Covid-19: Tighter restrictions imposed in the north of England as cases spikeBMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3066 (Published 31 July 2020) Cite this as: BMJ 2020;370:m3066
All rapid responses
The world is still learning how to cope with Covid-19 impact, and doesn’t know as yet, the best method to prevent and cure this disease. This is obviously causing confusion and concerns about not knowing how to be sure who is giving right advice?
It doesn’t require randomised trial evidence to prove this reality, given the human effect of this covid 19 seen worldwide, which is self-explanatory. The large picture around the UK and the world shows people often tend to be confused and less convinced with the government advice they receive and as a result many do not follow it seriously.
There is still ongoing debate on facemask both in favour and against and even the BMJ has published a selective “letter of the week” showing a long list of reasons against wearing Facemask. However I am yet to learn how many Covid 19 patients have been detected or admitted or died as a result of wearing facemask? On the other hand the current situation is self evident that number of Covid 19 patients in the community and hospitals possibly could have been reduced, if not avoided, if the people used more protective measures adding the facemask.
The world is uneasy with the WHO advice which seems to change as or when, subject to the flow of the debate. The UK medical community via the government channels passing advice to the public, which is often, reported by various sources as unclear and confusing. The media and the BBC have reported the government was very careful in not using the word facemask but “face-cover”. This message could be viewed by public that there is lack of confidence in government advice. This could also be the reason that people are not so serious, and despite there is a £100 fine notice, many are still not wearing facemasks in shops, supermarkets. I asked a manager in a local supermarket why I see customers without facemasks? I was told this is not for them but police to handle. This is a situation I often face in my own practice when my patients ask me why so many people are not wearing facemasks?
So, it’s no surprise that the new rules and restrictions have to be imposed in parts of the country. It seems, while the government has reasons to be frustrated with the people not following the rules in the affected areas, the people may feel the matter is not that serious, when the advice itself had not always been confident and clear.
This is a situation similar to other parts of the world like in India, where general public largely ignores medical advice and despite that the mortality rate in India is astonishingly low relative to the number of cases identified. This strikes me that there could be some kind of natural immunity or herd immunity playing a role, particularly in densely populated urban and underprivileged areas where millions live closely surrounding many environmental biohazards, making them resistant to Covid-19.
However such kind of suspected automatic herd immunity is unlikely in native western population like in the UK and there is therefore the need for the public to have better knowledge and understanding about the disease process to be able to apply their own civic sense and pro-active approach and follow the medical advice accordingly. The difficulty is that everybody wants the government restriction advice rules should suit their own needs and life style, but in medical science there can’t be any one size fits all blue print protocol advice applicable to all needs regardless. There will be some exceptions and the public should be advised to apply reasonable and sensible balance as much as possible to suit their personal needs. And I would also suggest that government should set up public advice lines similar to NHS 111, where public can call to clarify their individual queries and needs about lockdown restriction rules rather than complaining about unclear, confusing government advice.
This is a situation where public should realise that the social restriction rules are for their own benefit and to save lives and they have equal responsibility to follow that as much as the government and the medical community has to advise that, in this battle.
Competing interests: No competing interests