London, potentially is going to be a problem again BUT some of the more deprived areas have already been hit hard, so i think we have to hope that this will offset problems and offer some protection.
I think we need to consider who now may have some immunity too. The number of key workers who caught it early, particularly in London, whilst not offering herd immunity may offer a degree of protection too. Key workers have a high number of social contacts - particularly with more vulnerable individuals - so if they now have greater immunity, they might slow the spread too.
It depends on how long antibodies offer some immunity which is an unknown quantity.
I should add from what we know in terms of antibody testing, nhs workers have had covid-19 in higher numbers than the general population and theyve found that some who have tested positive for COVID-19 have come back negative or with very few antibodies in an antibody test, so this leaves some question marks. As does the research into T cell immunity which suggests that for every person with antibodies, 2 people are showing signs of t cell immunity. We dont know enough about this, but its possible that people with different ancestry may have different levels of immunity for this reason too.
London also has a younger population to many other parts of the uk though. London is also better served if you centralised health services than more provisional areas. Its health services have had a baptism of fire and now have greater expertise in caring for those with covid-19 than perhaps exists in other parts of the country - that may also reflect in survival and complication rates.
This is why its not regarded as somewhere which is on the list of places most at risk.
So i can see arguments for and against London being an issue.
Going forward I see issues being linked more to provincial areas in part because of this centralised approach to the crisis and how local authorities have now been put in charge of management of restrictions.
A lot of the most deprived communities have the least resources at a local level to cope with localised restrictions. Local councils are not a level playing field and many are already on the verge of bankruptcy. Luton is one place that is financially screwed atm (ironically in part due to its dependence on the airport filling the councils coffers).
As i say the things to keep an eye on: deprivation and provisional issues.
This also links back to a vaccine.
What no one is talking about in terms of the vaccine is how quickly they will be able to distribute and administer it.
The manufacture of possible vaccines is being done pre-emptively before the effectiveness of each possible vaccine has been proved which will save time.
But this means there has been expense invested already. We might not necessarily get the best vaccine out the end, at least initially. It might have limited effectiveness. But this might be preferable to the alternative in the short term.
Whats worrying me more is the logistics and management of administering a vaccine though.
Is it going to be done through GPs or more centralised to increase capacity?
So far weve seen a very centralised approach and in general weve seen a move to more centralised healthcare (cos its cheaper to provide).
The flip side to this is that those from deprived communities with the less mobility have less access to healthcare. And my fear is the same will happen with a vaccine.
My suspicion is that we will, once again, see a real inequality and delay to getting a vaccine for some of those who are a priority. I can see London getting the vaccine sooner than the rest of the country purely from this logistical point of view.