COVID-19 response: government sets out its plan for autumn and winter

Last week the government published its COVID-19 response: autumn and winter plan 2021 which made it clear that, despite the high level of daily infections (and an acceptance that these are likely to increase), it doesn't intend to impose any new lockdowns - at least not for now. 

Instead, it has two plans - plan 'A' and if that doesn't keep the virus at 'manageable levels', it will invoke its contingency, plan 'B'. 

1. Plan A

The government's strategy is predicated on its vaccination programme offering the main line of defence against the virus rather than lockdowns. 

Vaccines

Data suggests that vaccines provide 95% protection against severe disease. However, over 5.5 million people aged 16 and over haven't been vaccinated and this 'heightens the risk of rising hospitalisations'. The government will continue to encourage everyone to be vaccinated (particularly in those communities with lower rates of vaccine) and will make it easy for people to do so.

It will also offer COVID-19 booster jabs to those most at risk (priority groups 1-9) because evidence suggests that the levels of protection offered by the vaccines reduces over time, particularly in older people. 

People with severely weakened immune systems are already being offered a third vaccine. And, children aged between 12 and 15 will start to be offered the vaccine this week.

Testing

The test, trace and isolate system will continue. Anyone with symptoms is expected to self-isolate and take a PCR test. Anyone who tests positive must self-isolate for 10 days by law.

Lateral flow tests will remain free of charge (for now) and should be used to help identify people who are asymptomatic particularly in high risk settings such as the NHS, social care, prisons and in education. 

NHS COVID-19 app

The app will remain active and will continue to 'ping' users who have been exposed to the virus. However, those who have been fully vaccinated don't have to self-isolate unless they have the virus.

Clinically extremely vulnerable people

Shielding advice was paused on 1 April 2021 and, since 19 July 2021, people who were previously identified as CEV have been advised to follow the same guidance and behaviours as the rest of the adult population. The government believes that the majority of CEV people will be protected by the vaccine and they will be given priority over receiving the COVID booster jabs. Anyone in this group should talk to their doctor to find out if they need to take any additional precautions.

Flu vaccines

The government believes that there may be a substantial resurgence of flu this winter and recommends that those people who are invited for a vaccine, get jabbed. Those who were previously eligible will continue to be offered a free vaccine (primary school children, those who are aged 65 or older, vulnerable groups and pregnant women). The programme has been extended and is now also available to secondary school children and 50-64 year olds.

Safe behaviours

In general, the risk of catching or passing on COVID-19 is higher in crowded spaces (where there are more people who might be infectious) and in enclosed indoor spaces (where there is limited fresh air). To reduce risk, the government wants people to take individual responsibility to increase ventilation when indoors (by opening a window etc), wearing a face covering in crowded spaces, staying at home if they are unwell, getting tested, washing their hands and downloading the app.

Employers should continue to follow the 'work safely during COVID guidelines and are encouraged to:

• Ask employees to stay at home if they are feeling unwell.
• Ensure there is an adequate supply of fresh air to indoor spaces by identifying poorly ventilated spaces and improving fresh air flow in these areas (the HSE has guidance to help businesses improve ventilation and air conditioning during the pandemic)
• Provide hand sanitiser to enable staff and customers to clean their hands more frequently, and clean surfaces which people touch regularly.
• Display an NHS QR code poster for customers to check in using the NHS COVID-19 app, so they are alerted if there’s an outbreak and can take action to protect others.
• Consider using the NHS COVID Pass.

2. Plan B  

If Plan A doesn't work and the NHS comes under unsustainable pressure the government will implement its contingency plans which include reintroducing some measures to control the virus.

Communication

The public will be told that the level of risk has increased and that they need to behave more cautiously. The government will issue 'clear guidance' to the public and to employers setting out the steps they need to take to control the virus.

Mandatory vaccine-only COVID status certification

At present, the government continues to encourage the voluntary use of the NHS COVID Pass which certifies individuals based on vaccination, testing or natural immunity status. If Plan B is implemented, at that point the NHS COVID Pass will change to display full vaccination only. Exemptions will continue to apply for those who cannot be vaccinated for medical reasons, for those on COVID vaccine clinical trials, and for under 18s.

COVID status certification will be legally required in some settings including nightclubs, some indoor and outdoor crowded venues, and any settings with more than 10,000 or more attendees. Wedding ceremonies, places of worship, funerals and other mass participation sporting events will be exempt.

Organisations will be given at least one week's notice before mandatory vaccine certificates are introduced and the government will publish more detail about the regime shortly. 

Face coverings

The government will reintroduce a law requiring people to wear face coverings in certain places, such as on public transport. It will decide the precise settings at the time.

Working from home

The government may ask those who can work from home to do so to reduce the number of people using public transport and having face to face meetings. 

3. Lockdowns

The government is very keen to avoid new lockdowns. Yesterday, Boris Johnson refused to rule out Christmas Covid disruption. However, it has made it clear that it can't give guarantees' and will take 'whatever action is necessary' to protect the NHS from being overwhelmed.

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'However, the last 18 months have shown the pandemic can change course rapidly and unexpectedly and it remains hard to predict with certainty what will happen. There are a number of variables including: levels of vaccination; the extent to which immunity wanes over time; how quickly, and how widely social contact returns to pre-pandemic levels as schools return and offices reopen; and whether a new variant emerges which fundamentally changes the Government’s assessment of the risks.'”