BMA sets out COVID-19 lockdown exit strategy

by Peter Blackburn

The BMA has launched a ‘blueprint’ for leaving lockdown which could save lives and prevent the collapse of healthcare services this winter.

Location: UK
Published: Wednesday 18 November 2020
Chaand Nagpaul

A report by the BMA warns that lifting lockdown without new measures in place would risk deepening the crisis in our health service and will leave hospitals and GP practices overwhelmed – unable to provide even the most critical of patient care.

The report, Exiting the lockdown – a strategy for sustainably controlling the transmission of COVID-19 in England, outlines major reforms for England, once lockdown is lifted, to keep infection rates low and pull back the NHS from collapse this winter.

The BMA is calling for the new measures – which are intended to bridge the time between the planned end of lockdown in England, on 2 December, and an effective vaccine programme getting under way – to be rapidly brought in. Doctors fear that, without these reforms, the toll on patient care and lives will be severe.

Plan of attack

BMA council chair Chaand Nagpaul (pictured above) said: ‘We must not squander the efforts of the many people who have followed the law, stayed at home, sacrificed freedoms and incurred financial loss in order to contain the virus.

'When the first lockdown ended, there was no coherent plan for keeping COVID-19 at bay, no clear and simple public messaging; this was followed by spiralling infection rates, more businesses failing, new ‘local’ lockdowns, and now we have a death toll at more than 52,000.’

Dr Nagpaul added: ‘As England prepares to exit its second lockdown, it is unthinkable that we make the same mistakes again because this time, the impact will be far worse. It’s reasonable to conclude, that without these measures, the NHS will not be able to cope with caring for even the most critically ill patients.

‘This report demonstrates a sustainable plan for reducing the level of infections from COVID-19 until a vaccine programme is under way.’

Phased approach

In the report, the association details the steps required to control COVID-19 in a three-phased approach.

In phase one – before lockdown ends – the BMA wants to see widescale reform to the testing and contact tracing programme. For example, a far greater proportion of the national budget for track and trace needs to be given to local public health teams so they’re able to provide more effective tracing and testing, led by public health in local authorities and Public Health England health protection teams.

And in phase two – once England exits lockdown – doctors want to see far more effective and robust national measures up and running to reduce infection rates and keep the virus at bay.

The BMA has said the Government must learn from the first lockdown, where rapid relaxation of infection control policies, inadequate monitoring, and encouragement to socially mix in restaurants and bars, and to return to work, resulted in a surge of virus spread, leaving us unprepared to face autumn and winter.

Rule of two

To prevent another surge in infections and the collapse of health and social care services, the BMA wants to see a number of measures in phase two, including:

  • Replacing the ‘rule of six’ which allowed mixing of up to six households with a ‘two households’ rule to reduce social mixing
  • No travel between or across different local lockdown Tiers
  • Publication of rules rather than guidance for the creation of COVID-19 secure environments in public settings, hospitality and workplaces and for the rules to be enforced
  • No return to encouraging people to ‘go back to the office’ when it’s possible to work from home
  • Practical changes to the NHS COVID-19 app so it provides infection information at a local level and guidance in a simple ‘airline safety’ style
  • Targeted support for clinically extremely vulnerable individuals and for communities that have been hit hardest by the pandemic (including BAME communities).

The third phase covers the widespread uptake of a safe and effective vaccine, which doctors leaders say is the best way of tackling COVID-19, protecting vulnerable people and easing economic and societal restrictions.

The report says this needs to be properly planned and resourced and the Government must use the current lockdown as the time to do this.

Find out more about the report