Almost a year ago to the day, the clamor started for another lockdown as Covid cases began to accelerate after a summer of relative calm. The reason given was to ‘protect the NHS’, exactly what we are hearing again as autumn progresses and seasonal respiratory illnesses become more prevalent.
This time around, pressure is on the government to trigger its so-called Plan B, described by Boris Johnson last month as a fallback position if the virus escalates. We said then that far from being a last resort, it is strangely like the policy to be followed during the winter months. This would imply, among other things, a renewed requirement for people to work from home if they can, mandatory masks, and restrictions on certain indoor gatherings.
In order to avoid recourse to Plan B, Mr Johnson said it would be necessary to rely heavily on immunizing children and offering booster shots to those over 50 to remove the worst impacts of Covid when ‘it will spread faster, as it will. Yet neither of these two things happens with sufficient urgency. The stimulus package in particular seems sluggish which, given that it was critical to the government’s ability to stick to Plan A, is serious business. What is the cause? As Sajid Javid, the Secretary of Health, said at a press conference last night, the jabs are available but the turnout is lower than expected.
All over 50 are eligible for a booster six months after their second dose and yet many say they have not been contacted. This was previously done by general practitioners, but is now a central responsibility of the NHS. Is there a bureaucratic heist and, if so, is it being resolved? Stephen Powis, national medical director for NHS England, appeared to suggest that anyone who is eligible who has not yet been contacted can book online, but they are not.
These are critical questions given the potential consequences of any waning immunity from the first doses of vaccine. Cases are increasing rapidly but this should not be a problem as long as they do not develop into serious illnesses requiring hospitalization.
But the flu is expected to be more virulent this year, with some clinicians predicting as many as 60,000 deaths. Inevitably, this means a lot of people are hospitalized and in the past years of bad flu brought the NHS to the brink of collapse. The prospect of a peak in Covid coinciding with higher than usual flu levels is ringing alarm bells among health care planners.
Just to add to the renewed sense of dread, a new, more contagious offshoot of the Delta variant has been identified behind the recent rapid increase in the number of cases. The proportion of cases constituted by the sub-strain doubled in one month.
Matthew Taylor, chief executive of the NHS Confederation – an organization that represents the NHS trusts – said preparations were underway for “the most difficult winter on record” and predicted a crisis without urgent action. Ministers are adamant that whatever happens, there will be no repeat of the severe lockdowns where people are urged to stay at home and prohibited from socializing. But they said that last year, and after a confusing period involving multi-tiered measures in different parts of the country, a nationwide shutdown was imposed, with schools closed, homework reinstated and family reunions banned. even at Christmas.
Mr Javid has said no one wants to go back after the gains of the past few weeks and he is right about that. But it is up to the government to ensure that the NHS is able to withstand winter respiratory illnesses and yet it is its apparent inability to do so where the real difficulty lies.
Emergency powers given to ministers to order a lockdown remain in the Statute and were renewed by Parliament this week for an additional six months without a vote. If there is no intention to use them, why keep them? Moreover, no one will say what the precise benchmarks are to trigger Plan B, or C for that matter, other than the pressure on the NHS becoming ‘unsustainable’.
These capacity issues should have been addressed. Everyone had known for months what was coming. As MP Steve Baker said, our freedoms cannot become an annual tool for managing the capacity of the NHS. Locking in, or even measures just short of one, should not become the default response when other mitigation measures are considered too difficult.