Calls for the government to introduce extra measures to contain Covid have grown louder. At the last count these came from the NHS Federation, the British Medical Association, Macmillan Cancer, the behaviours and modelling subcommittees of the emergency science group Sage, the president of the Royal College of Emergency Medicine, the president of the Royal College of Obstetricians and Gynaecologists, regional public health directors and metropolitan mayors. Yet the government has responded by saying it sees no need for restrictions, and that it is opposed to lockdown in all forms.
What is telling here is not only the decision not to act, but the way in which the government’s framing of the issues serves to justify that decision. Covid measures are characterised as Covid restrictions or even a lockdown. Those calling for action can thereby be characterised as fanatics who want to remove our liberty while the government presents itself as defender of our freedoms, preserving “normality”.
This has been an effective strategy. After all, who wants lockdown? So if you are labelled a lockdown supporter, you have probably lost the argument. And the reason why this finger-pointing strategy has gained traction is because – probably more as a result of thoughtlessness than collusion – it is echoed by most of the media. Almost daily I am asked by journalists whether people will accept new Covid restrictions.
So in response to all those queries: if I had to list the most important new measures necessary to supplement vaccines and bring infections down, this is what they would be: to ensure adequate ventilation of all indoor public spaces, which can mitigate the effect of even mass indoor gatherings on infection spread; and to limit the number of contacts people have through measures based on protection rather than restriction – because if you double contacts, you double the number of people we are each likely to infect or be infected by. As the Immensa lab scandal showed, it’s very harmful when large numbers of infected people continue to circulate in the community.
Regarding ventilation, I would institute a system whereby all public spaces were required to indicate their “clean air” status, just as kitchens in restaurants are required to indicate their hygiene status. I would also improve the messaging so that people know how important it is and how to know when they are safe. This wouldn’t amount to a restriction. It’s a protection. It doesn’t limit choice. On the contrary, in increasing the number of spaces that are safe, it gives us more choice.
In order to limit social contacts, I would give people the choice to work from home where possible. Studies of mixing show that we had on average 11 or 12 contacts a day pre-pandemic. In the spring of this year, that went as low as three. It then crept up to four in the summer, and now stands at about five. But this isn’t because of people socialising more. It’s largely down to people mixing at work, whether they want to or not. Obviously, working from home isn’t possible for everyone. But give people the option. Once again, this is not a matter of restriction but of protection; and it increases, rather than limits, choice.
Finally, in order to increase self-isolation – without which all the money spent testing and tracing is largely squandered – I would do the obvious thing. It’s the thing that has been called for since the start of the pandemic, and which government has consistently ignored. I would provide comprehensive support for people to stay at home: adequate financial support, support with hotel accommodation for those in crowded, multi-generational households, practical support (if one has caring responsibilities for instance, or needs the dog walked), and emotional support.
The former health secretary Matt Hancock notoriously rejected such measures on the grounds that people might “game the system”; such disdain for the public has come at a huge cost. Self-evidently, here too we don’t need a restriction. These provisions would give people the choice to do what is demanded of them to stay at home.
I am certainly not suggesting that these are the only measures needed. A requirement to wear masks in crowded places would involve a mild amount of restriction: though if everyone does wear masks this would provide more choice overall, especially to vulnerable people who may not feel safe to leave home. However, masks certainly don’t constitute lockdown, and three-quarters of the public support the wearing of them.
What I would also suggest is that it’s unhelpful for the discussion of a “plan B” to focus on such measures as mask-wearing and to characterise the plan as being about restriction – or, worse, about lockdown.
What we need right now, to supplement the vaccine rollout, is a set of protections and support measures to reduce the harm inflicted by Covid and relieve pressure on the NHS. In order to make that clear, politicians and journalists need to reframe the way they talk about the pandemic. Stop asking: will the public stick to the restrictions? Instead ask: will the government protect and support the public to keep one another other safe?
The real irony is that, by conflating protection with lockdown and refusing to implement the protections necessary to bring infections down, keep people safe and relieve the pressure on the NHS, this increases the likelihood, as Sage noted this month, that more draconian measures will be needed in the future.
In the end (and as we saw last year), the true lockdown party would be the “do nothing” party.