Chris Whitty: keeping Covid restrictions will only delay wave

Maintaining the current Covid restrictions through the summer would only delay a wave of hospitalisations and deaths rather than reduce them, the chief medical officer for England has warned.

Prof Chris Whitty told a Downing Street briefing that while scientific opinion was mixed on when to lift the last remaining restrictions in the government’s roadmap out of lockdown, he believed that doing so in the summer had some advantages over releasing in the autumn.

“At a certain point, you move to the situation where instead of actually averting hospitalisations and deaths, you move over to just delaying them. So you’re not actually changing the number of people who will go to hospital or die, you may change when they happen,” he said.

“There is quite a strong view by many people, including myself actually, that going in the summer has some advantages, all other things being equal, to opening up into the autumn when schools are going back and when we’re heading into the winter period when the NHS tends to be under greatest pressure for many other reasons,” he added.

But he also admitted decisions were being made in a situation of uncertainty.

Whitty’s comments build on modelling from Imperial College London that revealed an apparent “sweet spot” in when to take step 4 in the government’s roadmap.

The team, led by Prof Neil Ferguson, found that delaying step four until late July could prevent thousands of deaths. But under some scenarios, deaths were actually higher if restrictions remained in place until all adults had received two shots – estimated to be in early December.

The longer delay can lead to more deaths, the scientists believe, because people emerge from lockdown at a time of year when respiratory viruses, including coronavirus, spread more easily, and people mix more indoors.

But the modelling did not take account of the proposed Covid booster programme which would offer further single shots to all over-50s from September.

Whitty conceded cases will continue to rise sharply in England if further restrictions are lifted as expected on 19 July. He referred to the “doubling times” for the number of infections – and how the hope is that the peak of this wave will come before the weather turns.

“So the question is, at what stage along this path are the doubling times getting to the point where the numbers are very high before we actually lead to a reduction because the peak of the epidemic happens?

“And what the modelling would imply is that we will reach that peak before we get to the point where we have the kind of pressures we saw in January, for example, of this year. But, inevitably, with all models you have to say there is some degree of uncertainty.”

Sage documents released on Monday warn that it is important to take steps to keep prevalence low.

“There is significant risk in allowing prevalence to rise, even if hospitalisations and deaths are kept low by vaccination,” the Sage document states. If a more pathogenic variant emerges when case numbers are high and have to be brought down “then restrictive measures would be required for much longer”, it adds.

The same document warns that lifting restrictions may create the conditions for “super-spreader events” and emphasises that beyond test, trace and isolation, the spread of disease can be reduced by more Covid-secure workplaces, better ventilation, Perspex screens, and urging people to stay at home when they are sick.

Calum Semple, professor of child health and outbreak medicine at the University of Liverpool, and a member of the Sage committee of experts, said there are many measures people can take to reduce the risk of spreading the virus once restrictions have been lifted.

“If we’ve come through 18 months of Covid and people are still not persuaded to change their behaviour, they are probably a group that are in denial for their own reasons and it may be very hard to modify their behaviour. It’ll be for the silent and sensible majority to take the lead,” he said.

“If you can work from home, I don’t know why employers shouldn’t encourage it, and I’d have no prob[lem] if a particular organisation said they’d like you to wear a face covering in their establishment. We should respect that and they should have the right to turn you away,” he added.

Catherine Noakes, professor of environmental engineering for buildings at the University of Leeds, also a member of Sage, said: “One of the main benefits from wearing a face-covering is that if you are infected it substantially reduces the amount of virus that is emitted into an environment, and therefore wearing a face-covering protects other people. I think this is a really important consideration for moving to a position of ‘personal responsibility’ – we need to consider the risks to others when making our own personal decisions around appropriate actions.”