Living with COVID-19

We knew it was coming. New restrictions announced over the last couple of weeks by the Prime Minister and leaders of the devolved nations have confirmed that COVID-19 is not going away any time soon. As we contemplate a new raft of measures to tackle the second wave, it’s worth reflecting on what has happened so far, what we have learnt and where we are headed.

Looking back

When we entered lockdown back in March, the national mood was sombre but determined. People across the country made considerable sacrifices to halt the spread of the virus. While individuals endured considerable curtailing of their personal freedoms, the Government enjoyed significant public approval and overwhelming support for lockdown restrictions. From mutual aid groups to Clap for Carers, collectively the public pulled together to support and protect one another.

Meanwhile, Environmental Health Practitioners (EHPs) have been working tirelessly to support efforts to fight COVID-19, including providing advice to those businesses able to continue trading on how to do so safely, contact tracing, managing local outbreaks and, where necessary, enforcing business closures. Following the gradual reopening of businesses over the course of the summer, EHPs have also been at the forefront of inspecting establishments to ensure that they are COVID-secure and complying with government guidelines.

Right from the very start of this pandemic, we have been vocal about the vital importance of an effective contact tracing system for containing and controlling the virus. In Wales, local authorities are working collaboratively with local health boards and Public Health Wales to deliver a largely effective service. In Northern Ireland, the Public Health Agency leads the process. But in England, the design process and recruitment for track and trace has been fraught with problems. An appetite for speed, an overly centralised approach, and too much reliance on the private sector has impeded the development of a properly functioning system.

As we have consistently argued, this work, in order to be effective, must be led by local government and EHPs who have the skills and experience to support this critical work. We have seen some signs of progress in England, and are hugely encouraged by the Government’s decision to move away from a centralised model and towards focusing on local knowledge and expertise. However, the system is still not working as effectively as it needs to.

Looking forwards

Of course, we all hope that an effective vaccine will be found as quickly as possible. But while scientists tell us they hope to produce a coronavirus vaccine within the next 12 to 18 months, we know that vaccines normally require years of testing and time to produce at scale. The hard truth is that there are no guarantees that a vaccine will actually be found and, even if it is, a vaccine does not necessarily offer us a quick and simple route out of this pandemic.

The overwhelming likelihood is that we will be living with this virus for a long time to come. Six months into this pandemic, it’s time to make peace with this reality and learn to adapt our lives and livelihoods to the confines of what is possible in a COVID-19 world.

While voices calling for a reconsideration of lockdown tactics in the interests of preserving the economy have recently grown louder, we cannot allow public health to be side-lined as case numbers rise. We know the costs of this pandemic have been exponentially high and of course it is true that lockdown will create other problems, including increased unemployment and negative impacts on mental health. Yet, as the Government’s chief scientific and medical advisors have warned, unless decisive action is taken, cases numbers will surge and sadly more deaths will follow.

What should we be doing?

Now more than ever, it is vital that we continue to practice good personal hygiene, washing hands regularly and thoroughly with soap and water. Face coverings are increasingly becoming a fact of life, and wearing them will help keep others safe, especially in indoor settings or where social distancing is not possible. Despite the difficulties, we must continue to limit our face-to-face interactions with those outside of our households or social bubbles. We know this can be tough, but the evidence is clear that the best way to break to the chain of infections is to practice social distancing to protect our families, friends and vulnerable people in our communities.

These measures, combined with an effective test and trace system, are our best hopes of staving off the worst-case scenarios in the short to medium term. Effective testing, tracing and isolation remain key to controlling the spread of this virus. Sadly, we are still not getting this right, and this must be addressed as a matter of urgency.

Public approval of the Westminster Government’s handling of coronavirus may have hit a new low, but now is not the time to flout the rules. As we reach this six-month milestone, it’s unsurprising that many people are feeling burnt out. To keep the virus at bay, we need a renewed focus on human behaviour and what drives people to change their habits.

Clear communication and guidance are essential, as are nudges and incentives to influence and motivate people to behave responsibly. The burdens of this pandemic have not been felt equally, and the new £500 Test and Trace Support payments for people self-isolating on low incomes is a welcome step in the right direction.

Last week, we explored these issues in more detail in a webinar which looked at the challenges around the large-scale behaviour changes required to live with COVID-19. In particular, we considered how EHPs can influence citizens’ behaviour rather than relying on sometimes costly and time-intensive enforcement.

The role of environmental health

The weeks and months ahead will be challenging but we have learnt a lot during the early stages of this pandemic, and EHPs will no doubt continue to be central to the nation’s response. Now more than ever, their knowledge of infection control, links to local communities and businesses at a national and local level, and their communication and enforcement skills are essential to protect public health. The Prime Minister himself recently recognised the vital role of EHPs in tackling COVID-19, and we will continue to demonstrate the critical importance and value of the profession to society.