Boris Johnson is understood to be looking at three options to try to curb spread of the new variant
- Coronavirus – latest updates
- See all our coronavirus coverage
Last modified on Mon 20 Dec 2021 10.50 EST
What new measures are thought to be under consideration in England?
The prime minister is understood to be considering three options to curb the spread of Omicron. The least restrictive would be asking the public to limit social mixing, without legal enforcement. This would bring England into line with measures in place in Scotland, where people have been advised to reduce their socialising and limit gatherings to three households.
A step up from this would be mandatory restrictions on household mixing, the return of social distancing, and forcing pubs and restaurants to close at 8pm. The third option is a return to full lockdown, or something like it, with a two-week “circuit breaker” rumoured to be on the cards. Boris Johnson said on Friday he was not “closing things down”, but increasing pressures on the NHS may prompt a rethink.
Given Omicron’s transmissibility, would 2-metre social distancing make a difference?
Although Omicron appears to be more transmissible than previous variants, the fundamental mechanisms for transmission probably remain the same – the virus is emitted in aerosols and droplets from breathing, talking, singing, coughing and sneezing.
Cath Noakes, a member of the Scientific Advisory Group for Emergencies (Sage) and a professor of environmental engineering for buildings at the University of Leeds, said: “We don’t yet know whether people with Omicron emit more virus or whether the balance of transmission at close proximity versus through the air at a longer distance has changed. But regardless, the concentration of aerosols and droplets is always greater at closer distance and hence physical distancing remains an important measure.
“However, we know from experience throughout the pandemic – not just Omicron – that in many environments, 2-metre distancing on its own is not enough, and people can be infected when they share a poorly ventilated room with each other.”
Another advantage of 2-metre distancing is that it restricts the number of people in indoor settings, reducing the chances of an infectious person being present – and the number of people they could transmit the virus to. For the same reason, the return of social distancing would be extremely bad news for hospitality businesses.
How much impact would indoor mixing and hospitality rules have?
Mrinank Sharma at the University of Oxford and colleagues recently modelled the effectiveness of 17 Covid-19 measures implemented during Europe’s second wave, and found that restaurant, pub and cafe closures had a large effect, with an estimated reduction in the reproduction (R) number of 12%.
Closing nightclubs, or non-essential retail and services such as hairdressers and beauty salons, similarly reduced the R number by roughly 12% each, highlighting the potential risks of brief but very numerous indoor contacts. Closing leisure and entertainment venues such as zoos, museums and theatres had only a small effect – approximately 3%.
Sharma said: “We’d expect measures on indoor mixing and hospitality to have strong effect sizes, especially since there are few restrictions at present and transmission is much more likely indoors than outdoors. The stronger the measure, the stronger the reduction in transmission.”
Together, the Oxford team estimated a ban on all gatherings and the closure of all non-essential businesses would reduce the R number by approximately 52%.
What difference to cases, hospitalisations and deaths would it make to enforce measures before Christmas Day rather than 27 December?
With Omicron cases doubling every one-and-a-half to two days, each day counts. Yet whereas the Netherlands has reacted to the new wave of infections by imposing a nationwide lockdown effective from Monday, England has adopted a wait-and-see approach until now.
Although this policy is understandable from a societal point of view, it may result in measures being introduced too late to avoid huge pressures on health services, should hospital admissions rise consistently, said Hans Heesterbeek, a professor of theoretical epidemiology at Utrecht University in the Netherlands.
“I think we have now learned that we should not wait until we know for certain either way, and that half-hearted measures are not sufficient,” Heesterbeek said. “Acting now decisively, however painful to society, is therefore probably the best approach.”
Sharma said: “Five days’ difference of interventions could make a large difference to the numbers of cases in the coming weeks. In general, there is little room for manoeuvre.”
However, he added that since the severity of Omicron remained unknown, the effect on deaths and hospitalisations was even more unclear. “It is also unclear whether interventions would reduce R below one, or delay the spread,” he said.
Prof Rowland Kao of the University of Edinburgh said: “Broadly speaking, Omicron is doubling in terms of the numbers of cases, roughly every two to three days. This pattern has been consistent since the first rise in cases was seen in November.
“Voluntary changes in behaviour and the recent recommendations and requirements from government may slow this down, but there is as yet no evidence to quantify it. If the doubling pattern holds, a four-day delay may mean two to four times worse of a problem.”
Are mandatory curbs more effective than strongly worded advice?
Public compliance tends to be strong when measures are mandated by law. Not only is there the fear of judgment, or being reported to the authorities, there is also less room for interpretation by individuals.
Dr Nilu Ahmed, a psychologist at the University of Bristol, said: “When you have suggestions and very strong recommendations, it means that it’s up to the public to interpret that, and it can put a huge amount of pressure on individuals, because not everyone will interpret it in the same way.
“Right now, there are people who don’t want to go and meet family for Christmas, and there are family members who are saying, ‘Well, the law allows it and we might go into another lockdown post-Christmas, so if we’re going to do it, we have to do it now’. That amount of pressure can be really exhausting and cause high levels of anxiety and mental health issues.”
Whether mandatory restrictions would be as effective as they were earlier in the pandemic remains to be seen. Images of Downing Street parties and senior politicians or advisers not following their own regulations and laws could result in a backlash if rules were introduced, Ahmed said. “We behave in the ways that our social group behaves, and so if we see if there’s a law prohibiting us from getting together, then we can’t really be the one to break the law – unless everyone else is doing it.”
Source: Read Full Article
