Faux ruffled hair. Solemn tone. Boris Johnson’s emergency address this weekend about the new Omicron variant felt like a return to the old days of the pandemic. The measures announced, though, were hardly significant: for example, introducing mandatory masks in shops and on public transport only brings England in line with what the other home nations have long been doing, and hospitality venues such as pubs and restaurants aren’t included in the new rules.
This is far removed from the long discussed “plan B” – including working from home guidance and Covid passports – that some leading medics have been calling on ministers to implement for more than a month, but that is being resisted by Tory backbenchers.
Perhaps most worryingly, protections for those most at risk from the virus, such as older and disabled people, were not even mentioned. There is no government advice as yet on how clinically vulnerable people are meant to live throughout the winter. Previously, 3.7 million clinically vulnerable people in England were asked to shield in their homes, and were given some government support to do so. Now they are effectively on their own, left to navigate having to go into the office, or meet friends at Christmas in a pub with no masking rules.
Even before the discovery of the new variant, people with underlying health conditions were being widely ignored, despite case numbers remaining high. Months after the official shielding programme ended, ONS data from October showed almost one in four clinically extremely vulnerable (CEV) people were still shielding, while 68% were leaving the house but taking extra precautions.
Many CEV people tell me they’re bracing against the cold and only socialising outdoors, while others aren’t seeing loved ones at all. As one young man with cerebral palsy and asthma, who is not leaving his flat other than for vaccine appointments, told me: “I feel like a hamster on a wheel. If anything, the isolation of shielding is getting more entrenched than ever before by the rest of the population returning to ‘normal’.”
Ministers have only made matters worse. Over the past few months, the government has removed many measures that would have helped clinically vulnerable people. In England, the legal requirement to wear a mask ended as far back as July, apart from in healthcare settings and care homes. Once furlough ended in October, clinically vulnerable people had fewer options to shield themselves. Many were sent back to packed offices or public-facing roles, without the legal right to work from home or still be paid if they couldn’t.
Since August, close contacts of people in England who test positive for Covid haven’t had to self-isolate if they have been double-vaccinated. The government appears to have little interest in either preventing or tracking non-hospitalised Covid cases – a strategy that is dangerous to even vaccinated clinically vulnerable people in the UK, who must try to avoid contracting Covid in a population where 1 million people currently have the virus.
The government clearly believes vaccines – and the booster programme in particular – can form its main line of defence, but while the rollout is providing huge relief, it is not a silver bullet. More than 100,000 extremely vulnerable people are yet to have their third jab after confusion over who is eligible. Medication or certain health problems mean two in five people who have impaired immune systems have a “low or undetectable” antibody response after being double vaccinated, meaning they in particular require a “vaccine plus” strategy – such as masks and increased distancing – to feel safer. The consequences of all this can’t be ignored: millions of people with underlying health conditions are being shut out from public life.
The government’s new strategy is a step in the right direction, but to get through the winter and protect clinically vulnerable people we need to take further low-cost measures. Reintroducing “work from home if you can” guidance would have the biggest individual impact on reducing Covid transmission, according to scientists. There also needs to be greater support for workers who need to self-isolate. Statutory sick pay isn’t sufficient for people to pay their bills, while many insecure workers say they’re afraid they won’t be given hours in the future if they take time off to isolate. Unless the government provides better support, employees will turn up sick, increase transmission and infect vulnerable colleagues.
There needs to be more focus on ventilation and regular lateral flow tests, particularly in schools and large venues. It makes little sense to bring back masks in shops, but not offices. But the real issue will likely be inspiring compliance. It is natural for pandemic fatigue to be setting in, and the government’s contradictory messaging has only compounded this.
The same prime minister who was photographed without a mask in hospital now expects to command public trust on mandating them in Asda. There needs to be an emergency public health campaign, particularly over the high effectiveness of masks in reducing transmission. The public acted with solidarity early in the pandemic because the message was that measures would protect not only ourselves but others – there should be no reason why we can’t rediscover that sense of community.
The government’s framing around “saving Christmas” suggests anyone who asks for more Covid measures now is the Grinch. But this is surely backwards thinking. As Hans Kluge, the WHO’s regional director for Europe, puts it: Applied “correctly and consistently”, preventive measures “allow us to go on with our lives, not the opposite”.
With rising cases in Europe resulting in new lockdowns, and the NHS facing its regular winter crisis, it’s long been in all of our interests to reduce transmission. It is a stain on Johnson’s government that it took the emergence of a new variant to spur the preventive action we already needed. Minsters have a duty to do more to protect the public this winter – and that includes clinically vulnerable people.