Like many of my constituents, I had hoped that we were now on an irreversible return to normality, following the intense challenges of the past two years – not least, thanks to the huge success of the vaccine rollout.
I was therefore extremely concerned when it was first announced that the Government intended to implement Plan B, despite the number of hospitalisations from Covid remaining at a steady – and manageable – level here in Buckinghamshire. In particular, the potential impact on the local economy, especially the hospitality sector, could be profound.
However, I have had the opportunity to speak to a number of Government Ministers, in the Department for Health, the Treasury and elsewhere, in order to understand the rationale behind the decision. It is clear that this has been a very difficult step to take, especially as there is currently a limited amount of data. Based on the conversations I have had, I am absolutely confident that Ministers explored all other options before reluctantly concluding that it was necessary to bring in the new restrictions.
I hope that the following points will reassure you both about the reasons for the steps being taken, and the extent of them.
- Omicron is spreading extremely fast in the UK. As of 9 December, there are 817 confirmed Omicron cases in the UK, up 45% from 568 on the day before. This is a rapid rate of increase but these are only cases confirmed through the lengthy process of genomic sequencing, so the true number is far higher (estimated to be higher by a factor of c.20). Based on other testing data which provides a reliable proxy for Omicron, the UK Health Security Agency estimates that Omicron is doubling every 2.5-3 days. Data for 7-9 December suggests Omicron makes up 8% of cases in England and 30% in London. Omicron is likely to become dominant in England next week. This is much faster growth than we have seen since the early days of the pandemic.
- Hospitalisations are doubling every 5 days in South Africa suggesting Omicron still causes severe disease. Early data from South Africa offered hope that Omicron was much less severe than Delta, but now hospitalisations in South Africa are doubling every 5 days. There is always a lag of a couple of weeks between cases and hospitalisations, then a further lag to deaths. South African doctors are telling us that the increase in hospitalisations reflects a real increase in severe disease, not simply people being admitted for other reasons who happen to test positive. Given that infections in the UK are following the same pattern as South Africa, it would be a big gamble to assume that hospitalisations won’t follow the same pattern. It’s true that the UK has higher vaccine immunity, but on the other hand South Africa has higher natural immunity from Beta (which is more similar to Omicron).
- Even if Omicron is less severe, it could lead to massive numbers in hospital if too many people get sick at the same time. It would be very good news if Omicron is less severe, though there isn’t yet enough evidence to prove this. Hospitalisations are now doubling rapidly in South Africa, so even if there is a reduction in severity, it may only be moderate. The danger remains that if Omicron spreads so much more quickly – because it’s intrinsically more transmissible, or because it escapes immunity, or a combination of the two – that so many people get sick at the same time and hospitals can’t cope with the flood of patients. For example, if hospitalisations follow infections and double every 3 days, even if Omicron is half as severe, the benefit of that reduction in severity is wiped out in just 3 days – and numbers will keep on doubling until the virus runs out of people to infect. The NHS is already running at 95% of capacity due to winter and Delta pressures.
- By the time we know more, it could be too late. “Wait and see” could mean you are in a much worse position by the time you intervene. With infections doubling every 2.5-3 days, delaying action would bake in many more infections, meaning it would be much harder to bring the epidemic under control, potentially requiring more stringent measures. Moving to Plan B is therefore a judgment call in the absence of complete information, designed to buy time to find out more and get more boosters in arms. If we choose not to act, we would be taking a greater gamble with people’s lives.
- Plan B is not lockdown. There are no business closures and no restrictions on social gatherings. Work from home is in guidance – there is no mandatory “stay at home” order. The only legal restrictions are mandatory face masks in most indoor public places and requiring proof of a negative test or double vaccination to enter some venues (specifically nightclubs and mass events, but not pubs or restaurants).
- The Government are not introducing “vaccine passports” – a negative test is enough. As a result of concerns from MPs, the Government are not proceeding with vaccine passports as originally intended in Plan B – instead negative tests will be allowed. Anyone will be able to attend mass events and nightclubs if they show proof of a negative lateral flow test, regardless of vaccination status. Unvaccinated people can get lateral flow tests for free from gov.uk or pharmacies and take them at home. People who have had two vaccine doses won’t need to take a test. Boosters are not required and under-18s are exempt.
- The Government are monitoring 4 key metrics on a daily basis: the efficacy of vaccines and boosters; severity of disease; extent of transmissibility; rate of hospitalisation. New data on these variables is coming in every day, from the UK, South Africa and around the world. Slowing down the spread of infection through Plan B helps buy time so we have a better idea of what we are dealing with. We need to prepare for a potential scenario where many workforces are affected by too many people being off sick with Covid at the same time.
- Our exit strategy is vaccines. Scientists are confident that, while 2 doses of vaccine are likely to be less effective against Omicron, the boosters will still provide at least some protection – we just don’t know exactly how much at this stage. As data comes in, the Government will crunch the numbers to work out how many people we need to boost to prevent too many people getting sick at the same time, such that hospitals couldn’t cope. As soon as we can exit Plan B, we will. In the medium term, vaccines will be reformulated to tackle specific variants, and “multi-valent” vaccines will be able to take on multiple variants. Importantly, the Government are also ensuring the NHS is ready to cope with an increase in demand.
- Boosters should provide at least some protection and we have the fastest booster programme in Europe. Scientists are confident that people who are boosted will have a much better immune response to Omicron, even if effectiveness is reduced somewhat compared to Delta. Boosters should provide good protection against severe disease and death, though effectiveness against transmission may be less. We have already boosted 32% of our population, compared to 17% of Germany, 15% of France and 15% of Italy. We will go further and ensure that every eligible adult is offered a booster by the end of January – but at the moment it’s important to go down the age range so that the most vulnerable are boosted first.
- The regulations ensure these measures won’t be in place longer than necessary. These regulations automatically expire after 6 weeks, (on 26 January, having come into force on 10 and 15 December). Ministers will review the measures after 3 weeks and update the House of Commons as soon as it returns in the New Year.
- Even with Plan B, we still have far fewer restrictions than most of Europe. In response to Omicron, Denmark has closed schools, Norway has imposed legal limits on gatherings, and Ireland has closed nightclubs, introduced the rule of 6 in hospitality and limited visitors to private homes. In response to Delta, Germany has locked down the unvaccinated population and proposed mandatory vaccination, Austria is emerging from a full lockdown, and France has closed nightclubs and requires health passes for hospitality. We have been able to introduce fewer restrictions than these countries because of the success of our vaccine procurement and rollout.
I hope that this provides you with an idea of the circumstances that have driven this decision, and provides a degree of reassurance about the nature of the restrictions and the way they will be reviewed.