SOME call it a calculated risk, others a reckless gamble. Earlier this week, UK prime minister Boris Johnson announced that almost all remaining covid-19 restrictions in England are set to be lifted on 19 July, now called, by some, 鈥渇reedom day鈥�. This may be good politics, but is it good public health policy?
Scientific opinion is divided. The UK鈥檚 vaccination programmes are hitting one of their goals: to decouple infection from severe disease and reduce the need for masks and distancing. Even in the face of the highly transmissible delta variant, cases are rising but hospitalisations aren鈥檛 going up too much. That is good, given that the new UK health secretary, Sajid Javid, says cases could hit 100,000 a day as a result of easing restrictions.
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There is also the stark reality that countries must probably go through some sort of 鈥渆xit wave鈥� before returning to normality. The delta variant means that herd immunity is probably out of reach. Meanwhile, no country is likely to get to 100 per cent vaccination. To get over the line, at some point a partly vaccinated country has to decide to let the virus run through the population, despite the inevitable deaths, leaving the survivors largely immune, although a proportion will have long covid. That requires a difficult conversation about how many deaths and chronic cases are acceptable to a society. It also requires judicious decision-making about when and how quickly it is allowed to happen.
Some modelling suggests that dropping restrictions going into summer is better than waiting until autumn. But it doesn鈥檛 have to be a binary choice between now or later. Removing restrictions one at a time is indisputably a more responsible approach. It would also help individuals and employers navigate a world in which, with the government stepping back, they are now effectively responsible for public health. That is a grave responsibility indeed. So far, workers who couldn鈥檛 stay at home have been protected at work by masks, distancing and barriers, for example. What happens when those protections are dropped and people get sick? What lawsuits will we see?
And where does a new restriction-free landscape leave individuals, particularly those who are vulnerable to the virus? What is certain is that England is taking a big gamble. The world will be watching to see how the chips fall.