Local public health chiefs in England are breaking from the government’s official guidance and recommending so-called plan B protective measures to combat a surge in coronavirus cases. At least a dozen directors of public health (DPHs) have called on residents in their areas to readopt protective measures such as mask-wearing and working from home. The government is likely to face questions over why local authority public health experts feel it necessary to break from the official national guidance. Alice Wiseman, the DPH for Gateshead who is among the health leaders to call for changes, said: “Given the concerning rise in case numbers and the considerable pressures that we’re already seeing on NHS services, now is the time for us all to do whatever we can to avoid reaching crisis point. Taking basic precautions now like wearing face masks, working from home where possible and keeping indoor spaces well ventilated could help us to avoid returning to more disruptive restrictions. “So although mandatory measures are not yet being introduced, I’d urge all of our communities to pull together and take these simple but effective steps now. They’re actions which cause minimal inconvenience for individuals but collectively will make a big difference in reducing the spread of Covid, flu and other seasonal illnesses – which, together, could stretch our NHS beyond its limit.” Wiseman has written to headteachers in the local authority area recommending they take additional measures at their schools when pupils return from the half-term break, including all adults and pupils wearing face coverings in secondary schools. She also recommends reintroducing class bubbles in primary schools and year group bubbles in secondary schools. Dominic Harrison, the DPH for Blackburn and Darwen, has called for plan B measures to be introduced nationally by mid-November at the latest but the “sooner the better”, although he is not currently recommending tailored additional measures for his area. Helen Lowey, the Bolton DPH, is backing other protective measures. She wrote on Twitter: “We can’t rely only on vaccines. It’s test when have no symptoms, wear face covering more often than not, give people space, work from home when can, vaccines, isolate when symptoms, ventilate etc.” Other DPHs recommending additional measures in schools such as mask wearing include those covering Walsall, Calderdale, Trafford, Suffolk and Swindon. The Guardian understands that the DPH for Southend is considering recommending additional measures for schools after half-term. Lancashire’s DPH is not recommending a blanket approach for schools but is recommending additional measures at specific schools that have shown signs of outbreaks. The DPH in Hertfordshire, Jim McManus, has recently encouraged residents of his county to work from home. In North Somerset, the deputy council leader has expressed frustration that further mitigation measures are not being introduced and highlighted the particular struggles faced in the south-west after the Immensa testing fiasco, in which the results of 43,000 Covid tests were incorrectly returned as negative. Mike Bell, North Somerset’s deputy leader and lead member for health, said: “I am also really frustrated to hear the government confirm that they have no plans to tighten restrictions in England. This situation must not be allowed to escalate. Lives must not be put at risk. “We will soon enter the winter period which is always a challenging time for the most vulnerable members of our community and for our health and care workers. I would much rather action is taken now to protect people before case rates spiral and people become ill, and to ease the winter pressures on our hard-working care and health services.” On Wednesday the health secretary, Sajid Javid, predicted new infections could hit a record 100,000 a day and urged millions of eligible people to come forward for booster jabs. Javid urged people to wear masks in crowded places and test themselves before going to Christmas parties. The NHS Confederation, the membership body for organisations that commission and provide NHS services, and the doctors’ trade union, the British Medical Association, have called on the government to enact plan B. The British Medical Association council chair, Dr Chaand Nagpaul, has accused ministers of being “wilfully negligent” after Javid ruled out immediately implementing the government’s coronavirus plan B. • This article was amended on 24 October 2021. Dr Chaand Nagpaul is the British Medical Association council chair, not the “British Medical Council chair” as an earlier version said.