Mixing between more than two households and travel between tiers should be banned in England until a vaccine is rolled out to prevent the NHS being swamped after lockdown, the main doctors’ organisation has warned.
With ministers due to announce next week a return to regional tiers of coronavirus restrictions from 2 December, the British Medical Association (BMA) said that without tough action, hospitals and GPs will become overwhelmed.
A BMA report argues that robust measures will be needed until an effective vaccine is widely available, and that ministers must learn from what it called the over-lax exit from the last lockdown.
As well as a two-household maximum for mixing and a ban on travel between areas in different tiers, the BMA says people should be urged to continue working from home where possible, and that guidance on Covid measures in workplaces and businesses must become compulsory.
The report also calls for “wide-scale reform” of the test-and-trace system, with more funding given to local public health teams and a more effective app.
Dr Chaand Nagpaul, chair of the BMA council, said: “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.”
The report came as a hospital in Kent declared an internal critical incident after coming under serious pressure from treating what is thought to be around 110 patients with Covid-19.
The Medway NHS trust, which runs Medway Maritime hospital in Gillingham, took the action after a sharp increase in Covid cases in recent weeks, the Health Service Journal reported. It is thought to be the first trust in the south-east, which has so far seen many fewer cases in the second wave than the north and Midlands, to declare an internal critical incident.
Meanwhile, public health experts said people should prepare for a low-key Christmas, or even one spent outdoors, because the second lockdown may not significantly suppress the rate of coronavirus infections.
Officials and ministers are still awaiting key data on the effectiveness of the four-week restrictions imposed across England, meaning a promised update to parliament on the next steps is unlikely to happen before late next week.
Scientists said that while they accepted the economic need for shops and hospitality businesses to reopen before the crucial festive season, the advent of seemingly effective vaccines meant people could consider postponing big family get-togethers.
“We really have to be careful that we don’t just focus on what is going to happen in six weeks’ time,” said Prof Catherine Noakes, a member of the government’s Scientific Advisory Group for Emergencies (Sage), who was speaking to the Guardian in a personal capacity.
“I know it is human nature to do that, but we will be better off planning for the longer duration and thinking of, actually, can we have a more low-key Christmas and new year this year and perhaps plan to do the bigger family celebrations in the summer when the risks are likely to be far lower for all sorts of reasons,” said Noakes, an expert in the transport of airborne pathogens from the University of Leeds.
Prof Gabriel Scally, a visiting professor of public health at the University of Bristol and a member of the Independent Sage group of experts, said he had little hope that the latest lockdown will quash the spread of the virus, given the spring lockdown had little effect in reducing infection levels in some parts of England.
“We know that the [last] and even more severe lockdown did not get the virus under control, so how can we expect that this will bring the virus under control given that some things have not changed?” he argued.
“How can we be in a good place by Christmas? I think it is impossible,” Scally said, adding that the aim should be for “a new, Covid-safe Christmas”, involving well-ventilated homes and lots of outdoor time. He suggested people could plant a Christmas tree in their garden, if they have one, and open presents underneath.
But Downing Street faces intense pressure from Conservative MPs in the newly-formed Covid Recovery Group to limit restrictions.
One senior backbencher who is in the group said even the pre-lockdown tier 2, which bans household mixing indoors, “would be fatal for huge numbers of restaurants, pubs and bars”.
They said: “It would be crazy to go into some sort of lockdown, in tiers, that was broadly the same for large swathes of the country and cause immense damage.”
One government source said that while anecdotal evidence was that infection and hospitalisation rates were “moving in the right direction”, ministers were awaiting data from the midway point of the lockdown, which falls on Thursday.
Christmas, they said, was being treated as a separate issue in terms of restrictions: “You’ve got to factor human behaviour into this. You can’t just say: ‘It’s winter, bringing elderly people indoors with high Covid prevalence and during flu season isn’t a good idea.’ You’ve got to acknowledge that it is Christmas.”
