Intended for healthcare professionals


Covid-19: Government ignores scientists’ advice to tighten restrictions to combat omicron

BMJ 2021; 375 doi: (Published 21 December 2021) Cite this as: BMJ 2021;375:n3131
  1. Gareth Iacobucci
  1. The BMJ

The government has ignored its scientific advisers’ advice to impose immediate restrictions to stop the NHS becoming overwhelmed by the rapid spread of the omicron variant.

The decision came after a Cabinet meeting on 20 December, in which members were divided over the need for stricter measures. Prime Minister Boris Johnson, under pressure from many within his own party not to impose fresh restrictions, did not rule out further measures later and said data on the threat of omicron was being monitored “hour by hour.”

But experts accused the government of dithering and ignoring the latest modelling1 provided to its Scientific Advisory Group for Emergencies (Sage), which show that without additional restrictions now, hospital admissions across England could peak at between 3000 and 10 000 a day, while deaths could reach between 600 and 6000 a day.

On 20 December, 91 743 people tested positive for covid across the UK as cases continue to surge.

In London, the epicentre of the UK’s omicron outbreak, data23 from the UK Health Security Agency show that there were 1349 hospital admissions with covid in the week from 12 December, a 38% increase from the 981 admissions between 5 and 11 December. London hospitals treated 1819 people for covid-19 on 20 December, a 30% increase from the previous Monday.

Amid growing concern that London is a precursor to the rest of the country, Christina Pagel, professor of operational research at UCL, said, “With omicron spreading so fast, waiting for definitive evidence that it could cause the NHS to be overwhelmed will be too late to avert the crisis. Instead, the government should follow Sage advice and return to step 2 of the roadmap to prevent thousands of infections over the coming days and then monitor the situation hour by hour so that measures can be lifted as quickly as possible, hopefully even in time to enable limited household mixing over Christmas weekend.”

Speaking about the omicron situation globally, Jeremy Farrar, director of Wellcome and former member of Sage, said, “As we have learnt from the very beginning of this pandemic, it’s better to act sooner than later. It is staggering and deeply frustrating that two years into this pandemic—when we have gathered so much evidence and made huge scientific progress—governments are still not anticipating events and acting early on anywhere near the scale that is required.”

The Scientific Pandemic Influenza Group on Modelling (Operational) subgroup of Sage1 advised last week that if measures equivalent to those in place after step 2 or step 1 of the government’s roadmap for England4 are enacted early enough this could “substantially reduce” the potential peak in hospital admissions and infections compared with measures currently in place.

Minutes from Sage’s meeting5 on 16 December said, “If the aim is to reduce the levels of infection in the population and prevent hospital admissions reaching these levels, more stringent measures would need to be implemented very soon.

“The timing of such measures is crucial. Delaying until 2022 would greatly reduce the effectiveness of such interventions and make it is less likely that these would prevent considerable pressure on health and care settings.”

Slowing the wave of infections would also allow more people to receive boosters before they are potentially exposed to omicron, which would prevent—not just delay—some hospital admissions and deaths, Sage added.

Meanwhile, concern is mounting over the impact of covid related staff absences6 in the NHS, with the Health Service Journal reporting7 that one in three of the NHS workforce in London would be absent by New Year’s Eve if the current rate of growth in sickness absences continues.

In a bid to ease staff shortages, the government is reported8 to be considering reducing the length of the covid self-isolation period from 10 to 7 days for everyone if people return a negative lateral flow test, pending advice from its scientific advisers.


  • Correction: On 18 January 2022 we amended this article to clarify Jeremy Farrar’s comment.

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