The UK cannot afford to be complacent and must be prepared to introduce tougher measures to control the spread of Covid-19 this winter if necessary, a government adviser and leading epidemiologist has said. As mainland Europe is gripped by a new wave, some countries have imposed strict measures to control the spread of the virus. Given Austria’s plans to introduce mandatory vaccinations from February and a new lockdown starting on Monday, and German ministers’ declaration of a national emergency, Prof Andrew Hayward, co-director of the UCL Institute of Epidemiology and Health Care, was asked whether the UK could be forced to take similar action in the coming weeks or months. He said the UK was “on a knife edge” and that much depended on the booster jab campaign and the speed of uptake. Hayward, a member of the New and Emerging Respiratory Virus Threats Advisory Group (Nervtag), which advises the government, told the BBC’s Today programme that the situation in Europe looked different. “I think there’s a number of differences, the main one being that we’ve been running at very high levels of infection for a long time, since July … when we opened up, and so we’ve really had a high plateau of cases, with associated hospitalisations and deaths.“Europe’s only really begun to increase since about the beginning of October and now that’s built up speed and is in some parts of Europe becoming an exponential increase,” he said. The UK recorded more than 46,000 cases of Covid over a period of 24 hours on Thursday, the highest daily number in almost a month. “We’re still higher than the European average,” Hayward said, adding that some countries in eastern Europe, as well as Austria, currently had higher infection levels than the UK, and that Germany was also “catching up with us”. Germany’s seven-day average of new daily confirmed infections had climbed to 46,648 cases by Friday. Asked whether the different approaches employed in Europe and the UK had played a crucial role in how the Covid winter season has panned out so far, Hayward said: “We’ve had a strategy really to rely on the vaccination and population immunity, which is in some ways at very high levels. If we measure antibodies across the adult population, about 98% of people have antibodies as a result of either vaccination or infection. “But in fact it’s not just whether you’ve got antibodies, it’s what level those antibodies are at, and we can see that after vaccination, antibodies wane quite considerably and that increases your risk of infection.” Hayward said there was a lot of uncertainty in models predicting how the pandemic might develop in certain places in the future. “But what I know is, every winter since records began respiratory infections have increased during the winter, and hospitalisations and deaths peak in the winter, and I don’t particularly see a reason why Covid would be different from that.” To what extent those extra infections will translate into hospital admissions and deaths “will depend very, very much on the speed of the booster campaign”, he said. “So, if we can get the most vulnerable people revaccinated with a booster, we can make a substantial impact on that.” When pressed on whether the UK could afford to be complacent in terms of its measures, he said: “Well, we can’t. We’ve got over 8,000 people in hospital with Covid, nearly a thousand of them on ventilators. We have, compared to Europe, far lower numbers of hospital beds available to put people in, so we are on a bit of a knife edge here with Covid. “But when you add in all the other respiratory infections that come in the winter when we’ve got high levels of population mixing, when you add in that huge [patient] backlog, the NHS is already in serious trouble. So I think we do need to be prepared to take action.”