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End of Lockdown and Shielding

From Monday 29 March, many of the legal public health precautions which have applied during lockdown will be removed. Also, from Wednesday 31st March, the Government will no longer advise extremely clinically vulnerable people to shield. The big question is whether these changes are safe for people, especially higher-risk older, disabled and shielding people. BuDS’ expert team has put together a lot of fact-checked information to help you decide what to do.

This is a long article, but you can skip down to ‘Conclusions’ at the bottom to get a quick summary. If you need help or support or you’re anxious about Covid-19, BuDS is here for you. Please e-mail [email protected], call 01494 211179 (voicemail) or message us and we’ll do all we can to help.

The information in this article is for England only and some information applies to Buckinghamshire only – we say if this is the case.

 

WHAT’S HAPPENING ON 29 MARCH?

From 29 March, a lot of the legal rules around lockdown will be removed. These are the things that people legally will be able to do from 29 March1:

  • Leave home for any reason and travel as far as you like to any destination
  • Go to work in a workplace
  • Meet other people outdoors (e.g. in your garden or in a park) – either up to 6 people from different households or all the members of two households
  • Play sports and swim outdoors

The Government ‘roadmap’ asks people to continue to work at home if they can and avoid making journeys, but this is now up to people to decide for themselves. The roadmap actively encourages people to meet up with friends and family out of doors.

BuDS will be writing a much more detailed post about the end of legal lockdown – look for it here: https://buds.org.uk/articles-about-covid-19/

 

WHAT’S HAPPENING ON 31 MARCH?

From 31 March, the Government will stop advising people who are ‘extremely clinically vulnerable’ to Covid-19 to shield, or self-isolate at home for their own safety.  This means that shielders can no longer claim Statutory Sick Pay (SSP) or Employment & Support Allowance (ESA) from 1 April and employers can insist shielders go back to work from that date too.

However, the Government still recommend that shielders take ‘extra precautions to protect yourself’ such as reducing your contacts with other people and trying to keep your distance from other people.

BuDS will be writing a much more detailed post about the end of shielding – look for it here: https://buds.org.uk/articles-about-covid-19/

 

WHAT’S THE VIRUS DOING?

In England, the Office for National Statistics’ Infection Survey uses large-scale random testing to estimate the percentage of people in the community (that is, not in hospitals, care homes etc) who have Covid-19. This is the most accurate way to work this out. The Government publish numbers for people testing positive after feeling ill with Covid-19, but these are always much lower than the ONS figures because a lot of people who are infected with Covid-19 do not get tested.

The ONS Infection Survey shows that in England in the week ending 13 March, 0.29% of the population2 or around 160,200 people in the community had Covid. In Buckinghamshire, in the week ending 13 March, 0.3% of the county population or around 1650 people in the local community had Covid-19. This is roughly the same number of infected people as there was in early October 20203.

The ONS Infection Survey and the PHE test data have shown huge drops in the numbers of infected people since January. This is because people have not been mixing together and so less people have caught the virus from another person.  But for the last 6 weeks, the number of infected people has gone down much more slowly4. This shows that people were mixing together even in the lockdown and so the virus could continue to spread slowly.

The latest ONS survey information is from 13 March and the latest PHE test data is from 22 March. Neither of these measuring methods are showing an increase in the number of infected people yet. However, the NHS Chief Medical Officer has clearly warned that there will be a ‘surge in the virus’ at some point5 as more contact between people allows Covid-19 to spread more quickly.6 So, the numbers of infected people in England and Bucks are probably not going get much lower, and they will probably start to climb in the next few weeks.

So, the important things to remember about the Covid-19 virus situation are:

  • The national lockdown from 5 January to 8 March did NOT get rid of Covid-19 in England or Bucks or even reduce the number of infected people down to low levels. The lockdown has managed to get the number of infected people down to how it was in October last year.
  • However, back in October 2020, BuDS was warning that people were at high risk of catching Covid-19 in the community and that clinically vulnerable people should be voluntarily shielding to protect themselves. So, the situation in England and in Bucks after the lockdown is STILL DANGEROUS, especially for older, disabled and shielding people.
  • Another way of thinking about the current situation is that there are NINE times more infected people in Bucks now than there were in August 20207.
  • The removal of legal restrictions on what people can do will lead to more mixing and so the number of infected people will rise. This might happen quickly or more gradually depending on what happens after 29 March.

 

WHAT ABOUT VACCINATIONS?

The Government roadmap hopes that ‘vaccinations will replace restrictions’. This basically means that, even if the virus starts spreading quickly through the population again, the number of people who will get seriously ill or die from Covid-19 will not go up in the same way. The roadmap suggests that this will happen because enough people will be ‘vaccinated’ to stop them getting seriously ill or dying even if they get infected.

However, it is NOT scientifically valid to say that ‘vaccinations can replace restrictions’ at the current time. Only 2.1 million people in the UK so far have been vaccinated with both doses of vaccine and have a high level of protection against Covid-198. The 26.8 million people who have had one dose (to 19 March) have only part-protection against Covid-19 which will vary from person to person9. And the UK Vaccine Taskforce has warned that over a million people currently CANNOT be vaccinated10. There are over 800,000 pregnant women11 and an estimated 500,000 people with a damaged immune system in the UK12 (an eighth of the Shielding Register) who cannot be vaccinated with any current vaccine, for example.

This means that there are still plenty of people now who can get ill and die from Covid-19. These include some older and clinically vulnerable people with only one dose of vaccine, high-risk people who cannot be vaccinated yet and some younger unvaccinated people.

 

WHAT ABOUT LONG COVID?

New NHS information shows that up to a fifth of people who get infected with Covid-19 still have one or more Covid-19 symptoms 5 weeks after being infected. These long-lasting symptoms like cough, exhaustion, pain or fever are known as Long Covid. There isn’t enough information yet about Long Covid to be too sure, but there is the real possibility that Covid-19 could lead to many hundreds of thousands of people of all ages, including children and teenagers, having a long-term condition like fatigue. And catching Covid-19 is increasingly being linked to serious conditions like diabetes and hearing loss too.

We do not know yet if vaccines offer any protection against catching Long Covid or other conditions linked to Covid-19. Vaccine testing so far has looked at whether they are effective against immediate acute symptoms of Covid-19, not whether vaccines prevent long-term conditions linked to Covid-19.

This means that the risk you face from Long Covid if you catch Covid-19 is real but unknown, whether you are young or old, or partially or fully vaccinated.

 

WHAT ABOUT NEW VARIANTS?

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. Vaccines are designed to stop people getting ill if they catch Covid-19, not stop them getting infected. So, if the millions of people who are part-vaccinated or recently vaccinated catch Covid-19, there is a much higher chance of a mutated virus which can bypass the vaccine. This may have already happened – the South African Covid-19 variant is believed by many scientists to be partially resistant to vaccines as well as being much easier to catch than older variants13.

While new vaccines will be developed to cope with new variants, this will take months, and in that time many people may become ill or die.

What this means is that there is a risk that vaccine-resistant new variants of the Covid-19 virus could start to spread while society is unlocked, potentially making even vaccinated people seriously ill and making it necessary to start the vaccination programme all over again.

 

CONCLUSIONS

From 29 March, a lot of the legal rules around lockdown will be removed and the Government will be encouraging people to meet up out of doors in small groups.14 This will make it easier for the virus to be spread from person to person and the Chief Medical Officer has warned of a ‘surge in cases’.  There hasn’t been a rise in the number of infected people in England or Bucks yet but there are early signs that a rise is beginning to happen.

From 31 March, the Government will stop advising high risk people to shield and cut financial support for shielders, while still encouraging shielders to ‘take extra care’.15

The national lockdown from 5 January to 8 March did not reduce the number of infected people down to lower, safer, levels. The situation in England and in Bucks after the lockdown is still dangerous, especially for older, disabled and shielding people.

It is not scientifically valid to say that ‘vaccinations can replace restrictions’ at the current time, because only 2 million people are fully vaccinated. There are still millions of people now who can get ill and die from Covid-19. These include some older and clinically vulnerable people with only one dose of vaccine, high-risk people who cannot be vaccinated and some younger unvaccinated people.

There is a continuing risk that up to a fifth of people who catch the Covid-19 virus, whether young or old, or partially or fully vaccinated, might develop Long Covid symptoms.16

There is a risk that vaccine-resistant new variants of the Covid-19 virus may develop or take hold in the UK and spread rapidly even to people who have been vaccinated.17

 

BUDS RECOMMENDS…

Bringing all of this together, BuDS feels that it is too early for older, disabled and shielding people to start taking chances with their own safety. There are many things that could still go badly wrong with the Government’s roadmap and it is higher-risk groups like older, disabled and shielding people who are most at risk if the roadmap does go wrong.

HIGHER-RISK GROUPS: BuDS recommends that higher-risk groups – including those who have had one dose of vaccine – continue to shield themselves until the situation becomes clearer. By Easter, we think, we will have a better idea of how the roadmap plan has worked out and what the risk is for higher-risk groups.

LOWER-RISK GROUPS: BuDS recommends that lower risk groups – including children, teenagers and young adults – take every precaution to avoid catching Covid-19. It isn’t safe for anyone, whatever their age, to catch Covid-19. Lower-risk groups may not be at high risk of immediate acute Covid-19 symptoms, but the risk of getting Long Covid or another conditions linked to Covid-19 infection is very real.

 

MORE INFORMATION

To see all BuDS’ articles about Covid-19, use this link: https://buds.org.uk/articles-about-covid-19/

To read BuDS’ analysis of the Government’s entire unlock ‘roadmap’, use this link: https://buds.org.uk/buds-reaction-to-governments-pandemic-roadmap-6-march/

To learn more about the people who are more likely to die or have serious illness if they catch Covid-19, use this link: https://buds.org.uk/how-dangerous-is-covid-19-if-you-catch-it/

To learn more about how face coverings and face masks can protect you, and read our recommendations about using them, click this link: https://buds.org.uk/information-about-face-coverings-and-masks/

To learn more about the changes to the Government’s list of people who should be shielding, use this link: https://buds.org.uk/1-7-million-people-added-to-shielding-register/

To learn more about the vaccines currently in use, as well the answers to some frequently asked questions about them, use this link: https://buds.org.uk/vaccine-update-and-faqs-04-03-21/

To learn more about Long Covid and its impact, use this link: https://buds.org.uk/long-covid-in-children-and-young-adults/

 

FINALLY

Please share this article on social media, but always credit BuDS. If you need help or support or you’re anxious about Covid, BuDS is here for you. Please e-mail [email protected], call 01494 211179 (voicemail) or message us and we’ll do all we can to help.

 

References

[1] https://www.gov.uk/government/news/prime-minister-sets-out-roadmap-to-cautiously-ease-lockdown-restrictions

[2] https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/coronaviruscovid19infectionsurveypilot/latest

[3] Approx. equivalent to the number of infected people around the 10th/11th October, based on both ONS infection survey and PHE test data

[4] Using PHE test data: fall of 269 (w/c 8 Feb), then fall of 148 (w/c 15 Feb), then fall of 148 again (w/c 22 Feb), then fall of 110 (w/c 1 March), then fall of 43 (w/c 8 March), then fall of 0 (w/c 15 March)

[5] As quoted in https://www.bbc.co.uk/news/health-56334902

[6] https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-how-is-it-transmitted – noting the words “Current evidence suggests that the main way the virus spreads is by respiratory droplets among people who are in close contact with each other. Aerosol transmission can occur in specific settings, particularly in indoor, crowded and inadequately ventilated spaces, where infected person(s) spend long periods of time with others” (paragraphs 4 and 5 of the “How does COVID-19 spread between people?” section

[7] As of the 3rd August, BuDS estimates there were approx. 66 people infected with Covid-19 in Bucks. On the 22nd March, BuDS estimates there were approx. 636 people infected with Covid-19 in Bucks, which is 9.64 times the number recorded in August. For more information on these estimates, please see https://buds.org.uk/buds-risk-posts/ and follow the links

[8] Taken from Department of Health and Social Care bulletin, 20 March 2021 https://www.gov.uk/government/news/half-of-all-adults-in-uk-receive-first-dose-of-covid-19-vaccine

[9] For an explanation of this, please see https://buds.org.uk/vaccine-update-and-faqs-04-03-21/

[10] As referenced by the UK Vaccine Taskforce chair in an interview with the BBC covered here https://www.bbc.co.uk/news/health-55022288

[11] As recorded by the ONS for 2018 https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/conceptionandfertilityrates/bulletins/conceptionstatistics/2018

[12] Estimated using data from https://digital.nhs.uk/coronavirus/risk-assessment/population and https://digital.nhs.uk/dashboards/shielded-patient-list-open-data-set-by-disease-group. Based on data from these sources, there are 3,792,970 shielded patients in England (as of 12/03/21), so approx. 500,000 who cannot be vaccinated would be about 13% or just over 1/8 (12.5%) of the total shielding number

[13] As taken from the 5th paragraph of the WHO’s statement on Covid-19 variants, https://www.who.int/csr/don/31-december-2020-sars-cov2-variants/en/

[14] https://www.gov.uk/government/news/prime-minister-sets-out-roadmap-to-cautiously-ease-lockdown-restrictions, paragraph 11 (after the second bullet-point list)

[15] https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19

[16] https://buds.org.uk/long-covid-in-children-and-young-adults/ (as of 24/03/21)

[17] As discussed in SAGE meetings, and summarised in this report https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/954990/s1015-sars-cov-2-immunity-escape-variants.pdf (notably “There is therefore theoretical and experimental data supporting the possibility that SARS-CoV-2 variants may arise which evade monoclonal antibody therapies, convalescent plasma therapy, vaccine derived immunity, or naturally acquired immunity”)