A political hot potato has been made of physical distancing when really what we need is a transparent public discussion, argue health and safety experts.
Current evidence supports 2m physical distancing and in some circumstances this may even need to be extended, said the lead author of a report, Professor Andrew Watterson from the University of Stirling. The report is also backed by the health and safety campaign group Hazards.
Watterson argues that most of the current international and national guidance is modelled on droplet transmission only, but recent evidence indicates a key role in aerosol transmission.
Proposed changes to reduce the 2m physical distancing rule need to be based on sound evidence that can demonstrate – “not simply suggest” – control measures will be effective following the precautionary principle. While there may be “gaps in the science” a cautious approach must be taken.
Watterson said: “The media and newspapers have been bombarded by voices calling for an end to the 2m restriction. Far less but some mentions and coverage have been made of the damage that may be done to public health and economy by reducing the 2m guidance and the possibility of new spikes and even pandemic waves occurring. In this respect the debate has been quite unbalanced and ‘fact-poor’.”
Physical distancing must be considered as part of a wider context, taking into consideration multiple factors such as PPE, hygiene, epidemiology of COVID-19, length of contact, environment, and more. But here, concerns around the ability of workplaces to carry out risk assessments, and enforcement, are raised in the report due to funding cuts to public health and enforcement agencies over years.
But a most pressing concern Watterson raises is, he says, the fact that “the UK, the test and trace system is still not fit for purpose” despite there being general acceptance that a “fully effective” system needs to be up and running before lockdown easing should commence.
He said: “The World Health Organization (WHO) and the UK government argue if there is no conclusive evidence or consensus, then we can opt for a less safe standard. This is simply not good epidemic prevention practice. Had we not taken WHO’s incautious lead – and assumption that a new virus would behave like MERS and SARS – and instead set policy based on caution, the outbreak would have been more effectively tackled, particularly in workplace settings.
“One of the underpinning principles in public health is to do no harm. With COVID-19, adopting ‘the precautionary principle or a cautious approach is the only way to proceed. This does not mean avoiding all risks but it means acting on the basis of evidence. Where there is no or limited evidence, then a prudent and precautionary approach is needed with small steps forward.
Watterson is not alone, last week the Independent SAGE group, chaired by the former chief scientific adviser Sir David King, released a review of the scientific evidence and found that it was not safe to relax physical distancing measures. It also called for transparency and said it was crucial for the government to publish evidence it bases its decision on so that “public, parents and businesses can make their own decisions”.
The Independent SAGE statement concurred with many points raised in Watterson’s report, including that the number of new cases are too high to ease lockdown measures, and concern around protecting vulnerable workers including black and minority ethnic groups. In a statement it said there is “no way of containing outbreaks without functioning contact tracing system in place”.
It questioned why the government was ignoring its own SAGE committee advice to keep the 2m physical distancing, and that reducing it to 1m indoors will ‘effectively end’ social distancing measures.
Stephen Reicher, professor of social psychology at the University of St Andrews, said as part of the Independent SAGE statement: “It is too soon to reduce social distancing from 2m to 1m. The proposed reduction will have behavioural consequences and, in effect, dump the concept of distancing altogether. It sends a ‘back to normal’ signal when we are still in the middle of a deadly pandemic.
“We need to remain more on guard than ever. And it is crucial that we see the full evidence being used by the government to override the scientific advice from its own SAGE committee.”