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Covid-19: Ending all restrictions in England on 19 July “dangerous and premature,” say experts

BMJ 2021; 374 doi: (Published 09 July 2021) Cite this as: BMJ 2021;374:n1751

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  1. Jacqui Wise
  1. Kent

The UK government’s decision to end all covid-19 restrictions in England on 19 July has been branded “dangerous and premature” by a group of 122 scientists and doctors.

Their letter to the Lancet urges the government to delay complete reopening until everyone, including adolescents, has been offered vaccination and until mitigation measures such as adequate ventilation and spacing are in place in schools.1

The letter was a follow-up to the “John Snow memo,” written in October 2020 in response to the Great Barrington declaration that advocated a herd immunity approach.234

The signatories to the latest letter, which include the former chief scientific adviser and chair of independent Scientific and Advisory Group for Emergencies, David King, and the BMA’s chair of council, Chaand Nagpaul, said the government was embarking on a dangerous and unethical experiment.

On 7 July the UK reported more than 30 000 new daily cases for the first time since January and more than 40% rises in hospital admissions and deaths. The health and social care secretary for England, Sajid Javid, has said that infections could climb to 100 000 or more a day by the end of the month.

The letter said that, with only half of the UK population fully vaccinated and infections still growing exponentially, it “will likely continue until millions more are infected, leaving hundreds of thousands with long term illness and disability.” Unmitigated transmission will disproportionately affect unvaccinated children, young people, and people in deprived communities, it said.

The government’s strategy also provides fertile ground for the emergence of vaccine resistant variants that would place everyone at risk, including people already vaccinated.

Speaking at an “emergency summit” and press conference, Deepti Gurdasani, clinical epidemiologist at Queen Mary University of London and a signatory of the letter, described the government’s strategy as “callous and inhumane” and said ministers had “completely abdicated responsibility” for controlling the pandemic. She said the government was “dooming an entire generation to infection with a disease they could have been vaccinated against in the coming weeks.”

To the government’s argument that delaying full opening up until the autumn would cause a bigger wave of infection because of waning immunity among elderly people coinciding with schools reopening, Gurdasani said this was false framing. “If we open up later it will allow more people to be vaccinated. We can also offer mitigations such as booster doses and vaccinate children.”

Trish Greenhalgh, professor of primary care health sciences at Oxford University, who also signed the letter, said that “the government policy seems designed to increase cases” and predicted there will be hundreds of superspreading events in the coming weeks. She called for mask wearing to continue in indoor spaces and for a greater focus on mitigating airborne transmission of the virus. Belgium, for example, has placed requirements for businesses to put in CO2 monitors to measure air quality.

The letter said the government’s strategy will have a significant effect on health services and exhausted healthcare staff. Rachel Clarke, an NHS palliative care doctor and author, and a signatory, said, “Hospitals are already struggling and overstretched.” For example, this week Leeds Teaching Hospitals NHS Trust had to call off some planned non-urgent operations to cope with an increase in patients with covid-19. She added that allowing 100 000 people a day to get infected with covid-19 would have an impact on all patients, whether they had cancer or heart disease or had been in a car crash.

Richard Horton, editor in chief of the Lancet, said the government’s plan was “driven by libertarian ideology” rather than by the data. “We should not be epidemiologically stupid,” he said.

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