Doctors urge Boris Johnson to cancel relaxed Christmas restrictions to protect NHS

A joint editorial post from the British Medical Journal and Health Service Journal has called for the PM to ditch the household mixing planned for over Christmas.

The two medical journals have come together on a rare joint editorial which calls for prime minister Boris Johnson to scrap plans that allow household mixing over Christmas in order to protect the NHS.

The first joint editorial in 100 years, the British Medical Journal and Health Service Journal have called for the prime minister to change tactics due to the rising cases in England.

The BMJ is published by the doctors’ union, British Medical Association, and the HSJ is read by NHS staff, managers and professionals.

It warns that hospital bed capacity risks being overwhelmed due to the Christmas relaxation of rules, calling on the government to ‘reverse its rash decision to allow household mixing […] in order to bring numbers down in the advance of a likely third wave’.

Crucially, the journals point out that a third peak in Covid-19 will hit non-Covid treatments the hardest. They warn that it could ‘wipe out’ almost all the reductions in wait times that have been achieved in the past 20 years.

They added: “This joint editorial is only the second in the more than 100-year histories of The BMJ and HSJ.

“We are publishing it because we believe the government is about to blunder into another major error that will cost many lives. If our political leaders fail to take swift and decisive action, they can no longer claim to be protecting the NHS.”

The prime minister confirmed a controversial five-day period of relaxed rules which will allow three different households to mix from December 23rd to December 28th, including overnight stays. 

London and other parts of the South East are now being moved to the highest tier from December 16th, and the falling cases of Covid elsewhere are beginning to flatten, causing the plan to come under scrutiny. 

Based on current projections, the joint editorial warns that hospitals in England could have ‘just short of 19,000 Covid patients on New Year’s Eve’, the same as the peak of the virus in April.

Stating that: “This figure, derived by extrapolating a straight line from December 5 to December 14 through to December 31, would be almost the same as the 18,974 peaks of the first wave on April 12.”

The journal also added scathing reviews of the government’s Test and Trace service, explaining: “‘NHS Track and Trace’, which has almost nothing to do with the NHS, continues to squander money on failure. So too does the mass testing of asymptomatic people using lateral flow tests that are not fit for purpose.”

The joint editorial advises that rather than lifting restrictions, the UK should follow the cautious examples of Germany, Italy and the Netherlands.

It goes onto explain that should a third resurgence of the wave be similar magnitude to the second the health service should manage. However, they add that this will only be the case if the resurgence starts at a similar caseload of Covid-19 inpatients as was in the beginning of the second resurgence, which was around 450.

They say that as the current restrictions continue to fail to control the virus, this figure will be more than 40 times higher. Adding to that is the additional demands of winter on the NHS.

In the past two weeks, despite much of the country in the highest form of restrictions – Tier 2 and  3 – the number of Covid inpatients has begun to rise again. This is despite the decline following the second lockdown on November 5th.

By December 5th, there were 12,968 inpatients, if the rate of decline had continued there would be 11,000 on December 31st. However, by December 14th – the latest data available – Covid bed occupancy is back to 15,053.

The journal concludes that unless something changes to this trajectory, England will have just short of 19,000 Covid patients on New Year’s Eve. 

The impact of this will be felt most prominently by non-Covid patients as in order to manage a large influx of patients, staff and resources will have to be diverted from non-Covid patients. 

The journal highlights how much the NHS is currently overstretched, delivering the largest vaccination programme in its 72-year history as well as seasonal outbreaks of norovirus and increased admissions of frail older people. This is all during a time where staff absence is also at its peak. 

A particular concern is the impact this will have on staff, who have already worked through the hardest nine months of their professional lives. The journal explains that levels of burnout and sickness absence are likely to exceed those already experienced.

The journal concludes that the public should ‘mitigate the impact of the third wave by being as careful as possible over the next few months’. Adding that the government was too slow to introduce restrictions in spring and again in autumn. 

They explain that the government should review its ‘rash’ decision to allow household mixing and instead extend the tiers over the five-day Christmas period. They should also review the tier structure.

It concludes: “This joint editorial is only the second in the more than 100-year histories of the BMJ and HSJ. We are publishing it because we believe the government is about to blunder into another major error that will cost many lives. If our political leaders fail to take swift and decisive action, they can no longer claim to be ‘protecting the NHS'”, and is signed Alastair McLellan, Editor, HSJ and Fiona Godlee, Editor in Chief, The BMJ.