The strategy to ease lockdown

What should the roadmap be for easing the current lockdown?
26 January 2021

Interview with 

Gabriel Scally, Independent SAGE


cartoon image of person holding a stay at home sign


Here in the UK, we remain in a lockdown with many people unable to work, we're banned by law from socialising, festivals like Glastonbury and many sporting events are on hold. In England, the legislation underpinning these rules is in force until March the 31st, but many are asking what is the roadmap for easing this third and - hopefully final - lockdown, and what provisions must we have in place by the time it's over? Public Health physician and independent SAGE member Gabriel Scally told Chris Smith how he's reading the situation…

Gabriel - I think our position is really very serious. Certainly the virus infection is still at an extremely high level. It is coming down thankfully and so it should do because of the level of restriction, but it's got a long way to go and we really want to see it come down just as fast as it went up, because every day it lingers at a high level, it causes more cases. So that's good it's coming down, but needs to come down faster.

Chris - What do you think that the risk is of stepping back too quickly? Because Chris Whitty chief medical officer for England made this point several times in last week's Downing Street press briefing, where he said, we need a managed retreat back from where we are. So we don't release things too quickly. Obviously the question he was being asked was about easing lockdown restrictions. So what do you think is the correct way from where we are now to get out of this?

Gabriel - Well we do absolutely need to get the virus under control, keep it under control and preferably keep new variants out. I think if we did those three things, getting it down through the restrictive measures is absolutely important. Keeping it down really depends on a raft of other measures being done properly, things that haven't been done properly, such as putting in place a really good find, test, trace isolate and support system. And we haven't really explored what we can do to improve ventilation because that is a key preventive key public health measure - ventilation in our schools before they go back, ventilation in our workplaces, in our retail places, all of the places behind a door where that door would be much better open and the windows open as well.

Chris - What do you think about the current vaccine situation? Because obviously when 2021 was born and we launched in with not one, but now two vaccines - so we're fighting the virus on two fronts - and I mean, you have to acknowledge, they've got to more than 4 million people very, very quickly with these vaccines, but is this the right approach and, and what should be our expectations from this vaccine campaign?

Gabriel - I think getting the most vulnerable people, those really elderly people and also those with serious other conditions troubling their health, getting them vaccinated as quickly as possible is extraordinarily important. But it's also really important to make sure that we get a really high uptake of the vaccine. I know from my own personal experience of running vaccination programmes that getting the first 50, 60, 70% even is relatively simple. Getting it up 80 to 90% and over 90% in an adult population is extraordinarily difficult, but that's what we have to really concentrate on doing. So I'm heartened by the progress so far, but it's still got a long way to go and one of the things we must not do is take our foot off the pedal here. I'm very clear that people must understand just because you've had one dose of a vaccine, doesn't mean that you are immune from the virus. It will, over a period of weeks, give you a certain amount of immunity, but everyone just still has to retain the same social distancing, the same safety measures essentially to keep themselves safe, particularly if you're a vulnerable person.

Chris - Is your expectation then that this virus is not going to go away. It's not something we can eliminate. Like we have eliminated polio from many places, measles from many places, sadly, not our own country anymore. And that basically we need to make plans for expecting this to be with us for the foreseeable future and therefore we need some way of suppressing it and suppressing its effects, but accepting it's always going to be there.

Gabriel - Well, both of those things, they're not incompatible. Many countries in the world have achieved elimination. Elimination doesn't mean that there are no cases at all. It means that there's no local transmission, that the infection doesn't roll on in a community. Particularly Australia, New Zealand and plenty of Asian countries who have got to zero COVID and kept to zero COVID, they're still picking up cases, but they're picking them up in the managed isolation facilitates that I think we should have. So it is possible to have the virus eliminated in the sense that there's no longer any local spread, but lots and lots of countries will not have the ability to do that and therefore, I think it's very likely that the virus is going to be with us for some time. And the whole way of thinking about this may change, of course, at any moment, if the virus starts to produce variants that somehow circumvent the effect of the immunisation, then we're in difficulty. And it may not be as easy as it is with the influenza virus to find those variants, produce a vaccine for them, and then vaccinate the whole population. We know now, what a difficult task that is. So I think we're going to have to continue for some time to have a mixture of measures. If I had my choice, I'd rather live in one of those countries that had zero COVID and was operating normally, rather than a country that was trying somehow to live with the virus.



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