Lockdown weak, NHS in danger, where next?

With coronavirus case numbers still growing strongly (though perhaps slowing a little according to symptom tracking) and the NHS struggling to cope with the numbers of people needing hospitalisation already, driven by the much lower case numbers of 2 or 3 weeks ago, this is clearly the most dangerous time of the whole pandemic for any of us to contract the virus; there is every chance, wherever we live, that the NHS may not be able to give us the treatment we might need.

Acceleration of the vaccine programme is of course essential and the delay to second doses to give more people the protection of a first dose is a proportionate response to a crisis of this magnitude. But it will take until mid February to vaccinate (first dose) the most vulnerable 15 million people, accounting for 88% of deaths. So we should expect a big drop in pressure on the NHS by mid March. But that is 7 weeks away. For now, growth in the virus is adding pressure faster than vaccination can relieve it.

I’m not going to repeat the point that the government has been slow to act at every point to prevent exponential growth of the virus. But where we are now, we have a much stronger virus than last March/April and a much weaker lockdown. People are moving about more, more is open, more children are at school, etc, etc.

It is self-evident, as it has been for weeks, that restrictions need to be tougher than this. Schools have (kinda) closed, which is, rightly, the “last resort”, so what else is there?

Close more?

Nurseries? Coffee shops? Estate Agents? All reasonable. There was a major problem with funding nurseries last time they were closed except for key workers. But they could be funded for a few weeks.

Schools? Some schools are reporting 50% attendance due to the expanded definitions of key workers, including, for example university lecturers working from home. Helpful to have the children in school, yes. Essential? Perhaps not in every case. We need to take transmission more seriously than last April, not less.

Beef up “covid secure” standards for workplaces and public transport?

I asked a question about this to our Director of Public Health

I think the unspoken truth here is that ‘covid secure’ was always more spin than substance. Try to do these things but a nod and a wink if you can’t, we won’t close you down. I think it is time to take transmission in the workplace seriously and close down sites that can’t or won’t operate safely. And maybe mass testing will help here.

Social mixing?

A great unfairness of the pandemic, possibly as great as the economic unfairness, has been the somewhat arbitrary imposition of complete isolation on some people while other have human contact more or less as before, based on who you live with and how you work. Support bubbles gave some welcome relief.

But even now, you can take exercise with one other person, and the next time you take exercise it can be a different person, and the time after that a different person again. Perhaps extending the support bubble idea would be better than this, i.e. limit the total number of people you mix with. And if you live in a large household or have to mix at work, that spends your mixing budget. A much fairer way of limiting social mixing without leaving some people utterly alone.

I do believe such steps will be necessary for only a few weeks while we have very high numbers and before the most vulnerable are best protected with vaccines.

And maybe there is scope to adjust the vaccination programme again. Start a parallel programme of vaccinating people by occupation, according to the occupations of patients we see in the hospitals. (Some argue specifically for teachers, police, taxi drivers, etc, but let’s follow the evidence.) This would slow down vaccination of the most vulnerable but could save lives overall. It would mean asking some elderly people to shield a bit longer.

What we can’t do is just hope this crisis goes away.

* Joe Otten was the candidate for Sheffield Heeley in June 2017 and Doncaster North in December 2019 and is a councillor in Sheffield.