Calls grow for No10 to bring back masks and £2bn-a-month free testing scheme


Calls are ramping up for Covid restrictions to return in the UK despite a raft of data showing the virus has been reduced to a bad cold for the vast majority of people.

A number of high profile experts publicly urged the Government to bring back face masks and free tests after a health minister admitted they could be reintroduced if the NHS becomes too busy to clear its backlogs.

The renewed calls for onerous public health measures are based on high levels of Covid cases admissions to hospitals — despite figures showing two-thirds of ‘Covid patients’ in the NHS are not primarily sick with the virus.

Deaths and ICU rates — which used to be the barometer for social restrictions — have remained flat despite the uptick in cases, which has been attributed to milder variants, vaccines and growing natural immunity.

Yet Lord Syed Kamall, a junior health minister, said on Monday that if Covid impedes on the NHS’ ability to treat other conditions then ‘clearly measures may well have to be introduced’.

Individual hospitals have already started to reintroduce face masks and social distancing in corridors and waiting rooms, in the first sign of curbs creeping back into normal life.

And today several scientists on Independent SAGE — a campaign group that used to advocate for a Chinese-style zero-Covid strategy — started publicly lobbying for the return of the extortionate free lateral flow scheme and more social restrictions, including outdoor mixing and face coverings.

But experts told MailOnline they expect the current surge to burn out naturally in the coming weeks as the virus ebbs and flows before settling into a more consistent pattern. They warned that by the time masks or lateral flows were rolled out, the latest wave will be ‘history’.

MailOnline analysis shows how the rate of severe illness from Covid has fallen over time. At the beginning of the pandemic, one per cent of all people infected with the virus (based on the Office for National Statistics infection rate) required mechanical ventilation within two weeks. But most recent NHS bed occupancy rates show just 0.015 per cent of those infected are admitted to an ICU bed – 100 times fewer than the start of the pandemic

But only a third of patients are primarily sick with Covid, which suggests rising admissions are a symptom of high infection rates rather than severe disease. The majority (64 per cent) are known as 'incidental' cases ¿ patients who went to hospital for a different reason but happened to test positive. The above graph compares incidental cases throughout the pandemic

But only a third of patients are primarily sick with Covid, which suggests rising admissions are a symptom of high infection rates rather than severe disease. The majority (64 per cent) are known as ‘incidental’ cases — patients who went to hospital for a different reason but happened to test positive. The above graph compares incidental cases throughout the pandemic

The Office for National Statistics ( ONS ) weekly infection survey found more than 2.7million Britons were infected with Covid in the last week of June

The Office for National Statistics ( ONS ) weekly infection survey found more than 2.7million Britons were infected with Covid in the last week of June

This graph shows the number of deaths directly due to Covid recorded in England and Wales. The number of deaths being recorded these nations currently is far below that of previous waves earlier year and a sheer fraction of those seen at the start of 2021

This graph shows the number of deaths directly due to Covid recorded in England and Wales. The number of deaths being recorded these nations currently is far below that of previous waves earlier year and a sheer fraction of those seen at the start of 2021

Britain’s fifth wave is being driven by the Omicron sub-strains BA.4 and BA.5, with the latter regarded as the most infectious variant of the virus yet.

The emergence of the strains has caused infections to rise across Britain for the past five weeks, with 2.7million (one in 24) people estimated to have been infected last week.

They have also caused daily Covid hospital admissions to rise to a near 18-month high, with around 2,000 people being hospitalised with the virus every day.

But BA.4 and BA.5 are both as mild as their parent strain, which has meant ICU admissions and deaths have remained steady despite cases rising for weeks. 

And two-thirds of NHS patients with Covid are not primarily sick with the virus, which suggests rising admissions are a symptom of high infection rates rather than severe disease. 

The majority are known as ‘incidental’ cases — patients who went to hospital for a different reason but happened to test positive. 

Covid ICU inpatient numbers are currently 20 times lower than at the height of the second wave in January 2021 and are lower than at any other point when infections were this high.

There are currently just 218 patients with the virus on mechanical ventilators in England — about 100 more than a month ago.

For comparison, there were 3,600 patients on ventilators at the peak of the second wave in January 2021.

Meanwhile, only 25 people are dying per day with Covid as the main cause, according to separate Office for National Statistics figures.

Deaths hit 1,300 a day last January and the vast majority were primarily due to the virus.

The changing severity of Covid is due to a mixture of growing natural immunity, vaccines and the milder strains that are currently dominant.

Yet Professor Christina Pagel, an expert in mathematics at University College London and member of Indie Sage, said wearing masks, particularly high-quality ones, was vital.

She told The i: ‘To stop this cycle happening over and over again, so that we can sustainably live with the Covid, we need the Government to do much more: bring back free testing for people, increase sick pay and encourage those with Covid or symptoms of Covid to stay home.’

She said she still wears a FFP2 mask ‘on public transport and in shops and during work meetings’.

‘I try to socialise outdoors as much as possible – sitting outside in pubs or restaurants, having picnics in the park – and I’m as vaccinated as I can be,’ she said.

Professor Pagel also said that for the next few weeks ‘at least’, she would be ‘avoiding crowded indoor places – so I’m not at the moment going to concerts, the theatre, indoor gyms.

‘I’m also testing if I’m seeing lots of people or anyone at risk or if I have any cold and flu symptoms.’

Dr Steve Griffin, also a member of Indie Sage, also backed the call for more restrictions.

Indie Sage — a group made up of far-left scientists and an active Communist party professor — had lobbied heavily for a Christmas lockdown but quietly softened its stance after the milder Omicron wave subsided naturally and the NHS was not overwhelmed.

Around 2.1m ¿ the equivalent of one in 25 ¿ had the virus in England alone by June 29 (shown), which was up from one in 30 the previous week

Around 2.1m — the equivalent of one in 25 — had the virus in England alone by June 29 (shown), which was up from one in 30 the previous week

 

The calls for more restrictions comes amid fears that the knock-on effects of lockdown are still killing more than 1,000 people a week in England and Wales.

Official figures showed there have been around 1,500 ‘excess’ deaths every week for the past three weeks in England and Wales. These are the number of fatalities above and beyond what would normally be expected at this time of year.

Only a small fraction of them — around 300 — are from Covid, which has led to calls for an urgent investigation into what is behind the excess mortality.

Throughout the pandemic, scientists warned shutting down society and cancelling operations could cause the worsening of other conditions like cancer, diabetes and heart disease.

The Government moved away from all Covid restrictions in April as part of its learning to ‘live with Covid’ plan — in which ministers recognised the harms caused by lockdowns and restrictions. 

Meanwhile, Swansea University’s Simon Williams, a researcher on Covid behaviours and public attitudes and member of the Indie Sage group, also called for free testing to make a return.

He told The i: ‘The problem is that the current strategy has taken all the learning out of ‘learning to live with Covid’.

‘The Government has removed protections like free testing and financial self-isolation support, and little seems to have been done to fundamentally improve things which can help to reduce the impact of Covid in the long run.’

Indie Sage’s Dr Deepti Gurdasani, an epidemiologist at Queen Mary University of London, added: ‘It is unsustainable to live with three waves occurring within six months, leading to significant impact in terms of long Covid, pressures on the NHS, deaths, and societal disruption.’

Prime Minister Boris Johnson told MPs in January that the Test and Trace programme cost £2billion ‘in January alone’ at the height of the Omicron wave.

The Government is under pressure to ease the cost of living crisis on families. 

Professor Paul Hunter, an expert in medicine at the University of East Anglia, told MailOnline free testing for the public would be unnecessary.

He said ‘about one in 10 infections were being picked up before the Government took away free population testing’, which was ‘almost certainly because of reinfections’.

He said at the start of the year, people were less likely to go for testing because they’ve had it before and were more likely to be asymptomatic.

He said: ‘The testing level that we’ve got, the proportion of actual infections that are picked up has plateaued. So it is now a reasonable marker of what’s going on.’

Professor Hunter said it is a question of ‘whether it’s worth the extra cost and the disruption to health services’.

He said: ‘Even if we were to reintroduce [free testing] and set up everything again, it’s going to take [the Government] about at least a month to recruit people, train them, take them away from other aspects of the health service, perhaps, where they are desperately needed, to put them into testing.

By the time free testing would be back in place, ‘the current wave will probably be history. I really don’t think there’s any benefit to it at all’, he said.

Professor Hunter told MailOnline the problem with implementing more restrictions is that it would only ‘prolong the epidemic and the current wave’ because ‘non-pharmaceutical interventions generally delay infections, they don’t actually usually prevent them’.

He said: ‘The way things are at the moment, we would have more disruption to society and to the health service for a prolonged low wave, then we would for a sharp, short wave.’

He recommended wearing a mask in crowded indoor spaces only if you are a vulnerable person and haven’t had Covid recently.

‘It makes sense for health services to require people to wear masks because generally vulnerable people tend to congregate in hospitals. I think that’s sensible,’ he said.

A Government advisor, who wished to remain anonymous, told MailOnline that when restrictions were in place, ‘they didn’t make a significant impact on Covid’.

They said that people can take measures to protect themselves depending on their own risk.

‘If you’re in a higher risk group, you need to get vaccinated and wear well-fitted FFP2 or FFP3. For the general public, washing hands and wearing masks in crowded places can all help,’ they said.

They added: ‘I would focus more on public health messaging than legal restrictions because it’s also based on likely compliance with these restrictions. Restrictions only work if people are willing to do them and I think that’s unlikely at the moment.

‘When Scotland had a mask mandate, it didn’t really make much difference to the overall outcome, but individuals can protect themselves by wearing well-fitted FFP2 or FFP3 masks.’

So do we REALLY need to start wearing masks all over again? As other countries start to make face coverings mandatory amid case surges, experts are divided over whether Britain should do the same

Do you still wear a face mask to go shopping, say, or on public transport? If so, you’re in the minority — but for how long? 

Millions of us ditched masks in January when the Government axed their requirement by law. But against a rising tide of cases, hospital trusts in Cambridgeshire, Hampshire, Nottinghamshire, Devon and Wales have reinstated guidance urging people to mask-up.

Last week, for example, the Royal Devon University Healthcare NHS Foundation Trust in Exeter started handing out disposable face masks and antiviral hand gel to all visitors.

‘We moved back to mandatory face masks for all, and I think it’s a sensible move,’ Dr David Strain, an honorary consultant in medicine for older adults at the Trust, told Good Health.

‘The point is to protect vulnerable patients at a time when one in 20 people in the population has Covid.’

Millions of us ditched masks in January when the Government axed their requirement by law. But against a rising tide of cases, hospital trusts in Cambridgeshire, Hampshire, Nottinghamshire, Devon and Wales have reinstated guidance urging people to mask-up

Millions of us ditched masks in January when the Government axed their requirement by law. But against a rising tide of cases, hospital trusts in Cambridgeshire, Hampshire, Nottinghamshire, Devon and Wales have reinstated guidance urging people to mask-up

Infection rates aren’t just rising in the UK — they are on the march across Europe, fuelled by Omicron sub-variants thought to be even more infectious than the BA.2 strain that caused UK cases to soar to a record 4.1 million in April.

Governments are revisiting face mask guidance as a result.

France’s former health minister Brigitte Bourguignon recently said people have a ‘civic duty’ to wear masks in crowded places, such as on public transport, at work and in shops; German Chancellor Olaf Scholz has warned that face masks ‘will play a bigger role’ in Germany in the coming months; and in Australia, Dr Kerry Chant, New South Wales chief health officer, last week urged residents to don a mask when they can’t socially distance.

Meanwhile, the government of Cyprus announced it is to make it mandatory for people to wear face masks when indoors.

So should the UK follow suit? Cases are, after all, rocketing — partly because the new strains of Omicron, BA.4 and BA.5, appear to be more transmissible than earlier versions.

That’s because changes to the protein on the spike of the virus make it easier for it latch on to host cells, so it is better able to evade immunity from vaccines and previous infections.

Cases in England have doubled in the past month, with 1.8 million infected as of June 24, according to data from the Office for National Statistics (ONS).

Hospitalisations are also rising. According to NHS England, there were 10,658 patients in hospital last week up from 3,835 on June 4.

That’s why all seven health boards in Wales are either insisting on, or encouraging the use of, face masks for hospital visits.

Many GP surgeries, care homes and hospitals throughout the UK have already brought back the requirement to wear a mask.

But should those rules change not just in healthcare settings, but also for places such as supermarkets, cinemas or restaurants?

Danny Altmann, who is a professor of immunology at Imperial College London, believes this is now a necessity. ‘Most of us working on Covid-19 were incredibly surprised that masks have not remained mandatory in healthcare and very strongly advised in other enclosed settings, such as schools or public transport,’ he told Good Health.

He wears a mask whenever he is in a public area and in close proximity to others, raising it only to drink or eat. ‘We are in the grip of a major wave and BA.5 is massively more transmissible than the early waves and is causing some quite serious illness,’ he adds.

There isn’t only a risk of illness and hospitalisation but also of developing debilitating long Covid, which causes symptoms such as fatigue and brain fog that can last for months, adds Professor Altmann.

‘There have been nearly three-quarters of a million new long Covid cases during the so-called ‘mild’ Omicron wave of 2022. Why would you take the risk of not wearing a mask?’ he says.

It’s a contentious subject — so much so that one consultant surgeon at a teaching hospital in southern England who opposes the reintroduction of mask-wearing would speak to Good Health only on condition of anonymity for fear of criticism from patients and colleagues.

The surgeon said: ‘I know it’s not a popular view, but I think we need to ditch masks unless you are in a medical setting. We have to learn to live with this virus.

‘The fact is that most people will have no symptoms or minor illness if they are infected with Covid, and we have a successful vaccination programme and drug therapies to relieve more serious symptoms.’

These therapies include antiviral medicines such as nirmatrelvir, ritonavir, remdesivir and molnupiravir, which are available to people at risk of getting seriously ill from Covid-19. This includes people with Down’s syndrome and patients receiving some cancer treatments.

There are, the surgeon says, solid arguments against masks.

‘Mask-wearing can give people a false sense of security so they don’t take precautions such as isolating if they have symptoms.

‘Covering faces all the time leads to poorer social interaction and people’s ability to recognise and identify others. It can lead to some people feeling isolated, particularly the elderly, who may already have difficulty with poor hearing.’

Dr Michael Lewis, a reader in the School of Psychology at Cardiff University, agrees that mask-wearing affects how people interact.

‘Most obviously, it is more difficult to interpret facial expressions, but this effect is reduced somewhat by people using the top half of their face more in order to communicate — for example, people smile with their eyes more when wearing a face mask.’

Mask rules from around the world 

United kingdom

Mask-wearing is no longer required by law.

United states

Mask-wearing is not required in public spaces, including on public transport.

Germany

Medical-grade masks (usually FFP2) are required on public transport and in health and care settings.

France

Masks are again requested in public places, particularly on the transport system.

Cyprus

Compulsory mask-wearing in indoor areas was reintroduced for everyone over 12 last Friday.

Spain

Masks are required on planes and in airports. The government of Andalucia said last week it was in favour of reinstating mask mandates for indoor public spaces.

Hong Kong

Masks are required in all public spaces including on public transport and when exercising.

Italy

FFP2 masks are required when entering Italy by ferry, train or coach; on public transport; and for visiting healthcare facilities.

Australia

Although it isn’t mandatory, politicians in all states are encouraging people to wear a mask in public places.

Compiled by Judith Keeling and Cherilyn Panganiban.

 

Children wearing them in school could, however, be affected, he says. ‘Face masks in an educational setting can act as a barrier to learning, but the data is not conclusive on this.’ 

Mask-wearing can also exacerbate dry eye symptoms, according to a survey in the journal Contact Lens & Anterior Eye, published last January.

People with sensitive skin may develop rashes caused by chemicals used to sterilise disposable masks such as formaldehyde, according to tests carried out at Hamburg Environmental Institute in April 2021.

Meanwhile, a study concluded that ‘prolonged use of N95 and surgical masks by healthcare professionals has adverse effects such as headaches, rash, acne and impaired cognition in the majority of those surveyed’, reported the Journal of Infectious Disease Epidemiology in 2020.

However, for many people, face masks never went away. Around three in ten adults (27 per cent) across the UK reported always or often maintaining social distancing, and roughly four in ten (38 per cent) said they wore a face covering when outside their homes, according to ONS figures.

But do they really work? Despite billions of people wearing them to reduce Covid transmission, gold‑standard scientific evidence — in other words, randomised controlled trials — remain thin on the ground.

Instead, the evidence comes mainly from observational studies, which look at samples of people without interfering or controlling them in any way.

According to these studies, there is a benefit to wearing a mask. For example, a review of public health measures published by the BMJ in October 2021, looking at 72 observational studies of nearly 400,000 participants, found a 53 per cent reduction in Covid-19 incidence from wearing masks.

Dr Michael Lewis, a reader in the School of Psychology at Cardiff University, agrees that mask-wearing affects how people interact

Dr Michael Lewis, a reader in the School of Psychology at Cardiff University, agrees that mask-wearing affects how people interact

And a study in the journal Science in May 2021 showed that even home-made masks stopped larger virus-filled droplets being passed on from an infected person wearing a face cover.

However, the type of mask you need varies according to your environment.

Yafang Cheng, head of a Minerva Research Group at the Max Planck Institute for Chemistry, reported that masks became less efficient if the air is full of virus droplets, as in a Covid ward. In this case, more advanced masks (N95/FFP2) would be required.

Most people in the UK wear disposable ‘surgical’ blue masks comprising three layers of synthetic materials that act as a filter to particles and droplets.

These are the type handed out at the Royal Devon.

As a gerontologist working there with elderly patients, Dr Strain wears a higher grade FFP3 mask, which blocks fine particles down to three micrometers in size.

‘This type of mask is designed to protect me, not just stop me passing on the virus,’ he says. ‘Most people don’t need such protection, although Germany is moving to FFP2 masks for its entire population, so we shall see.’

Professor Altmann wears a higher grade of mask, and not just on hospital wards.

‘I wear a high-grade N95 mask in any indoor public setting, except when I have to take it down to drink coffee, for example,’ he says. ‘In that situation, I make sure we are well spaced in an airy place.’

An N95 has a filter and the edges form a seal around the nose and mouth. In his opinion, the German move to make these mandatory indoors is the correct one.

‘That’s precisely what we should be doing,’ he says. ‘Sadly, the UK is doing badly: high caseload, antibody levels have waned since the boosters, and a poor rollout and uptake of fourth doses.’

More than five million people in England were invited for a spring booster dose, of which more than four million — about 86 per cent of those aged 75 and over — have had it so far. Those who are eligible include older care home residents, people aged 75 and over and the immunosuppressed.

But Dr Strain doesn’t believe masks need to be mandated by law because ‘most people are reasonable enough to put on a mask in a GP surgery, a hospital or on public transport’.

Professor Altmann, however, believes the need to return to mask-wearing is urgent. He says: ‘We are heading through the summer into autumn in a precarious state, and masks could make that marginally better.’



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