It is not too late for the UK government to develop an effective Covid strategy | Gabriel Scally

TThe emergence of a disturbing new variant of Sars-CoV-2 should come as no surprise to anyone. Omicron appears to be a real threat and should give thought to how countries can protect their populations from this and other similar challenges in the future.

The UK has helped create the conditions for the emergence of variants by opposing the granting of a patent waiver so that countries around the world can step up production of much-needed vaccines. At the same time, the British government has given priority to vaccinating its own people. Vaccines are of course an important tool in protecting most individuals from serious disease when infected, but no single intervention, no matter how technological, would keep the virus suppressed and under control in the population.

An appropriate strategy at this stage would be one that is solidly based on the three pillars of an effective public health response – prevention, vaccination and control. These are not alternative actions. Their combined effect would not only be additive but synergistic – producing a benefit greater than the sum of the parts. Prevention means preventing us from coming into contact with Sars-CoV-2 by reducing the risk that the air we breathe can carry the virus. Vaccination helps us reduce the risk of illness if we come in contact with the virus. Control means we help those who are infected to avoid passing it on to others.

One of the main reasons for the government’s lack of strategy and planning is that it is not interested in prevention and public health. His instinct is to put responsibility on individuals whenever possible, rather than taking collective action. This explains why the government emphasizes individual hygiene measures such as hand washing and surface disinfection. Failure to demonstrate the well-established fact that the virus is transmitted primarily by air, rather than by contact with surfaces or contact with large droplets, severely hampers the necessary actions around ventilation and filtration of the air. air in confined spaces.

Occupational health and safety legislation clearly states that it is the duty of employers to ensure that employees working in confined spaces have an adequate supply of fresh or purified air. The Health and Safety Executive has confirmed that the regulations still apply during the pandemic. But there are few signs of enforcement. Without a rapid reversal of its 50% reduction in real funding between 2010 and 2020, a weakened HSE is unlikely to be able to undertake the colossal enforcement work needed to protect workers and the public.

People of all ages working or visiting offices, educational, retail, hospitality or leisure establishments need to be confident that there is sufficient ventilation or air purification to ensure their safety. The “gate scores” approach, similar to the food hygiene notes in places serving food, is recommended by the Independent Sage group of scientists and should be highlighted as an urgent priority. This system would increase the confidence of the public to enter all kinds of premises and undoubtedly reduce infections. The amount of money currently wasted on obsessive cleaning and sanitizing regimes would go a long way to paying for permanent ventilation improvements.

Clear and consistent messages on the use of face masks are also needed. We will rightly only accept high-efficacy Covid-19 vaccines but seem to be content to promote the use of very basic face covers that offer comparatively less protection than masks meeting international standards, like KN95 or FFP2.

Controlling the spread of those unlucky enough to be infected is a critical task the UK has failed to do effectively. There are currently a large number of people get infected every day, and it’s critical that we quickly identify these people through testing and help them self-isolate. It is also necessary to identify and trace their close contacts so that they can be tested. Right now, close contacts of a person who tests positive are advised to self-isolate, but only get tested if they develop symptoms. This does not comply with international guidelines for control the Covid-19.

Calls for an effective system of research, testing, tracing, isolation and support have been ignored from the start. It is not too late to rebuild the system, based on local directors of public health working with the local NHS and primary care. But the hesitations and delays that have hampered the government’s response to the pandemic now appear to have been consolidated into a permanent position of inaction and obscurity.

Omicron is a stark reminder that Sars-CoV-2 is a dangerous and ever-changing virus that we desperately need to get under control. We are a long way from eliminating it from our communities, but we can remove it significantly and reduce disruption, illness and death. The government and its advisers must recognize that prevention, vaccination and control is the only sensible approach and, for the first time since the pandemic, define a comprehensive strategy focused on public health.

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