The government’s roadmap for ending Covid restrictions in England commits it to steps that may increase the rate at which the virus spreads. Some of that is unavoidable. But even as we reopen, there is more that we could do to mitigate the risk, and get us to the summer – and normality – without a resurgence.
One reason that east Asian countries have done better during the pandemic is that prior experience with Sars has given people the understanding of how respiratory diseases spread, and how to avoid them. Japan’s three Cs guidance – avoidance of closed spaces, crowded places, and conversations – helped it avoid a serious epidemic without imposing a national lockdown.
But the UK’s messaging still prioritises hand washing, surface cleaning and 2-metre distancing, and there has been no public education campaign about ventilation on the scale of last year’s hand-washing campaign.
The guidance downplays the fact that Covid mostly spreads through the air, and emphasises the risk of surface spread, which does not seem to be a major transmission mechanism. Polling done last month suggests that many people do not realise that opening windows is one of the best ways to avoid catching the disease, and do not think this has been emphasised by the government.
Schools are due to reopen fully on 8 March, and are the first significant risk in the government’s plans. Although children rarely show symptoms of Covid, they can still catch and spread it asymptomatically. The main danger from schools is not that children themselves will get sick, or even give it to their teachers. It is that they will catch Covid at home, bring it to school, and infect their classmates, who will then bring it home to their families, all asymptomatically.
According to Sage, children aged 12–16 were nearly seven times more likely than older family members to be the first infection in their household. They were also twice as likely as older people to pass the virus on to another family member after being infected. Successive studies have indicated that school closures led to big reductions in transmission and Covid mortality, and are one of the most effective non-pharmaceutical interventions we have against Covid.
So reopening all at once could mean case numbers begin to rise again suddenly, and in a way that is politically difficult to reverse. Phasing in school reopenings gradually, with younger school groups brought in first, would allow us to monitor the effect that reopenings have on cases and change course on other age groups if necessary. Allowing parents who are not comfortable with sending their children back to delay their return would reduce the rate of spread as well.
Right now, schools are advised that students do not need to wear masks, and that staff only do “in a very small number of cases” such as when caring for a child sick with Covid, “and only then if a distance of 2 metres cannot be maintained”. The prime minister has said the new guidance will change this, but only for older pupils. While some schools have kept windows open to allow ventilation, it is not universal, and the government’s advice still emphasises hand washing and surface spread ahead of ventilation.
Giving better and stronger guidance on ventilation, requiring masks for children of all ages (as many other countries have), and distributing CO2 monitors to measure fresh air in classrooms could all help to reduce the virus’s spread in schools. At this time of year, this will make it cold in classrooms: school uniform rules could be relaxed so children can wrap up warmly, and the government could take on schools’ heating bills until the summer, including extra rented heaters in older buildings.
Schools should be instructed to make every possible effort to reduce indoor class numbers. Where possible, unused offices and other empty spaces near schools could be hired and staffed temporarily, at the government’s expense (recruitment of newly qualified teachers was down sharply last year, so some may be available). This, and giving more time to outdoor play and instruction when the weather permits, could allow classes to be divided up into smaller groups, so that when outbreaks do arise, the number of children exposed is kept to a minimum.
Obviously, not all of these steps will be possible for every school. But every extra precaution any school takes reduces the risk for the whole country.
The reopening of businesses will bring dangers, too. Throughout lockdown, many estate agents have been open, with staff sitting in high street offices, maskless, under the impression that sitting two metres from each other makes things “safe”. That may have helped to spread Covid and meant that this lockdown has been longer than it needed to be. And when more businesses reopen that problem will grow.
Allowing pubs and restaurants to initially reopen for outdoor service only is a good idea, and they should be given street space and car parking spaces by local councils for seating. But minimising indoor spread has to be extended to other businesses as well. Unventilated spaces are dangers as long as Covid is present, even with plastic barriers and distancing between customers. The “Covid secure” meme has to die.
On top of this, we’ll need to give adequate support to people told to self-isolate, so those told to isolate actually do it and the testing we do is worth something. And if we can get cases low enough, forwards and backwards contact tracing might let us stem new outbreaks as we detect them.
The UK’s vaccination programme has been miraculous. But we still have tens of millions of people left to protect, and if the virus comes back before that, a vaccine-resistant variant could emerge that sets us back by months, and requires another lockdown. If we can make it to the summer, then the seasonal fall in cases combined with the vaccines could allow us to get back to normal for good. It would be crazy not to do everything we can to get there safely.