UK COVID-19 Update: 2 Metre Rule Relaxed in England

Tim Locke

June 23, 2020

These are the UK coronavirus stories you need to know about today.

2 Metre Rule Relaxed in England

The 2 metre social distancing rule is being relaxed in England from July 4th, the Prime Minister announced. This, Boris Johnson told the Commons, will allow pubs and restaurants to reopen, and "our long national hibernation is beginning to come to an end”.

He said: "Where it is possible to keep 2 metres apart people should, but where it is not we will advise people to keep a social distance of 1 metre plus, meaning they should remain 1 metre apart, while taking mitigations to reduce the risk of transmission."

The decisions were taken after a civil servant, Permanent Secretary Simon Case, reviewed the evidence.

However, Mr Johnson said experts were involved: "The chief medical officer, the chief scientific adviser, have been intimately involved in every stage of developing this programme, and they do believe that it is a step in our plan that allows us to go ahead, whilst meeting that crucial test of not triggering a second wave."

The changes do not apply to Scotland, Wales, and Northern Ireland.

Mr Johnson set out the improving data that allowed the changes: "The number of new infections is now declining by between 2% and 4% every day. Four weeks ago, an average of 1 in 400 people in the community in England had COVID-19. In the first half of June, this figure was 1in 1700."

Other changes, with safety measures, include:

  • Two households of any size should be able to meet in any setting inside or out

  • Hairdressers can open using visors

  • People can stay overnight in self-contained accommodation

  • Also reopening will be outdoor gyms, playgrounds, cinemas, museums, galleries, theme parks, arcades, libraries, social clubs, community centres, and places of worship (including for weddings with a maximum of 30 people)

Nightclubs, soft play areas, indoor gyms, swimming pools, spas, water parks, and bowling alleys remain closed.

As he eased the lockdown the PM advised: "The fewer social contacts you have, the safer you will be."

He said the changes won't risk a second peak of infections "that might overwhelm the NHS".

He added: "At every stage caution will remain our watchword and each step will be conditional and reversible.”

Plus he said: "We will not hesitate to apply the brakes and reintroduce restrictions, even at national level, if required."

Advisers' Warnings

At the Downing Street briefing, Government Chief Scientific Adviser Sir Patrick Vallance said: "Don't be fooled that this means it's gone away. The disease is growing across the world. It's coming down in the UK. But it hasn't gone away." 

Government Chief Medical Adviser Professor Chris Whitty said: "We have to live alongside this virus for the foreseeable future...No decision is going to be risk-free. It's about finding a balance of risks that allows us to operate in a reasonably normal way for a prolonged period."

He was asked if he'd signed off the changes: "Personally, am I comfortable with it? This is a balance of risk, it's like many things in medicine, you don't go through an operation unless you absolutely have to. It's a balance of risk. And I think that this is a reasonable balance of risk." 

He added that "the job of advisers is not to sign things off, it is to give advice".

Sir Patrick said: "In terms of the package that's been announced, it is not risk-free. It cannot be risk-free. Every time you take a step to open up there is some associated risk with that." 

Prof Whitty was asked for his predictions: "I would be surprised and delighted if we weren't in this current situation, through the winter, and into next spring."

However, he said: "I have an absolute confidence in the capacity of science to overcome infectious diseases. It has done that repeatedly, and it will do that for this virus."

He added: "I think we should be planning for this for what I consider to be the long-haul out into 2021."
 

Expert Reaction

Among experts commenting on easing the lockdown via the Science Media Centre, Dr Gabriel Scally, visiting professor of public health, University of Bristol, said: "This is not the time to be relaxing restrictions, it is the time to be getting a working, locally based Find, Test, Trace, Isolate, Support (FTTIS) in place."

Professor Cath Noakes, professor of environmental engineering for buildings at the University of Leeds, said: "It remains the case that 2m is safer than 1m, but in some cases mitigation measures can be taken to reduce risks at a closer distance.  The announcement by the Prime Minister today recognises the critical importance of the mitigation measures that will be necessary."

Dr Gail Carson, director of network development at ISARIC (International Severe Acute Respiratory and Emerging Infection Consortium), and consultant in infectious diseases, University of Oxford, said: "I would like to hear in parallel what the plans and steps being taken now are to plan for the winter when we will have flu circulating and other respiratory diseases. 

"I expect that with better respiratory hygiene and hand hygiene that circulation of other winter respiratory infections will decrease but outbreaks teach us to - assume nothing." 
 

Second Wave Preparations

Medical, nursing, and public health experts have written an open letter to the Government asking for an urgent cross-party review to prepare for a second wave of COVID-19.

The letter, published in the BMJ, is signed by leaders of the Royal College of Physicians, the Royal College of Nursing, the BMA, and the editors of the Lancet and BMJ, and others.

They warn that "available evidence indicates that local flare ups are increasingly likely and a second wave a real risk".

They add: "We think there’s a strong case for an immediate assessment of national preparedness, with the first results available no later than August, and that all its work should be completed by the end of October."

They say they don’t underestimate the complexities of establishing the review in the required timeframe, but: "We stand by ready to help in whatever way we can."

Latest ONS Data

Latest data from the Office for National Statistics show the number of deaths registered in England and Wales in the week ending 12th June (week 24) was 9976. That's 733 lower than week 23 and 5.9% (559 deaths) higher than the 5-year average.

In week 24, 1114 deaths mentioned COVID-19, the lowest number in the last 9 weeks, and accounting for 11.2% of all deaths.

Deaths involving COVID-19 in care homes also decreased to 17.3% of all deaths.

Meanwhile, ONS will be expanding its English Infection Survey to include Wales. Welsh health minister Vaughan Gething commented: "Research happening in Wales such as this COVID-19 Infection Survey, is integral for us to progress forward through this pandemic."

Daily Deaths and Data

Another 171 UK COVID-19 deaths were announced today, taking the total to 42,927.

There were 237,142 tests counted yesterday. This figure includes home tests that have been sent out but not yet processed. This takes the total tests to 8,309,929.

Figures for the number of people tested were last given on Friday 22nd May.

Another 874 positive cases were reported today taking the total UK confirmed cases to 306,210.

There were 283 people admitted to hospital in the UK (excluding Scotland), and 340 mechanical ventilator beds are in use by coronavirus patients.
 

More News in Brief

  • Oxford's RECOVERY trial has now published its preprint on dexamethasone treatment of seriously ill COVID-19 patients which led to the investigators describing it last week as a "major breakthrough". Based on the early results, the drug is now standard treatment in UK hospitals for COVID-19 patients receiving oxygen or mechanical ventilation. On Twitter, Professor Whitty called it: "An important read for those treating the disease."

  • The Local Government Association (LGA) has raised concerns it is not yet getting postcode level information from England's test and trace programme. Helen Atkinson, director of public health at Portsmouth City Council, told the LGA website: "We are not yet getting postcode level data. It means we are only getting part of the picture. As we develop test and trace, we will need geographic data on where our confirmed cases are to ensure we can do the outbreak control work and getting up-to-date information will be crucial to that."

  • Animal trials showed that Oxford University’s COVID-19 vaccine boosted immune response in pigs. The preprint from the Pirbright Institute reported how two doses produced a greater antibody response than a single dose.

  • Men make more COVID-19 antibodies than women, according to NHS Blood and Transplant (NHSBT). The data come from analysis of convalescent plasma donations collected for the REMAP-CAP and RECOVERY clinical trials. Forty-three percent of male plasma donors had high antibodies so that their donation could be used in the trial compared to 29% of women. Rachel Johnson, NHSBT statistics lead, commented: "The difference between men and women was statistically significant, so we can be pretty confident, even in this relatively small study, that men are more likely to donate the potentially life-saving plasma we need for coronavirus patients."

  • Five percent of smokers have quit due to COVID-19, according to a YouGov poll for Action on Smoking and Health (ASH) and UCL. The survey of 1370 current and former smokers also suggested under-30s were more than twice as likely to have quit due to coronavirus than those over 50.

  • The Guardian reported on claims staff at the Royal Free Hospital in London were emailed a report at the peak of COVID-19 warning that the trust would "track any leaks to the media" and "offer you the chance to post your P45 on Facebook for all to see". The hospital told the paper the email didn't reflect its policy and was "badly worded".

  • Today saw the last of the regular Downing Street briefings. In recent weeks they became weekday only, and then ministers often gave briefings without the help of scientific or medical advisers. In his first briefing on March 16th, Mr Johnson urged people to avoid pubs. Today he told people to get ready for opening time again soon.

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.

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