Lifting all restrictions. The lunatics really are in charge. – Experts.
The views of experts and health professionals on whether the government is right to stop free COVID testing, on the vaccination of children aged 5-11, the end of face mask requirement, and on the lifting of COVID self-isolation after a positive test.
The views of experts and health professionals on whether the government is right to stop free COVID testing, on the vaccination of children aged 5-11, the end of face mask requirement, and on the lifting of COVID self-isolation after a positive test.
First published in February 2022.
Question: NO MORE TESTING?
Having removed Plan B restrictions, the UK Government has suggested that it is time for the British people to live with COVID-19 “like it does flu”. For this reason, free home-delivered lateral flow tests (LFTs) for everyone could be totally scrapped within weeks and PCR tests not long after. The government thinks it will save it a great deal of money.
What the experts say...
▫ Dr David Nabarro, WHO Director-General’s Special Envoy on COVID-19 Preparedness and Response, Co-Director and Chair of Global Health at the Institute of Global Health Innovation, Imperial College London:
“I think it’s really very unwise and I don’t understand why that’s been introduced.
“I appreciate their concerns about absenteeism... but at the same time, what we know about this virus is that it is not good for people and simply just treating it as though it is a harmless virus we think – that’s myself and colleagues in the World Health Organisation – we think that’s unwise.”
▫ Professor Graham Medley, Professor of Infectious Disease Modelling, London School of Hygiene and Tropical Medicine, Chair of the SPI-M sub-group of SAGE:
“The main purpose of making tests for infection freely available to the UK population is so that people can make individual decisions about their risks to themselves and others.
“If we deprive people of testing then the population will not be able to make informed choices.
“The [ONS’] COVID-19 Infection Survey (CIS) surveillance is the best way we have of knowing what the virus is doing in the community – if this is removed then we will largely be ‘flying blind’. Governments have to make decisions from multiple perspectives. Testing and the CIS are expensive. But we will need them again at some point in the future and need to be able to restart them quickly.”
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▫ Chris Hopson, CEO of NHS Providers:
“One of the distinguishing features of the pandemic has been our inability to predict its course. While NHS trust leaders recognise the ongoing cost of [testing and surveillance] regimes, they are clear that the government should err strongly on the side of caution before dismantling or scaling them back.”
▫ Dr Julian Tang, Honorary Associate Professor/Clinical Virologist, Respiratory Sciences, University of Leicester:
“If testing is not free, people won’t do it.
“The virus is likely to evolve to become milder, but on the way, there may be the occasional more virulent variant that causes more hospitalisation briefly before dying out – as we have seen with Beta, Gamma, Lambda, Mu variants.”
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▫ Professor Stephen Reicher, Professor of Social Psychology, School of Psychology & Neuroscience, University of St Andrews, Member of the Scientific Advisory Group for Emergencies (SAGE) subcommittee on behavioural science:
“This week, a 95-year-old woman catches COVID. Having been tested early she can be prescribed anti-virals which need to be taken within 3-5 days of infection to be effective.
“Next week another 95 year old may catch COVID, not be able to afford tests and only find out when it is too late to benefit from anti-virals.
“The story won’t be in the headlines.
She won’t be sent best wishes from the Prime Minister.
But her life matters too.”
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▫ Dr Stephen Griffin, Virologist, Associate Professor in the School of Medicine, University of Leeds:
“One thing that will really go to waste here is the sense of altruism that testing yourself gives... we are not going to be able to do people the courtesy of keeping away from them if we have this dangerous virus infection.”
▫ Dr Chaand Nagpaul, Chair of the Council of the British Medical Association:
“Without access to free testing for the public or a legal requirement for the sick to self-isolate, protecting others from illness and surveillance of the disease and its prevalence vanishes; we won’t know where outbreaks are happening, whether they are circulating among more vulnerable populations, and this means local public health teams will be lacking key information to be able to respond effectively to COVID outbreaks in their local areas. Charging for tests will only discourage people from checking if they have COVID, especially if their symptoms are mild enough for them to continue socialising and mixing with others.”
▫ NHS Confederation, Membership organisation that brings together, supports and speaks for the whole healthcare system in England, Wales and Northern Ireland:
“The government is expected to publish its COVID-19 exit plan on 21 February. This comes a month earlier than initially scheduled and is expected to lift existing restrictions – including the requirement to isolate after testing positive – in England from 24 February.
“Given the continued high prevalence of the Omicron variant, and pressures on services, this plan must represent a cautious and carefully planned exit if the NHS is to continue to concentrate on delivering the full range of care that people value and expect.
“A survey of NHS Confederation members, which asked what elements of the plan should be maintained, highlighted the importance of prevention and limiting transmission. Over 90 per cent of more than 300 health leaders who responded showed strong support for the continued provision of free tests for key workers and the public, as well as retaining the use of masks in healthcare settings.
“Around three-quarters of respondents said that they would be against ending the compulsory self-isolation period. There was over 80 per cent support for the Office for National Statistics survey to continue in order to monitor case levels and enable the NHS to plan accordingly, should infections increase rapidly, or a new variant appear.
“In addition to these important preventative measures, the government’s exit plan must be accompanied by unambiguous messaging and guidance for the NHS and the public and a preparedness plan for future waves or even pandemics. This should include maintaining the necessary infrastructure to be able to rapidly ramp up COVID-19 measures and capacity, in areas such as diagnostics capacity.”
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Support PMP MagazineQuestion: VACCINATION OF CHILDREN AGED 5-11... ABOUT TIME?
England and Northern Ireland will finally offer COVID jabs to children aged 5-11, after Scotland and Wales accepted the recommendation from the Joint Committee on Vaccination and Immunisation (JCVI). Jabs will be offered from next April at pharmacies, vaccination centres and some GP surgeries.
What the experts say...
▫ Dr Helen Salisbury, GP Principal, Honorary Senior Clinical Lecturer in Communication Skills, Medical Advisor to the Health Experience Research Group, University of Oxford, and Member of Independent Sage:
“If we hope to make vaccines easily accessible to all families who want them, it makes sense to do the vaccination in schools which is where the children already are.
“The further option of mass vaccination centres is likely to limit the vaccination uptake to the most motivated families who also have access to transport, and is likely to widen inequalities.
“In other age groups, we can see that the least advantaged in our society have the lowest vaccine coverage: the mode of delivery of children’s vaccines needs to be considered carefully to prevent this being duplicated in this age group.”
▫ Professor Christina Pagel, Director of University College London’s clinical operational research unit, member of Independent Sage:
“I definitely welcome the news that parents are given the choice whether to vaccinate their primary-school-age children with a vaccine that has proven both very safe and very effective. Unfortunately, it is coming too late to prevent the maybe half a million or more infections in five- to 11-year-olds this year so far, and the lack of transparency around JCVI decision-making and government intervention remains worrying.”
“Waiting until after the end of the term seems perverse, when rates in that age group are the highest in all age groups. This delay in announcing is just causing additional stress and confusion for the many families that have been waiting to vaccinate their children with no clarity.”
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▫ Dr Simon Williams, Senior Lecturer in People and Organisation, Swansea University:
“The fact that the JCVI have now apparently recommended the offer, and the UK government have delayed action on this, despite the fact that a majority of parents report wanting it for their children, and the fact that COVID is ripping through the primary school population, beggars belief.”
▫ Dr Nathalie MacDermott, clinical doctor sub-specialising in paediatric infectious diseases in the NHS, King’s College London:
“It is unusual that the government have chosen not to announce the decision made by the JCVI in relation to the immunisation of five- to 11-year-olds against COVID-19, particularly as they have not given a clear reason for this.”
“If they are doing this because they are seeking information or evidence from other sectors then this is perhaps understandable, but then this reason should be clearly stated. To simply delay... without giving a reason, when it is public knowledge a decision has been made, raises concerns, not least since recent comments and decisions relating to public health no longer seem to be ‘following the science’.”
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Support PMP MagazineQuestion: LIFTING ALL RESTRICTIONS, INCLUDING SELF-ISOLATION?
England will soon announce the lift of all remaining restrictions, including the self-isolation rules on positive cases.
What the experts say...
▫ Professor Dame Sarah Gilbert, Vaccinologist, Professor of Vaccinology at the University of Oxford, Co-founder of Vaccitech, Co-developer of the Oxford-AstraZeneca vaccine:
“I hope that people are going to exercise some degree of caution as we go through the spring.
“I think it would be beneficial if we are still taking care of those around us.”
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▫ Professor Susan Michie, Professor of Health Psychology, Director of the Centre for Behaviour Change, University College London:
“We need to change our whole culture to be more oriented to health and safety, with presenteeism at work disapproved of and people told by employers to stay at home if unwell or likely to be infectious.”
▫ Dr David Nabarro, WHO Director-General’s Special Envoy on COVID-19 Preparedness and Response, Co-Director and Chair of Global Health at the Institute of Global Health Innovation, Imperial College London:
“I really do worry that if Britain is taking a line that is against the public health consensus that other countries, others leaders, will say, ‘If Britain’s doing it why can’t we?’ and this will create a bit of a domino effect around the world.”
▫ Dr Chaand Nagpaul, Chair of the Council of the British Medical Association:
“It’s clear that we will have to learn to adjust to the reality of COVID-19. However, the BMA agrees with NHS leaders that living with COVID doesn’t mean ignoring its continued harm to many, and must not result in removing protections to some of the most vulnerable in our society. Scrapping all restrictions and allowing the infection to spread in an unmonitored and unfettered manner would be damaging to the health of millions, including for those who go on to suffer Long COVID symptoms.
“The decision to remove all restrictions is not based on current evidence and is premature. It clearly hasn’t been guided by data or done in consultation with the healthcare profession. As the BMA has previously warned, COVID poses a serious risk to public health as well as NHS capacity if cases are allowed to spread rapidly again. Living with COVID-19 doesn’t mean ignoring it. As well as keeping free testing and self-isolation measures, it’s vital that the ONS infection survey carries on, and that local authorities are supported to contain outbreaks with necessary restrictions.
“This is particularly important for protecting the vulnerable, and Government must ensure that these groups are allowed to live as normal a life as possible as the pandemic subsides. This means giving them access to free FFP2/3 masks where required so they can protect themselves, and providing healthcare professionals with clear, clinical guidance to advise them and other patients in the community. Healthcare settings are places which people attend to get better not to get sick, so it would be totally wrong to remove the protections in healthcare settings that currently exist, such as mask-wearing, without discussion with healthcare workers and without evidence to support it.”
▫ Dr Kelly Fearnley, NHS Doctor with long COVID, Leeds:
“It is a strategy of denial, driven by the need to cut costs. I feel angry and let down.
“The health of the economy takes precedence over the health of the nation. And yet their strategy to ‘live with COVID’ not only fails to follow the science, but it also fails to follow the money.
“The human and economic burden of long COVID alone will dwarf the sums of money they expect to save through their strategy to ‘live with COVID’.
“It neither makes moral nor economic sense. The lunatics really are in charge of the asylum.
“I expect we will see the long-term health impacts of this virus for decades to come.”
▫ Dr Christian Yates, Senior Lecturer in Mathematical Biology, University of Bath:
“If the proposed moves haven’t come from the government’s own scientists, then where have they come from? These decisions appear to be politically motivated rather than guided by science and public health interests – moves designed to win favour with the public by restoring “freedoms” and to distract from the ongoing partygate scandal engulfing Number 10.
“Self-isolation is one of the most effective measures we have to limit COVID’s spread. Only those who actually have the disease are asked to isolate, making it one of the least restrictive disease-control measures on society as a whole.
“Encouraging people to work while infectious will only serve to increase transmission and may lead to a spike in infections.
“No government interested in protecting the health of its people can seriously believe it’s better to be less informed when it comes to tackling an infectious disease.
“While some will welcome the removal of COVID monitoring as marking the pandemic’s end, what it really signifies is an end to caring about the people who will become infected. For a significant minority – the clinically vulnerable, elderly and children (the majority of whom are unvaccinated) – this will make life much more uncomfortable.
“For these people, and many more besides, the clamour to “live with COVID” seems misplaced. We don’t reach a level of road traffic fatalities below which we decide to remove seatbelts, increase speed limits or raise the legal blood alcohol limit.”
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Support our independent journalismQuestion: STILL WEARING A MASK?
In England and Northern Ireland, people are no longer legally required to wear face-covering in most public places.
What the experts say...
▫ Professor Susan Michie, Professor of Health Psychology, Director of the Centre for Behaviour Change, University College London:
“Removing legal requirements for masks wrongly signalled that the risk is not great or that the measures are not effective enough. The extent to which they will be retained will depend on the messaging from government and other institutions.”
“We may be a minority but important not to be put off by that. The more who wear facemasks, the more who will wear them, due to the power of social norms.”
▫ Dr Christian Yates, Author and Mathematical Biologist, Senior Lecturer, Department of Mathematical Sciences, University of Bath:
“Don’t let people tell you that because you still wear a mask or take lateral flow tests before meeting up with people that you are “living in fear”.
“To me it demonstrates that you care about your fellow humans. It’s something to be admired, not scorned.”
▫ Dr David Nabarro, WHO Director-General’s Special Envoy on COVID-19 Preparedness and Response, Co-Director and Chair of Global Health at the Institute of Global Health Innovation, Imperial College London:
“The best way to prevent other people from being infected with the virus is the combination of a well-fitting face mask and physical distancing. And that has to continue, especially in places where there’s a lot of virus around. If it’s dropped, it is I believe, creating an unacceptable risk for people.”
Xtra | Where do I need to wear a face-covering in England?
- Face coverings remain a requirement in healthcare settings, such as GP surgeries, hospitals and care homes
- The government recommends that people wear face coverings in enclosed or private spaces where they are mixing with people they do not know
- Masks are required on public transport in London, including the Tube, and passengers can be refused entry or told to leave for not complying
- Many major retailers including Tesco, Sainsbury's, Lidl, Waitrose and John Lewis have asked staff and customers to keep wearing a face covering
(Source: BBC News)
Where do I need to wear a face-covering in Wales?
- Face-coverings are required on public transport and most public spaces, including shops.
- Secondary school pupils are being asked to wear masks in class until the end of half term.
- The guidance in Wales applies to everyone aged 11 or over.
(Source: BBC News)
Where do I need to wear a face-covering in Scotland?
- In Scotland, masks must be worn in most indoor public spaces including public transport, shops and gyms (although they can be temporarily removed when exercising).
- They must be worn in pubs and restaurants when not seated or dancing, and in the workplace in communal areas and canteens.
- They are compulsory for all school staff as well as secondary school pupils and are required in indoor public spaces in universities.
- However, pupils will no longer have to wear them in class from 28 February.
- Under-12s are exempt.
(Source: BBC News)
Where do I need to wear a face-covering in Northern Ireland?
- Mask-wearing is no longer legally enforced in Northern Ireland.
- However, they are still recommended in certain places, such as enclosed public settings and health and social care settings.
(Source: BBC News)
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Sources
- Text: This piece was first published in PMP Magazine on 20 February 2022.
- Cover: Flickr/Number 10. - Boris Johnson hosting Prime Ministers Business Council. | 8 February 2022. (Licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.)
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