May 31, 2020

expert reaction to easing of restrictions on vulnerable people shielding

The government has announced that from Monday, some vulnerable people currently shielding from COVID-19 will be allowed to go outside.

Prof Sally Bloomfield, Honorary Professor, London School of Hygiene and Tropical Medicine, said:

“In the last few days we have seen a procession of measures introduced to ease lockdown from June 1 which build on the reopening of schools on that day. On Friday it was announced that we could now meet with non-household members, not just in the park but in our own gardens.  Since then we have heard that elite sporting events (albeit behind closed doors) and small independent shops will restart – and now, today, that shielded individuals may leave their homes.

“But yesterday Professor Jonathan Van-Tam warned that abusing new liberties would fuel the spread of infection and said that the lifting of curbs should be treated as if gently lifting the lid on a coiled spring – ‘painstakingly’ slow.  He said – and I fully agree – that the country is at a ‘very dangerous moment’ in the crisis, where things could swing either way.

“So why introduce all of these measures at the same time – which means that if the situation deteriorates it will be impossible to know which measures need to be re-imposed and we will just have to go back to lockdown.  This does not look like gently lifting the lid – and from what I have seen these past 3 days I fear that our desire to socialise means that the critical nature of our situation is being forgotten.

“In reality, the option to meet with non-household members in private gardens is only a small extension of meeting in public parks, but my fear is that it is not being seen this way. I had a number of telephone calls from media over the weekend asking me to comment on the announcement that “from Monday we can start having barbecues again”, which for those who do not directly listen to government announcement, implies something very much less restrained – i.e  “we can start socialising again”. It means we are going to have to hammer home the message of personal responsibility for maintaining physical distancing, and hand and hand contact surface hygiene, if we want to sustain this activity – as well as sustaining an R value below 1.

“I note that 40% of the workforce is still working from home and wonder how much this may increase in the next few weeks, adding a further burden.

“Of all the easing measures, the one that will have little effect will be easing of restrictions on the most vulnerable groups, who I suspect will be very cautious of using this option in the current critical situation.”

Dr Stephen Griffin, Associate Professor in the School of Medicine, University of Leeds, said:

“The announcement of relaxed measures for those most at risk from severe COVID19, the shielders, seems to lack any obvious rationale other than to add to an ongoing “good news” narrative that appears to have little grounding in reality.

“As we have heard from Prof Van Tam, members of SAGE and its unofficial counterpart, and numerous other members of the scientific community, the daily case incidence, death rate and R0 in the UK does not represent a controlled, safe scenario. Test, track and isolate protocols are still being established and are largely untested on the scale necessary to ensure a safe route out of lockdown. Moreover, other relaxation measures recently announced mean that those venturing out will likely face difficulties in ensuring social distancing. SARS-COV2 is markedly more prevalent in the UK compared with when lockdown was first implemented.

“What appears lacking from this, as well as other relaxation measures announced recently, is a clear explanation of precisely why it is felt that the situation justifies such actions. Is it felt that risk has somehow been mitigated despite ongoing virus circulation? Does the government consider that increasing social interactions are unlikely to maintain or increase case incidence? Have other considerations now become more significant compared to the risk of those most vulnerable contracting the virus? We all recognise the socioeconomic pressure to restore a sense of normality amidst this crisis, but the long-term implications of an extended epidemic are severe.

“We must also consider the effects that this announcement might have upon those currently shielding. How, without a clear rationale, are shielders supposed to judge whether it is indeed safe for them to alter their behaviour? The perception for many will be that it is safe, but this can also apply considerable emotional pressure to those most vulnerable to either comply, or to repeatedly have to justify why they might not feel comfortable now seeing loved ones or leaving the relative safety of their homes. Furthermore, should measures be further relaxed, shielders may experience difficulties relating to the workplace or childcare that were previously covered by simple criteria.

“It is imperative that the sacrifices made during lockdown are not undone by relaxing measures in haste. Clear guidelines in terms of why risks are now different are essential to provide the UK population with the tools to decide for themselves when it is safe.”

https://www.bbc.co.uk/news/health-52862440

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