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Speaking after a cabinet meeting, Boris Johnson did not announce any new measures in England but said that they “will have to reserve the possibility of taking further action to protect the public”.
Dr Shaun Fitzgerald, Royal Academy of Engineering Visiting Professor, University of Cambridge, said:
“A decision to not impose further measures right now is really significant. It means that it is even more important that we all do everything we can collectively to look after ourselves, others, and of course the NHS. When we do mix, we should try and mix outdoors but if this isn’t practical then doing so in a reasonably well ventilated space is a pre-requisite. We don’t need to over-ventilate and freeze as there is a law of diminishing returns on ventilation in indoor spaces. Opening high level windows if we can rather than low level ones is an excellent way of not only ensuring all the air in the space is replenished but also of helping reduce cold draughts. There are lots of thing we can do to help even without restrictions being imposed.”
Dr Simon Williams, Senior Lecturer in People and Organisation, Swansea University, said:
“With Omicron rapidly spreading across the UK, there is considerable doubt as to whether voluntary guidance to exercise ‘caution’ will be sufficient to reduce social contacts and mixing to an extent to slow transmission down enough to prevent considerable and potentially unsustainable pressure on the NHS in January.
“There is some evidence that many people have started to voluntarily reduce social contacts already, with one recent poll suggesting that one in six have cancelled some type of Christmas event: https://yougov.co.uk/topics/lifestyle/articles-reports/2021/12/20/how-many-britons-christmas-plans-have-had-change-b.
“Compliance has been extraordinarily high throughout the pandemic, with research showing that most people have been following most of the rules most of the time: https://www.covidsocialstudy.org/. But would people comply with new restrictions after all this time?
“In our research, we find that many people may have been slowly becoming ‘desensitized’ or ‘habituated’ to the risk posed by COVID-19 and its many variants: https://psyarxiv.com/vam4t. In this sense, Omicron may be seen by some as just another variant, people may be switching off to news coverage and announcements on COVID-19, or they may feel like we should already be “living with” the virus. And so, some may not have been dramatically changing their behaviours in relation to the new variant. On the other hand, most people would still likely comply with rules, albeit reluctantly, if for no other reason than they are legally required to. The most important thing is to provide the necessary financial and practical supports to help mitigate the harms from restrictions (especially more stringent ones) to businesses as well as to individuals and their mental wellbeing.
“The idea that most people would still comply with rules, even over Christmas, is also seen in another recent poll where two-thirds suggested that they would still comply with the ‘rule of six’ or the ‘two metre rule’: https://docs.cdn.yougov.com/l9gt9vzzho/Internal_XmasRestrictions_211209_w.pdf. The big one that many people are opposed to is not being able to mix at all with other households over Christmas – where as many people said they were unlikely to follow them as said they would follow them.
“But risk perception is one of the biggest factors driving adherence to health guidance and compliance with rules, and so, as the statistics change each day to show more and more Omicron cases, it is likely that people’s willingness to be even more cautious, and to follow new rules if asked to do so, will increase. The question is whether this will be quick enough.”
Prof Amitava Banerjee, Professor of Clinical Data Science and Honorary Consultant Cardiologist, UCL, said:
“Throughout the pandemic, COVID-19 has three types of effects: direct (such as acute hospital admissions and mortality), indirect (disruption of care of non-COVID diseases, such as cancer and cardiovascular disease), and longer-term (i.e. long COVID, which is the persistent symptoms and impairment which affects a proportion of infected individuals, sometimes for many months). To mitigate all three effects, infection rate needs to be minimised.
“If there is a decision to not consider a lockdown it would appear to be solely based on the acute direct effects and is not taking into account the indirect and longer-term effects. Even in the case of direct effects, the sheer number of cases and the strain on the health system is a cause for great concern, particularly in London. Based on prior waves of the pandemic, we know that lockdowns work when enacted early and pre-emptively rather than late and reactively. I would want to know the level of hospitalisation and infection where lockdown would be considered necessary. The “vaccination-only” strategy will not bring hospitalisations down acutely, and there needs to be clearer guidance regarding non-pharmaceutical interventions, such as mask-wearing, social distancing, and potentially lockdown.
“If we are to truly protect the NHS and to protect the population, we must include both indirect effects and long-term effects in policy considerations as to how and why to reduce infection rate in the population.”
Dr Simon Clarke, Associate Professor in Cellular Microbiology, University of Reading, said:
“There has been clear advice from SAGE that the government need to tighten Covid-19 controls if the country is to avoid a potentially catastrophic number of infections. People understandably focus on hospitalisations and deaths, but we should not overlook the effects of a mass sickness on public services, infrastructure and economic activity.
“The news that the NHS administered closed to 1 million vaccine doses on Saturday is good news, as all the evidence so far points to boosters providing far improved levels of protection against infection and serious disease from Omicron. We still lack real-world data and there is a lot we don’t know about how well the booster surge will work in practice. What we do know about Omicron is that it spreads very quickly and being double jabbed, doesn’t provide much protection at all.
“We still don’t know what the UK’s infection fatality rate will be and it’s possible that the developing Omicron wave will look very different to ones we’ve seen before. Politicians need to be crystal clear with the public as to what they will tolerate before needing to strengthening Covid-19 controls. One of the Nolan principles of public life requires ministers and backbench MPs to take decisions impartially, fairly and on merit, using the best evidence and without discrimination or bias, but it’s currently impossible not to wonder whether decisions are being made through the prism of Tory leadership ambitions.
“The effect of the coronavirus on the UK population will not be influenced by normal political considerations, and the opinions of politicians, however senior, will count for little if they allow infections to run out of control.”
Prof Christina Pagel, Professor of Operational Research, UCL, said:
“The Prime Minister said they will delay action while looking at the data hour by hour. With Omicron spreading so fast, waiting for definitive evidence that it could cause the NHS to be overwhelmed will be too late to avert the crisis. Instead, the government should follow SAGE advice and return to step 2 of the roadmap immediately to prevent thousands of infections over the coming days and then monitor the situation hour by hour so that measures can be lifted as quickly as possible, hopefully even in time to enable limited household mixing over Christmas weekend.
“There is still so much that is unknown but as Chris Whitty said last week, what is known is bad. Boosters remain critical but will not take effect in time to change the pandemic trajectory over the next week or two. I believe Boris Johnson has to be honest with people that the speed with which the situation is changing means that longer term certainty is not possible, but that as soon as information becomes available, it will feed into policy making.”
Prof Sheila Bird, Formerly Programme Leader, MRC Biostatistics Unit, University of Cambridge, said:
“Knowing both admission-date and the date when the admission was reported-in allows an estimate to be made (with uncertainty) about the number of new Omicron hospitalisations that actually occurred on 18 December versus were reported-in on 18 December 2021. Analysts are carefully studying the hospitalisation-rates (e.g. at 5, 10, 15 days after PCR-positive date) for Omicron cases according to the vaccination-status of those infected versus those subsequently hospitalised. However, as SAGE has been clear about, with such high transmissibility as presented by Omicron, modelling-informed decisions need to be taken on a precautionary, pre-empirical basis.
“What Ministers weigh in the balance, for example in economic and social terms, against hospitalisations and deaths may also be subject to (say) economic modelling. About which, there could usefully be more transparency.”
Prof Robert Dingwall, Professor of Sociology, Nottingham Trent University, said:
“I don’t envy either modellers or policymakers at the moment. There are difficult decisions to be made under conditions of great uncertainty and rapidly updating information. By the time a model gets to Cabinet, it is already out of date. Wait and see is a perfectly legitimate position to take, given that the omicron variant has not so far taken off at the high end of possibilities and that there is more positive early data coming out of South African and Denmark. The evidence base for the effectiveness of most NPIs is very thin, thanks to the reluctance to fund evaluations over the last two years, and the break over Christmas and New Year will reduce many risks. Many workplaces will be closed, in addition to those where working from home is possible, and travelling will be much reduced. The cautious messaging from government over the last few days can also be expected to have an impact. This may be a moment to think hard about the transition to an endemic state, where controls would not normally be introduced, although there will obviously be a squeeze on public services and the economy from high rates of sickness absence, as there was during the flu pandemics of 1957 and 1968. The focus of policy should probably be on institutional resilience in the face of high levels of absence rather than on confining people to their homes when they are not sick.”
Dr Charley Baker, Associate Professor of Mental Health, University of Nottingham, said:
“What is missing from the government’s messaging is an acknowledgement that this state of constant uncertainty itself is having a huge impact on people’s mental health. While we all can appreciate the finely balanced decisions that need to be made, clear statements are required that set out exactly what paths are under consideration and which parameters need to be met for each path. Delay, prevarication and constant rumour leaves us all very much struggling as we try to prepare for the onslaught of the difficult days ahead.”
Prof Trish Greenhalgh FMedSci, Professor of Primary Care Health Services, University of Oxford, said:
“Mr Johnson acknowledges that cases of Omicron are surging and hospitalisations are rising quite steeply in London. He claims that getting booster vaccinations “could not be more urgent” but refuses to apply the same standards of urgency to the full range of preventive measures needed. The scientific arguments for further restrictions are not “finely balanced”. On the contrary, there are strong scientific arguments for people to immediately cease the activities that are known to cause transmission of this exceptionally contagious variant. In particular, large indoor gatherings of unmasked people, especially those involving singing, should not occur. This means, unfortunately, cancelling carol concerts and other seasonal festivities. Well-fitting, high-filtration masks should be worn at all times when indoors, especially in crowded settings such as supermarkets. Masks that do not cover the nose and mouth with a snug seal will not provide adequate protection against Omicron. Traveling on public transport with people who are unmasked is extremely risky. Nobody wants another locked-down Christmas but there are good scientific reasons for avoiding social contacts in the few days before Christmas so as to reduce one’s chance of passing on the virus to vulnerable relatives over the festive season. For evidence-based advice on how to reduce transmission of Omicron see this new YouTube video I’ve helped make with an animator: https://www.youtube.com/watch?v=It5BmKjoVJc&feature=youtu.be.”
All our previous output on this subject can be seen at this weblink:
www.sciencemediacentre.org/tag/covid-19
Declared interests
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