December 21, 2021

expert reaction to Boris Johnson saying there will be no new measures in England before Christmas

The Prime Minister has announced via twitter that no new measures will be introduced before Christmas.

Dr Simon Williams, Senior Lecturer in People and Organisation, Swansea University, said:

“With Omicron rapidly spreading across the UK, and with no substantial policy protections in place, the public have been called onto slow the spread of the virus to buy time for the booster to be rolled out and in order to prevent unsustainable pressure on the NHS.

“Earlier protections, including policy to limit indoor mixing backed by adequate financial support for those businesses and individuals most affected, could have helped to prevent the need for more stringent restrictions after Christmas.

“Nevertheless, the question remains as to whether voluntarily changes in behaviour lead to enough of a reduction in social contacts, and if so will this happen quick enough?

“In our research, we find that many people may have been slowly becoming ‘desensitized’ or ‘habituated’ to the risk posed by COVID-19 and its many variants (https://psyarxiv.com/vam4t).  In this sense, Omicron may be seen by some as just another variant, people may be switching off to news coverage and announcements on COVID-19, or they may feel like we should already be “living with” the virus.  And so, some may not have been dramatically changing their behaviours in relation to the new variant.

“However, there might be some signs that some people have started to voluntarily reduce social contacts already, with one recent poll suggesting that one in six have cancelled some type of Christmas event (https://yougov.co.uk/topics/lifestyle/articles-reports/2021/12/20/how-many-britons-christmas-plans-have-had-change-b).

“Also, mobility data suggests that people are moving about less compared to a few weeks or months ago – but movement has reduced nowhere near to the extent we saw in previous phases of the pandemic (e.g. during lockdowns or stringent restrictions).  Also, contact data suggests a decline in our average daily contacts – but this has been quite slow and gradual.

“However, this may change if the virus continues to spread and if more people start to get hospitalised from COVID – with the perception of risk or threat being one of the biggest things driving behaviour change or adherence to guidelines.”

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

“The government has made its choice not to act, which follows the decisions to unlock completely in July, delay childhood vaccines, remove mitigations from schools and now ignore a newly established antibody evasive variant that is growing rapidly.

“Sadly, cases DO matter, despite our excellent vaccines.  High prevalence drove the need for boosters with delta, before omicron.  It also exposed the clinically vulnerable to infection risk, and has driven a delta epidemic in schools that has cost lives and keeps putting more and more under 18s in hospital…those unable to be vaccinated due to their age or clinical status remain at risk, as do those who have bewilderingly chosen not to have one.  In addition, long COVID levels continue to escalate.

“Much has been made of omicron virulence being reduced, but this notion is confounded by unknown clinical lag time, younger demographics and high vaccine induced immunity to severe disease.  Whilst there is evidence that omicron may better infect cells of the upper airway, we have yet to understand how this relates to pathogenesis.  Simply put, omicron will need to cause profoundly reduced disease for the sheer scale of infection not to have considerable impact.

“Thus, combined with delta and other respiratory viruses, it is hard to understand how anyone can be uncertain that an already overburdened NHS will suffer, possibly becoming overwhelmed.  Moreover, in many people’s view, the toll we already suffer week by week in terms of SARS2 related disease is already unacceptable in the extreme.

“It seems the lessons of the parliamentary committees have been forgotten or ignored, and politicians are ignoring, or indeed actively fighting against the advice provided by their own advisers.  Admittedly, given recent displays of attitude to following rules, it is certainly a hard sell to impose harsh restrictions at Christmas.  However, this is surely all the more reason for the government to have acted preemptively?  We all need a break from this pandemic, but I for one find it difficult to reconcile the excesses of Christmas with the knowledge that illness and suffering could have been averted.  There is a way forward through this, centred on vaccines, but we must remember past mistakes and, finally, learn from them.”

Prof Lawrence Young, Virologist and Professor of Molecular Oncology, Warwick Medical School, University of Warwick, said:

“This is a very risky approach and is very likely to result in the need for more stringent restrictions in the near future.

“Given the extraordinarily and inexorable rapid spread of the omicron variant, it’s never been more important for people to take individual responsibility to protect themselves, their families and friends.  While we are hopeful that vaccines will do a lot of the heavy lifting when it comes to keeping omicron under control, other interventions are also required to prevent case numbers rising and the NHS becoming overwhelmed.  Limiting the size of gatherings, avoiding crowded indoor spaces with poor ventilation, wearing a face covering and frequent use of lateral flow tests are all protective measures that we can take to limit the spread of this variant.

“If the omicron variant continues to spread at the current rate, it is inevitable that more restrictions will be necessary in England.  Waiting for case numbers and hospitalisations to increase is likely to be too late to suppress the spread of the omicron variant and will subject the NHS to unprecedented pressure.  We need to buy time to get booster jabs into arms and for those vaccinations to take effect, not let omicron continue to spread unfettered while we try to protect ourselves.  A short circuit break now would have prevented more people from getting infected and from having to isolate which is now impacting many essential services.  Have we learnt nothing from our previous experiences with coronavirus?  Dither and delay will only mean more harsh measures later while we run the very real risk of many folk getting sick and massive disruption due to staff absences.”

Prof Neil Greenberg, Professor of Defence Mental Health, King’s College London, said:

“Today’s announcement by Boris Johnson that Christmas celebrations can go ahead is likely to have a positive impact on most of the population’s mental health, not just because new restrictions were not announced, but because it removes an important uncertainty which is likely to have been causing great concern for many people.  It is of course not easy for the Government to provide firm and certain messages given the changing nature of the pandemic, currently caused by Omicron.  However, there is also a danger in perpetuating uncertainty which can lead to anxiety symptoms in many especially for those who are predisposed to experiencing them, and who perhaps too closely follow the ever changing, and often highly negative, media headlines.  However, today’s news may be far less well received by NHS staff, particularly those who are feeling exhausted, burnt-out or who are experiencing mental health difficulties.  There is certainly, now more so than ever, a pressing need for NHS managers to ensure that staff support is made a key priority.  Unless the NHS has sufficient numbers of  psychologically healthy staff, able to provide high quality care to those in need, then there is a real risk of mental health problems within staff spiralling downward in a rapid fashion leading to potentially avoidable further staff absences.  There has been much published over the last two years, and before, about the best ways to support teams of personnel carrying out highly challenging duties; the NHS must make sure that they continue to put in place evidence based support mechanisms.  Alongside this the NHS needs to be clear on plans as to how they will increase staffing in the longer term to ensure so that healthcare workers can feel confident that ‘the cavalry is coming’ even if it might take some time to get here.  Merely asking staff to ‘crack on’ without glimmers of bright light in the future is unlikely to be an effective strategy.”

Dr Peter English, Retired Consultant in Communicable Disease Control, Former Editor of Vaccines in Practice, past Chair of the BMA Public Health Medicine Committee, said:

“This is an extremely brave position for the cabinet to take.

“It is clear that the Omicron variant is spreading extremely quickly, with the numbers doubling every couple of days or quicker.  Exponential growth means that case numbers are rocketing.

“We know that you are more likely to be infected with omicron than with delta if you have had a previous infection or been vaccinated.  We know that immunity – both to infection and to serious illness – wanes faster than we’d hoped, so that people who have had two doses of vaccine but not yet a third are at risk of severe disease (causing death, or requiring hospitalisation).

“We know that third doses of vaccine will never be rolled out quickly enough to stop many of the cases.

“And we know that a proportion of the cases will end up dying or in hospital – even if they are fully vaccinated.

“Hospitalisations and deaths arise 10 days to several weeks after infection, so don’t be falsely reassured that numbers of hospitalisations and deaths from the omicron variant haven’t yet hit large numbers.  It’s just a matter of time before they do.

“We know that tight restrictions on social mixing have both economic and psychological adverse consequences; but the consequences of out-of-control Covid-19 are worse on both accounts.  The pain is worth it.

“It now seems inevitable that the NHS and many other public and private services will now be overwhelmed in January.  Action now can reduce the harm done; but it is too late to prevent it altogether.

“The best that we can all do is to follow the rules the prime minister should have set for us, even though there’s no legal obligation to do so:

• Minimise contact with other people.  Don’t attend indoor events if you can possibly avoid it.  (And don’t assume you can’t catch it outdoors: we know that, pre-delta, you were unlikely to catch Covid-19 outdoors; but delta was considerably more infectious, omicron very much more infectious again, so it would be unwise to assume you can’t catch it outdoors).
• Ration the number of people you meet up with.  Keep it to just those you really want to see.
• Make sure that you get tested – and, ideally, that everybody else you will meet up with does too.  Omicron variant disease comes on quicker than previous variants, so test as close as possible to the time of the meeting – a test done the previous day, or early in the morning, may be invalid a few hours later.
• If you test positive – or you have symptoms, even if they seem like an ordinary cold (ignore the symptoms on the NHS and government web sites – they are no longer useful) you should assume you have Covid-19, self-isolate, and get a test.  And if the symptoms persist but you have a negative test, it could well be a false negative.
  • It is unfortunate that people who, for the benefit of others, isolate themselves when they have minor symptoms but may be infectious are not better compensated by the state.  They should be supported and compensated for their public-spirited self-denial.
  • Similarly, it would make sense to compensate businesses who struggle financially because of the lost revenue as people restrict contacts and avoid meeting in public places.
• If you are a business where people meet up, make the space as Covid-safe as possible.  Ensure good ventilation and, where this can’t be done adequately, put in suitable air filters.  Ensure your staff and any visitors or clients follow mask regulations – wear a well-fitted mask, preferably an FFP2 or properly fit-tested FFP3 mask; have policies to ensure people who don’t are removed, to reduce the risk the pose to others.  If you can, impose a covid-pass type rule, checking that everybody has a recent, negative Covid test result, and that staff in customer-facing roles are also fully vaccinated.
• If you do have to meet up with people who aren’t  members of your household indoors – 
  • Wear a good-fitting mask.  Preferably an FFP2 or FFP3 mask.
  • Improve the ventilation if you can, by leaving doors and windows open as much as you can bear.  Scarves, Christmas jumpers, and thermal underwear help.
• Look after your health as much as you can.  Try not to get injured or ill.  Remember that the NHS is running on vapour at present, and will run out of juice very soon.  If you need medical or social care in the next few weeks or months, it might not be available.

“Check Independent Sage’s advice at https://www.independentsage.org/covid-scores-on-the-doors-an-approach-to-ventilation-fresh-air-information-communication-and-certification/.”

https://twitter.com/BorisJohnson/status/1473337565235363850?s=20

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www.sciencemediacentre.org/tag/covid-19

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