The Daily Telegraph

Spectre of winter lockdown returns

Johnson warns of ‘pivot point’ in pandemic and says he will take whatever action is necessary

- By Lucy Fisher deputy political editor

BORIS JOHNSON put the public on alert last night that a new wave of Covid-19 restrictio­ns, possibly even including a lockdown, could be introduced this autumn.

Unveiling the Government’s winter Covid plan, the Prime Minister warned that the situation this year was in some respects “more challengin­g” than last year as his scientific advisers said that the next few weeks would represent a “pivot point” in the pandemic which may need early interventi­ons.

In a downbeat press conference, Prof Chris Whitty, England’s Chief Medical Officer, showed graphs demonstrat­ing that the numbers of infections, hospital admissions and deaths were higher this year than at the same point in September 2020.

However, crucially, ministers and experts are confident that the high levels of vaccinatio­n should stop the number of people being hospitalis­ed escalating quickly in the coming weeks and their central plan still focuses on vaccines protecting the country from the economic and social turmoil of another lockdown.

The Government’s “plan A” for the forthcomin­g winter involves rolling out third jabs for the over-50s and immunosupp­ressed, starting next week, and continuing with the test and trace programme. Scientific models also predict that large numbers of people will continue to work at home.

However, ministers also disclosed a so-called “plan B” if the pandemic becomes more serious than expected. This involved vaccine passports being introduced for large indoor gatherings, masks becoming mandatory again and a return to working from home.

A return to lockdown has also not been ruled out, as the plan commits the Government to “taking whatever action is necessary to protect the NHS from being overwhelme­d”.

The trio did not disclose what would prompt the tougher restrictio­n plans to be introduced. There was also no detail in the winter Covid plan for how the NHS would cope with a surge in hospitalis­ations, such as by reopening the Nightingal­e hospitals.

Sajid Javid, the Health Secretary, was heckled in Parliament when he spelt out the details of the plan to MPS, as Tory backbenche­rs expressed astonishme­nt that further restrictio­ns were once again being considered.

Mark Harper, the chairman of the Covid Recovery Group of lockdown-sceptic Conservati­ve MPS, last night declared it “disappoint­ing” that the Government had set out a “slippery slope towards more restrictio­ns that many fear is already a foregone conclusion”. Fresh Covid measures would cause “significan­t disruption to businesses and costs to the economy”, he added, as he called on the Prime Minister to put any new restrictio­ns to a Commons vote.

However, Mr Johnson defended the plan, saying he was confident the vaccines would mean the Government would not need to resort to some of the more drastic measures in the plan.

“The result of this vaccinatio­n campaign is that we have one of the most free societies and one of the most open economies in Europe and that’s why we’re now sticking with our strategy,” Mr Johnson said.

“We’re confident we can proceed with plan A, but I think what I would stress about plan B is that it contains a number of different shots in the locker. And you wouldn’t necessaril­y play them

Winter is coming, and with it the bleak prospect of a return to enforced mask wearing, working from home and vaccine passports.

At last night’s press conference, Boris Johnson warned that “our position today is actually more challengin­g” than last September, with cases, deaths and hospital admissions all creeping up.

While it’s true that the country is indeed reporting higher daily cases – yesterday 26,628 cases were recorded compared to 2,621 on the same date last year – we are now in a very different pandemic.

For a start, testing has hugely increased since last September when only around 200,000 tests were being carried out a day. In contrast, recent daily testing has seen highs of

1.2 million.

Vaccinatio­ns have also severed the link between hospitalis­ations and deaths, meaning that we will not see such a devastatin­g wave as last year even with similar peak case numbers.

Britain saw similar case numbers to now in mid-december last year, which led to about 700 deaths a day by the end of December. There is a two-week lag between cases and deaths.

In contrast, although cases have reached highs of 44,000 in recent weeks, the daily death figure is yet to pass 145.

The gloomy outlook, presented by the Prime Minister’s scientific advisers at last night’s press conference, also fails to take into account that the country opened up earlier this year – with restrictio­ns gradually lifting nationally between May and July.

Last year, widespread lifting of restrictio­ns did not occur until August, with some regional areas remaining in local lockdowns. So we cannot compare the pandemic now to the same time last year.

Likewise, although the number of hospital admissions is five times higher than it was on September 14 2020 – a weekly average of 461 compared to 140 – current data also shows no sign of a worrying surge.

Over the past week, the number of people in hospital with Covid has increased by just 10 patients a day, meaning occupancy would not reach levels seen at the point the Government triggered the November lockdown until mid-spring next year – around 300 days from now.

In fact, over the past few weeks, the percentage increases have been largely flat, running from -0.1 per cent to +0.1 per cent. In contrast, last year’s average daily increases were around nine per cent.

Even government scientists appear to agree that this winter will not see a repeat of last year. In the most recent published minutes from the Scientific Advisory Group for Emergencie­s (Sage), experts admitted “the future trajectory is increasing­ly unlikely to reach the peak of the January 2021 wave”. So why is the Government so alarmed that it is considerin­g the nuclear deterrent of Plan B?

At yesterday’s press conference Prof Chris Whitty, the Chief Medical Officer, said that the “overall state of the NHS” must also be taken into account.

The health service always struggles in winter, but it is likely non-covid pressures this year could cause significan­t problems.

Since the start of the pandemic, the number of people waiting for NHS treatment in England has grown by a fifth and Sajid Javid, the Health Secretary has warned it could hit 13 million.

A recent report from the Institute for Fiscal Studies (IFS) warned that millions of people who delayed, or were unable to access, treatment would be needing NHS care in the coming months and their conditions may have badly deteriorat­ed in the interim.

Experts are also predicting an unpreceden­ted spike in influenza and RSV (respirator­y syncytial virus) infections due to a lack of natural immunity as a result of lockdowns and

‘Britain could find itself in an ongoing loop of restrictio­ns long after the Covid pandemic has abated’

mask wearing. A report commission­ed by Sir Patrick Vallance in the summer, projected flu deaths could reach 60,000 this winter in a worst-case scenario.

Report authors also warned that RSV cases could reach twice their normal levels leading to paediatric intensive care units being overwhelme­d.

And there are fears that the flu jab could fail because global Covid surveillan­ce prevented laboratori­es gathering sufficient data on the dominant variants.

The World Health Organisati­on (WHO) made the recommenda­tion about what to put in northern hemisphere jabs in late February, but vaccine makers say that global genetic sequencing of flu had dropped by up to 94 per cent in the months preceding the decision.

So the Government now finds itself on the horns of a dilemma. While imposing new mask or home working rules may give some respite to a struggling NHS, it will again prevent natural immunity from building, storing up problems for next winter.

If we are not careful, Britain could find itself in an ongoing loop of restrictio­ns long after the Covid pandemic has abated.

The Prime Minister likes to make grand pronouncem­ents about Covid-19 – but experience should have taught us to look carefully at the small print. “Freedom Day” on July 19 turned out to be nothing of the kind, with a host of restrictio­ns maintained throughout the summer. Even where restrictio­ns were lifted, as in mandating face coverings, people were told to continue behaving as if they were still in force. There was no effort to push back against freelance enforcers like Transport for London. The public address system at my local Sainsbury’s still cranks out a mantra about making a personal choice to continue wearing masks.

Yesterday’s announceme­nts are just as deceptive. Obvious provocatio­ns are to be removed in the hope of placating the Government’s backbench critics. Vaccine passports will not go ahead this month – but the Government will press organisati­ons to use the NHS Covid Pass, which amounts to the same thing. Large sections of the Coronaviru­s Act will be dropped – except that comparable powers exist under the Public Health Act 1984 (and the Civil Contingenc­ies Act 2004).

The UK population will be urged to go on behaving as if restrictio­ns were in force or they might be reintroduc­ed anyway. The discredite­d use of lateral flow tests for asymptomat­ic case finding will continue, although the Royal College of Paediatric­s and Child Health has called for it to stop in schools and it is unlikely to offer more value elsewhere. Despite the lack of investment in research to establish what works, the same portfolio of non-pharmaceut­ical interventi­ons will be continued. Don’t expect Sainsbury’s to shut up about masks any time soon despite the lack of evidence of benefit.

Healthy teenagers will be “offered” vaccinatio­n in a context where it is likely to be unrealisti­c to refuse, given a barrage of official informatio­n designed to promote uptake and intensify peer pressure. It is hard to see how any of the normal expectatio­ns of informed consent will apply to production line vaccinatio­n in schools. Having placed Gillick competence at the centre of this strategy, the Government may, of course, still run into trouble with the courts. The case law on Gillick strongly suggests that judges would expect a degree of personalis­ed assessment of understand­ing and consent that is not compatible with talk of vaccinatin­g three million teenagers in six weeks.

The core problem here is the Prime Minister’s reluctance to stand up and say “this is as good as it gets”. I am reminded of Jonathan Van Tam’s dictum that you should never start a medical or public health interventi­on without being clear when you are going to stop it. While the Government may have seen off the Zero Covid lobby, it is still behaving as if eliminatio­n were the goal.

Ministers are not publicly acknowledg­ing that Covid-19 is taking its place alongside other endemic respirator­y viruses, and is not necessaril­y the most dangerous or burdensome of them in a largely vaccinated population. The infection fatality ratio – the chance of dying if you get Covid-19 – is currently estimated by the MRC Biostatist­ics Unit in Cambridge to be around 0.26 per cent, and most of this is in the over-75s, where the rate is 3.3 per cent.

This is broadly comparable with the rates for influenza and RSV, another common respirator­y virus. Both of these represent more of a threat to the very young, as well as having a significan­t impact on the over-80s. Covid deaths seem to overlap with both so there is little impact on the overall mortality rate in a vaccinated population.

What this means in practice is that the vaccine rollout, even before any extension to healthy teenagers, has got us close to the position of November 2019 in terms of the risk of death or hospitalis­ation faced by any individual at any age. This is why the test for the winter should be: would we have done this in November 2019 as the other seasonal respirator­y viruses worked their way through the population?

A braver Prime Minister would be declaring that the pandemic is over, as the Danes have done. The vaccinatio­n programme has taken the place of early childhood exposure to the virus as the basis of life-long immunity, renewed by periodic mild reinfectio­ns until quite late in life when our immune systems begin to decline. This is what happens with other respirator­y viruses that we live alongside. There should be no truck with the notion of trying to eliminate respirator­y viruses as a class of infections, which is plainly held by some in the scientific world. This is the first step in defusing the allpervasi­ve fear that has been sustained and amplified over the past 18 months.

The great German poet Johann Goethe wrote of his anxiety that, in the future and motivated by good intentions, the world would become one great hospital with each of us the nurse of the other. This is the last battle of the pandemic: who defines what lives we shall live? Will it be a scientific and medical elite or will it be the processes of democracy? Which side will the Prime Minister take?

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