacted the shopping habits and attitudes of consumers aged 65+ living and shopping in rural communities in the South of England.

A series of practical recommendations to encourage older shoppers in rural areas back into local stores in the wake of COVID-19 have emerged from research commissioned by the National Innovation Centre for Rural Enterprise (NICRE).

The research found that while many older shoppers were already returning to use rural retail stores, the majority also had similar concerns and apprehensions that prevented it being a ‘normal’ experience. For others, at the time of the survey in summer 2021, physical shopping remained a step too far, often for one or more of the reasons that were also inhibiting those who had already returned.

The findings led to seven recommendations for stores to help welcome more older shoppers back, make those who already had feel more comfortable, and encourage an improved experience for customers:

• Simply recognise that pandemic fear persists
• Maintain a physical distance
• Offer multiple modes of payment to reduce anxiety
• Encourage and facilitate [even more] personalised service interactions
• Mitigate against merchandise contamination
• Ask for feedback (and listen)
• Go the extra (delivery) mile

Last year’s boom in British summer holidays was not enough to save thousands of tourism businesses, despite increased domestic bookings to popular places such as Cornwall and the Yorkshire Dales.

A survey by the Tourism Alliance of 1,927 tour operators, hotels, attractions, language schools and other travel and hospitality businesses serving foreign tourists found that 11% believe they are “very likely to fail” in 2022, and a total of 41% think they are “quite likely to fail”.

The first three months of 2022 are looking bleak, with cancellations soaring in the wake of the Omicron variant. Almost a third of businesses surveyed have lost at least half of bookings made for domestic holidays between January and March this year.

Fly-tipping incidents in England increased last year, with household waste accounting for by far the biggest proportion of the problem, which has been worsened by the impacts of the coronavirus pandemic.

From March 2020 to March 2021 in England, 1.13m fly-tipping incidents were dealt with by local authorities, an increase of 16% on the 980,000 reported in the previous year, according to data released by the Department for Environment, Food and Rural Affairs on Wednesday. Higher numbers of incidents were reached in 2007-09, but the way the data is collated has changed, so direct comparisons with years before 2018 are not possible.

Despite the increase in numbers, the number of enforcement actions went down over the period, with only 456,000 actions taken, compared with 474,000 in the year 2019-2020.

The survey of the most senior executives running hospitals, ambulance services, mental health providers, community services, primary care and integrated care systems comes hours before new performance figures for the NHS in England are due to be published.

The number of people waiting for hospital treatment in England has hit a record high of 5.7 million as the NHS struggles to clear the backlog of care that has been worsened by the pandemic. Updated figures are expected on Thursday.

The greatest areas of concern for NHS leaders are primary care, and urgent and emergency care, according to the survey.

Matthew Taylor, the chief executive of the NHS Confederation, said: “Almost every healthcare leader we’ve spoken to is warning that the NHS is under unsustainable pressure, and they are worried the situation will worsen, as we head into deep midwinter, unless action is taken. They are also sounding alarm bells over risks to patient safety if their services become overwhelmed, on top of a severe workforce crisis.

“The health and social care secretary says the NHS is not under unsustainable pressure, but NHS leaders are clear that we have reached a tipping point. Frontline providers across all parts of the NHS are under intolerable pressure.”

A major analysis of the spread of Covid within hospitals has shown a massive gulf in ability to contain the virus during the first wave.

Overall, more than one in 10 people in hospital with Covid actually caught the virus while they were there.

But the analysis of 314 UK hospitals showed that ranged from just one in 100 cases caught in hospital, to more than one in four.

The researchers said the wide variation needed “urgent investigation”.

Stark difference

The study, by nine UK universities and published in the Lancet, analysed hospital data from two-thirds of Covid patients in the first wave.

They estimate between 5,700 and 11,900 people were infected in hospital.

“There will be tragedy behind this story, people that came into hospital with one problem, caught Covid and sadly died,” one of the researchers, Prof Calum Semple, from the University of Liverpool, said.

There was a stark difference between general hospitals, which the researchers said could not be explained by the number of patients coming in the door.

Reliable tests

“Even hospitals with literally thousands of patients coming in there are outstanding examples of infection control,” Prof Semple said.

“There’s a number of factors – we know there were challenges around PPE [personal protective (or protection) equipment] at the start.”

The design of some hospitals – such as those with more side rooms – would also affect how easy it was to contain Covid.

The availability of testing, which is now used to separate Covid and non-Covid patients, may also have been an issue.

“Reliable tests in the emergency department, that come back within the hour, has been a game-changer and has made my life a million times easier,” critical-care consultant Dr Annemarie Docherty, from the University of Edinburgh, said.

More infectious

Specialist residential hospitals had even bigger challenges with the virus spreading.

More than two-thirds of Covid cases in mental-health hospitals were caught there.

Things are improving, though.

The average proportion of cases caught in hospital was 11% in the first wave but now stands at 2-5% despite the emergence of the more infectious Delta variant, first identified in India.

Part of this will be down to understanding of the virus and how it spreads, such as airborne and asymptomatic transmission, that has emerged since the early days of the pandemic.

One in five firms plan on letting staff go in response to Sunday’s furlough policy change, which will see employers contribute more, a survey has found.

The British Chamber of Commerce said extra training was needed to deal with thousands of redundancies predicted.

From Sunday, government payments reduce to 60% towards salaries, with employers paying 20%.

The government said the approach was “right” and meant “we can focus support elsewhere” as the economy recovers.

According to the most recent figures up to 30 June, about 1.9m workers were on furlough, down from a peak of 5.1m in January.

The government said 11.6 million jobs have been supported since the Job Retention Scheme launched in April 2020.

The scheme is due to close at the end of September.

Almost two million private renters fear they will be unable to find another property if they lose their home after the eviction ban is lifted, ministers are being warned.

With the ban coming to an end this week, the government is facing demands for emergency legislation to increase the permanent protection for those struggling to pay their rent as a result of the Covid pandemic. Councils are also warning of a “cliff edge” of homelessness in the months ahead unless action is taken, with a potential £2.2bn bill for the state.

Private renters are those most at risk at the end of the ban, which has been repeatedly extended amid concerns about the build-up of rent arrears during the crisis. Among private renters in England who are worried about losing their home and who are already cutting back on heating and food to pay rent, 72% are worried they will be unable to find another home in the future. The finding, from a study by homelessness charity Shelter, equates to about 1.9 million privately renting adults.

Regional restrictions in England are “probably about to get tougher” to curb rising Covid infections, the prime minister has warned.

Boris Johnson told the BBC stronger measures may be required in parts of the country in the coming weeks.

He said this included the possibility of keeping schools closed, although this is not “something we want to do”.

Labour leader Sir Keir Starmer has called for new England-wide restrictions within 24 hours.

Sir Keir said coronavirus was “clearly out of control” and it was “inevitable more schools are going to have to close”.

It comes as the UK recorded more than 50,000 new confirmed Covid cases for the sixth day in a row, with 54,990 announced on Sunday.

An additional 454 deaths within 28 days of a positive test result have also been reported, meaning the total by this measure is now above 75,000.

England faces a wholesale closure of youth organisations, leaving a generation of vulnerable young people without life-changing support, according to research.

Almost two-thirds of youth organisations with incomes under £250,000 say they are at risk of closure, with 31% saying they might have to shut in the next six months.

The forced withdrawal of support officially recognised as “essential” comes at a time when the pandemic has left more than 1.5 million vulnerable young people in critical need of help, the research by the charity UK Youth found.

The responses from 1,759 youth organisations in England revealed that 58% are operating at a reduced level, with a further 20% temporarily closed or preparing to permanently close.