A small room, with the windows shut, packed tightly with more than 30 people, none wearing masks. This is the image the government released last week of Boris Johnson’s reshuffled cabinet at their first meeting. The people around the table may have changed but the fundamentals remain: this is still a government determined to cut support for low-paid parents during a pandemic and to target asylum seekers in its willingness to stoke the culture war. And it is still a government acting with gross hypocrisy with its measures to control the pandemic. Ministers say they “expect” us to wear masks in crowded and enclosed spaces but that expectation appears not to extend to the senior politicians running the country.
With the prime minister and his cabinet publicly flouting their own guidance, it is perhaps little wonder mask wearing has dropped significantly since mid-July, when the government made face coverings in England a recommendation rather than compulsory on public transport and in shops. Surveys suggest only six in 10 people had worn a mask when in public places in the past two weeks, down from seven in 10 a few weeks earlier.
This is concerning because, despite two-thirds of the population being fully vaccinated, the pandemic is far from over. Infection rates have stabilised in England after a steep rise up to mid-July but there is great uncertainty about what will happen this autumn, with most experts forecasting cases will rise further as a result of Covid spreading in schools. While the vaccination push has dramatically reduced death rates, and the booster programme for those aged over 50 and the clinically vulnerable will help combat waning immunity, vaccines provide substantial but not 100% protection against ending up in hospital. If hospital admission rates continue to increase, the knock-on impacts on the nation’s health will be severe. This is because the NHS has so little spare capacity, both as a result of a decade of underfunding and because of the impact Covid-19 has had on waiting lists, with treatment for life-saving conditions such as cancer delayed. Clinicians are expecting greater strain than usual from serious respiratory viruses and influenza as a result of reduced population immunity because of social distancing over the past year; if Covid hospital cases rise significantly, this will have a profound impact on people who have already waited months for life-changing surgery such as hip replacements.
The lack of urgency in the government’s winter plan for Covid, published last week, is extraordinary in light of this. It is clear the government has scrapped almost all focus on so-called “non-pharmaceutical interventions”, such as mask wearing and improving ventilation in buildings, particularly in schools, in the hope that vaccinations alone will be sufficient to get us through the winter – its “plan A”. Some of plan A’s measures – testing for travellers entering from amber-list countries – were scrapped barely 48 hours after the publication of the winter plan. The government has said it will only invoke “plan B” – compulsory face coverings in some settings, more working from home where possible, and the introduction of vaccine passports – as a response to “concerning” data.
This makes no sense. Mask wearing in public spaces is a cheap and effective way of reducing the level of community infections. The cost of providing proper ventilation in schools pales in comparison with the far greater costs of the NHS having to delay urgent care for non-Covid conditions. Yet the government has chosen to delay the reintroduction of compulsory mask wearing until the situation for the NHS, which is already under pressure, with non-emergency treatment levels significantly lower than normal thanks to Covid, gets worse. It has failed to invest in ventilation technology for schools, despite having months to prepare for the return of schools this autumn; no money has been allocated for improving ventilation in schools since January. Instead, the government has launched a pilot scheme, involving just a handful of schools in Bradford, to test the efficacy of measures to improve ventilation – when experts say there is more than enough existing evidence to justify spending now to improve ventilation across all schools, as many other countries have done. This is particularly worrying given the delay in expanding the vaccination programme to 12- to 15-year-olds, which means that most teenagers will go into school for the first few weeks of this term unvaccinated.
A successful vaccination programme cannot compensate for the other grievous mistakes the government has made in this pandemic. The government has repeatedly taken too long to introduce measures to control the pandemic, resulting in tens of thousands more deaths than necessary and longer, more expensive social restrictions. It has also been too reluctant to control the pandemic using measures other than vaccines, such as the delay in introducing travel restrictions from India earlier this year, which allowed the Delta variant to seed in the UK far more quickly than it otherwise would have done. The government is continuing to make these mistakes as we head into the autumn: it is sending confusing signals about mask wearing and eroding the all-important social norms that are holding up well in other countries.
Why would the government so recklessly abandon relatively low-cost measures that would further improve the effectiveness of the vaccine programme, preferring instead to wait until things get worse before introducing them? It is the product of a prime minister trying to compensate for his lack of an agenda by showing the public that the vaccine rollout has returned life to its pre-Covid normality. Compulsory mask wearing, investment in ventilation technology for schools: none of this is convenient for that narrative. However, the government’s lax approach simply increases the risk that people will not receive the critical healthcare they need this winter. That he regards this as a risk worth taking shows Boris Johnson has learned nothing from the tragic mistakes of the past 18 months.