Covid: two years on the Government has abandoned any form of public health strategy

In March 2020, just before the first lockdown, I penned a piece for Lib Dem Voice on the Government being behind the curve in implementing Covid restrictions. Last year in March 2021, I wrote a follow-up article saying we weren’t out of the woods. Now another year on, where are we?

The Office for National Statistics estimated in the week ending 12 March that around 3.3 million people in the UK had COVID-19. Of course, sadly, this increase in cases is now leading to increased hospitalisations and deaths. According to official statistics, There were 13,844 people admitted to hospital with Covid in the week to 19 March and there were 877 deaths in the 7 days to 23 March (up 133 on the previous week).

The fact that Covid patients are now filling up more beds in hospital again means that non-urgent treatment and operations are more likely to be cancelled – compounded by the fact that NHS hospitals are facing critical under-staffing, both because of existing staff shortages and because more NHS staff are now themselves off sick with Covid.

Many health experts are deeply concerned about all this. Where is the plan? Almost all restrictions have now been lifted, certainly in England, and people can no longer protect themselves in public spaces such as on trains and in shops as mask wearing has fallen off sharply. For people who are clinically vulnerable – maybe because they have an immunological disorder or because they on medication that lowers their immunity – this is quite a frightening prospect. The fact that the Government is now introducing fourth Covid jabs for people aged over 75 or those who are clinically vulnerable is very welcome, but otherwise letting Covid rip through the population seems irresponsible, especially as there is evidence that more people are becoming reinfected with the newer Omicron variant. The herd immunity argument never worked.

Jeremy Farrar, Director of the Wellcome Trust, tweeted on 23 March 2022:

We can all help reduce transmission, reduce illness, save lives, prevent variants by 1. People being fully vaccinated; 2. Using masks indoors and on public transport; 3. Supporting people to not travel/be in the workplace if they have symptoms; and 4. Testing.

So, are all these things happening? Well mask wearing has fallen off rapidly, despite it being effective in preventing transmission, and testing and surveillance programmes are being scaled back. For example, people are already having difficulty getting Lateral Flow tests to check whether they are safe to visit elderly relatives or go to work.

The UCL scientist Prof Christina Pagel said on Twitter also on 23 March

[The] decision to end free testing, surveillance studies and to relax all public health measures was made at a time when the Government assumed Covid prevalence would be low by now. They were wrong, and we are in the midst of yet another big wave which has not peaked yet.

The lack of official public health advice seems very inadequate on the part of the Department for Health and Social Care. The Chief Medical Officer is also silent on how we should be protecting ourselves, only saying recently that “a Covid variant worse than Omicron is likely to hit the UK with seasonal peaks over the next two to three years.” That is not very helpful.

So, two years on, it’s basically a free for all. That’s the policy. As someone who is triple vaxxed and on Day 18 of Covid as I write this – feeling very tired and rather out of sorts – this lack of any kind of coherent Covid policy seems inexcusable. We should surely be retaining masks in crowded public spaces, having a proper Covid strategy for schools, including better ventilation – as pupil absences rise yet again – and continuing with the UK’s vital Covid surveillance work: at the very least.

* Judy Abel has worked in the health policy field for around 15 years, including at the British Medical Association, for the All-Party Parliamentary Health Group, and in policy roles at Asthma UK, the Neurological Alliance and Versus Arthritis until the end of 2021. She was also the Constituency Office Manager and Senior Caseworker for former Lib Dem MP, Sir Simon Hughes from 2012 to 2014. All views are her own.

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  • The government’s whole approach has been binary – no room for nuance, or personal responsibility, or trust. But that’s because they don’t trust the public to exercise good judgement, and that’s all because they lied over Brexit and couldn’t believe it when the public bought the lie.

  • In March 2020, just before the first lockdown, I penned a piece for Lib Dem Voice on the Government being behind the curve in implementing Covid restrictions.

    As was every government in the world except for Taiwan. Even those countries, such as New Zealand and the Isle of Man, which went on to implement a ‘Zero Covid’ policy, only did so after having an extended lockdown to eliminate the virus first having first allowing it to spread.

    There were 13,844 people admitted to hospital with Covid in the week to 19 March and there were 877 deaths in the 7 days to 23 March (up 133 on the previous week).

    The majority of which are incidental admissions and deaths – patients admitted for other reasons who happened to have Covid on admission or caught it in hospital. They were mostly admitted or died with Covid, not from Covid. The key indicator of actual Covid pathology is the number of ‘Patients in mechanical ventilation beds’ which despite the large increase in infections remains low at around 300 patients for the whole of the UK:

    Where is the plan?

    It’s here…

    COVID-19 Response: Living with COVID-19’ [21st. February 2022]:

    This document outlines the government’s plan for living with COVID-19. This plan – underpinned by vaccines – will remove the remaining legal domestic restrictions while continuing to protect people most vulnerable to COVID-19 and maintaining resilience.

  • “They were mostly admitted or died with Covid, not from Covid.”

    Yet again we hear the most irrelevant claims in order to justify being opposed to public health measures
    Which incidentally are needed to control the spread of this awful disease and protect lives and to prevent a generation of people who are going to be living with disabilities due to the damage caused by Long-Covid

    Tell me Jeff, if someone with Aids, dies of Pneumonia, do we discount the Aids as it was the Pneumonia that they succumbed to?
    Or how about a Cancer Patient who catches an infection and passes away, do we discount the infection or the Cancer as an attributing cause of death?

    The fact remains that many people with underlying health conditions can lead perfectly normal lives with good medical support and medications, however, Covid has changed this for many many people and has made their underlying condition much more dangerous due to this new Virus.
    THAT IS A FACT and a public health crisis, no matter how you try to twist things

  • @Matt I totally agree – the whole ‘dying with’ and ‘dying of’ issue seems to be raised to confuse people. Since the first Covid death in early 2020, the total number of people whose death certificate mentions COVID-19 as being one of the causes of death is 186,094. Covid tragically contributed to all these deaths.

    The WHO also says the UK and some other countries have lifted public health measures far too quickly, hence the surge in cases.

    With people getting reinfected this is a worry for the NHS and our economy – and of course for people who go on to get Long Covid.

  • Brad Barrows 25th Mar '22 - 7:58am

    The ‘plan’ is that vaccination is the main defence again covid and that restrictions and impositions on the general population caused by covid need to end. Those who refuse the vaccine are responsible for any consequences that may befall them from that choice, and those who can not be vaccinated will have to choose their own balance of how much they are willing to adjust their lives to minimise the risks they face from covid.

  • Barry Lofty 25th Mar '22 - 8:59am

    Surely the problem is that the older and vulnerable citizens have no way of telling whether or not people they come into contact with have been vaccinated, some degree of restriction is surely not too much to ask while Covid continues to infect so many? But I suspect the right-wing elite, who Johnson relies on to keep him in power, are more worried about the bottom line on their financial investments than the ordinary citizens of the country, and it continues to appear that many of us are dispensable in the grand scheme of things.

  • Peter Martin 25th Mar '22 - 10:19am

    To be fair to Jeff (not a phrase I use often), the point I think he’s making is that some 0.8% of the population die every year in the UK. This was around 530,000 in the last year before the pandemic. Recently we’ve been given figures of around 1 in 20 of us infected with the Covid virus. So if we postulate the existence of a totally harmless virus, with the same infection rate, we can say that 26,500 of us would die every year or approx 73 people would die every day carrying this harmless virus. This is not far short of what we are actually experiencing at the moment as Covid related deaths.

    Having said this, we know that Covid isn’t totally harmless even if it doesn’t kill us. Many people become very ill and some suffer long term effects. The death rate jumped significantly in 2020; the first year of the Covid pandemic. The crude mortality rate jumped by about 10% to take us back to a similar level we experienced some 30 years ago.

  • Nonconformistradical 25th Mar '22 - 10:39am

    Agree with Barry Lofty – it appears that some people are being regarded as expendable.

  • Laurence Cox 25th Mar '22 - 12:24pm

    Excess deaths are the only good way to think about the effects of covid. If someone dies of cancer because the NHS was overwhelmed and they were not diagnosed or treated in time, that is just as much a covid-related death as if they had caught the disease itself.

    While Peter Martin is quite right to say that 0.8% of the population die every year anyway; the consequence of the covid pandemic has been to bring some of these deaths forward and we see these in the excess deaths statistics, which show that over the course of the pandemic (up to October 2021 in the FT data) the death rate in the UK has been 13% higher than normal. We need to ask what have countries like Norway (0% excess deaths) , Denmark (2% excess deaths) or Germany (3% excess deaths) been doing differently to the UK.

  • @Barry. That is the key issue. Some people have a weakened immune system so even if they are triple jabbed they are vulnerable, for example if they are on certain kinds of medication. Wearing masks in essential public settings such as on trains, buses and in supermarkets seems a small price ask to protect vulnerable people and it flattens the Covid curve too so less people end up in hospital with Covid all at once (which leads to cancellations of operations etc).

    Also some people who are tripled jabbed are getting Covid! I’m just getting over it! I could not have worked for the first two weeks as I felt pretty grim so that’s a loss to the economy.

    I also agree Barry that the right wingers in the Tory Party have had a lot to do with the Government’s recent ‘non-policy’ on Covid.

    And, yes, Laurence such a high excess death rate needs investigating. I think our high Covid case rate has had knock on effects on other areas of NHS care. The Covid inquiry cannot come too soon.

  • Laurence Cox 25th Mar ’22 – 12:24pm:
    …excess deaths statistics,…

    The most comprehensive comparative study of excess deaths due to Covid-19 is this one…

    ‘Estimating excess mortality due to the COVID-19 pandemic: a systematic analysis of COVID-19-related mortality, 2020–21’ [March 2022]:

    Their “Estimated excess mortality rate (per 100 000)” for a selection of countries…

    Norway: 7.2, Finland: 80.8, Sweden: 91.2, Denmark: 94.1, Germany 120.5, France: 124.2, UK: 126.8, Netherlands: 140.0, Belgium: 146.6, USA: 179.3, Spain: 186.7, Portugal: 202.2, Italy: 227.4, Russia: 374.6.

    We need to ask what have countries like Norway…been doing differently to the UK.

    Eating lots of mølje and foods fortified with vitamin D…

    ‘Vitamin D determines severity in COVID-19 so government advice needs to change, experts urge’ [May 2020]:

    This study shows that, counter intuitively, countries at lower latitude and typically sunny countries, such as Spain and Northern Italy, had low concentrations of vitamin D and high rates of vitamin D deficiency. These countries also experienced the highest infection and death rates in Europe.

    The northern latitude countries of Norway, Finland and Sweden, have higher vitamin D levels despite less UVB sunlight exposure, because supplementation and fortification of foods is more common. These Nordic countries have lower COVID-19 infection and death rates. The correlation between low vitamin D levels and death from COVID-19 is statistically significant.

  • Barry Lofty 25th Mar '22 - 4:08pm

    Jeff@ Interestingly there has been a,report today via The Queen Mary’s Hospital London. that their trials have proved that vitamin D sadly does not stop or cure Covid?? I have no expert knowledge on this subjec but it does throw a spanner in the works of the vitamin D theory!

  • Barry Lofty 25th Mar '22 - 4:15pm

    Nonconformistradical@ expendable is the word I should have used!

  • Most GPs think Covid restrictions were lifted too soon according to the medical magazine Pulse – almost all experts do in fact but the Government is no longer listening to the scientists or clinicians

  • Barry Lofty 25th Mar '22 - 5:12pm

    Also the BBC reported there has been a rise of a million cases of covid in a week!

  • And sadly Covid deaths are up yet again to 950 over the past 7 days alone (an increase pf 26.3% on last week).

  • Barry Lofty 25th Mar '22 - 6:02pm

    Judy Abel@ How depressing those figures are!

  • @ Barry I know – that’s why I think the Government needs to be more honest with people and at least present some kind of plan. I think they also need to listen to the epidemiological and public health experts – instead they are just burying their heads in the sand. Covid is also rife in some schools and that is disrupting children’s education again.

  • Brad Barrows 25th Mar '22 - 7:00pm

    @ Judy Abel
    Just to be clear, ‘covid deaths’ are not necessarily deaths caused by covid but deaths of people who died while having covid, sometime without symptoms.

  • @Brad Almost 185,000 people have died where Covid was listed as one of the causes of death on their death certificate

  • David Garlick 26th Mar '22 - 10:03am

    There is no better way of restricting the spread of a virus like Covid than wearing a mask.
    In schools for example children are not mask wearing, they are passing the virus around their classmates and to the teaching staff. Staff absent, children missing their education. So what can we do.
    If masks are so abhorant then every classroom needs to have an air filtration system in place. We know from examples in hospitals that they clear out the vast majority of the virus form that area .
    The lack of concern from the general public is as a direct result of the lack of concern from Government as their example is key. The lack of action from Government is nothing new but I have been surprised by the lack of action from schools.
    WE could not shout about mask wearing but just by wearing them indoors and on Public transport the statement would be clear. The lack of any action is depriving the most vulnerable of a reasonable life as they choose to not venture out and condeming thousands of otherwise fit individuals to a life with long covid. No problem?

  • Peter Martin 26th Mar '22 - 10:04am

    @ Brad Barrows,

    Just to be even clearer: the count of “covid deaths” includes those which occur within 28 days of a positive test.

    So what if someone dies on the 29th day? What if someone with Covid dies at home who has refused to take any test at all?

    There will be factors pulling the count the other way too. For example, if someone is unlucky enough to be killed in a traffic accident on the 28th day they will still be counted.

    So, it’s not at all straightforward to come up with a satisfactory definition.

  • Helen Dudden 26th Mar '22 - 6:52pm

    I was born in April 1948, my grandfather was one of 16 children, most ended up in the pits at Radstock. The Health Service was now a life saver to many.
    I was born with a large birth mark on the side of my face, removed when I was a few months old.
    I’ve been grateful for surgery when I went blind after a serious illness, but now I have a Wheelchair and see the shortage of medical and dental treatment, paying nearly £2000 to repair four broken teeth.
    I often comment about housing that’s accessible and very recently was totally shocked by the cladding scandal and the state of some properties run by the Housing Associations.
    What can be done to improve so many of the failures this government gives, to those who voted for them.

  • @ David Totally agree with you – the lack of any kind of plan especially for air filtration in schools is irresponsible. I spoke to someone today who said an operation of a family member may possibly be delayed because of rising Covid cases – but the hospital are not sure. How can people live like this?

  • @Helen You are so right. Dental treatment is very expensive and out of reach of so many people now if it is anything complex as it can cost hundreds of pounds.

    And yes SO many things are going wrong now – with housing policy and the environment. Basically we need a Government that really cares about people and their health and wellbeing.

  • @Peter As you say the 28 day cut off can work both ways when assessing the mortality statistics (which I still think are shockingly high) but if you look at the 60-day figures that awful total is around 191,000 people who have passed away within 60 days of a positive test. And we know many people are ill for longer than 4 weeks. Absolutely brutal.

  • Brad Barrows 27th Mar '22 - 1:07pm

    @Peter Martin
    Absolutely correct, which is why the only sensible estimate of the net effect of covid is the excess death measure. This measure takes into account all extra deaths resulting from covid, both directly from the illness and indirectly through the consequences of covid on society and also the negative effects on morbidity and mortality of covid restrictions that may be placed on society.

  • George Thomas 28th Mar '22 - 11:28am

    I still don’t understand those conversations about aiming to get covid to be just as bad as a seasonal flu when we now know that simple things (proper hand washing, ventilation, vaccines, increasing the options for working at home and allowing quicker access to sick pay) prevent disease spreading around communities and finding vulnerable people.

    From a work-place productivity viewpoint, I wonder if there is a measure of number of sick days for those who could work from home? I would hypothesize that telling people they didn’t have to wake up as early to commute through congested roads or busy public transport or get home when it’s dark meant lots worked (or worked more effectively) when usually they wouldn’t have.

  • Peter Martin 28th Mar '22 - 11:30am

    @ Brad

    I wouldn’t disagree. However the jump in the mortality figures for 2020 is broadly consistent with the number we both agree is problematic on the basis of the 28 day definition.

    We don’t have the figure for 2021 yet. That will help give us a clearer picture of the effects of the Pandemic.

    My own opinion is that we got the response broadly correct. Lockdowns were necessary until effective vaccines became available. However they weren’t totally effective and there had to be a build up of naturally acquired immunity in the population too.

    Those countries which had tighter restrictions than we did are yet to acquire that in their populations.

  • Phil Beesley 28th Mar '22 - 1:07pm

    David Garlick: “There is no better way of restricting the spread of a virus like Covid than wearing a mask.”

    Well said. One of the many things which surprised me during the early stages of pandemic was the absence of reported scientific research about mask effectiveness, particulate size of sneezes and snuffles etc. It seems that East Asian practices of wearing masks were based on hunch feeling or anecdote, unless, improbably there are scientific papers which have not been translated in to English or other Western languages.

    If find it quite dismaying, two years after the start of this pandemic, many more after SARS was identified as a human threat, that so little science of masks has been reported.

    When Covid established its presence in the UK, I grumbled here about theatrical measures such as disinfecting road surfaces. Presumably part of UK government’s informed response at the time. Masks would have helped but UK pandemic plan didn’t consider them as a health or care service necessity, let alone for the public.

  • @Phil – you are so right. And there is a great deal of evidence in the medical literature now about the effectiveness of masks too. Wearing a mask is certainly preferable to getting Long Covid.

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