The BMA says the Government’s measures to reduce the spread of the Covid-19 infection are not working and that clearer additional measures are needed to avoid communities suffering the paralysing and economic impact of local lockdowns.
The Association warns the public is in danger of losing faith in existing measures – demonstrated by infection rates spiralling out of control because at times the messaging has been inconsistent.
In July, new cases of the infection were as low as 500 per day. The BMA believes more robust, decisive and clear to follow rules alongside the introduction of a new three-tiered approach, could boost public confidence and lead to the rates reducing once again.
With the UK government considering a three-tier lockdown approach for England, the BMA has put forward a series of recommendations which, if implemented without delay, could reduce the level of infection as well as supporting businesses and those who are in vulnerable groups.
The recommendations include:
• Modify the current ‘Rule of 6’ with the rule that only two (exclusive) households can meet (and those should not exceed 6 people) – ideally outdoors, rather than indoors.
• Making the wearing of face masks mandatory in all offices and working environments, unless you are working alone.
• Wear masks in all outdoor settings where two metre distancing isn’t possible
• Provide financial support to businesses, retail and hospitality settings to enable them to make premises Covid secure and provide clear rules on what ‘Covid secure’ means.
• Provide medical grade masks, free of charge, to those who are over 60 or in a vulnerable group, as recommended by the WHO
• Provide masks free of charge to those who are exempt from prescription charges and also at the entrance of all public settings if a person has not brought one (nominal charge)
• Add more functionality to the NHS Test and Trace app to give people more detailed information on infection rates in their area including actual figures of rates of infection and trends
The BMA believes these additional measures pose a very low risk to the economy in the immediate term and could be crucial to providing people with the confidence they need to go out safely and boost the economy.
Putting the right safeguards in place now will minimise the risk of further lockdowns and significant disruption to business and economic activity down the line.
These measures are all the more important given that the Test and Trace programme is still not yet fully functional and is not able to identify all those with the infection and their contacts.
The BMA is also hugely concerned that, without new stringent measures, rapidly introduced, the NHS and its workforce, will very quickly be overwhelmed and the consequences for staff and patients alike will be disastrous.
The BMA Chair of Council, Dr Chaand Nagpaul, said: “Simple effective rules and tighter restrictions are urgently needed to avoid communities suffering the paralysing impact of full local lockdowns and the impact that uncontrolled infections will have on our NHS.
“With admissions to hospitals for Covid climbing rapidly in parts of England, there is an opportunity for the Westminster Government to bring in simple stronger restrictions alongside the introduction of its much trailed three-tiered approach.
“The Government has a duty to regain the public’s confidence and faith in measures being taken to get the spread of the virus back under control. It must also provide the financial support businesses need to enable them to make premises and settings Covid secure while providing clear rules on what ‘Covid secure’ means.
“We know that with the right public behaviour and renewed public confidence, the infection can be brought under control, given that we had less than 500 new cases a day in mid-July.
“The infection has risen following rapid relaxation of measures and with the Westminster Government letting down its guard – as recently as August, the Government was encouraging people to travel, go to work and mix in restaurants and pubs. There was inconsistency in where and when to wear a face masks and how and when to mix socially.
“We have drawn on a range of expertise from within the BMA to publish a set of recommendations which we feel, if introduced very quickly, could have a positive effect.
“We are having to swallow a very bitter pill of the infection continuing to spread at a perilous rate. Stronger measures brought in now could be a far sweeter pill in the long run for far more people.”
Notes to editors
The full list of recommendations is:
• Greater support to improve adherence to self-isolation
Recent research suggests that a low proportion of people in the UK are fully adhering to rules on self-isolation. Alongside the government’s current enforcement regime, more support is required for businesses and individuals to ensure that staff who need to isolate are not disincentivised financially from doing so. The government’s current support package while welcome, is likely to be insufficient and is not available to all.
• Further restrictions in social mixing between households
The current rule of six should be amended so that only two households can meet (while not exceeding six people) and this should be on an exclusive basis to limit contact across several households.
There is clear evidence (including from PHE surveillance reports) that mixing within private households indoors is a significant factor driving spread of the virus. Steps should be taken to encourage any mixing to take place outdoors where possible. We recognise the significant impact that such measures may have on social isolation. It is important therefore that people are able to continue to form exclusive support bubbles and that formal and informal caring arrangements can continue.
• Much clearer and more consistent guidance to the public
The BMA supports the introduction of a tiered or ‘traffic lights’ system. People have been left confused by the patchwork of local restrictions that have been introduced in different parts of England. To support adherence to local measures it is important that this system is applied consistently. The BMA has been calling for the introduction of metric ‘trigger points’ at which restrictions would consistently be applied across local areas since July.
The public should be provided with the information they need to understand how the rate of infection is changing in their local areas and make informed decisions – making this as easy to look up as the weather or pollen count. The Covid app should evolve to reflect this – with more granular level detail, including on the levels of infection not just in your home postcode, but also the area you are currently in and neighbouring areas.
• Support to improve the implementation of infection control measures
More support is required to allow businesses (including in hospitality) and employers to put physical infection control measures in place – including financial support for retrofitting screens and signage.
• Support to ensure more widespread mask wearing
We recognise the steps that government has already taken to increase the wearing of masks in different settings. Given the increased risks of transmission in indoor settings, the mandatory use of face masks must now be extended to people working in offices and other workplaces, whenever they are not working alone in a room.
To support adherence to mask wearing steps should be taken to supply masks to those on low incomes (eg those with children eligible for free school meals, on benefits or eligible for free prescriptions).
• There should also be clearer messaging to the public on how to wear masks appropriately
In line with WHO guidance steps should be taken to ensure medical grade masks (fluid resistant surgical face masks) are available to vulnerable people (aged 60 and over and those with comorbidities).
The BMA is a trade union and professional association representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.