It is 1.35pm and I’m having to explain coronavirus transmission to a nurse. I am due an appointment at 2.30, and I’ve been phoned because I say I’m clinically vulnerable. I ask whether the nurse has an N95 mask (as they’re proved to be most effective). She does not. I ask whether she and the team are taking weekly lateral flow tests, like her colleague said. She is not, and is unsure why that was promised.
“We don’t need to do that any more,” she says breezily. What she means is: she has no official duty to do so any more. Clinically vulnerable (CV) patients still “need” the Covid-19 protections. They just don’t get them.
We don’t really talk about this. We don’t really talk about coronavirus at all. More than three years on from the start of the pandemic, there’s understandably a desire to “move on”, to bury painful memories of lockdowns and watching loved ones dying on iPads. This has only been encouraged by the government, which has honed the message “Covid is over”, as if saying this somehow makes it so.
Since February last year, when Boris Johnson removed all protections, such as the legal obligation for people with coronavirus to isolate and most free testing, there’s been no official strategy or guidance on reducing transmission of the virus. The result is a kind of mass denial – an agreed forgetting. The subject crops up from time to time. A breaking news banner announces a new variant. A friend texts that she’s stuck in bed “with the worst summer cough”. Then we carry on – until we are forced to remember once again.
Watching coronavirus make a return to the headlines in recent days has subsequently felt like a weird deja vu, like the return of your least favourite guest star in a long-running television show. First, the vaccine rollout in England was hastily brought forward in light of concerns over the new variant BA.2.86, which recently caused an outbreak in a care home in Norfolk. Then it was announced that testing and monitoring would be scaled up again after scientists warned the country was nearly “flying blind”.
That sound you can hear is a stable door closing and the horse bolting. Though cases and hospitalisations are thankfully significantly lower than at the height of the pandemic, the daily number of positive coronavirus tests in England has been increasing since the end of June – a trend that is likely to grow in the coming weeks, as we socialise more indoors and children mix at school. It’s hopeful that many cases of Covid-19 are now mild, but that isn’t true for everyone: at last count, 1.5 million people were experiencing long Covid symptoms that adversely affected their daily activities, and the virus still poses a significant risk of death to many people with pre-existing health conditions.
Not that you’d know it. When was the last time you heard a minister even say the word “coronavirus”? As Rishi Sunak’s government lurches from crisis to crisis, Covid is labelled as “job done” because it is simply more convenient that way. Britain’s “Covid policy” in 2023 is effectively King Canute’s courtiers watching another wave coming and insisting sheer will alone can stop the tide.
Take immunisation. This week, the vaccine rollout for people at the highest risk (over-65s, some clinically vulnerable people, and health and care staff) begins – but 12 million fewer people are eligible for a jab compared with last year, as part of plans for the NHS to “get back to normal”. On Friday a group of MPs called on the government to extend the booster programme, but currently those outside the slim eligibility criteria won’t even be able to buy a vaccine privately. This winter, it will be possible to pop into Boots to buy a flu jab – but not a Covid jab. This is clearly dangerous (even many clinically vulnerable people don’t qualify for protection), but it’s also a false economy. Fail to fund vaccines and the taxpayer pays more in the long term, from ICU beds in a buckling NHS to more long Covid patients falling out of the workforce.
Or consider the lack of support for clinically vulnerable people. The 3.7 million high-risk people previously asked to shield at home – including 500,000 immunocompromised people who get little to no protection from vaccines – have effectively been abandoned to survive alone. With nationwide coronavirus precautions removed, many disabled people I’ve spoken to feel forced to avoid shops, pubs and public transport. Others who previously stayed safe by working at home are being told to return to packed offices as the shift to WFH is reversed. The so-called return to normal has always been one-sided: while non-disabled people rightly enjoy freedom, clinically vulnerable people are told to accept indefinite isolation.
Just look at the way the NHS has dropped many of the rules for staff that were meant to protect vulnerable patients. While some healthcare workers are taking precautions at their own discretion, NHS staff in England don’t have to wear a mask, and the majority who have respiratory symptoms are no longer asked to test for Covid. That means a patient with lung disease could be forced to get treatment from a nurse with a Covid cough.
A new poll shown to me by Clinically Vulnerable Families, a support group involved in the coronavirus inquiry, finds 69% of CV people surveyed said they had cancelled or not made a medical appointment due to concerns over lack of Covid precautions; 80% said this was having an impact on their physical health.
Still, best not mention it. Time to move on. The trouble is, denial is not a long-term plan. Coronavirus is effectively a fire. Ignoring it doesn’t stop the virus – it just lets the damage spread. The paradox of the pandemic has always been that the only way to “move on” is to actually engage with it. That means embracing smart, non-invasive public health measures such as masks in hospitals, a thorough vaccination programme, ventilation in public spaces and sick pay to help workers isolate.
But it also means confronting our impulse to believe that all of this is unnecessary and arduous. Even the phrase “Covid restrictions” – a term used by almost every media outlet – is loaded, suggesting low-key mitigations are heavy burdens rather than simple ways to free clinically vulnerable people. That the virus primarily “only” affects those with underlying health conditions has always been the unspoken excuse for indifference.
After three years, hundreds of thousands of deaths and a shared national trauma, there is something to be said for not only building a better relationship with Covid but with each other. In the meantime, millions of people at the highest risk will be left to shrink their lives or leave the house afraid – and ministers will do nothing to help. But why does it matter? We don’t need to do that any more.
Frances Ryan is a Guardian columnist
