Chair's focus - easing lockdown plans require decisive action to protect lives

by Dr Chaand Nagpaul

BMA council chair Chaand Nagpaul speaks about the relaxation of lockdown measures.

Location: UK
Last reviewed: 2 July 2020
Portrait of BMA chair Chaand Nagpaul

The pandemic has disrupted day-to-day life in this country like no other event in recent history.

The virus has been deadly. In the UK alone it has so far claimed the lives of 43,906 people and included among these are the deaths of 35 doctors – 33 of whom were from BAME backgrounds.

It has also exposed race and wider inequalities in society, posed enormous challenges to the economy and people’s livelihoods, to children’s education and, of course, the NHS.

On a human level COVID-19 has placed considerable strain on people’s personal lives, relationships and, by extension, their mental and emotional wellbeing.

Without question, the sacrifices made by millions of ordinary people through many weeks of self-isolation and social distancing have been vital to efforts to limit the virus’s spread, and it is perfectly natural and understandable that the public desire as swift a return as possible to ‘normality’.

But the relaxation of lockdown measures cannot be allowed to jeopardise all the previous efforts to curb the spread of COVID. Ministers must take steps to ensure that appropriate mitigations are in place and that the public understand how to conduct themselves safely in public spaces, at work and when interacting with others, or else run the risk of provoking a second spike in infections.

Unfortunately, the Westminster government has taken a cavalier approach to delivering the next stage of its lockdown easing plan, which will see the re-opening of venues such as pubs, restaurants, hotels and hair salons from 4 July.

Levels of viral transmission in England remain significant with data published by the ONS showing an estimated 22,000 new cases each week and 51,000 people nationally believed to be carrying the virus at any one time.

The government’s approach to lifting lock-down appears all the more questionable when compared to the rates at which other European countries began to re-open their societies.

While the UK had 829 confirmed cases on 1 July, France, which re-opened bars and restaurants on 2 June did so while having a daily infection rate of 338.

Germany which also reopened bars and restaurants on the same date and, like France, subject to strict hygiene and distancing rules, had at that time a daily rate of just 213 infections.

At the same time the majority of towns and cities are preparing to ease restrictions, Leicester has become the first place in England to be placed in individual lock-down due to a recent spike in the number of infections there.

The case of Leicester should by no means be regarded as anomaly and highlights how virulent COVID remains and how this pandemic is far from over.

The measures imposed in Leicester, while necessary, have seen health leaders and local government officials warn that they have not be provided with adequate timely information of individual cases and contacts, allowing them to act swiftly to stop the spread of the virus in its tracks.

Especially given that the government’s ‘world beating’ app hasn’t materialised, this will of course require an agile test and trace system with proper public health capacity. We are also calling for the Government to set clearly defined metrics of triggers around infection rates at local and national levels so a consistent, objective and decisive approach can be taken swiftly to protect communities and prevent a second spike.

The BMA has also asked for a guarantee that areas facing surges in the virus be ensured adequate supplies of PPE and that local health providers be given the ability to reprioritise care services in the event of a new wave in infections.

These commitments are all the more critical given the current state of confidence held by doctors battling the pandemic.

In the latest BMA COVID-19 tracker survey, 61 per cent of surveyed doctors said that they were either not at all or not very confident in their ability to manage patient demand as normal NHS services are resumed

When asked as about their confidence in handling a second spike in the virus, 49 per cent expressed the same lack of confidence.

Unfortunately, a lack of clarity from the Government on a whole range of issues relating to COVID has hamstrung efforts to get a firmer grip on the outbreak.

A case in point would be the decision to reduce the two-metre requirement of social distancing to the rather subjective metric of ‘one metre plus’ whilst providing no clarity about what the “plus” refers to, creating a risk of the public letting down its guard on the need for effective social distancing.

Given the virus remains as infectious in a hair salon or a supermarket as on a bus, it is utterly illogical for the Westminster government to only mandate the wearing of masks on public transport and not in all indoor public areas – something that the BMA has been urging for weeks.

Boris Johnson is desperate to appear as the leader of a country that has returned to ‘normal’, urging people to shop, socialise and even go on holiday, yet his government has produced no clear guidelines on how people can go about this safely.

By contrast, Scottish first minister Nicola Sturgeon has today announced that the wearing of face masks will become mandatory in shops from July 10, while maintaining the two-metre social distancing rule.

The BMA has also sought to provide clarity by publishing our own guidance: Tourism in the time of COVID, which explains when and how people can take a vacation safely.

I wrote to the health secretary Matt Hancock emphasising that it is of paramount importance that his government provide clear and unambiguous guidance to both members of the public and health professionals.

Because while advice has often been uncertain, I advised Mr Hancock that there is no doubt whatsoever as to the devastating and overwhelming consequences a second national wave of the pandemic would have on our NHS, particularly if it were to come during the flu-season of the winter months.

The national battle against the pandemic is now at a crucial juncture.

The decisions that policymakers take now will have a significant bearing on how the struggle against COVID plays out over the second half of this year, and it is perhaps more essential than ever that the voices of the NHS and of the medical profession and our public health experts is listened to and heeded.