The UK’s prime minister, Boris Johnson, announced this week that he aimed to abolish all Covid regulations, including the requirement to isolate after testing positive, in England from 24 February. Here’s what experts around the world think of that plan, which would make Britain something of an outlier when it comes to coronavirus precautions.
France is unlikely to follow the UK in abandoning all coronavirus measures before late March or early April, according to Arnaud Fontanet, a senior epidemiologist at the Pasteur Institute and a member of the government’s scientific advisory council.
Fontanet said measures such as mask wearing, home working and quarantine remained vital in order to slow the number of infections and keep hospital admissions down. “Allowing the virus a free run would be a fundamental error,” he said.
“Quite small changes in behaviour can really influence the dynamic. Reducing contacts now by just 20% – a bit of home working, wearing masks in indoor public spaces – will halve the number of hospital admissions in a fortnight; we know this.”
Fontanet added that France’s vaccine pass, which has been needed since August to access leisure venues – including cafes and restaurants – and use long-distance public transport was also likely to remain in force until spring. “Vaccination, including boosters, is still key.”
He said infections had been falling, “but hospitals are under very heavy pressure and will remain so for some time. It’s too soon to lift restrictions now.”
Although societies will “need to learn to live with the virus”, he said, new variants will emerge and “we will have to decide what is acceptable. Do we accept 300 deaths a day, or are we prepared to reduce contacts again? Societies will have to decide, and different societies may decide differently.”
“Britain’s management of the pandemic is being watched with interest in Germany,” said Johannes Knobloch, an infection prevention specialist at Hamburg’s University Medical Centre.
“It strikes me as quite brave to lift all restrictions at the same time. I would have thought it possible to keep in place some measures that aren’t too troublesome or intrusive – such as mandatory mask-wearing on public transport – but would still slow down the dynamic of new infections.
“Britain’s vaccination rates are encouraging, but the big challenge in the coming months will be to protect those for whom vaccines don’t offer protection, such as people undergoing cancer therapy.”
German states this week took steps to lift some restrictions, such as the rule whereby only those with proof of vaccination or recent recovery are allowed to access non-essential shops. Other rules, including FFP2 mask mandates in shops and on public transport and vaccine passport checks at restaurants and bars, remain in place.
“I don’t see Germany going down the UK’s path quite so quickly,” said Knobloch. “But then you need to bear in mind there are broader philosophical differences in our health system, with avoidance of death still playing a fundamental part in the German system, while Britain’s system places more emphasis on maintaining the ability to work.”
Prof Rafael Bengoa, a former World Health Organization health systems director who is now co-director of the Institute for Health and Strategy in Bilbao, said that while the lifting of restrictions in England would doubtless prove popular, it was premature.
“Because of our bias to normalcy, people want to believe it’s over, which is what politicians are saying,” said Bengoa. “But most of us in public health across Europe are saying that it’s not quite over and it’s not like the flu.”
He said lifting restrictions – especially the use of face masks in interior spaces – would slow down the descent rate of the Omicron wave because people would continue to get infected.
Bengoa also said that people who tested positive for the virus needed to stay in home quarantine for five to seven days. “If you over-normalise the situation – if you lift everything and you say, ‘This is over’ – people will not stay at home for those five or seven days,” he said.
“If you go out and infect children who are not completely vaccinated yet, and you go out and infect vulnerable people and immunocompromised people – and those three groups are not small in numbers – you’re going out to infect people who are still vulnerable. And since this is not like the flu, and it’s quite serious and you can also have long Covid with this, why is it that one needs to precipitate the lifting of restrictions so fast?”
Bengoa said that restrictions could be lifted in two months’ time, but added that Spain’s decision to maintain the use of masks in interior spaces and require people who test positive to self-isolate for seven days would accelerate the containment of the Omicron wave.
Italy has among the strictest Covid rules in Europe, with health passes required for everything from getting on a bus to going to work, and while the country is cautiously relaxing restrictions as infections and hospitalisations fall – the outdoor mask rule was dropped on Friday – scientists are perplexed by the UK’s plan to scrap quarantine rules for people who test positive for Covid-19, especially with the two countries still registering stubbornly high daily death rates.
“These are political choices, not scientific ones,” said Roberto Burioni, a professor of microbiology and virology at Vita-Salute San Raffaele University in Milan. “We’ve never quarantined people who have the flu, but the flu doesn’t kill two or three hundred people a day.”
In Greece, which has one of Europe’s highest Covid-19 death rates, reaction to the decision to end restrictions was relatively upbeat.
“I think the situation in the UK allows for relaxation of the measures,” said leading epidemiologist Gkikas Magiorkinis. “Given the country’s good vaccination and epidemiological profile, it seems to be a reasonable move.”
Magiorkinis, who sits on the committee of experts that advises the government, said Athens would likely follow suit if, at this point in the pandemic, Greece had similar rates of fatalities, hospitalisations and intubations. “We would end up doing the same,” he said.
“If the health system is not under heavy pressure, we need to use the opportunity to try and return to normality, because if, in five months’ time, there is another mutation, people might not listen to us, and that would be serious.”
In the past two years, Britain has been used by Chinese media as an unsuccessful example in the fight against Covid. Some Chinese media outlets and social media users call the UK’s approach “lying flat” – tang ping – a term often used to describe individuals who strive for nothing more than what is absolutely essential.
State media cite criticisms over Johnson’s announcement, but Chinese experts have tried to understand the logic behind it, with some expressing admiration. The UK is now the first country prepared to achieve herd immunity, said Prof Chen Wenzhi of Chongqing Medical University. “This is because their scientists have said the peak of the new variant had passed … and suggested the end of the pandemic is in sight.”
Zhang Wenhong, one of the country’s best-known epidemiologists, recently used the UK as an example to persuade the Chinese public to get vaccinated as soon as possible. Citing data from the UK Health Security Agency, he said the reason why some countries could end restrictions was because vaccines had led to a dramatic reduction in hospitalisation and mortality rates.
In New Zealand, the epidemiologist and public health expert Prof Michael Baker said the data on hospitalisations and deaths from Covid-19 in the UK told their own story. “The numbers, I think, are screaming out a message [that] the pandemic response has been very poorly managed – the waste of lives, the excessive periods under lockdown and the flip-flopping policies.”
While death rates in the UK were down from their peak, he noted: “In New Zealand that would still be [equivalent to] 20 people dying a day – we would regard that as high mortality … On the face of it, it would certainly seem premature to be relaxing all safeguards.”
Inevitably, Baker said, the results would be felt more harshly by some than others – frontline workers, elderly people, ill people, the immuno-compromised. “That partly reflects just how the virus behaves and who’s most vulnerable, but also the priorities of different governments. Most of us would regard that the balance is not right in the UK in that respect – that there’s a need for greater emphasis on protecting the most vulnerable.”
“In terms of scientific depth, the UK is currently amongst the leading contributors to understanding [the] virus, and combating it at a science level … they gave us the AstraZeneca vaccine and some of the best large population studies in the world,” he said. “The science is absolutely top – it’s just the policy translation has been shockingly poor. That’s one of the frustrating things. We’d normally look to the UK … and they have not given us the leadership we’d hope for.”
Stuart Turville, associate professor in the immunovirology and pathogenesis program at the Kirby Institute, University of New South Wales, points out that the UK’s “base of immunity” is high and that “the waves of Delta and Omicron (albeit high) did not translate into the deaths that they observed in earlier waves”. But, he said: “There are always people in our community where vaccination is not an option – for example, because their vaccine response is not strong.”
The virologist’s primary concern was that Omicron would be replaced by another variant. “We planned for Delta and got Omicron, and although we didn’t have the lockdowns of the past, it did create significant disruption, not to mention those that also sadly passed away. I have always said it is better to be vigilant and cautious.”
He added: “It’s very difficult to predict this virus, though. It has made a fool of many of us.”