The tiered system of Covid-19 restrictions is “inadequate” and must be revised before England leaves lockdown leading medics have said.
The British Medical Association (BMA) said the previous system was “inconsistent” and did not contain the spread of the virus, echoing a government adviser who warned the tiers needed “strengthening”.
The government will decide next week how to end the second national lockdown as ministers come under pressure to outline any restrictions which could be in place over the Christmas period.
Ministers have insisted it is too early to tell whether the lockdown has succeeded and virus infection levels will be low enough to allow festivities to go ahead but Housing Secretary Robert Jenrick said it was his “very firm expectation” that measures will be eased significantly in December.
Now the BMA, which represents doctors, has presented its own blueprint for leaving lockdown, including “triggers” under which areas would move up and down the tiers.
The blueprint suggests non-essential travel between tiers should be “restricted” and “more robust” quarantine procedures should be put into place.
Social mixing should be encouraged to take place outdoors and there should be a two-metre distance between tables in pubs and restaurants, according to the proposals.
The blueprint also suggests the rule of six be replaced with a “rule of two households”.
Professor Neil Ferguson, whose modelling led to the original lockdown in March, suggested support bubbles could be extended to help enable families to meet at Christmas.
He told BBC Radio 4’s PM programme on Tuesday the proposal would increase the risk of coronavirus transmission but in a “controllable way”.
“There are ways of going part way which still reduce the risk – basically extending what are called bubbles – social bubbles, support bubbles,” he said.
“You could think of allowing three or four households to bubble together for a week but not contact anybody else, which would give more opportunity to see loved ones but not a free-for-all.
“And that, modelling would suggest, increases risk somewhat but in a controllable way.”
Prof Ferguson also warned that reopening pubs and restaurants in the run-up to Christmas would be likely to lead to rising infection levels.
It comes as the government announced a further 598 people had died within 28 days of testing positive for Covid-19 as of Tuesday, bringing the UK total to 52,745.
The BMA added that before ending lockdown the government should ensure that the Test and Trace programme is fit for purpose.
“We must not squander the efforts of the many people who have followed the law, stayed at home, sacrificed freedoms and incurred financial loss in order to contain the virus,” said BMA chairman of council Dr Chaand Nagpaul.
“When the first lockdown ended, there was no coherent plan for keeping Covid-19 at bay, no clear and simple public messaging; this was followed by spiralling infection rates, more businesses failing, new local lockdowns, and now we have a death toll at more than 52,000.
“As England prepares to exit its second lockdown, it is unthinkable that we make the same mistakes again because this time, the impact will be far worse. It’s reasonable to conclude that without these measures, the NHS will not be able to cope with caring for even the most critically ill patients.
“This report demonstrates a sustainable plan for reducing the level of infections from Covid-19 until a vaccine programme is under way.”