Tough restrictions on socialising will be needed before and after Christmas to keep the spread of coronavirus under control if families and friends are to be allowed to meet over the festive season, government advisers have said. Dr Susan Hopkins, of Public Health England, said at a Downing Street briefing on Wednesday that she was keen for Christmas to be “as normal as possible” but any increase in social contact over the period would have to be followed by more restrictions. She said previous advice from Sage, the government’s expert committee, had noted that for every day that restrictions were eased, they would need to be tightened up again for two days more. Public Health England later issued a correction saying the advice referred to Sage modelling that found that “for every one day of relaxation, five days of tighter restrictions would potentially be needed”. The corrected figure emphasises how little wiggle room there is for society to reopen in the run-up to Christmas. “We are very keen that we have Christmas as close to normal as possible. That requires all of us to make every effort over this national restriction period, and even in early December, to get the cases as low as possible and to reduce the risk of transmission within households and between families,” she said, adding that a final decision on families and friends mixing over Christmas lay with the government. Coming into Christmas, Hopkins said, “we need to be very careful about the number of contacts we have” to keep transmission of the virus down. “Hopefully, the government will make a decision that will allow us to have some mixing, but we will wait and see what that is. And then I think once we have got past the Christmas period, if there’s been a release on some socialisation, we will all have to be very responsible and reduce contacts again.” Prof Angela McLean, the government’s deputy chief science adviser, echoed the call for people to adhere to the latest lockdown. “What’s really important is that we go into a festive week – when you want to mix with our friends and our family – with the number of infections in the community as low as possible,” she said. Data released at the briefing showed that the R number – the number of people whom each infected person goes on to infect – had come down in England since the beginning of October, largely because of the tier 3 restrictions in place before the latest national lockdown. If R is above 1, cases will grow; below 1 they will fizzle out. The rate of new infections is still rising, but at a slower rate than in recent weeks, with marked regional variation. In the north-west, Yorkshire and the Humber, the east of England and London, the percentage of the population testing positive may be falling, but uncertainties around the data mean the reality is unclear. In contrast, there are apparent rises in the south-west and south east. The number of people in hospital with Covid has risen steeply since the end of August. While the admission rate is expected to fall in the coming weeks as the effects of lockdown feed through, McLean said she did not expect it to fall as quickly as it did in the first lockdown. “During the March lockdown the number of hospitalisations, which was really all we could keep track of at that time, was halving every three weeks. I don’t think we’re going to achieve that. I do not think we will halve before the 2nd of December.”
Since England went into a second national lockdown on 5 November, advisers have made clear that the tiering system will be reviewed and probably modified to control the virus through December and into the new year. The medium-risk tier 1 is known to have almost no effect, prompting speculation that a higher tier may be introduced. McLean said Sage had submitted advice to the government over the weekend but she refused to elaborate on the recommendations. She said the tier 3 restrictions put in place in some areas before the lockdown appeared to have been effective. “When I look at the north-west and the north-east and I look at what’s happened with the Office for National Statistics surveys there, I see interventions that have worked. I see epidemics that are flattening,” she said. Hopkins said that during the latest lockdown, the increase in NHS testing capacity had allowed for a reduction in turnaround times for results, and local authorities would soon be in a better position to trace contacts of those testing positive. “By the end of this month, almost every lower-tier local authority will have local contact tracing in place, so that’s really allowed us to step up,” she said.