November 23, 2020

expert reaction to the Government’s COVID-19 Winter Plan

The government have released a COVID-19 Winter Plan.

Dr Julian Tang, Honorary Associate Professor/ Clinical Virologist, Respiratory Sciences, University of Leicester, said:

“We’ve been here before – after the first lockdown and the release followed by a summer of eating out to help out, travel with some national and international holidays, etc. 

“It took a bit longer back then because it had been more suppressed, but the virus soon came back, starting slowly in mid-August then more explosively during Sep-Oct – with a second, larger wave (only partly due to more testing) not just in the UK but across Europe also.

This time it is different. There really is more virus around which has seeded the population more widely, despite the various restrictive tiers going into a second national lockdown. So as we emerge again it will be into more restrictive tiers, rather than into the freedom we experienced over the summer. 

“This is partly to keep the virus sufficiently suppressed to allow some relaxation for a few days around Christmas (which is sorely needed), but inevitably, as a result of this enhanced mixing, there is likely to be a surge of new cases in the New Year.

“The virus spreads just through people talking to each other and sharing the same air – if no masks are worn (which they won’t be). If families are staying together in the same house for 5-6 days, in the absence of any natural immunity, they will likely cross-infect each other.

“But there is a new kid on the block. If a new COVID19 vaccine roll-out can occur quickly (whilst maintaining existing restrictions), smoothly across the country during Dec-Jan-Feb with no unexpected issues, after 2-4 weeks (to allow the immune response to develop) this could then act as a national firebreak – suddenly reducing the numbers of susceptible hosts for the virus to infect. 

“The numbers of new cases will gradually start to level off then fall. If the vaccination continues, these numbers will start to decrease more quickly, though due to various factors (vaccine refusal, non-responders, adverse effects, supply/availability, etc), the virus will not be fully suppressed – though natural immunity may help to further control the virus.

“Throughout this period over the next few months, we really need to maintain the various restrictions to  keep the virus well-suppressed, to enhance the protective impact of any COVID19 vaccine on the vulnerable groups – as we don’t want the virus to reach them before they can be vaccinated.

“This is a race – not between the vaccine manufacturers – but between the vaccine and the virus, to reach those who are most vulnerable to COVID19 first.”

Dr Simon Clarke, Associate Professor of Cellular Microbiology at the University of Reading, said:

“In the absence of proper scientific explanations of why different restrictions are put in place, it’s difficult to estimate how much effect they will have.  There is evidence from the United States that bars are places where transmission occurs and infection in domestic settings has been long established.  The advice to work from home is a tacit admission that previous attempts to encourage people back to workplaces was misguided.  Similarly, there appears to be recognition that some areas were not moved up through the tiers in a timely manner; it is to be hoped that lobbying against professional public health advice will not be heeded to the extent it was previously.

“In the run up to Christmas, retail will be open come what may, but it must be recognised that this could afford the virus an opportunity to spread rapidly. We may have to pay a further cost in 2021, not only in terms of restrictions but also illness, hospitalisations and deaths.

“Worryingly, some Tier 3 regulations are vague or contradictory.  For instance, group exercise and sports ‘should not take place’, which suggests a choice and lack of compulsion.  There is to be ‘no mixing’ with people outside of your household or support bubble, indoors or outside, but overnight stays with such people are only ‘advise[d] against’.  There will always be some people looking for opportunities to play the system – it appears that the government has not taken care to close loopholes which seem certain to be exploited.”

Prof Liam Smeeth, Professor of Clinical Epidemiology, and Dean of the Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, said:

“It is increasingly clear that the stricter measures implemented in recent weeks, especially tier 3 and the circuit breakers in Wales and England, are having an impact. Infections were rising rapidly – and everything we know, including direct experience from the first wave – tells us that infections would have carried on rising and would still be rising now. The collective actions of society have quite literally re-shaped the pandemic. Working together we have been able to control this virus. Obviously the terrible economic and social impacts, and the ongoing health impacts, mean there is little impetus to celebrate. But this should not detract from just what an amazing achievement controlling viral spread has been.

“A road-map towards a much better time for the UK is becoming clear. A period of tiered measures in December is warranted now in order to allow some social mixing at Christmas. A further circuit breaker in January or possibly February may well be needed because Christmas will place huge upward pressure on transmission rates. But, it is realistic to hope that by March or April the vast majority of older people, care home residents, and those with severe conditions will have been immunised. We can then work towards wider immunisation – with ideally most or all of the population covered in time for next winter. Life won’t ever be the same as it was before Covid-19, but within a few months it will feel a whole lot better than now.”

Prof Sheila Bird, Formerly Programme Leader, MRC Biostatistics Unit, University of Cambridge, said:

“I hope that the Prime Minister will publish the in-context evidence on which he relies when claiming, as the second of two scientific breakthroughs (after vaccines), the use of lateral flow testing to identify asymptomatic cases.

“Furthermore, the Prime Minister mentioned that the Liverpool the testing trial has contributed to a decrease in cases. Will the Prime Minister therefore please publish the study-protocol for the Liverpool testing trial – as the scientific standard should be OPEN PROTOCOL. Furthermore, the evidence on which the Prime Minister relies in citing that the testing trial has contributed to a decrease in cases is clearly important and should also be in the public domain.”

https://www.gov.uk/government/publications/covid-19-winter-plan

All our previous output on this subject can be seen at this weblink:

www.sciencemediacentre.org/tag/covid-19

Declared interests

Prof Sheila Bird: SMB is a member of the Royal Statistical Society’s COVID-19 Taskforce and, more than 15 years ago, chaired the RSS’s working party on Performance Monitoring in the Public Services which commended the drafting of study-protocols.

None others received.