England is currently experiencing a surging third wave of the covid-19 pandemic, and cases are increasing exponentially. We do not subscribe to the policy of letting the virus rip loose through the community, ostensibly to give us immunity against it. While Boris Johnson, the UK prime minister, has claimed that the link between cases and hospitalisations has been broken, this is not the case. This link has weakened, but hospitalisations are clearly rising, with almost 400 people being admitted to hospital daily—an increase of 45% on the previous week. In the healthcare service we have watched with grave concern while our government has decided to completely lift restrictions on 19 July, knowing full well that this will very likely lead to record breaking case numbers and our hospitals will yet again be stretched by covid-19. The collective failure of governments has pushed covid-19 through 2020, into 2021, and doubtless now as a result of Freedom Day, it will push it into 2022. 

The public will once more bear the brunt of rising infections. There must be no illusions on the impact this will have on the NHS. The NHS entered the pandemic chronically underfunded and seriously understaffed. Years of underfunding and a lack of staff, compounded by Brexit, had already challenged us. Over the last 18 months the NHS has been devastated by two waves of the pandemic and the continued fallout from these. NHS staff have been left exposed and unprotected. Their concerns have been repeatedly ignored. Many are suffering from unspeakable trauma of moral injury, burnout, and long covid. There are huge backlogs and millions of patients waiting for routine care. There are many who will be suffering the consequences of having had covid-19. 

The government has still not learned lessons from its many mistakes, and is now taking steps that are exposing our public to even greater risks rather than protecting them. The last seven days has seen a 33.6% increase in positive cases, 47.7% increase in deaths and 46.8% increase in hospitalisations. Our new secretary of state for health and social care, Sajid Javid, has admitted that it is very likely that we will see 100,000 cases daily cases over the summer. Even if only a small percentage of these go into hospital, that would mean potentially 1000s of people admitted to hospital. The spectacle of numbers going up like a feverish thermometer will mean untold suffering for those affected and so we must take all possible steps to avoid this. Freedom Day will be a release for many who have waited so patiently during the lockdowns, but only to risk a further lockdown further down the road.

The most vulnerable in our society are likely to be affected again, only this time the most vulnerable will be young people and children, who are not yet vaccinated. So far they have escaped the ravages of this virulent pandemic. And as we are aware, the impact of these government policies will disproportionately affect already disadvantaged groups. Michael Marmot’s recent report shows us that the fall in life expectancy due to covid has been much greater in some regions, leading to even greater health inequalities. The social determinants of health inequalities have become wider during the pandemic, and any further mass infections and lockdown will simply make matters worse. Worryingly, we’re seeing more and more younger people needing care. Long covid clinics are filling up with thousands of referrals, but prioritising emergency care over the two waves has meant that many who have suffered the consequences of government failures to control the pandemic are waiting for care, even as our government once again pursues a policy that will impact adversely on hundreds of thousands of people.  

The government has actively chosen to pursue a policy that will result in mass infection, and which will result in huge levels of sickness and hospital admissions. The fact that we are close to achieving sufficient vaccine coverage in a matter of weeks is a reason to celebrate, but there is still debate about the use of the vaccine in children, and adolescents. We still await the Joint Committee on Vaccination and Immunisation’s decision on this. As the oft repeated mantra goes, “we are not safe until we are all safe.” The government must act urgently to protect our public, and our NHS. Making its intentions clear about lifting all restrictions two weeks before Freedom Day, has already resulted in the public dropping its guard. Major recent sporting tournaments such as Wimbledon and the Euros facilitated the mingling of large crowds from a wide range of countries. 

We fear that lessons are still not being learnt by a government that is driving health policy on the basis of the economy, rather than lives affected by the pandemic. But it’s not too late. The government must continue to pursue a policy of mass vaccinations rather than mass infections, mandate mask wearing in public places, limit social gatherings, and strengthen public messaging on PCR testing, isolation, and travel to/from high risk areas. A graded opening up will ensure that we do not have the health hazards expected if this policy continues, which threatens the very economy that the government is trying to kick start. 

J S Bamrah, Chairman, BAPIO

Kailash Chand, former deputy chair, BMA

Competing interests: None declared.