Boris Johnson has signalled a new phase in the pandemic.
The possible early lifting of restrictions this month could mean ‘freedom’ for thousands of families across the country.
No more five-day isolation after a positive test, an end to mask-wearing and even the winding-down of free testing may, for many, be a welcome prospect after two years of compromise and sacrifice.
But vulnerable people living in Greater Manchester fear that this new era of 'living with Covid', amid continued high transmission of Omicron and the removal of a legal safety net to stay home from work when sick, will actually curtail their freedoms and limit their choices.
READ MORE: What does Greater Manchester's public health leader think about plans to scrap Covid isolation?
Among them is Amy Somers, 37, who suffers from the autoimmune condition Lupus.
Amy, from Chorlton, lives with fatigue, joint pain, brain fog and problems with her kidneys and takes immunosuppressants along with steroids and other supplements, to stop her body attacking itself.
Despite having been quadruple-jabbed, Amy still feels like 'normal life' is a ‘gamble’ for those more vulnerable to serious illness.
With plans afoot to start charging £30 for lateral flows, she worries about how less well-off vulnerable people, already facing a rising cost of living and energy bills, will afford them, and what that means for Covid transmission in the population.
Amy, whose ill health forced her to quit her job working for the BBC as a camera assistant, is also concerned that when people no longer have a legal obligation to self-isolate, her trips to the shops will become far riskier to her health.
“I feel anxious. I want to live my life and see friends, it’s been two years," she said.
“But it feels too soon. It limits the freedoms for people like me who are vulnerable, and increases the risk.
“I’ve already got a condition which means my body doesn’t work properly, if I catch Covid it’s more complicated.
“You want to interact but there is a level of anxiety where you can’t tell if someone is asymptomatic.
“It’s constantly weighing up what you want to do versus the risk.
“The freedom will be less for the immunosuppressed,” added Amy, who was diagnosed with Lupus 10 years ago.
“There are more things in place - vaccines, anti-viral treatment and biologic treatment - but it’s still early days for those and I know the talk is that omicron is less severe but that doesn’t seem to be unilaterally the case.
“It’s also the fact they have lifted restrictions now instead of in summer when we can be outside. We avoid winter anyway because of other infections. I think if they had delayed it a little bit we would have had more freedom."
Amy isn’t alone in questioning the timing of Boris Johnson’s announcement during a particularly scrappy period in his leadership.
When approached by the Manchester Evening News on Tuesday, Number 10 said that Mr Johnson would ‘like’ to bring forward an end to restrictions but that plans had not been finalised.
The final decision, said a spokeswoman, would be based on the 'data'.
But Mr Johnson's speech has prompted a growing demand, echoed by Greater Manchester’s health chiefs, for Chris Whitty and Patrick Vallance, the government’s most senior advisers on Covid, to share the evidence that backs ending all pandemic restrictions.
Meanwhile, clinicians on the ground, and charities for those most vulnerable to Covid, have branded the move potentially ‘deadly’.
James Taylor from Scope urged the Government not to forget about disabled people, while Phillip Anderson, Head of Policy at the MS Society, called on leaders to include 'vital measures' like free testing, employment protection for people at risk and access to Covid treatments so immunocompromised people could live 'normal lives, free from fear'.
The Manchester Evening News spoke to one GP in Greater Manchester who is awaiting surgery for a serious medical condition.
Already exposed to Covid and other bugs, the doctor, who asked not to be named, now faces the extra pressure of resisting infection from those who are no longer testing or self-isolating.
He said: “I am waiting for serious treatment in hospital and the last thing I want to do is come across people who have Covid and run into trouble, not be able to have the operation.
“I am already constantly worried about getting Covid for this reason.
“We’ll now have more patients coming in with Covid, also hundreds sitting in the waiting room. I am already at risk, now this.
“I’m also concerned for my patients. You will have young people saying ‘we don’t need to self-isolate’, they will come into the surgery and give others the infection.
“What will happen to they lady with COPD who picks up that infection, who is already vulnerable, already fragile?”
'Less safe, more fearful'
Sandhia Shah, 54, a mum of two from Cheadle Hulme, suffers from MS and psoriatic arthritis, both autoimmune conditions which mean she’s on medication which suppresses her immune system to stop it attacking her own body.
Sandhia lives with fatigue, cognitive issues, pins and needs and bladder and bowel issues and, for someone who used to regularly hike and run, it’s been a painful lesson in compromise compounded by the limitations of the pandemic.
Sandhia, who is married to pharmacist Dev Shah, has just recovered from an exhausting bout of Covid, with the help of anti-viral medication, and is fearful that a more severe strain could be round the corner.
“I instantly feel less safe and more fearful with restrictions lifting,” she said.
“I’m nervous because there’s no guarantee even with all the vaccinations that I won’t get it again and I’m going on stronger immunosuppressants soon which will knock my immune system out even more.
“If I was bad with Omicron, which everyone said was just like a cold, then how would I be next time round?
“I do feel at some point we have to learn to live alongside this but it feels like too much too soon.
“He should have eased restrictions slowly, at least keeping masks and isolation until summer when we know that the numbers have genuinely gone down and it’s not just because less people are testing.
“We don’t know if it’s going to mutate, we just don’t know what is around the corner.
“I just feel that this decision has been made too quickly without any thought to those millions of people in the vulnerable category, who have for the last two years or so been isolating anyway.”
Sandhia will continue to wear a mask, but worries that people will stop testing, adding: "I question whether it's more about image than scientific evidence."
Meanwhile, Manchester clean air campaigner Ruth Todhunter has concerns about an end to self-isolation in a city with so many people vulnerable to the virus due to lung conditions.
Fellow campaigner Fidaa, 47, from Moston, who asked us not to use her full name, has a nine-year-old daughter with severe asthma which has led to multiple hospital admissions.
She added: “I’ve been so scared since the beginning of the virus. I think they really need to keep self-isolation rules in place.
“I had Covid last year and wouldn’t let my daughter near me for fear she’d catch and thankfully she was okay."
So many questions
GP Zahid Chauhan, a Greater Manchester doctor, also questions the timing of the announcement, and the evidence to support it.
He said: “If there's no need for legislation then why was it put in place to start with?
“What we are saying now is confusing to the public. I hope this is a scientific evidence-based intervention and not politically motivated."
Dr Chauhan shared 'genuine concerns' about Covid-positive patients sitting in waiting rooms, on buses and trains, adding: “That will spread infection and different people will react differently, if you are immunocompromised, vulnerable or elderly you will be at higher risk.
“What happens when NHS staff come to work with Covid and start treating people? There are so many questions and I would love to see the science behind it.
“We know that the intensity of infection has reduced, but that intensity is different for different people. If you are a vulnerable person with a chronic condition catching Covid might be the last thing you do.
“I think the blanket approach does not feel very sensible, we need to look at the scientific evidence."
No right time - but we need a plan
Over to scientist Dr Thomas House, a mathematical epidemiologist based at the University of Manchester who says there may be no 'right time' to lift restrictions - but remains concerned about workers' rights without the legal protection of self-isolation.
He added: “I think a bigger question and one never resolved is ‘are people supported to stay at home when they are ill?”
Questioning the workplace culture even before the pandemic, with zero hours contracts having put pressure on people to work when ill, he added: “A lot of employers don’t even allow for normal diseases, we’ve heard of bosses demanding PCR tests over lateral flows.
“Coronavirus is still worse than flu. We can’t change society forever but people still do need to stay home when they are ill.
“Most don’t want to go out and infect people but they need to be able to afford not to.”
He says restrictions, which are an ‘emergency measure’, have to be lifted a some point - but is wary of this being done for ‘political reasons’.
He added: “Scientifically there’s no right answer. But we are not at the stage when coronavirus is just like flu or other things - it’s not settled down into a predictable pattern and there’s no certainty. We don’t know what next winter’s coronavirus wave will look like.
“The big worry is people who are most vulnerable or where their immune system has not responded well to the vaccine. If we have enormous workplace outbreaks it’s harder for those people to reduce exposure.
“Although it’s not the threat it was two years ago, it’s still there. This shouldn’t just be done for appearances.
“Of course politics are influencing this, the politics of wanting to look like we’ve got through it.”
It comes amid warnings from SAGE that the removal of free testing will increase anxiety among the clinically vulnerable, and 'unintentionally' communicate the message that it is 'acceptable' to continue with social contacts regardless of symptoms.
They also mention the need for staff to be able to stay at home when sick, especially if Covid becomes hidden among 'everyday' infections.
Others are calling for a clear plan to protect people over the longer term.
Prof Christina Pagel, a member of Independent Sage, recommends research into better indoor ventilation, which will protect against all airborne diseases, as well as global surveillance of new variants and diseases.
She highlights the need for permanent surveillance of Covid infection rates and investment to understand long Covid, as well as urgent funding and staffing for the NHS to cope with 'regular Covid surges, existing backlogs and years of under-staffing and funding'.
Prof Pagel also calls for a plan to tackle inequalities in health, housing, the workplace and education to make places - like Greater Manchester - more resilient to future outbreaks.
A hallmark of Covid has been its knack to expose stark pre-existing inequalities, with this region having felt the pandemic more than other areas of the country.
Greater Manchester is also still seeing a high level of infection - even with a significant degree of under-reporting.
This week, Prof Kate Adern, Greater Manchester's lead director of public health, pointed out that national policy had so far failed to recognise regional differences in Covid's impact.
Experts admit that even the science can't accurately predict the exact 'right time' to lift restrictions.
But with no discernible detailed 'plan' to live safely with Covid in regions like Greater Manchester, and just a week after Michael Gove's 'levelling up' white paper, Boris Johnson risks making another decision that is detrimental to the most vulnerable people in one of the most exposed areas of the country.
As background, Number 10 said no decisions have been made on lifting restrictions.
They said in light of the 'metrics we're seeing on the progress of the epidemic' they hoped to be in a position to bring forward 'regulations' - but that a decision had yet to be taken.
Any decision would be informed by clinical advice, they said, and they continue to review all metrics, which are showing consistent declines, particularly in hospitalisations.
