Coronavirus: ‘Inadequate’ tier system must be revised before England exits lockdown

British Medical Association claims previous system did not contain spread of the virus

The existing tiered system of Covid-19 restrictions is “inadequate” and must be urgently revised before England exits lockdown, leading medics have said.

The British Medical Association (BMA) claimed the previous system was “inconsistent” and did not contain the spread of the virus before the country was plunged into a second nationwide lockdown.  

It warned the NHS will struggle to cope with caring for even the most critically ill patients if the government does not learn from its “mistakes” and ensure a coherent plan is in place.  

It comes after ministers implied the nation will return to a tiered approach when the current lockdown ends on 2 December.  

The BMA has drawn up a blueprint of what they think the new system should look like, which includes “triggers” whereby different areas would move up and down different tiers.  

It argues non-essential travel should be “restricted” between tiers in higher and lower prevalence areas and that criteria should be published for establishing and removing travel corridors.  

The blueprint also suggests the “rule of six” should be replaced with a “rule of two households” and social mixing should be encouraged to take place outdoors.  

There is a string of other suggestions, including a “more robust” quarantine procedure and an “airline safety style” video telling people how to properly wear masks.  

The document states: “The previous tiered system was inadequate and inconsistent in the way it was applied and did not contain spread of the virus.  

“The tiered system must be urgently revised, with agreed ‘triggers’ for moving up and down a tier.  

“With any reintroduction of the tiered system, the government must clarify the rules on travel between different tiers.”  

On clearer guidance being needed for hospitality settings, the report adds: “Crowded restaurants and pubs with little social distancing, as seen after the first lockdown, encouraged by the eat out to help out initiative, represent a danger to public health.”  

The BMA said the government should ensure the test and trace programme is fit for purpose before lockdown.  

Dr Chaand Nagpaul, BMA chair of council, said: “We must not squander the efforts of the many people who have followed the law, stayed at home, sacrificed freedoms and incurred financial loss in order to contain the virus.  

“When the first lockdown ended, there was no coherent plan for keeping Covid-19 at bay, no clear and simple public messaging; this was followed by spiralling infection rates, more businesses failing, new 'local' lockdowns, and now we have a death toll at more than 52,000.  

“As England prepares to exit its second lockdown, it is unthinkable that we make the same mistakes again because this time, the impact will be far worse. It's reasonable to conclude, that without these measures, the NHS will not be able to cope with caring for even the most critically ill patients.  

“This report demonstrates a sustainable plan for reducing the level of infections from Covid-19 until a vaccine programme is under way.”  

Susan Hopkins, a director of Public Health England (PHE) and chief medical adviser to NHS test and trace, said on Monday that ministers would have to look at “strengthening” the tiered system.  

She said the tier 1 restrictions, which covered huge parts of England before the second lockdown, had “very little effect” and that even tier 2 only worked in some areas.  

It is currently unclear exactly how the tiered system will be revised, but most public comments from those involved in the government’s coronavirus response have pointed to a toughening of the rules.  

Documents released from the Scientific Pandemic Influenza Group on Modelling, which reports to the Scientific Advisory Committee for Emergencies, said there was a “clear effect” on infection rates from strict tier 3 interventions but “much less from tiers 1 and 2”.  

Coronavirus-related deaths rose by 598 on Tuesday, according to the latest government data, bringing the total number of fatalities in the UK to 52,745.  

This is the highest daily increase since 12 May when 614 new deaths were recorded.  

A further 20,051 Covid-19 infections were also confirmed across the UK, bringing the total number of cases to 1,410,732. 

Additional reporting by PA