Pandemic restrictions are over… sort of… Where do we go from here?

You might find yourself wondering why, when the Prime Minister, the Chancellor of the Exchequer and the Secretary of State for Health are all self-isolating, and new cases have reached the peak levels seen last over the New Year, today is a good day to declare as “Freedom Day”. And yet, for all of the bombast that the Prime Minister offered in the days leading up to today, even he is now quoted as saying;

So please, please, please be cautious. Go forward tomorrow into the next step with all the right prudence and respect for other people and the risks that the disease continues to present.

Whilst I agree with him for once this time, that’s not exactly the freedom that he so boldly claimed would be ours come 19 July.

You Gov poll, image from The Times

But, yet again, Government attempts to cajole the public in one direction have run, Wile E. Coyote style, into the anvil of public opinion, as has been the case pretty much throughout the pandemic. The public are cautious, and opinion remains that a more measured relaxation of Covid-19 restrictions is preferred.

There will be those who welcome the lifting of restrictions. It’s been a pretty terrible time to be young, for example, and being at the end of the queue to be vaccinated must feel like punishment when your life feels like it’s slipping away. And yet, my sense is that young adults have been pretty supportive of restrictions and willing to abide by them.

So, what now?

I tend to the view that we need to seek a balance between reassurance and freedom. There are 3.8 million people over the age of eighteen who are immuno-compromised, and thus highly vulnerable, and we cannot surely think it right to oblige them to shut themselves away, so encouraging people to continue to wear masks in confined spaces seems like a sensible move. Indeed, transport providers and retail outlets are strongly encouraging, or in some cases, obliging, customers to wear masks. We could provide better education on mask etiquette and cleaning – it amazes me how many people still don’t understand that the mask should cover both nose and mouth, for example.

We also need to find ways to overcome disincentives to test and report. As the furlough and self-employment income support schemes are wound down, targeted support to those needing to self-isolate, and for the businesses they work for, should be better designed, as without financial support, there are many who simply cannot afford to do so. And, if people feel obliged to opt out of tracking and tracing, the pandemic will last far longer and cost much more than it might otherwise do.

There is, in truth, not so much that Government can do that is practical or sensible. It is as much about encouraging our communities and, more importantly, the individuals within them, to think about others and not just themselves. That’s a problem when you have a Government like this one, where the concept of personal responsibility is utterly alien. The messages that emanate from 10 Downing Street are undermined by the occupant’s unfamiliarity with truth, or with facing the consequences of ones actions.

We need a roadmap out of the pandemic which leads public opinion rather than following it a couple of steps behind, but is honest about the uncertainties that lie ahead – new variants, NHS capacity. The public have shown incredible resilience and common sense, but still need to be encouraged back to whatever a new normal looks like. There are many, understandably, cautious people out there, and they need reassurance before filling shops and restaurants again. And, until they do, the damage to our economy will drag on and the long term impact will be all the greater.

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20 Comments

  • On the question of “What are The Tories thinking” – their aim is to shift any responsibility & therefore, any Blame from The government to The Public. They want to get us blaming each other rather than them.

    So far, the plan doesnt seem to be working.

  • George Thomas 19th Jul '21 - 12:18pm

    “As Liberal Democrats we are true believers in devolution.” (John Armah | Thu 15th July 2021 – 6:45 pm)

    Err…

    Once again, I respect the writing beside that point and don’t want to distract from your overall message (it may even help demonstrate that Boris Johnson doesn’t want to recognise devolution either so has at times deliberately confused people to imply he has greater control) and some key points mentioned aren’t devolved areas.

    In the first wave LSE produced a study which showed group behaviour, the feeling of being all in together and wanting to protect the NHS were bigger factors of people following measures rather than whether it was the law or not. Clear messaging and education is now probably more important than whether it’s legal or not and will be important again in the winter when we’re expecting a nasty flu but no one wants to return to full lockdown.

  • Peter Martin 19th Jul '21 - 12:23pm

    I’m not sure if the question “What are The Tories thinking?” is actually worth asking.

    But there does seem to be a section of scientific thought which is broadly in agreement with Govt strategy. The idea, if I correctly understand what Prof Ferguson and others are trying to say, but without wanting to be too blunt about it, is that the vaccine will protect most of the highly vulnerable from too much harm but there aren’t enough people being vaccinated to reach ‘herd immunity’. The non vaccinated include those who are vaccine hesitant and younger people.

    So, to increase the population’s overall resistance to Covid we need to top up the partial immunity which is brought about by vaccination with the partial immunity brought about by natural infection and the summer time is the best time for this. It’s like fighting fire with fire or a ‘controlled burn’

    Personally I think this is too risky, the fire may well get out of control, and additional efforts should be made to vaccinate everyone before removing too many restrictions. But we’ll see.

  • Jenny Barnes 19th Jul '21 - 2:21pm

    With the restrictions that have just been lifted we were up to 60k infections a day. Why isn’t that enough for “herd immunity”? All removing the restrictions does is push the peak higher and threaten to overwhelm the NHS. Still, then private health care can “rescue” it, I suppose. Murderous pyschopaths. How come 125k deaths is ok if you’re a politician, but 1 is too many if you’re Ms Ordinary?

  • Peter Martin 19th Jul '21 - 3:12pm

    @ Jenny Barnes,

    “……60k infections a day. Why isn’t that enough for “herd immunity”?”

    It would be if it carried on long enough as would 100k or 200k per day. There is just over half the population which is fully vaccinated. So that is 32 million people which are vulnerable to infection and/or transmitting the virus.

    So, at 100k per day, that potentially would be 320 days. It probably won’t be quite that bad in terms of total numbers of infections but could be much worse in terms of numbers of infections per day.

  • ><iThere are 3.8 million people over the age of eighteen who are immuno-compromised
    There are circa 14.3M under 18s in the UK, who, current government policy (and I’m taking into account today’s announcement about limit vaccine availability to certain U18’s) aren’t going to be vaccinated any time soon. Which given the experts place “herd immunity” somewhere in the 80~90% region, means we aren’t going to achieve the outcome desired for the vaccine programme.

    Yes, we know that in the main children don’t get CoViD as badly as adults – just as children don’t get MUMPS, Rubella, Chickpox etc. as badly as adults. However, we also know that not only are schools good places for infections to be passed on but that children tend to be among groups of people who are more likely to have an adverse reaction – hence why children are given the MUMPS and Rubella components of the MMR.

    So by extending the vaccination programme to the under 18’s we not only remove a major transmission vector but also meet the herd immunity threshold. By surpassing the herd immunity threshold we improve the extent to which those who are immuno-compromised are protected from coming into contact with Sars-Cov-2.

    I therefore hope, given how the LibDems want to extend voting rights to the under 18’s, that they will be as vocal about the need to vaccinate the under 18’s as they have been about other less important CoViD matters…

    The only question I can see is at what age do we set the threshold at: is it 3-5 years old (ie. pre-school, MMR second dose) or is it 12 months (MMR first dose).

  • @Roland

    Basically politicians should stay as far as possible out of whether specific cohorts should be vaccinated or not. It should be a medical determination.

    And a medical determination means one that is best for the individual concerned. It may seem a good idea to go for the “greater good” or substitute a more “political” opinion but it is easier to see how this would backfire in mistrust among the vaccine-hesitant. And the right people to determine what is right medically for someone are doctors not politicians!

    In the UK the JCVI is the medical body given the responsibility that’s where it should stay.

  • Jenny Barnes 19th Jul '21 - 4:35pm

    peter martin ” could be much worse in terms of numbers of infections per day.”
    and the more infections per day, the more hospitalisations per day and the less able the NHS would be to cope. Why not wait with the current restrictions till the curve stops growing exponentially? I reckon we’d easily get to 100k without eliminating any restrictions. Still, only 40k today, so that’s alright then.

  • George Thomas 19th Jul '21 - 5:35pm

    For the first few days Boris Johnson, the UK government minister’s and Tory-support press pushed the idea of “freedom day” with many expressing concern, but since that point most, though not the tory-press, have become much more cautious and private companies have decided to request mask-wearing which is more line with public attitude.

    Are we going to end up in a position where the majority are still doing the right thing despite the efforts of the UK government (speaking for England) thus making it appear that the actions taken by the UK government (speaking for England) were the right ones to take? It really is what we’re all hoping for.

  • @Michael 1 – Fine words, only Pfizer/BionTech vaccine has been approved as being suitable for use by people aged 12 years and above. So what is missing in the UK is the political will to give the go ahead. I expect in the coming months to see that lower age be lowered as more data becomes available.
    What is clear from the language Boris et al are using, they have no real intention of vaccinating the under 18’s.

  • @Roland

    It’s not “political will” – I suspect if anything that the Government would have liked the JCVI to have recommended it for children. The BBC reports: “The government’s vaccine advisors say the benefits of being vaccinated are very small in healthy children. This is because so few children become seriously ill or die from Covid.” And those 12+ with certain medical conditions *will* be vaccinated.

    https://www.bbc.co.uk/news/health-57888429

    I think you are probably right that we may well see more data coming available and that may well move things in the direction of vaccination. But dare I say it – we have seen the dangers with Trump in politicians substituting their alleged medical opinions for real medical opinions.

  • John Marriott 19th Jul '21 - 7:41pm

    If I were the virus and saw my potential targets being fortified (ie all over 18s) I would find a way of targeting those of a younger age. I might even change my composition while I had to chance to get round those pesky vaccines.

    Or, I could cut my losses and learn to live on, like my relative, influenza and the common cold.

  • @Michael 1 The BBC reports: “The government’s vaccine advisors say the benefits of being vaccinated are very small in healthy children. This is because so few children become seriously ill or die from Covid.”

    And as I pointed out, the benefits of being vaccinated against mumps and rubella are very small in healthy children (and are probably smaller than those associated with CoViD)… yet we still insist on them being vaccinated… The “government’s vaccine advisors” advice doesn’t stand up to scrutiny.

    @John Marriott – children are some of the best breeders of variants…

  • Peter Martin 20th Jul '21 - 9:56pm

    @ Jenny Barnes

    I’m not sure why you are quoting me in such a misleading way. Especially as I’m in general agreement with your take on it all.

  • @Roland

    You may be right. But there are a number of issues. The first is to proceed cautiously – children’s bodies are obviously different from adults and it may be as with other vaccines for other diseases once we have had more data then we could go ahead.

    You are citing one side of the benefits/risk equation – the benefits of vaccination but not the (potential) risks.

    The JCVI do note: “Real-world data on the safety of COVID-19 vaccines in children is currently limited, but there have been extremely rare reports of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the membrane around the heart) following the use of the Pfizer-BioNTech and Moderna vaccines in millions of younger adults.”

    https://www.gov.uk/government/news/jcvi-issues-advice-on-covid-19-vaccination-of-children-and-young-people

    Germany have followed a similar route to us. And JCVI *do* recommend it for those aged 12-17 with other risk factors.

    My *personal* opinion is that it would be “useful” if 12-17 year-olds soon. I am not an epidemiologist but the high R0 of the delta variant is a challenge. And children over the summer will mix, pick up covid and then pass it on in September when they will mix again – often with new children. Hopefully we will get to enough vaccination to reduce R0 to an R of below 1 and there are complicated issues of “localised” herd immunity etc. but immunising 12-17 year-olds *might* well be useful.

    But ethically you do have to be very carefully to do what is the best for the individual concerned – otherwise you shoot to piece the trust on which vaccination and public health and bodies such as JCVI is based.

    @John Marriott

    The (slightly) good news is I understand covid has a DNA correction mechanism so is thought to be some five times less prone to mutation than flu. And different viruses vary in how much their mutation. We have had just under 200m (recorded) cases and only a handful of variants of concern. But of course there is a lot of virus about (in the UK at least!) and of course the evolutionary “prompt” of coming up against the vaccine.

  • John Marriott 19th Jul ’21 – 7:41pm:
    Or, I could cut my losses and learn to live on, like my relative, influenza and the common cold.

    SARS-CoV2 is a betacoronavirus and unrelated to the orthomyxoviruses which cause flu. There are two alphacoronaviruses (229E and NL63) and two betacoronaviruses (OC43 and HKU1) which in total cause around 15% of common colds. The vast majority of colds are caused by rhinoviruses.

    Michael 1 20th Jul ’21 – 10:01pm:
    The (slightly) good news is I understand covid has a DNA correction mechanism so is thought to be some five times less prone to mutation than flu.

    SARS-CoV-2 is a single stranded RNA virus with 29,903 nucleotide bases. It’s a single strain which mutates relatively slowly to produce new variants. The orthomyxoviruses which cause flu have eight segments of RNA with around 14,000 bases in total. When two strains of flu viruses infect the same cell the RNA segments can exchange and recombine to form a new strain that may escape immunity.

  • Jenny Barnes 19th Jul ’21 – 2:21pm:
    With the restrictions that have just been lifted we were up to 60k infections a day.

    Actual infections have been over 100,000 a day for some time now. A lot of people don’t come forward for testing and many, particularly young people, are asymptomatic so don’t know they are infected. Based on the infeasibly high Case Fatality Rate seen earlier in the year it seems likely that the number of infections is somewhere between three to five times higher than reported cases.

    Why isn’t that enough for “herd immunity”?

    The UK is ahead of any other major country in both vaccination rates and the spread of the Delta variant. There is tentative evidence that some parts of the country are close to herd immunity, at least in these summer conditions with high UV exposure and vitamin D levels. Looking at the areas where the Delta (formerly Indian) variant was first seeded, such as Bolton, shows that reported cases have levelled out and are now below the national average…

    BL3 5LR – Rumworth North:
    https://coronavirus.data.gov.uk/search?postcode=BL3+5LR

    The ZOE COVID Study run by Professor Tim Spector of King’s College London, which tracks ahead of official figures using self-reported health status via an app, also shows new cases levelling out…

    ‘New cases plateau ahead of Freedom Day’ [15th. July 2021]:
    https://covid.joinzoe.com/post/new-cases-plateau-aead-of-freedom-day

    According to ZOE COVID Study incidence figures, it is estimated that among unvaccinated people in the UK there are currently 17,581 new daily symptomatic cases of COVID on average, based on PCR test data from up to five days ago. A decrease of 22% from 22,638 last week. Suggesting that the wave in the unvaccinated population has now peaked in the UK. The overall number of estimated cases is 33,118 which remains similar to last weeks which was 33,723.

    All removing the restrictions does is push the peak higher and threaten to overwhelm the NHS.

    It’s unlikely that the NHS will be overwhelmed over summer although the requirement for staff to self-isolate will reduce capacity. Of more concern is that even more people may be left with long-Covid. However, if at all possible, we need to obtain herd immunity before autumn to prevent both flu and Covid circulating simultaneously – a potentially deadly combination that could overwhelm the NHS.

  • Jayne mansfield 21st Jul '21 - 8:14am

    As far as infection is concerned, no one preventative tool works 100%.

    Jeff mentions Professor Tim Spector, and I would argue that he gives clear, sensible advice on the best way to protect oneself and others following ‘ Freedom Day’.

    Check our his 7 tips to live with COVID after ‘Freedom Day’.
    Briefly,
    1. Respect others
    2.Wear a mask
    3. Socialise outdoors in poorly ventilated or cramped areas.
    4.Keep practicing good hygiene.
    5. Get your second jab of the COVID vaccine.
    8. Know all the COVID symptoms
    9.Keep logging with ZOE COVID study.

    A reading of the above sections of advice is rather more useful that the chaotic government’s meaningless nonsense about ‘the need to live with the virus’ , or ‘be cautious with no indication of what these phrases mean, ( because they don’t know, or choose not to because they are putting politics before science}.

    British science has been world beating during this pandemic. If Johnson dug into his dressing up box and came out for a photo opportunity dressed as Edward Jenner, he would not be more ludicrous.

  • Jayne Manssfield 21st Jul '21 - 12:18pm

    2. should of course have read, wear a mask in poorly ventilated or cramped areas.
    3. Socialise outdoors.

  • @Michael 1 – Thankyou for your consider reply. I agree we do need to proceed with “our eyes open”, and yes I was expecting a gradual lowering of age for vaccination, putting pressure on the experts to come off the fence.

    I think one of the big lessons from the global CoViD vaccination programme, is both the data sharing and the volume within a small space of time. Hence why we are hearing about some of the adverse reactions that would probably not have been spotted and linked to the vaccination under normal conditions. I suspect going back to the Wakefield MMR scandal, if we had administered the MMR vaccine on the scale of the CoViD vaccine, it would have been much easier to discredit the association Wakefield was claiming.

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