As we all know, the Government have published a ‘roadmap’ for ending the national lockdown in England, the first step of which is the re-opening of all schools and colleges on Monday, 8 March. BuDS has taken a hard look at the roadmap and here is our considered reaction to it. This is a long article, but you can skip down to ‘What does BuDS recommend?’ at the bottom for a quick summary.
Remember, the roadmap only applies to England. Scotland, Wales and NI have their own plans which are different.
ZERO-COVID VERSUS MANAGED-COVID
In looking at the roadmap, BuDS wanted to make sure people understand the two basic ways that nations have dealt with the pandemic so far.
Many nations like China, Korea, New Zealand and some European nations decided in 2020 to impose a relatively short but very strict and tightly enforced lockdown to drive down infections to a very low level. After this ‘short, sharp, strict’ lockdown, they removed restrictions for everyone and dealt with occasional flare-ups of Covid by widespread thorough testing and strict local lockdowns. This strategy imposed a lot of restrictions on businesses and people for a period but cut deaths and illness to a minimum and allowed a return to near normal life afterwards. This approach is often called the ‘Zero Covid’ option, because it seeks to get rid of Covid infections in the population altogether.
Other nations, like the UK, tried in 2020 to ‘manage Covid’ by imposing relatively weak public health precautions on everyone for long periods, alongside weak testing and tracing of infections. This approach accepted that there would be a lot of infected people and a high number of ill people, hospital admissions and deaths, but balanced that against the hope of less disruption to businesses and everyday life. Shorter, less strict, local or national lockdowns and restrictions were used when the number of deaths and patients in hospital threatened to become unmanageable either in an area or across the whole country. As a result, ‘manage Covid’ nations had high death and illness rates and a very unpredictable, disruptive, 2020 with lots of changes to rules.
Fast-forwarding to 2021, ‘zero Covid’ nations are now able to vaccinate their citizens on a fairly relaxed schedule because Covid is not widespread in their country and they are living fairly normal lives, with businesses back to normal. In ‘manage Covid’ nations, however, an emergency crash programme of vaccinations is necessary because they are always on the edge of an unmanageable public health emergency.
‘Managed Covid’ nations like the UK now have two basic options. They can keep themselves in lockdown, with lower Covid levels and lower deaths and illnesses, until the whole population is vaccinated, then unlock quickly and completely. Or they can continue to ‘manage Covid’ by unlocking quickly before vaccination is complete, accepting that there will be a high number of illnesses, hospitalisations and deaths, but hoping that the quicker unlock will bring benefits to people and businesses.
In BuDS’ opinion, the ‘roadmap’ shows that the Government have chosen the second option – ie to make another attempt to ‘manage Covid’ with a quick unlock to give maximum short-term relief for people and businesses, but also accepting a high level of associated illnesses, hospitalisations and sadly deaths from Covid.
Here are six things to think about if you’re older, disabled or shielding:
ONE: FAVOURING UNLOCK OVER PEOPLE IS EXTRA RISKY FOR DISABLED PEOPLE
The roadmap openly accepts that lifting lockdown *will* result in more infected people, more hospitalisations, and more deaths. But the roadmap also says that the Government ‘cannot persist with restrictions that damage the economy’. Looking at the rapid pace that the roadmap suggests for lifting public health precautions and re-opening places where people mix together, it’s obvious that the roadmap favours the short term needs of the economy and the interests of businesses over the health and wellbeing of people. This means that older, disabled and shielding people’s interests and needs may be out of step with the roadmap’s priorities. For example, the roadmap may encourage people to go back to work or shops at a time when that is still quite dangerous for high risk people, or the roadmap might end shielding before it is clinically safe to do so.
TWO: THERE’S NO WAY BACK
The roadmap says that once a public health precaution has been lifted, that change is ‘irreversible’ – in other words, whatever the harm caused by lifting a public health precaution, the Government will never put it back in place. That means, for example, that if the ‘big bang’ of opening all schools next week on 8 March does lead to another wave of infections and deaths, as the Government’s own advisors predict it will, all schools will never be closed again, even if that would reduce deaths and illnesses. Again, this approach is extra risky for older and disabled people and those who are shielding.
THREE: IT’S NOT REALLY A CAUTIOUS APPROACH
Thirdly, although the roadmap says that it sets out a ‘cautious’ approach, the central idea is that all legal public health precautions could be lifted as early as 21 June, only 4 months away. BuDS does not feel this suggested timetable can be described as ‘cautious’ – it is in fact extremely optimistic and very fast. While the roadmap says that it will not be automatic for each step to follow on the timetable set out, it clearly encourages people to expect a very rapid removal of public health precautions. Given the many things that could still go wrong along the way – such as new peaks of infection, new variants of the virus, etc – BuDS feels this deliberate raising of people’s expectations about a quick return to ‘normality’ will make it very difficult for the process to be stopped or significantly delayed, whatever the human cost. Again, this approach is extra risky for older and disabled people and those who are shielding.
FOUR: THE VACCINE SITUATION ISN’T AS POSITIVE AS IT SEEMS
The roadmap is extremely optimistic about the benefits of vaccination, saying confidently that “vaccines will replace restrictions”. BuDS feels this statement is not scientifically correct.
While the national vaccination programme is going ahead very quickly, so far less than a million people have been ‘vaccinated’ in the sense of having had both doses required to give the best level of protection. One dose of vaccine gives only partial protection, meaning that some part-vaccinated people can and will still get seriously ill or die. On the roadmap’s own calculations, even extremely clinically vulnerable groups will not be fully (two doses) vaccinated until the end of May, and clinically higher risk groups will have only had one dose by the end of July. Yet, by May, the roadmap predicts to have ‘irreversibly’ removed many of the public health precautions which prevent the virus spreading quickly.
If the roadmap is followed and public health precautions are removed quickly, the virus will be allowed to spread through a population which is only partially vaccinated. Many more people will catch Covid and be ill or even die than if precautions were kept in place until *after* everyone is vaccinated. So, the roadmap’s approach is extra risky for older and disabled people and those who are shielding.
FIVE: THE SCIENTIFIC DANGER OF MUTATION
The roadmap acknowledges the danger from mutations or ‘new variants’ of the Covid virus, which could be more infectious or more lethal than current variants, or not controlled by vaccines. However, the roadmap does not underline the obvious scientific fact that allowing the virus to spread again, especially in a population which is only partially vaccinated, is the ideal way to encourage new mutations.
Viruses mutate when they pass to another person. Taking away public health precautions and allowing greater mixing of people increases infections, which in turn increases mutations. If people who are part-vaccinated or recently vaccinated catch Covid, there is a much higher chance of a mutated virus which can make people ill even if they have been vaccinated. While new vaccines can be developed to cope with new variants, this will take months, and in that time many people may become ill or die.
Older and disabled people and those who are shielding have been encouraged to see vaccination as a way back to safety and normal life. If the quick pace of the roadmap’s changes allows vaccine-resistant new variants of the virus to develop, which is a real risk, then older, disabled and shielding people will suffer the most.
SIX: BEWARE OF ‘LONG COVID’
‘Long Covid’ is a medical condition that people develop *after* catching the Covid-19 virus, even if they were not necessarily ill with Covid itself. The symptoms include tiredness, cough, headache, loss of taste, loss of smell, aches and pains, sore throat, fever, shortness of breath, nausea/vomiting, diarrhoea, and tummy pain. These symptoms can be mild, moderate or severe. The latest NHS data says that between a fifth and a quarter of people who catch Covid-19 show at least one symptom of Long Covid in the weeks after they caught the virus – a very high number. Even children and young people who are not ill at all when they first catch Covid are showing signs of Long Covid. Some estimates are that up to a million people of all ages might be affected by Long Covid or disabled by it in the future.
The fact that so many people are now showing signs of Long Covid is another reason why it’s really important not to catch the Covid-19 virus, even if you are not in a high risk group or likely to be very ill when you first catch it. But the roadmap seems to assume that allowing lower risk groups to catch Covid virus is acceptable as long as they do not get very ill at the time. This is scientifically not accurate.
WHAT DOES BUDS RECOMMEND – TAKE CHARGE OF YOUR OWN SAFETY
BuDS thinks that it more important than ever that older, disabled and shielding people take charge of their own safety during this ‘unlock’ period. Because the roadmap is designed to quickly unlock the economy and return things to ‘normal’ even if this means a very high level of deaths and serious illness, it is likely that older, disabled and high-risk people will be advised or allowed to do things which are not always going to be safe for them. So, people should make up their own mind about what’s safe for them, rather than necessarily always following the ‘official’ guidance.
BuDS will continue to help disabled people understand Covid risks so that they can decide for themselves how to keep themselves safe.
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