Coronavirus on ‘Freedom Day’: What does the future hold?

From today England moves to stage 4 of the ‘roadmap out of lockdown’. The so-called ‘Freedom Day’ means all legal Covid restrictions end.

Since the start of the pandemic, Visiting Professor of Nursing (and former Dean of the University’s Faculty of Health, Education and Society) Dr Steve O’Brien has been keeping a close eye on developments. In this blog, he looks at where we are now and what the future could hold for us.

The coronavirus pandemic is a public health crisis the likes of which none of us have seen in our lifetime. Since 23 March 2020, the UK has been subject to social restrictions aimed at containing the pandemic. To date there have been just short of 153,000 deaths with Covid-19 on the death certificate. The pandemic has put enormous strain on the country’s health and social care system and had a massive toll on the wellbeing of the population.

At the time of writing this blog, we are experiencing a significant third wave of infections fuelled by the highly transmissible Delta variant. Despite this situation, in England today all legal restrictions end allowing the economy to fully open. It is fair to say that this decision has been met with a mixed reaction. Many welcome the move but it appears the majority remain anxious about what the immediate future will hold.

Why remove most Covid restrictions?

To relax restrictions at all at this time is solely down to the success of the vaccination programme. The importance of the vaccine is primarily in protecting people from serious illness caused by the virus thus reducing hospital admissions and mortality, although research is indicating that vaccination can reduce onward transmission by up to 50%. With such good vaccination outcomes, it is argued that the most vulnerable are now protected and the restrictions can be lifted.

However, there are some ongoing concerns. Given that the current UK rates of infection are rising and will continue to rise as restrictions are swept away, three key concerns need to be considered:

• Rising infection rates provide an environment within which the opportunity for the virus to mutate increases.
• Anyone infected with the virus is at risk of developing long term debilitation.
• Rising infection rates will inevitably lead to increased hospitalisation and deaths.

Plusses and minuses

Nevertheless, the complete removal of restrictions will be a positive one for many with such importance for social beings as human interaction, as well as our mental and physical health. In a wider sense the end of restrictions will have a very welcome and helpful impact on the economy and education. The widespread disruption to children’s education is being tackled as isolation rules in schools also change from today.

On the other hand, many will struggle with the psychological shift required to move from a restricted state with its obvious safety benefits to a state of openness with continuing fears for personal and family health.

That responsibility after a period of ‘following the rules’ may be psychologically and socially challenging for some. The Chief Medical Officer for England (CMO) Professor Chris Whitty himself has urged a steady and cautious approach.

What we see in the changes is a shift from Government legislation and mandate to one of personal and collective responsibility for action. It will also require everyone to undertake a personal risk assessment.

What will be our personal risk and the risk of those we encounter in our everyday lives? What are the risks to our family, friends and community? How do we best protect those who are vulnerable and how should we behave collectively for the safety of all?

The coronavirus has not gone away, and we are going to have to learn to live with it for a considerable time yet. The major risk factors to continue considering include age, environment (indoor, crowded, less well-ventilated areas pose the greatest transmission risk), people (how vulnerable are those you meet) and, of course, travel.

This risk balance will be a delicate one and in terms of shaping behaviour is probably best described in the debate on the need for continued mask wearing many arguing it should be mandatory in certain circumstances such as public transport whilst libertarians will be happy to discard the mask complaining it was always an affront on personal liberty.

How will we stay Covid safe?

Whatever the future holds it is fair to say that none of us will be fully protected but we can reduce those risks especially through vaccination. In a pandemic vaccination needs to be on a global scale and therefore no one is safe until we are all (globally) safe which is why mass global vaccination is such a priority. This will include booster doses for the most vulnerable on a regular basis.

From today, England embarks on a large-scale experiment. No other country in the world has unlocked to such an extent in the face of a growing wave of infections. If we get it right, we can claim to be genuinely “world beating”, but if it goes wrong then the health, economic and political ramifications could be catastrophic.

So, embrace the so-called ‘Freedom Day’ with continuing caution and follow the advice offered by Lucy Wightman the Director of Public Health for Northamptonshire that “just because you can doesn’t mean you should”. For the time being I would urge you all to follow the guidance set out below and stay safe:

• When offered the vaccine take it up. It is safe and effective.
• Make sure you also go forward for your second dose when this is due.
• Continue to follow the general guidance about washing hands, wearing a mask in public indoor spaces and on public transport, maintaining social distance wherever practicable and ensure all indoor environments are well ventilated.
• If you develop any of the known symptoms: High temperature, new cough, headache, loss of smell or taste sensations get a test immediately and follow the isolation rules.
• Look after your personal physical and mental health through a good diet, exercise and ensuring you access the NHS as soon as you need it.

Dr O’Brien can be heard each Tuesday morning on BBC Radio Northampton, explaining the latest Covid updates and answering your questions. Tune in from around 7:10am.