'CALL OFF XMAS'
Christmas bubbles ‘must be AXED’ say experts as they slam ‘rash’ plan to relax rules
MEDICAL journals have urged Prime Minister Boris Johnson to axe Christmas bubbles as cases of the coronavirus continue to spread across the UK.
In a historic plea the British Medical Journal (BMJ) and Health Service Journal (HSJ) called for the "rash" decision to relax social distancing measures over Christmas to be scrapped.
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Some ministers have already highlighted that changes could be made to the Christmas break.
The journals today said that the government "is about to blunder into another major error that will cost many lives".
The warning, authored by HSJ editor Alastair McLellan and BMJ editor-in-chief Fiona Godlee said: "When Government devised the current plans to allow household mixing over Christmas it had assumed the Covid-19 demand on the NHS would be decreasing.
"But it is not, it is rising, and the emergence of a new strain of the virus has introduced further potential jeopardy.
"Members of the public can and should mitigate the impact of the third wave by being as careful as possible over the next few months. But many will see the lifting of restrictions over Christmas as permission to drop their guard.
"The Government was too slow to introduce restrictions in the spring and again in the autumn.
"It should now reverse its rash decision to allow household mixing and instead extend the tiers over the five-day Christmas period in order to bring numbers down in the advance of a likely third wave."
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Chief Secretary to the Treasury Steve Barclay today urged people to "do the minimum" seeing family and friends this Christmas, a stark watering down of the Government's message.
Under plans agreed across the UK, up to three households will be able to form a "Christmas bubble" and meet between 23 and 27 December.
Cases have continued to rise across the country and it was yesterday announced that several areas - including London - would be moved into tough Tier 3 restrictions.
The Christmas break would mean a step back from the tiers, with families allowed to travel and mix with their bubbles for five days.
While you will be able to see your loved ones, you still have to follow the tier rules for whatever area you will be spending Christmas in.
The planned relaxation of restrictions over Christmas will boost the numbers further as the NHS also struggles with the additional demands of winter.
Alastair McLellan, Editor, HSJ & Fiona Godlee, Editor in Chief, The BMJ
A UK Government source stressed this morning there were "no plans" to change the Christmas rules.
And yesterday Downing Street insisted that the bubbles plans would go ahead - even for areas in the toughest tiers.
But it comes as other European countries have announced stricter rules over the Christmas break than the UK - and some worry the rules may be too lax.
One MP told Playbook: “I am kept awake at night imagining the nightmare of every other European country locking down much more severely over Christmas, while we don’t and end up with thousands more deaths.”
THIRD WAVE 'INEVITABLE'
As part of the joint plea between the two journals, the expert warned that if Christmas goes ahead then there could be a third wave.
They said: "Since the UK’s first lockdown in March, the government has had one (perhaps only one) consistent message — protect the NHS.
"Now, with the number of hospital patients with covid-19 again on the rise, and a third wave almost inevitable, the new year is likely to see NHS trusts facing a stark choice: be overwhelmed or stop most elective and non-urgent work.
"Rather than lifting restrictions over Christmas as currently planned, the UK should follow the more cautious examples of Germany, Italy and the Netherlands."
The editors stressed that while the NHS has coped well with additional Covid cases during the summer, a rise in cases could put pressure on the service.
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"The second wave began to hit hospitals at the start of September. Government figures report 451 inpatients with Covid 19 in England on September 2.
"Over the ensuing 10 weeks, the numbers rose steadily and then rapidly, peaking at a reported 14,712 inpatients with Covid-19 in England on November 23.
"If the third wave turns out to be of the same order of magnitude as the second wave, the health service should manage.
"But this will be the case only if that wave starts with a broadly similar extra case load of Covid- 19 inpatients as at the beginning of the second wave: around 450."
HOSPITAL ADMISSIONS
The editors said that current restrictions are "failing to control the virus" and that the number of inpatients could be 40 times higher than current figures suggest.
It is only the second time in the last 100 years that the two journals have come together.
The editors claimed to have published the letter to "stop the government blundering into another error".
They continued: "The planned relaxation of restrictions over Christmas will boost the numbers further as the NHS also struggles with the additional demands of winter.
"England went into lockdown on November 5 and the number of inpatients with Covid-19 began to fall, down to 12,968 on December 5.
"If this rate of decline had continued, the English NHS would have been on course for just under 11,000 Covid-19 inpatients on December 31. However, in the past two weeks, despite most of the country being in Tiers 2 or 3, numbers of inpatients have started to rise again.
"By December 14 (the latest data available) Covid bed occupancy had climbed back to 15,053.
"Unless something happens to change this trajectory, hospitals in England will have just short of 19,000 Covid patients on New Year’s Eve.
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"This figure, derived by extrapolating a straight line from December 5 to December 14 through to December 31, would be almost exactly the same as the 18,974 peak of the first wave on April 12."
According to the two editors the NHS currently has around 95,000 general acute beds.
At present it is operating with around 10 per cent fewer beds than a year ago as a result of infection prevention and control measures introduced to try to stop the spread of the virus in hospitals.
At the start of the pandemic in March, many people suffering from illnesses such as cancer had their appointments cancelled and the NHS were forced to focus on treating coronavirus patients.
WHAT NEEDS TO BE DONE?
In a joint letter Alastair McLellan, Editor, HSJ and Fiona Godlee, Editor in Chief, The BMJ, outlined what needs to be done in order to curb the spread.
They highlighted that while London and neighbouring counties will enter Tier 3 on Wednesday, areas that have remained in Tier 2 are still witnessing an increase in cases and hospital admissions.
These measures, they claim "are clearly inadequate".
Ministers are meeting tomorrow (16 December) to review the restrictions for England which could mean more areas moving tiers.
They said: "When government devised the current plans to allow house-hold mixing over Christmas it had assumed the Covid-19 demand on the NHS would be decreasing.
"But it is not, it is rising, and the emergence of a new strain of the virus has introduced further potential jeopardy.
"Members of the public can and should mitigate the impact of the third wave by being as careful as possible over the next few months.
"But many will see the lifting of restrictions over Christmas as permission to drop their guard."
It said the government need to "reverse" its Christmas decision and extend the tiers over Christmas.
They added: "It should also review and strengthen the tier structure, which has failed to suppress rates of infection and hospitalisation."
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The editors said that a surge in Covid inpatients would effect those with other conditions.
They continued: "The NHS has learnt from the first and second waves and has robust plans to rapidly increase intensive care capacity, including through the Nightingale hospitals.
"However, a large influx of Covid-19 patients similar or greater than that seen in the autumn can only be managed if staff and other resources are diverted from treating non-Covid patients."
During the summer months, cases of the virus dropped and the NHS was able to recover their capacity for elective and non-urgent care.
The editors said NHS trusts in the most pressured regional health systems are now having to cancel appointments like this because of the rise in cases.
They added: "A significant third wave could wipe out almost all the reductions in waiting times for elective procedures achieved in the past 20 years.
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"Average waiting times are on course to reach 12 months by March next year.
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"This will take years to recover from, at the cost of much suffering and loss of life."
The Covid vaccine this week started to be rolled out across the country and the journals warned that this - coupled with winter - would add extra pressure to the NHS.
They said: "Even if NHS England succeeds in vaccinating all those ‘at risk’ by Easter, this will not be in time to prevent hospitalisation and death for many during the next few months. “NHS Track and Trace,” which has almost nothing to do with the NHS, continues to squander money on failure."
Matt Hancock urges caution over Christmas but resists call to row back Covid bubble rules
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