As UK coronavirus cases continue to rise and leading figures warn about NHS capacity, the government may soon come under pressure to start rolling out its Plan B to tackle the virus this winter.
Health Secretary Sajid Javid set out the government’s options for the next few months back in September.
Plan A is largely a continuation of the status quo – vaccinating as many eligible people as possible, rolling out boosters and keeping society open, but Plan B involves the return of some restrictions.
Yesterday, Downing Street said it was sticking to Plan A. But Prime Minister Boris Johnson may soon be forced to change his plans if the number of COVID-related hospital admissions and deaths continue to rise.
What’s in Plan B and why could it be rolled out soon?
Mr Javid said “any responsible government must prepare for all eventualities” when he outlined Plan B for England in the Commons.
It was put forward as an alternative set of “contingency” measures that would be implemented “only if [it was] needed” to protect the NHS and only if it was “supported by the data”.
Under Plan B:
• The public would be told “clearly and urgently” about the need to exercise caution to help control the virus
• Legally mandated coverings would return in some settings and the the work from home mandate could be re-introduced
• The government also has the option of making COVID vaccine certificates mandatory in certain scenarios
Plan B is designed to “prevent unsustainable pressure on the NHS” but would be a tough sell for some Conservative backbenchers, particularly those in the COVID Recovery Group who are against limitations on freedoms.
Mr Javid tried to temper this back in September when he said: “Although [Plan B] is not an outcome anyone wants, we have to be ready just in case.”
What is Plan A?
Plan A is the government’s “comprehensive plan” to steer the country through autumn and winter and into 2022, while simultaneously protecting the NHS.
Last year, an autumn surge in COVID infections saw England enter a second and then third national lockdown in an effort to dampen the growth in cases and prevent hospitals from becoming overwhelmed.
But what makes this year different is the rollout of coronavirus vaccines, which has helped weaken the link between infections and hospitalisations.
Already in place, Plan A is the government trying to make sure a lack of COVID restrictions doesn’t translate into high numbers of critically ill people.
To this aim, the government has focused on “building our defences” by procuring and administering vaccines, antivirals and disease modifying therapies.
The early start to the vaccination programme means millions of people have been vaccinated for more than six months, and studies have suggested protection gradually wanes over time.
This is why the booster campaign for over-50s, those who are clinically vulnerable, people who work in care homes and frontline healthcare staff was implemented to keep the most vulnerable out of hospital.
Vaccines for 12 to 15-year-olds were also brought in to stop the return of schools pushing cases to high levels.
Meanwhile, Test, Trace and Isolate is cited as key part of Plan A by helping to limit the spread of the virus, as is monitoring variants coming across the border.
Though, the plan could be rendered useless by a number of factors like levels of vaccination; the extent to which immunity wanes over time; how quickly, how widely social contact returns to pre-pandemic levels as schools return and offices reopen; and whether a new variant emerges that escapes the current jabs.
Already, some scientists have criticised the booster programme for moving too slowly. More than half of the people eligible for a third dose haven’t yet received one.
The UK also waited longer than the US and many European nations to vaccinate children aged 12 to 15. Just 14% in that age group in England have had a jab since they became eligible last month.
Why are there calls to change direction?
Current data shows hospital admissions and deaths are rising, suggesting that Plan A might not be working.
On Tuesday the UK recorded 223 COVID-19 deaths within 28 days of a positive test, the biggest daily jump since early March.
On Monday, daily UK COVID cases stood at 49,156 – up 27% on the week before.
There were also 915 new hospital admissions, a weekly increase of 24%.
The latest seven-day average for deaths is 124.1, while the latest count for people in hospital for COVID is 7,097.
Both are much lower than the winter peak in January, and cases remain below the initial prediction of 100,000 per day made by the health secretary ahead of England’s so-called Freedom Day.
But there are fears these numbers could rise significantly in the coming months – and since the start of July, a growing proportion of hospital beds have been taken up by COVID-19 patients.
With a backlog of patients waiting for routine treatments and increasing COVID-19 admissions, many services in parts of England are operating at close to capacity.
This will be a cause of concern for the government as winter will increase demand even more.
England’s chief medical officer, Professor Chris Whitty, has already warned the health service faces an “exceptionally difficult” winter.
The UK’s former chief scientific adviser and founding chair of Independent SAGE, Sir David King, told Sky News this peak in cases “could be as serious” as last autumn’s.
Taking the data into account, experts have suggested now may be the time to switch to Plan B.
Epidemiologist Professor Neil Ferguson said: “Coming into the winter, there may be a Plan B that needs to be implemented, which involves some rolling back of measures.
“But I doubt that we’ll ever get close to lockdown we were in January of this year.”
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Downing Street admitted on Monday that the winter months look “challenging” and that it was keeping a “close watch” on cases.
However, it said new infections were roughly in line with predictions and that the vaccine programme had “substantially” broken the link between cases, hospitalisations and deaths.