Following the Prime Minister’s admission today that the UK is experiencing a ‘second wave’, the BMA is calling for a ‘near elimination’ strategy for the control of Covid-19.  This means introducing stronger measures in the short term to drive down case numbers to such low levels that any further infections are the result of re-introduction rather than community transmission.

The Association says that unless people stick rigorously to the social distancing and infection control measures in place, or there is better enforcement, infection rates will soar and the NHS will once again be crippled as it tries to cope with the number of patients with Covid-19.

Doctors are keen to avoid another full extended national lockdown because of the impact on the health service, the economy, education and the consequences of forced social isolation on peoples’ mental health and wellbeing. 

However, it’s clear that recent restrictions have been inadequate or not been adhered to, and have failed to make any significant impact on the spread of the infection. 

The BMA is therefore calling on the government in England to bring in stronger measures in the short term to help prevent a longer lockdown in the future. The Association wants the Government to provide better guidance, monitoring and enforcement of the practical steps people need to take in public settings and in workplaces to halt the spread of the infection.

The Chair of the BMA, Dr Chaand Nagpaul said:

“Rigorous adherence to infection control including handwashing, use of sanitisers, social distancing outside the home and always wearing face masks (for those who can) when that’s not possible, is crucial. The Government should take every step necessary to enforce this. Staff in workplaces, shops, pubs and eateries should be required to wear a face covering when within two metres of other people and at all times when serving customers. The government should provide clear guidance and support as necessary to businesses and employers to deliver robust covid-secure environments.

“It is also vital to reduce avoidable mixing of people at a time when the infection is spreading without the testing capacity to identify those with the infection. This requires revisiting the rule of six which allows members of six different household to meet indoors compared to a maximum of two previously, and reversing the encouragement to travel and return to work for those able to work remotely.

“There is also a huge need for better communication from the Government to local populations regarding real-time local infection rates - comparable to local weather information - and for this to be culturally competent. We also need clarity and consistency of how decisions about national lockdowns or other restrictions are being made. We need to know the criteria for when different restrictions will be introduced, and local public health specialists need to have the autonomy to act in the best interests of their own towns and cities.”

The BMA is calling for:

• The ‘rule of six’, as it is currently applied indoors, to be reconsidered.  It is now currently possible for members of six households to meet indoors, potentially many times over the course of one day.  Formerly, a maximum of two households could meet.
• Workplaces and offices to ensure Covid-secure environments for staff, including use of face masks or barrier screens when staff are within two metres of each other. Government should provide clear guidance as well as support to employers where necessary.
• Explicit guidance that visors alone are not sufficient and should be worn along with face masks, and better public education on how to wear a face mask to ensure effectiveness.
• Entrances to indoor public settings to provide inexpensive disposable surgical masks for members of the public who attend without one and sanctions for those who don’t comply.
• People over 60 and who have underlying conditions at risk of serious ill health from COVID to wear medical grade masks to protect themselves in keeping with WHO guidance. With high circulating spread of the virus, targeted protection of those at high risk of hospitalisation is important.
• Working from home to be actively encouraged where this is logistically possible to reduce spread of infection as a result of reduced contact between people including on public transport.
• Greater clarity and strict adherence to Covid-secure arrangements in bars, pubs and restaurants with strict distancing of tables and groups of people and recording of customer details– supported by greater monitoring and enforcement measures.
• Unnecessary travel and social mixing to be discouraged – and the ‘eat out to help out’ scheme to be complemented with a ‘take out to help out’ approach.
• The increased use of apps – such as those that are used to inform people about local weather and pollen count conditions – to inform people of local infection rates. Any “early warning” signs known to local populations will allow proactive action and behavioural change to stem spread of infection and avoid local lockdowns.

On testing, Dr Nagpaul said:

“Our testing programme is woeful and has nowhere near the capacity and agility we need to test at scale. Testing is now effectively rationed and so we must prioritise testing for those who need it - such as people with symptoms and key workers including healthcare staff and teachers, along with suspected cases who are contacts of key workers.”

 

Notes to editors

The BMA is a trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.