Lockdowns must not be the annual default

Ayear ago almost to the day, the clamour began for another lockdown as Covid cases began to accelerate after a summer of relative calm. The reason given was to “protect the NHS”, exactly what we are hearing once again as autumn advances and seasonal respiratory diseases become more prevalent. This time the pressure is on the Government to trigger its so-called Plan B, outlined by Boris Johnson last month as a fall-back position in the event of a surge in the virus. We said then that far from being a last resort this looked suspiciously like the intended policy to be followed during the winter months. It would involve, inter alia, a renewed requirement for people to work from home if they can, mandatory mask wearing and restrictions on some indoor gatherings.

In order to avoid recourse to Plan B, Mr Johnson said it would be necessary to rely heavily on vaccinating children and offering boosters to the over-50s so as to suppress the worst impacts of Covid when it spreads faster, as it will. Yet neither of these two things is happening with sufficient urgency. The booster programme in particular seems sluggish which, given that it was central to the Government’s ability to stick to Plan A, is a serious matter. What is the cause? As Sajid Javid, the Health Secretary, said at a news conference last night, the jabs are available but the take-up is lower than expected.

All over-50s are eligible for a booster six months after their second dose, and yet many say they have not been contacted. This was previously carried out by GPS but is now a central NHS responsibility. Is there a bureaucratic hold-up, and if so, is it being cleared away? Stephen Powis, national medical director of NHS England, appeared to suggest that anyone eligible who had not yet been contacted could book online, but this is not the case.

These are crucial questions given the potential consequences of any waning immunity of the first vaccine doses. Cases are rising rapidly but that need not be a problem provided they do not become serious illnesses requiring hospitalisation.

But flu is expected to be more virulent this year, with some clinicians forecasting as many as 60,000 deaths. Inevitably, that means a lot of people in hospital and, in the past, bad flu years have brought the NHS close to breakdown. The prospect that a spike in Covid will coincide with higher than usual levels of flu is ringing alarm bells among healthcare planners.

Just to add to the renewed sense of foreboding, a new, more infectious, offshoot of the Delta variant has been identified behind the recent rapid rise in case numbers. The proportion of cases made up by the sub-strain has doubled in a month.

Matthew Taylor, chief executive of NHS Confederation – an organisation that represents NHS trusts – said preparations were being made for “the most challenging winter on record” and predicted a crisis without urgent action. Ministers are adamant that whatever happens there will not be a repeat of the severe lockdowns where people are urged to stay home and forbidden to socialise. But they said that last year, and after a confusing period involving tiered measures in different parts of the country, a national closure was imposed, with schools shut, home-working reinstated and family gatherings not permitted even at Christmas.

Mr Javid said no one wanted to go backwards after the gains of recent weeks and he is right about that. But it is for the Government to ensure the NHS is capable of withstanding winter respiratory illnesses, and yet it is its apparent inability to do so where the real difficulty lies.

The emergency powers for ministers to order a lockdown remain in the Statute Book and were renewed by Parliament this week for a further six months without a vote. If there is no intention of using them, why keep them? Moreover, no one will say what the precise benchmarks are for triggering Plan B – or C, for that matter – other than pressure on the NHS becoming “unsustainable”.

These capacity issues should have been addressed. Everyone has known for months what was coming down the track. As the MP Steve Baker put it, our liberties cannot become an annual tool of NHS capability management. Lockdown, or even measures falling just short of one, must not become the default response when other mitigations are considered too hard.