Thursday, December 9, 2021
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Government must get ready for plan B now, Sage advisers warn

Senior scientific advisers to the government have told ministers to start preparing for the “rapid deployment” of basic Covid measures amid rising infections and hospitalisation rates, as local councils and authorities urged Downing Street to “act now, rather than later”.

The Scientific Advisory Group for Emergencies (Sage) said, in a meeting last week, the reintroduction of mask-wearing, working from home guidance and vaccine certification – key components to the government’s ‘plan B’ – would “reduce the need for more stringent, disruptive, and longer-lasting measures” further down the road.

In minutes published on Friday, Sage said that advice to work from home is “likely to have the greatest individual impact” in cutting infections, which are now increasing in the majority of age groups and regions across the UK, according to official data.

More than a million people were infected with Covid-19 last week, the Office for National Statistics said, with hospitalisations also on the rise in the elderly, as fears grow that vaccine immunity levels are starting to wane among the most vulnerable.

Local directors of public health and politicians across England have told The Independent that the government should act immediately in introducing its plan B to prevent the NHS being further overwhelmed.

“I definitely think we should act now, rather than later,” said Alice Wiseman, the director of public health for Gateshead council. “We need to take action now as the NHS is on its knees.

I definitely think we should act now, rather than later. We need to take action now as the NHS is on its knees

Alice Wiseman, director of public health for Gateshead council

“The measures are mild and not disruptive. They may not fully solve the issue, but will help to take the heat out of the fire. We could be forced to introduce stricter measures if we leave it too late.”

The intervention from Sage and local leaders adds further pressure to the government to impose what has been described as “light-touch” measures – a move that ministers are continuing to resist.

“We are sticking with our plan,” prime minister Boris Johnson said earlier this week, while health secretary Sajid Javid insisted the NHS is currently operating at a “sustainable” level, sparking dismay among health chiefs.

Modelling from Sage found that a “rapid increase in hospital admissions” could happen if the behaviour of the public swiftly returns to normal and the waning of the vaccines’ effectiveness is proved to be significant.

Contact patterns between children have largely returned to pre-Covid levels, though adults are still meeting and interacting less regularly with one another.

However, members of the group predicted it is “increasingly unlikely” that Covid admissions for this winter will rise above the peak seen last January.

In a meeting held on 14 October, Sage concluded that “reducing prevalence from a high level requires greater intervention than reducing from a lower level”.

Assessing the impact of the plan B mitigations, members said there was “some evidence” that vaccine certification may have a positive impact on vaccine uptake, particularly in younger age groups. The reintroduction of face masks in public spaces is also expected to reduce transmission.

However, a return to working from home, where possible, is “likely” to play the biggest role in limiting the current surge in cases, Sage said.

These measures should be reintroduced “in combination”, the group concluded, and advised ministers “that policy work on the potential reintroduction of measures should be undertaken now so that it can be ready for rapid deployment”.

“Modelling suggests that the stringency of measures required to control transmission of a growing epidemic is increased by a faster doubling time,” Sage said.

“In the event of increasing case rates, earlier intervention would reduce the need for more stringent, disruptive, and longer-lasting measures.”

The sharp increase in cases that has recently been recorded among school children is now beginning to drift into parental age groups and the elderly, data suggest.

This has coincided with a drop in immunity levels among those individuals who were vaccinated at the beginning of the year, typically the elderly and clinically vulnerable, putting them at greater risk of serious illness.

Research from Public Health England shows that protection against infection following a second AstraZeneca dose falls from 67 per cent to 47 per cent after 20 weeks. Protection against severe disease and hospitalisation falls from 95 per cent to 77 per cent over the same period.

Dominic Harrison, the director of public health for Blackburn with Darwen council, said the “indicators that are coming out at a national level tell us that we should be acting now”.

“If we leave it too late, we’ll have such high case rates and admission that we might need to make more drastic action,” he told The Independent. “Bring in light-touch measures that still maintain the freedoms we currently have, so mask-wearing, Covid passes and renewed guidance to work from home.”

Backing calls to implement Plan B, Evelyn Akoto, Covid-19 lead for Southwark council, in London, told The Independent: “Once again the government is failing to listen to the doctors and scientists and making the same old mistakes of inaction and complacency.”

On Wednesday, the British Medical Association accused the government of being “wilfully negligent” for not reintroducing rules including mandatory face masks. Before that, the NHS Confederation warned that the failure to implement the plan B measures would hinder efforts to tackle the backlog of 5 million patients waiting for treatment.

During last week’s Sage meeting, members also cautioned against “complacency around the risk posed by further viral evolution”. The government’s scientists warned there is a “very real possibility” that a new variant could emerge which displaces Delta and becomes dominant globally.


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