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Thursday, October 29, 2020

Public advised to wear face coverings under UK government’s lockdown easing plan

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The public will be advised to wear face coverings in crowded places and wash their clothes regularly, as the government imposes “smarter controls” to limit the spread the coronavirus until a successful treatment or vaccine is found.

After Boris Johnson’s address to the nation on Sunday, which prompted a backlash from unions and opposition politicians about the lack of a clear message, the government published a 60-page document called Our Plan to Rebuild.

More outdoor activities are being allowed from this week but the public will be expected to take extra caution, including by wearing face coverings in some situations.

People should “wear a face covering in enclosed spaces where social distancing is not always possible and they come into contact with others that they do not normally meet, for example on public transport or in some shops”, the government document says. Children under the age of two should not have their faces covered, and nor should any of primary age who do not have somebody with them who is supervising them.

This is aimed at preventing people who have the virus but are not experiencing symptoms from passing it on to others.

The World Health Organization (WHO) guidance on face masks has remained consistent during the coronavirus pandemic. It has stuck to the line that masks are for healthcare workers – not the public. 

“Wearing a medical mask is one of the prevention measures that can limit the spread of certain respiratory viral diseases, including Covid-19. However, the use of a mask alone is insufficient to provide an adequate level of protection, and other measures should also be adopted,” the WHO has stated.

Nevertheless, as some countries have eased lockdown conditions, they have been making it mandatory to wear face coverings outside, as a way of trying to inhibit spread of the virus. This is in the belief that the face covering will prevent people who cough and sneeze ejecting the virus any great distance. 

There is no robust scientific evidence – in the form of trials – that ordinary masks block the virus from infecting people who wear them. There is also concerns the public will not understand how to use a mask properly, and may get infected if they come into contact with the virus when they take it off and then touch their faces.

Also underlying the WHO’s concerns is the shortage of high-quality protective masks for frontline healthcare workers.

Nevertheless, masks do have a role when used by people who are already infected. It is accepted that they can block transmission to other people. Given that many people with Covid-19 do not show any symptoms for the first days after they are infected, masks clearly have a potential role to play, especially on crowded public transport as people return to work..

 Sarah Boseley Health editor

The chief medical officer for England, Prof Chris Whitty, stressed that face coverings were “not a substitute” for physical distancing and urged the public not to buy surgical or medical masks, needed for frontline carers, but to rely on scarves or DIY-type masks instead.

The public should wash their clothes regularly, the advice suggests, “as there is some evidence that the virus can stay on fabrics”.

The government is increasing fines for people who breach the new guidance, with the new penalties ranging from £100 for a first offence to a maximum of £3,200.


Coronavirus: what are Boris Johnson’s new lockdown rules? – video explainer

In his foreword to the document, Johnson suggested much of the document applied to all four nations of the United Kingdom, calling it “a plan to rebuild the UK for a world with Covid-19”.

But there has been tension with Scotland and Wales, which will make their own decisions about issues including when schools will reopen, and which have warned against any significant easing of restrictions.

The document sets out a three-step “second phase” of the government’s approach to tackling the outbreak, in what is called an “indicative roadmap”:

  • More people will be “actively encouraged” to go back to work from this Wednesday.

  • Potentially from 1 June, some schools and businesses, including non-essential shops, will reopen, and some sporting and cultural events will be allowed to take place behind closed doors.

  • Potentially from 4 July, some remaining businesses, such as hairdressers, and social spaces such as cinemas and pubs, will be allowed to reopen.

The document makes clear that the exact timing of each of the steps will depend on scientific advice.

The government’s chief scientific adviser, Sir Patrick Vallance, said he and his colleagues had “strongly supported the conditionality” of the government’s approach, and each step would have to be science-based, not “date-based”.

The government seeks to stress in the document that decisions are not being made solely on the basis of economics and health, but by balancing both, in what it repeatedly calls a “fair” way.

It says the aim is to “return life to as close as normal as possible, for as many people as possible, as fast and as fairly as possible … in a way that avoids a new epidemic, minimises lives lost and maximises health, economic and social outcomes”.

Facemasks explainer

Phase two, the first step of which begins this week, will aim to “gradually replace the existing social restrictions with smarter measures that balance its aims as effectively as possible”.

As well as advising the public to wear face coverings, employers are being urged to redesign workplaces to minimise the number of individuals people come into contact with, including increasing ventilation. This approach is described as “making contact safer by redesigning public and work spaces, and those with symptoms self-isolating”.

During this first, immediate stage, parliament will be expected to hold more physical sessions, to “set a national example of how business can continue in this new normal”.

The government is also changing its guidance to allow more childcare providers to reopen. The document says “paid childcare, for example nannies and childminders, can take place”, as long as health guidelines such as avoiding crowds and washing hand are followed.

Unlike the UK-wide “stay at home” advice, the document makes clear some measures could be applied locally, with the government’s aim described as “detecting infection outbreaks at a more localised level and rapidly intervening with targeted measures”.

The government has delayed plans to allow members of the public to mingle their household with another, creating a “bubble”, along the lines of measures that have been taken in New Zealand.

Vallance said: “We have been asked to look at this, and we will look at it and come back with the scientific advice.”

For the time being, contrary to what Dominic Raab, the foreign secretary, suggested in interviews on Monday morning, the public are only permitted to meet one other person, outdoors – not both parents, for example.

Ministers are still aiming at a 1 June return for some pupils, as part of the second step, which would allow “reception, year 1 and year 6 to be back in school in smaller sizes”, according to the document.

“This aims to ensure that the youngest children, and those preparing for the transition to secondary school, have maximum time with their teachers. Secondary schools and further education colleges should also prepare to begin some face to face contact with year 10 and 12 pupils who have key exams next year, in support of their continued remote, home learning.”

It adds: “The government’s ambition is for all primary school children to return to school before the summer for a month if feasible, though this will be kept under review.”

Government officials suggested parents would be strongly encouraged to send their children to school once classes had reopened. Teachers who are in the most vulnerable, “shielded” group will be expected to remain at home, while others who are vulnerable, such as pregnant women, could take part in “non-pupil-facing” work, such as lesson planning.


Coronavirus UK: should I be wearing a face mask? – video explainer

There will be little change for “those aged over 70, those with specific chronic pre-existing conditions and pregnant women. These clinically vulnerable people should continue to take particular care to minimise contact with others outside their households, but do not need to be shielded.”

However, the document hints that some individuals could be moved out of the shielded group as scientists understand more about the risk factors.

“As the government learns more about the disease and the risk factors involved, it expects to steadily make the risk-assessment more nuanced, giving confidence to some previously advised to shield that they may be able to take more risk, and identifying those who may wish to be more cautious,” the report says.

When to enact the various steps will depend on advice from a new joint biosecurity centre, which will “bring together the UK’s world-leading epidemiological expertise and fuse it with the best analytical capability from across government in an integrated approach”.

The government makes clear that a “new normal” will have to persist until a vaccine or treatment for the virus can be found. “There is no easy or quick solution. Only the development of a vaccine or effective drugs can reliably control this epidemic and reduce mortality without some form of social distancing or contact tracing in place,” it says.

It also rejects the idea that “herd immunity” was ever part of the government’s approach to dealing with Covid-19, despite Vallance at one point appearing to advocate it.

“In the medium term, allowing the virus to spread in an uncontrolled manner until natural population-level immunity is achieved would put the UK government’s Covid-19 recovery strategy under enormous pressure. At no point has this been part of the government’s strategy.”

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