Plan B shows Britain is still chasing Covid. Here’s how we can get ahead of it

·6 min read
<span>Photograph: Reuters</span>
Photograph: Reuters

New measures to tackle Omicron are weeks late – while the UK is lagging on vaccinating children and a balanced approach to travel

The Omicron variant is now in 57 countries. And that’s countries that have sequencing ability to find it. Even in Britain, estimates are that the hundreds of confirmed Omicron cases are just the tip of the iceberg. Given how fast it has spread globally, its probable increased transmissibility even compared with Delta, and the many mutations in this variant, this is another step change in the pandemic. And one in which governments again have to manage how a wave of infections would affect their health services, where staff are already hitting the emergency button and saying they can’t take on more patients. The good news is that vaccines (especially boosters) seem to be holding up well against Omicron so far. The bad news is that a more transmissible variant will find unvaccinated people faster, and infect more people. While the link between cases and hospitalisations is weakened, it is not broken.

I recently joined a call with NHS clinical colleagues who have been running Covid-19 wards and managing wave after wave in hospital since March 2020. Their words were stark. Staff are exhausted. Burned out. Medical professionals not only have to cope with difficult shifts, large patient loads and public sector pay, but also risking their own health and that of their families. One nurse recounted caring for a fit and healthy woman in her 30s who hadn’t been vaccinated and was now on a ventilator. She sees little compliance with masks in shops, or any kind of infection control measures in society. One world in hospitals where the pandemic is still raging. One world outside where the UK government prematurely announced victory over Covid-19 on “freedom day” last summer.

With this in mind, the UK government’s move towards plan B is a welcome step, but should have been introduced weeks ago, if not months. Again, waiting longer to take action means that stronger action might be necessary in the future. Scotland maintained face coverings in shops and public transport with high compliance and understanding that it is a necessary measure to maintain economic and social activity while a dangerous virus is circulating. Asking people to work from home is also wise as we head into the Christmas break, and a welcome move from the Scottish government. Testing regularly to catch infectious individuals is an important step so that chains of transmission are interrupted. The Cop26 conference in Glasgow showed that mitigations, such as vaccine certification and regular testing and masks, can make large events safer. There is a way to mix, socialise and maintain economic and social activity in a more secure way.

However, recent reports of government Christmas parties have resulted in a loss of trust in leadership, which is a major blow during a pandemic. And continual lies means a fuzzier line between what is true and what is false, which again is a huge blow to public health messaging and response. We follow public health measures, such as masks, getting vaccinated and testing often, not because of politicians or top-down directives, but to help protect our communities and each other. And to help keep pressure off health services so that when our loved ones need healthcare, it’s there for them.

I’d like to focus on two remaining issues that we haven’t heard enough about so far. The first is schools: school closures – like those we had last January and February – should be off the table completely. More than 100,000 children have been “lost in the system” and have not fully returned to school since the start of the pandemic, while in-person schooling is important not only for education, but child nutrition, wellbeing and safety. The UK is wasting time by not offering parents the option of vaccinating their five- to 11-year-olds and protecting them from illness. Around 5 million children under 12 have been vaccinated in the United States, with Denmark also rolling out jabs to younger people and the World Health Organization advising European countries to focus on this over the holidays. Again the UK is an outlier – and again, as with teenage vaccination, will probably go the way of other countries, just months later.

The second issue is around travel: international travel is likely to be disrupted for the foreseeable future. The red-list “kneejerk” approach isn’t effective at stopping the introduction of variants, because people can just avoid direct flights from certain countries, and it punishes those countries that can sequence and detect variants and then share this data. It also creates hesitancy to book overseas travel with the worry of what it may cost to return home. Instead, aviation ministers from the G20 countries should agree standard travel procedures that would offer certainty and stability to the aviation sector for the next six to nine months, and strike a balance between international mobility and infection disease control. This could include agreed pre-departure testing, vaccine certification and day two testing on arrival.

With all we have witnessed and the 146,000 lives lost in Britain, it should be clear by now that Covid-19 is a serious virus. Even to those in their 20s or 30s. And to those who think of themselves as fit and healthy and with a robust immune system. Fortunately we have vaccines now: their main role as new variants have emerged has been to blunt the full impact of Covid-19 on the body, and reduce it to a mild disease that can be managed at home for most. While people might think they’re getting vaccinated to save their grandparents, they’re actually getting vaccinated to save themselves.

The sobering message is that Covid-19 is here to stay, and the increased number of animal reservoirs being found, including deer, hippos and mink, mean that it can continue to mutate and jump back into humans. Sars-CoV-2 spilled over into one human in Wuhan and spread across the world. All it takes is one person to be infected with a new variant with a major selective advantage, and again it will spread across the world as Delta has. And while we focus on Omicron now, we have to be thinking ahead to what the next version of Covid-19 could look like this spring, and how we get ahead of this virus, instead of always trying to catch up. This involves managing Covid-19 using vaccines, testing, masks and clear messages to the public on where we are and why. And having someone in charge whom we can trust to be honest and public-oriented.

• Prof Devi Sridhar is chair of global public health at the University of Edinburgh

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