Plans to relax Covid restrictions at Christmas must be reversed or many lives risk being lost, according to a rare joint editorial from two of the UK’s most eminent medical journals.
That call was echoed by the head of the hospital doctors’ union, who described the government’s plans as “kamikaze”. Keir Starmer, the Labour leader, also urged Boris Johnson to reconsider the restrictions in a letter to the prime minister on Tuesday afternoon.
The British Medical Journal and Health Service Journal said the government could no longer claim to be protecting the NHS if it went ahead with its “rash” plans to allow households to mix indoors over Christmas.
“We believe the government is about to blunder into another major error that will cost many lives,” it says.
It warns that if current trends continue, there will be 19,000 Covid patients in English hospitals by New Year’s Eve – the same as at the peak of the first wave on 12 April. Those numbers do not factor in the impact of Christmas mixing between households and the freedom to travel to see family.
The editorial says the extra caseload of Covid-19 patients is likely to be 40 times higher than at the beginning of the second wave.
Labour has called on the government to rethink its decision to allow households to mix over five days at Christmas, saying the consequences could be unthinkable. In his letter to the prime minister, Starmer urged Johnson to convene Cobra and said Labour would support the government if they were to change the rules.
“This is a critical moment for our country. The failure of your tiered system to control the virus leaves us with precious little headroom,” Starmer wrote. “Put simply, if you take the wrong decision now, the ramifications for our NHS and our economy in the new year could be severe.”
Jeremy Hunt, the former health secretary who chairs the Commons health committee, has also urged the government to consider changing the plans for Christmas, saying it would be “a very, very dangerous and precarious situation” for the NHS to enter January with very high levels of bed occupancy from Covid.The interventions will add to the mounting pressure on the government to rethink its plans to allow three households to mix from 23 to 27 December.
France reopened non-essential shops this month, allowing Christmas shopping to begin. But an uptick in new infections since then means that while travel is permitted from 15 December, a nationwide 8pm to 7am curfew will begin then that will be lifted for 24 December, but not Christmas Day or New Year’s Eve. Bars and restaurants will not reopen until January and private gatherings are limited to six adults.
Germany's "lockdown light", with bars and restaurants closed since November, has not proved effective and the country has shut down further, closing all bar essential shops (such as supermarkets and pharmacies) as well as hair and beauty salons until at least 10 January. A maximum of five people from two households may meet, except for 24, 25 and 26 December when up to four close family members from other households can be invited.
Austria’s strict lockdown has ended and the country is carrying out a mass programme of 10 million tests over the next fortnight with the aim of allowing more families to reunite over the festive period. Christmas markets have been cancelled.
Italy's prime minister has said tougher restrictions will be needed over the holiday period,but they have not yet been announced. Inter-regional travel is already banned from 20 December to 6 January except for work, health or emergency reasons, and Italians may not leave their home towns on Christmas Day, Boxing Day or New Year’s Day. Midnight mass on 24 December has been brought forward so worshippers can get home before a nationwide 10pm-5am curfew.
Spain has appealed for people to be responsible but will allow movement between regions “for family reasons” between 23 December and 6 January. Regional curfews, which range from 10pm to midnight, will be pushed back to 1.30am on 24 and 31 December, when the limit for gatherings will be raised from six to 10, a measure that will also apply on Christmas Day and New Year’s Day.
The Netherlands has imposed a tough Christmas lockdown, closing non-essential shops and businesses, gyms, museums, cinemas and theatres for five weeks until 19 January. Bars and restaurants have been closed since mid-October. Schools are switching to online learning and people advised to stay at home. Households may invite up to two guests a day except for 24-26 December, when the ceiling is raised to three, excluding children under 13.
Belgium has said households may be in close contact with just one extra person over the Christmas period, although people living on their own will be allowed to meet two others. Fireworks are to be banned on New Year’s Eve to limit gatherings.
Poland will allow people to spend Christmas only with their immediate family, with no more than five guests to be invited to each household until at least 27 December and travel banned outside people’s home towns.
Britain is relaxing restrictions over the holiday with “Christmas bubbles” allowing up to three households to mix between 23 and 27 December. Scientists, government advisers and medical experts have called for an urgent rethink, suggesting the move could result in a disastrous third wave in the New Year.
Jon Henley Europe correspondent
The HSJ/BMJ editorial said circumstances had changed since the system was announced. “When government devised the current plans to allow household mixing over Christmas it had assumed the Covid-19 demand on the NHS would be decreasing. But it is not, it is rising, and the emergence of a new strain of the virus has introduced further potential jeopardy,” the editorial says.
“It should now reverse its rash decision to allow household mixing and instead extend the tiers over the five-day Christmas period in order to bring numbers down in the advance of a likely third wave. It should also review and strengthen the tier structure, which has failed to suppress rates of infection and hospitalisation.”
The government has announced that up to three households will be able to mix indoors and stay with each other overnight from 23 to 27 December under loosened coronavirus restrictions across the UK.
Can I eat out with my Christmas bubble?
No. In a blow to pubs and restaurants, and families who like to avoid the piles of washing-up, separate households in a Christmas bubble will not be able to meet up in hospitality venues. However, members of a Christmas bubble can meet at home, in places of worship and in outdoor public places including gardens. You can continue to meet people who are not in your Christmas bubble outside your home according to the rules in the tier you are staying in. If you are living in a tier 3 area in England, pubs ands restaurants will remain closed.
Is there a limit on the number of people who can meet up as part of a bubble?
There is no maximum size for a Christmas bubble, so you don’t need to worry if you and those you join with live in large households.
If I’m already in a bubble with another household, do we count as one household or two for the new Christmas rules?
Under the rules, a support bubble will count as one household when Christmas bubbles are being formed.
Can I join more than one Christmas bubble?
No, the bubbles have to be exclusive, and they cannot change over the five-day period – so pick your households carefully. This means that you can’t mix with two households on Christmas Day, and then a different two households on Boxing Day. However, children whose parents are separated will be able to move between two Christmas bubbles so they’re able to celebrate with both parents.
Do I need to socially distance from the people in my Christmas bubble?
Bubble members will not be required to social distance while they are together, so they can hug or kiss under the mistletoe. However, people are advised to exercise caution if there are vulnerable people involved in their bubble.
What about care home residents?
In England, some care home residents may be allowed to form a bubble with one other household, in agreement with the home and subject to individual risk assessments. In this case, social distancing should be maintained, with regular hand washing and ventilation to reduce risk. Care home residents should not form a three-household Christmas bubble at any point.
Can I travel to meet up with people in my Christmas bubble?
Individuals will be able to travel between coronavirus tiers and across the UK during the designated festive period (23 to 27 December). People will be able to travel to and from Northern Ireland for an extra day either side of that period, to allow for the extra time needed.
What if I live in a shared household?
In England, people living in shared households can split and join separate Christmas bubbles without breaking the three-household rule. So a group of, say, four young people living together would all be allowed to return home to their four separate families for Christmas and then come back to their shared home after the festive period.
NHS trusts in the most pressured regional health systems are already having to cancel almost all elective and non-urgent care because of the resurgent virus, the editorial says. “Even if NHS England succeeds in vaccinating all those ‘at risk’ by Easter, this will not be in time to prevent hospitalisation and death for many during the next few months,” it adds.
The BMJ and HSJ also criticise NHS test and trace and the government’s plan for mass testing with lateral flow tests. The tracing service “which has almost nothing to do with the NHS, continues to squander money on failure. So too does the mass testing of asymptomatic people using lateral flow tests that are not fit for purpose”, the editorial says.
Dr Claudia Paoloni, the president of the Hospital Consultants and Specialists Association (HSCA), backed the calls, stressing that Germany has more beds and more staff than the NHS yet it has announced a Christmas lockdown.
“The UK’s failure to do the same will see hospitals buckling, the mass cancellation of non-Covid work and propel us zombie-like into an avoidable emergency,” she said.“Inaction will mean patients dying needlessly and thousands of critical cases going untreated. The government must move now, urgently, to reverse these kamikaze plans.”
According to data from NHS digital, Covid-19 bed occupancy in England has risen from 9,782 on 31 October to 14,460 on 13 December. While some areas such as the north-east and Yorkshire have seen modest declines over that period, London’s Covid-19 bed occupancy rose 227% from 973 to 2,212, with occupancy more than doubling in the south-west, and tripling in the south-east.
Asked whether he would scrap the Christmas relaxation if he was in government, Hunt said: “If Chris Whitty and Patrick Vallance gave me advice that we should do that, if this is the way that we are going to save lives, if this is the way that we are going to stop having to potentially go into a third lockdown in January or February, then yes, I would follow that advice,” he told BBC Radio 4.
Hunt urged the government to do this if needed. “I don’t think we should ever criticise people for changing their minds in a pandemic as the data changes,” he said.
