For the first time during this pandemic, I think we should delay lifting restrictions. Looking at the latest data, it seems that the Prime Minister was right to postpone ‘Freedom Day’.
I am no zero-Covider. Its clear restrictions can be as harmful as Covid. Last September, it seemed obvious that a ‘circuit breaker’ lockdown would have just postponed the wave further into winter. In February, the government did the right thing by explicitly ruling out an elimination policy and introducing its roadmap.
At the front of everyone’s minds should be minimising harm. This time around, minimising harm means delaying reopening.
The situation is completely different from other stages of the pandemic. Vaccines are preventing hospitalisations and deaths. But we are faced with a variant with much higher transmissibility and an increased risk of hospitalisation. One dose of the vaccine has proven less effective than had been hoped (although it is lucky that after two doses the jabs remain strong).
All of the models and forecasts show that cases and hospitalisations will increase because not enough people have had two doses. As Philip Thomas wrote in the magazine last week, we could reach 100,000 cases a day by the end of July, which could mean up to 3,000 hospitalisations a day.
How can this be in Europe’s most vaccinated country? How could we have more restrictions than last summer when we didn’t have the cavalry of vaccines? The answer is that a small percentage of a very large number is still a large number.
The difference between this summer and last summer is this: we already have a higher average number of contacts per person than last summer. Schools are open, as are many offices. The Indian variant is around 60 per cent more transmissible than the strain we had last year. The new variant’s symptoms are also more opaque: a loss of taste and smell is far less common, and a headache and a runny nose much more so. The Indian variant seems more like a bad cold, which in hay fever season may mean that cases are harder to detect.
But what does the real-world data tell us? Bolton was one of the first places in Britain to experience the Indian variant and is a good guide. The wave peaked there in late May, with cases occurring among the young at similar levels to the January wave. Yet hospitalisations were less than half of what they were in January, reflecting the impact of the vaccines. Patients in hospital are also younger, and staying for shorter periods of time. Bolton shows us what we can expect to see across the whole country over the next few weeks.
So, will the four-week delay to ‘Freedom Day’ cause less overall harm — to health, education, the economy and society — than going ahead?
First on health, as has been the case throughout the pandemic, the focus should be on overall health — not just Covid. At the moment, about 1 per cent of hospital patients are admitted with Covid-19. Accordingly, people assume that hospitals aren’t that busy. However, they are actually the busiest they have been since the start of the pandemic. Medical staff are catching up on the backlog of maladies and delayed emergency admissions prompted by Covid.
Every extra admission also increases the pressure on health workers and the health service. Half the Covid patients seen in A&E are not admitted but they still increase pressure. While the NHS may not be overwhelmed with Covid, it may stop being able to provide services to non-Covid patients again. The backlog will increase, and the catch-up will take longer.
A four-week delay, however, would allow all over-forties to receive two doses and all adults to receive one. This should result in a 50 per cent reduction in Covid admissions. However, we should also look at non-Covid harms.
On education, a delay will be useful as we will not need to shut schools if cases increase dramatically. One third of children were missing from school during the Bolton peak. Parents then have to stay at home with them. We need to stop that happening across the country: children’s schooling has suffered enough.
The economy is also growing strongly and the data we have on mental health shows that happiness is above pre-pandemic levels. If cases increase dramatically, people’s fear of the virus might reverse this. They may start staying at home, going into ‘voluntary lockdown’ which decreases economic activity and happiness, while not restricting the spread of the virus.
Additionally, people often appeal to the travel industry when opposing restrictions. But if our cases skyrocket, we won’t be able to travel to other countries — and they won’t allow their citizens to travel here without having to quarantine on their return.
So the benefits of delay outweigh the benefits of reopening. But this is not sustainable forever. We do need to learn to live with the virus, but we should do so with our defences as strong as possible — the four-week delay will allow that. We all want a return to normality, and this delay makes that more likely, not less.<//>
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