Education, support and consent are the way to health...not coercion

In an open letter last week, more than 20 scientists said all lockdown rules should end on June 21. Professor Jackie Cassell of Brighton and Sussex Medical School explains why she signed

A GOOD vaccine allows us to forget the illness it protects us against, nearly all of the time.

When were you last asked to prove your measles or diphtheria vaccination status? Exactly. Can we get there with Covid-19?

Last week I signed a letter to this newspaper, widely criticised for its content and signatories.we advocated an end to legal restrictions on June 21 and of masking in schools from May 17.

We called on government to abandon plans for vaccine or immunity certification and to provide better financial and practical support for people affected by Covid.

The co-signatories come from both political extremes and centre ground, and from multiple health, biological and social sciences. Not all are personally known to each other – some had long “blocked” me on Twitter!

My own background is in public health, as a doctor and academic working on control of infection in various settings.

The UK is lucky to have a world-leading vaccination programme, building on NHS infrastructure and using vaccines of astonishing effectiveness.this means we can see long-absent family and friends.

The programme has also taken us into a new decision space, where it is even less clear what “following the science” means.

There is no ready-made scientific tool for trading off well-evidenced harms of social distancing against reduced Covid transmission and I suspect there never will be.

This is ultimately a matter of value judgments and “risk appetite”, complicated by the variability of transmission.

Social distancing harms fall disproportionately on children and young people growing their language, social and emotional capacities, people living with communication, cognitive or mental health challenges, poorer people in cramped accommodation with limited access to safe and comfortable outdoor spaces and care home residents.

As vaccination marches on, we will see smaller outbreaks, surge testing for new variants of concern and perhaps booster vaccines.

The burden of residual Covid-19 will increasingly fall on people less well off, who often and reasonably mistrust authorities.

“Ring vaccination” will in future be a common response to cases. Local public health teams led by Public Health England will continue to do patient and supportive “shoe leather epidemiology”.

A legal framework of criminalisation and coercion is unlikely to help them in their work. It is time to end criminalisation and go back to the old ways of doing public health – information, support and consent.

These have given us childhood vaccine coverage amongst the highest in the world and the high levels of trust we now see in the vaccine rollout. At this point in what is clearly a transformational vaccine rollout, it is time to move on from the emergency response mode that has shaped our lives since early 2020.

This includes returning to public health by education, support and consent, which has served us so well in the past.

ONE VOICE: Last

week’s letter