We need clarity, coherence and decisive action to prevent a second spike

by Chaand Nagpaul

The Government must promote COVID-19-safe lifestyle in a bid to negate a second wave

Location: UK
Published: Thursday 13 August 2020
chair of bma council chaand nagpaul

As the UK basks in a heatwave, millions of people have sought to take advantage of the restrictions of lockdown and resume many everyday activities of normal living such as meeting socially, gathering at parks and beaches and visiting pubs and restaurants.

This apparent return to normality belies the deeply worrying fact that infection rates in the UK have been significantly rising, with latest ONS data suggesting 3,700 new cases daily - more than double compared with that of the week of 6 to 12 July.

Increasing numbers of local lockdowns should further serve as warnings that the virus is ready to resurface with little notice.

The truth is that the coronavirus is just as contagious today as it was at the onset of the pandemic, and COVID’s capacity to spread exponentially is just as real now as it was then.

A second spike would overwhelm an NHS already contending with a backlog of millions of non-COVID patients left untreated during the first peak, coupled with forthcoming winter pressures as well as the possibility of a seasonal flu outbreak.

It would inflict further misery and mortality upon a nation that has already suffered the second highest death rate in the world.

It is therefore vital that the government takes decisive action to suppress the virus within the narrow window of summer and does everything in its power to avoid a nightmare winter for the country and the NHS.

Unfortunately, the current public guidance and messaging of the Westminster government has led to confusion and complacency and a lack of adherence to infection control measures.

A prime example would be the decision to reduce the level of safe social distancing in England from an unambiguous two metres to the rather nebulous definition of 'one metre plus'. There has been no clear explanation and hence there is a lack of public understanding about what the “plus” means.

The 'help out to eat out' campaign has seen large numbers of the public once again enjoying dining out, yet there has been little clarity on how restaurants can ensure that customers from different households can be physically distanced across a table.

Further, an undercover investigation by Sky News published this week revealed that nine out of 10 of the bars visited by reporters in Greater Manchester were not requesting customers’ contact details for track and trace purposes and with social distancing rules being flouted.

This can and will result in spread of the virus with several infection outbreaks in pubs and bars already reported nationally.

The government needs to explicitly outline what constitutes a 'Covid secure' environment and support business owners to take proactive steps to prevent the spread of the virus – such as installing screens and adaptations to enable physical distancing between members of the public and staff.

The public have further received inconsistent and fickle messages on the use of face coverings. After originally stating there was no evidence supporting the wearing of masks by the public – at a time when most nations had already begun advocating their use – ministers took until June to require the use of face coverings, but only on public transport.

In July, the mandatory wearing of face coverings was extended to shops, but the government told the public that the same rules didn’t apply in cinemas or museums. By the end of that month, they had changed their minds again and mandated the use of masks in those settings.

There is still no universal requirement for face coverings to be worn in offices or by staff in shops, with the government declaring that it is up to employers to determine whether they should be used ‘on a case by case basis’.

The virus is just as infectious in a train carriage, supermarket aisle or at work. With employees beginning to return to offices in greater numbers, there needs to be a single unequivocal rule that face coverings should be worn by all in any public setting or workplace where people cannot socially distance by two metres and where other mitigations such as screens are not in place.

The government should also make it as easy as possible for the public to adhere to its Covid-prevention rules.  

For example, face coverings could be made readily available at the entrance of public transport services, shops and other public areas for those who may have omitted to bring their own.

With disposable surgical masks now in abundance at a unit cost of as low as 15p, there is no reason why these could not be provided to members of the public arriving without one – either for free or for a token charge comparable to that for carrier bags. Surely this would be preferable to denying customers from entering a shop, or worse as is the case currently, that shoppers without masks mix with others in narrow aisles and risk of spread of infection.

The rules around people meeting those from different households continue to change and have not been communicated clearly and consistently. When local lockdowns were announced across Greater Manchester, east Lancashire and parts of West Yorkshire at the end of July, it made no sense to locals that families from different households were banned from meeting in a back garden, whilst it was perfectly acceptable for the same families to meet in an enclosed environment like a pub. Early signs suggest they therefore simply stopped following them.

The public rightly deserve to know when infection is rising in their local areas. Residents in Leicester were totally taken by surprise after a decision to impose a local lockdown was made. There can be little doubt that the local population would have been in a stronger position to modify their lifestyles and protect themselves and others had they been informed of an increasing trend.

Although it is possible to assess infection rates through postcode searches, the BMA has called for this data to be made far more readily accessible, in much the same way as weather forecasts or traffic bulletins.

The Government’s goal must be to dramatically suppress – even strive to eliminate – the virus rather than merely to implement lockdowns once an infection threshold has been crossed.

After three months of staying at home, it is understandable that the public want to return to a semblance of normality.

However, it is clear that we cannot simply resume our pre-pandemic lifestyles, and all of us need to adjust to a new norm of safe interactions with each other.

This requires that the government must be unambiguous in its messaging and set out what constitutes a Covid-safe lifestyle. Ministers must robustly put in place public health measures to prevent the virus’s spread and communicate them visibly, coherently and in easily understood terms – not relying on the public accessing information outlined only in the small print of government websites.

A failure to do so would risk tragically squandering the many sacrifices that the British people have already had to make, and severely jeopardise the recovery of a nation that has already endured so much.

Chaand Nagpaul is BMA council chair