Plans to let people across the United Kingdom meet up and celebrate Christmas together hang in the balance after medical experts warned it "will cost lives".
The government in England, under plans agreed with the devolved administrations of Scotland, Wales and Northern Ireland, will see restrictions suspended for five days to allow up to three households to form a "Christmas bubble" and meet between 23 and December 27.
U.K. Health Secretary Matt Hancock told a press conference at Downing Street that it remains the government's intention to allow the five-day relaxation of social distancing rules over Christmas but warned people to be "extremely careful" if they hope to meet up with elderly or vulnerable relatives.
The country's top medical officer Professor Chris Whitty also urged caution, saying: "The feeling was this was a very important time for families but - and the big, big but on this - the level of impact this will have is entirely related to how many people choose to do this in a very, very minimalist responsible way."
Two prominent medical journals have gone further, arguing government ministers in the U.K. should "follow the more cautious examples of Germany, Italy and the Netherlands" and not relax the rules.
In a rare joint editorial, the British Medical Journal (BMJ) and Health Service Journal (HSJ) said the government should "reverse its rash decision to allow household mixing and instead extend the tiers [England's current method of restrictions] over the five-day Christmas period". The government is "about to blunder into another major error that will cost many lives," the journals warned.
The main impact of a further surge in COVID-19 inpatients, the journals said, is likely to be felt most by those with other conditions who may see treatments or surgeries delayed as staff and resources will have to be diverted to treat COVID patients. This is on top of the major issue of staff absence.
Latest figures calculated by Newsweek suggest up to 39,000* NHS staff are currently off work due to COVID-19 across the U.K., either through sickness or self-isolating after coming into contact with a positive case.
HSJ editor Alastair McLellan tells Newsweek that if the Christmas break in restrictions leads to a surge in cases in the new year, it will hit at the same time as the general peak of staff sickness, which also happens to be the busiest time of the year for the NHS.
"What we have seen, you begin to show symptoms about a week after infection and if you get sick enough for the hospital, that's typically about two weeks after," he says. "As we are seeing now infections are going up about two weeks after December 2 [when lockdown ended in England] so yes, the influx of Christmas patients will be mid-January, which is at the height of staff sickness anyway."
It will be up to individual NHS Trusts as to whether staff treating patients for other conditions are redeployed to deal with COVID, and despite the reluctance of NHS leaders to make such a move, McLellan says: "If you look at the numbers now, they are getting so big, so quickly. People are bound to have to start doing that, if they are not already, quite soon."
A spokesperson for Number 10 said the government "has no plans to review the Christmas guidelines" but Sky News reports that minister Michael Gove is due to speak to leaders in Scotland, Wales and Northern Ireland about the relaxation, causing many to question whether the government will U-turn on the plans.
If this happens, the broadcaster lists potential alternative options as toughening up messaging about staying safe, reducing the number of days or households the relaxation applies to, or even moving the five-day break to a later date.
It comes after Hancock told Britain's lawmakers in the House of Commons that a new variant of the COVID-19 virus that is linked to a faster spread of the disease has been identified in southern England where cases are rising exponentially. Average daily hospital admissions across the U.K. have risen 13 percent and average daily cases by 14 percent in the last week, the health secretary said.
London, parts of Essex and south Hertfordshire in the south of England will now enter the toughest restrictions under "tier three" of the U.K. government's COVID regulations just two weeks after coming out of a second national lockdown.
Given the surge of infections, if a large proportion of the population takes advantage of the government's policy at Christmas there is a "very real danger of a third wave of the pandemic", experts have warned.
Writing in the BMJ, the Independent Scientific Advisory Group for Emergencies (iSAGE) which is separate from the government's pandemic scientific advisory group (SAGE), also called for a rethink in the light of surging rates of infection in parts of the U.K.
The group is urging people to avoid to consider meeting outdoors rather than indoors, if possible, and for the government to support this through a fund for outdoor community events. There could also be a "pandemic fuel allowance" so that people could keep their homes ventilated while at the same time turning up the heating to keep warm, iSAGE said.
Stephen Reicher, professor of psychology at the University of St Andrews and a member of iSAGE, said in the BMJ: "The government has said three households can mix, but 'can' does not mean 'should.' We are at high levels of infection throughout the country. From that base, if we mix, and if everybody takes advantage of three households mixing, then there is no doubt that the infection rate will spike and we will live to regret it in the new year.
"Not only will people die, but it will also overwhelm the NHS at a time when we are trying to roll out the vaccine. The safest thing, by far, is not to mix. If people decide to meet, then there needs to be clear guidance on keeping safe and clear support."
British Prime Minister Boris Johnson has been urged by opposition leader Sir Keir Starmer to "think again" about relaxing the rules. In a letter to Johnson, Starmer said that while he understood that people will want to spend time with their loved ones after an "awful year", the situation has "clearly taken a turn for the worse since the decision about Christmas was taken."
*Study Methodology & Notes
Using the latest data provided by the NHS:
- In Northern Ireland 819 NHS staff were recorded as absent due to COVID-19 sickness or self-isolation in the week to December 7.
- In Scotland, 2,766 NHS staff were absent due to COVID-19 up to December 8.
- In England, 32,280 NHS staff were abscent due to COVID-19 either through sickness or self-isolation up to December 2.
- In Wales, around 3,076 NHS staff were absent due to COVID-19 up to December 7. Wales presents its data as a percentage. Of the 85,458 NHS Staff working in Wales 1.4 percent (1,196) were off work with COVID-19 sickness, while 2.2 percent (1880) were recorded as being off work due to self-isolation.
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