Outlining the plans in parliament on Monday 12 July, health and social care secretary Sajid Javid admitted that infection rates were likely to rise – possibly reaching 100,000 cases a day – after the rules changed, and that hospitalisations would also increase. But he added that the vaccine programme had ‘severely weakened’ the link between the number of cases and hospital admissions and the NHS would not see the numbers admitted that it had in previous waves of the pandemic.
Mr Jarvis said that the government would be issuing new guidance setting out how clinically extremely vulnerable patients can protect themselves in the face of rising infection rates.
He also indicated that self isolation for fully-vaccinated healthcare staff who have been in contact with a confirmed case could end sooner than for the rest of the population in certain circumstances.
During a press conference later on Monday England’s CMO Professor Chris Whitty said that, while hospital admissions would rise, modelling data suggested that unlocking now would not ‘put unsustainable pressure on the NHS’.
However, he cautioned that ‘going slowly’ after restrictions eased was vital to reducing the amount of pressure the NHS would have to deal with.
The health secretary confirmed that the use of face masks would no longer be mandatory, but added that it was ‘expected and recommended’ that people should continue to use them ‘in crowded, indoor settings like public transport’.
Prime minister Boris Johnson also urged people to remain cautious in the coming weeks. During the press conference he said: ‘I cannot say this powerfully or emphatically enough – this pandemic is not over. This disease continues to carry risks for you and your family. We cannot simply revert instantly from Monday 19 July to life as it was before COVID.’
He added that people should continue to wear face coverings if they were meeting others indoors who they do not normally meet and to think about the risk of transmission to more vulnerable individuals.
However, both the prime minister and Mr Javid insisted that now was the right time to ease restrictions and that cases of COVID-19 would rise at whatever point the measures were lifted.
Mr Javid also confirmed plans to end self isolation for fully vaccinated people who have been in contact with a confirmed case of COVID-19 from 16 August. However, he added that with cases rising it was ‘vital’ that self-isolation measures ‘were proportionate and that they reflect the protection given by our vaccination programme’.
‘As part of this approach, we’ll be working with clinicians, and the NHS, to explore what more can be done for colleagues in patient facing roles,’ Mr Javid said. ‘This would only be used in exceptional circumstances, where the self-isolation of fully-vaccinated close contacts could directly impact the safety of patients. So we can keep our vital services going as we safely and gradually get closer to normal life.’
The government will also be conducting a review in September to assess if the NHS is prepared for autumn and winter.
Rise in cases
BMA chair Dr Chaand Nagpaul said that relaxing the rules around face coverings would lead to a rise in cases and hospitalisations, which would ultimately impact on the NHS’s ability to deal with the backlog of care that has developed during the pandemic.
‘Simply “expecting” people to wear one is not good enough and sends out a confusing mixed message to the public,’ Dr Nagpaul said.
‘We have soaring infection rates – the highest in Europe – which are already impacting the NHS, and we’ve seen the number of people in hospital beds and on ventilators double in the last month alone.
‘Even a modest increase in the number of COVID-related hospitalisations places immense pressure on our overstretched health service trying to cope with a backlog of more than 5.3m patients waiting for treatment. Allowing infections to escalate by removing all restrictions will mean more patients on waiting lists will suffer and wait longer for treatment.’
GP leaders have also warned that relaxing COVID restrictions will lead to a spike in practice workload as the number of cases rise. RCGP chair Professor Martin Marshall said the ‘inevitable’ rise in COVID-19 cases as restrictions were eased would have ‘significant implications for general practice, the wider NHS, and public health in general’.