The newest and most far reaching measures yet to ease the lockdown in England announced by the Prime Minister yesterday are being dubbed ‘Super Saturday’ by some Conservative MPs.
The reduction of the two metre physical distancing rule to one metre when other factors are in place, like mask wearing, was clearly a prerequisite for relaxing the measures and further opening up the economy. This isn’t uncontentious – scientists disagree about how much of a risk it is. The Prime Minister made it clear that ultimately this had been a political decision. As the Chief Medical Officer said at the press briefing following the PM’s statement to the Commons this is about the balance of risk.
Trade unions representing shop and hospitality workers have expressed concerns about the safety of their members and whether it could mean some people giving up on distancing measures altogether. Groups representing disabled people and the elderly have voiced some disquiet. In an open letter signed by the presidents of the Royal Colleges of Surgeons, Nursing, Physicians, and GPs published in the BMJ, they called for a rapid cross party review of the UK’s preparedness for a second wave (and interestingly one of the four policy areas they believe needs urgent review is governance including parliamentary scrutiny and involvement of regional and local structures and leaders).
But for many of us, being able to meet friends (at the correct distance) in a pub, or wander around an art gallery, or go to the cinema (if we haven’t had enough of films) will, indeed, feel liberating, however different it feels to what we took for granted not that long ago.
The government has kept more or less to its recovery plan. We are now well into phase two. July 4, Independence Day, is an appropriate date for this more radical easing of the lockdown – the onus is shifting much more to individuals (and businesses such as restaurants) taking personal responsibility for following guidelines.
But ‘liberation’ comes with particular concerns for some groups. The 2.2 million people who are shielded have not received much public attention from the government in the last two months. The announcements on shielding now, however, are of major significance to them. People who are shielded will be able to go out, meet other people in small groups. By the end of July the shielding scheme will be finished and those who had been shielded will be able to return to work in ‘Covid secure’ workplaces. From 1 August, the ‘clinically extremely vulnerable’ will receive only local authority and voluntary help. Many will welcome the easing of the restrictions that were severe and have had adverse effects on some people. But there have been concerns raised by charities and health bodies.
The Guardian quoting the Royal College of Physicians (RCP), said the announcement would be met with mixed emotions.
“The past few weeks and months have been challenging and we know that many patients will be unsure about what lies ahead,” said Professor Donal O’Donoghue, the RCP registrar.
“It is crucial that the government builds trust by regularly communicating and engaging with those who have been shielding up to now. Patients are likely to have many questions and we need to ensure that frontline NHS staff are equipped with the detailed scientific evidence base to be able to support patients to make their shared decisions based on individual assessments of risk and their personal priorities.”
Sue Farrington, chair of the Rare Autoimmune Rheumatic Disease Alliance, said: “Many people who’ve been shielding told us they have felt abandoned, and while an end to shielding is welcome, people are understandably wary and need to know that their concerns aren’t being brushed aside. We’re particularly concerned about people needing to return to work if their workplace is deemed ‘Covid-safe. Over the last few months people have told us how the guidance for employers is already too open to interpretation. We really need to see specific guidance on how this will be enforced, how people will be protected, and how any issues will be addressed.”
Family carers and care workers, as well as shielded individuals themselves, will need guidance that addresses the specific issues about particular groups and the relative risks. Again, there seems to have been little consultation.
What can other countries tell us about the possible impact on the relaxations to the lockdown? Germany is perhaps the most interesting recent example. The Guetersloh area has been put back into lockdown following a serious outbreak of infections at a meat packing plant. This is expected to be for a short period only, but it is clearly massively disruptive – and a warning. For the UK it seems to underline the messages that any future spikes will be dealt with locally. ONS figures published on 23 June show that regions are at different places in the pandemic. The East Midlands had the most ‘excess’ deaths in the period just before 12 June (+ 18 per cent) compared with two per cent for Wales.
My blog last week emphasised how central local authorities are to managing Covid-19. This becomes more so as the lockdown eases and more difficult in some ways as the rules change. Track and trace is still not fit for purpose. Council powers to put in place local lockdowns are still not clear. The app has been abandoned for now. The government is still not sharing detailed crucial testing data which is needed for public health and councils to be able to monitor what is happening in their area. There is a continued ’debate’ about the ongoing pressures on finance.
For many people, such as those who are shielded or workers who will be going back to work in pubs and restaurants, the easing of the lockdown brings opportunities, but also threats and anxiety. This week’s announcements make it even more essential that the systems underpinning the ability of local areas to effectively manage Covid-19 are fully in place as soon as possible and not in some distant timeframe.