Covid: Prepare to bring in Plan B measures now, advisers tell government

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The reintroduction of Covid measures, such as home working and face coverings, should be considered now, top scientists have advised, warning of a possible “rapid increase in hospital admissions” as coronavirus infection rates continue to soar.

While it is “increasingly unlikely” hospital admissions this winter will rise above the peak seen last January, the Scientific Advisory Group for Emergencies (Sage) said acting quickly would reduce the need for “more stringent, disruptive and longer-lasting measures”.

The guidance comes as latest estimates suggest nearly a million people in England may now have had Covid-19.

Earlier this week, Boris Johnson ruled out bringing in Plan B in England, which would include legally mandating face coverings in some settings, introducing mandatory vaccine-only Covid-status certification and asking people to work from home.

The advisers concluded policy work on the potential reintroduction of measures, including mandatory face coverings and working from home guidance, “should be undertaken now” so they can be ready for “rapid deployment” if needed, minutes from the October 14 meeting.

Led by Chief Scientific Adviser Sir Patrick Vallance, Sage said the modelling does not consider the burden from flu and other viruses or the emergency of new variants, adding it was difficult to predict epidemic trajectories due to uncertainty over the rate of vaccine-acquired immunity wanes, and behaviour.

One paper from Imperial College London, presented to Sage, warned that a pessimistic scenario could see almost 10,000 deaths over the winter, while any delay in the Covid-19 booster programme could result in “a much larger epidemic”.

Hospital admissions above those seen in January 2021 are increasingly unlikely, Sage said. Credit: PA

Currently, adults are not mixing as much as they were pre-pandemic, but if this were to change, it could have a big impact on transmission.

It is thought scientists are in favour of a relatively light touch approach, implemented early, to make a difference, rather than needing harder restrictions at a later date.

Speaking on a visit to the Covid-19 vaccine centre at the Little Venice Sports Centre in west London, the Prime Minister said while we are seeing “high levels of infection” they are not outside the parameters of what was predicted.

“But it’s very important that people do follow the guidance on general behaviour, on being cautious, on wearing masks in confined places where you’re meeting people you don’t normally meet.

“Wear a mask, wash hands, ventilation, all that kind of thing, but also get your booster jab, and that’s the key message that we want to get across," he said.

“Our autumn and winter plan always predicted that cases would rise" - Boris Johnson says while the UK is seeing “high levels of infection.” they are not outside the parameters of what was predicted

Sage advisers said that there has been a “decrease in self-reported precautionary behaviours such as wearing a face covering”, adding the reintroduction of working from home guidance is likely to have the “greatest individual impact” on transmission out of the measures under Plan B.

They added: “Sage advised that policy work on the potential reintroduction of measures should be undertaken now so that it can be ready for rapid deployment, stressing the importance of reintroducing measures in combination, supported by clear communication, consistent implementation that avoids creating barriers to adherence, and clear triggers for deployment.”

“A slower return to pre-pandemic behaviours and reduced waning are both expected to reduce and delay any further wave, although there remains potential for a rapid increase in hospital admissions if behaviours change quickly, and if waning is more significant and occurs after boosting,” they wrote.

The Scientific Pandemic Influenza Group on Modelling, Operational sub-group (SPI-M-O)  added: "If booster vaccinations are effective, have a high uptake, and do not wane over the timescales considered here, then hospital admission rates are also unlikely to get much higher than currently seen."

The scenarios assume that the rollout of boosters will be “rapid” and have a “high uptake” and warned that if people swiftly change their behaviour then there could be a major problem.

SPI-M-O also said it was “possible” that “action beyond Plan B may be required to control growth”, adding that “Sage have been asked to consider the potential effect of returning to the steps outlined in February 2021’s Roadmap”.

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The minutes noted the importance of face coverings at reducing the spread of the virus, but said booster jabs remained the most important measure against Covid.

"Face coverings are expected to have some effect to reduce transmission through all routes by partially reducing emission of and exposure to aerosols and droplets carrying the virus, reducing transmission risk at both close proximity (even for short periods of time) and over longer range.

"Effectiveness is dependent on the quality of the covering, the fit and ensuring both the nose and mouth are covered. Mandating face coverings in some settings is likely to also have benefits for reducing transmission of other respiratory viruses."

While there was uncertainty about the timing and magnitude of any future resurgence of the virus, modelling suggest hospital admissions above those seen in January 2021 are "increasingly unlikely, particularly in 2021,” they wrote.

Reported Covid cases in the UK topped 50,000 for the first time since July on Thursday. The government recorded 52,009 new infections in the latest 24-hour period and a further 115 deaths. On Tuesday, the UK reported 223 Covid-related deaths, the highest number of coronavirus deaths in a day since March.

Infection rates in school children are currently very high. Credit: PA

The percentage of people testing positive for Covid-19 was estimated to have increased in all regions of England except south-east England and the West Midlands, where it appeared to level off, and north-east England and Yorkshire and the Humber, where the trend was uncertain.

In north-west England and south-west England, around one in 45 people was likely to test positive in the week to October 16, the highest proportion for any region, according to the , according to the latest estimates from the Office for National Statistics.

London and south-east England had the lowest proportion, at around one in 75.

Around one in 55 people in private households in England had Covid-19 in the week to October 16, up from one in 60 the previous week.

One in 55 is the equivalent of about 977,900 people.

At the peak of the second wave in early January, around one in 50 were estimated to have coronavirus.

In Wales, around one in 45 people is estimated to have had Covid-19 in the week to October 16, unchanged from the previous week and the highest since estimates began in July 2020, while in Northern Ireland, the latest estimate is one in 130, down from one in 120 the previous week.

For Scotland, the ONS estimates around one in 90 people had Covid-19 in the week to October 16, down from one in 80 the previous week.

The current estimated positivity rate in England is higher than it has been ever since the ONS Covid infection survey began in April last year, apart from four weeks from 27 December 2020 at the very height of the second wave.

The government has continued to rule out Plan B despite acknowledging the high number of coronavirus infections in the UK.

On Thursday, Mr Johnson said the numbers were "within the parameters" forecast by his scientific advisers. Coronavirus cases could soon rise to 100,000 a day, the health secretary admitted on Wednesday evening, with experts saying infections were already likely to be exceeding that.