With the new Covid variant everywhere, it’s not enough to just wait for the vaccine

Stephen Reicher, Stephen Reicher is a professor of psychology at the University of St Andrews and a member of Independent Sage. This piece was written after discussion and detailed input from other members of the group. www.theguardian.com 

The new variants of Covid-19 have changed the nature of the pandemic. We are no longer facing the same situation as in March or even November. Our response must change accordingly.

It is now clear that variant B117 of Covid-19 is already established in all parts of the UK. Being an estimated 56% more transmissible than pre-existing variants, it is likely to constitute 90% of all cases by mid-January. According to UK government briefings, even current tier 4 restrictions are insufficient to deal with its spread. Indeed, no single measure is likely to be sufficient to bring the pandemic back under control. Rather we need an integrated response that brings together all the instruments we have to deal with the infection.

How do we do this? My colleagues and I on Independent Sage are proposing a five-point emergency plan, which would allow the UK to start 2021 with a comprehensive strategy in place to deal with the crisis. All five parts of the plan must happen in concert and they need to be accompanied by a comprehensive communications campaign.

First, there’s the question of vaccination. The rollout of vaccines is a key part of the strategy to combat Covid-19 and must be accelerated as a matter of urgency. This should be organised through the over 8,000 GP practices in the UK, supported through additional staff and resources, and coordinated via local public health structures.

However, vaccination cannot be the entire strategy. This is because of the time taken to complete it (that’s even if we reach the target of 2 million vaccinations a week called for by members of the government’s influenza modelling group), uncertainties over its duration of immunity and impact on transmission, and restrictions on its use in some populations (eg children, pregnant women and breastfeeding mothers).

All this is exacerbated by the fact that, due to the increased infectiousness of the new variant, a higher proportion of people need to be vaccinated in order to achieve population immunity. In the medium term there will be pockets of the population in which the infection continues to circulate, with periodic outbreaks inevitable. Vaccination can complement but not supplant other interventions.

This takes us to the second point: national control measures are essential. Further restrictions are necessary in two main areas. The first of these is personal travel, especially international travel. This must be monitored and regulated effectively, with advance application for travel to and from the UK, a negative PCR test prior to travel and managed isolation on arrival. The second area is education. Schools should remain closed until buildings are made as safe as possible for pupils and staff. This includes smaller class sizes (achieved through hiring extra teachers and teaching rooms), adequate ventilation and free masks for all pupils.

Universities should move to online teaching as the default until Easter at least. This will allow students to study from home, avoiding issues arising from travel and crowded campus accommodation. For school, college and university students, there should be universal provision of computers and wifi connections to ensure everyone can study remotely. Schoolchildren without space for home study should be taught along with vulnerable children and children of key workers.

Our third point in the plan is about the UK’s test, trace and isolate regime. Throughout the pandemic, the government has reduced the issue of a testing system to the numbers of people who are tested. However, testing is only the first step in the process. It must be part of a strategy designed to trace contacts as quickly as possible so as to isolate them before they can infect others. This requires not only forwards tracing (identifying who you might have given the infection to) but also backwards tracing (where you got it from).

The government’s contracting out of the test and trace system has shown the private sector is not up to the job – and nor can it be. Effective tracing and supported isolation depend upon local public health staff who know their patch and are trusted by the community. The need for a “public health reset” of the testing system remains urgent.

Practical support is necessary in order to enable people to self-isolate. The continued failure to address this issue in the UK has led to continued low adherence (less than 20% for those with symptoms) and contrasts markedly with the 90-95% rates achieved in places like New York, which supports isolation with everything from financial assistance and hotel accommodation to pet care.

Next, workplaces. When the government relaxed restrictions in July, they handed over responsibility to employers and owners of facilities to make their premises safe but with limited guidance, minimal support, and virtually no formal regulation. While many enterprises have worked assiduously to ensure that adequate Covid mitigations are implemented, this is not true of all. It is now critical to ensure that we have robust systems to prevent the spread of infection. This should include funds for necessary changes, inspection of all premises and certification of those meeting the required standards. This would have the added advantage of increasing public confidence in using certified premises (shops, hospitality etc).

Finally, financial support for the public is crucial. Inequalities are playing a central role in this pandemic. The disease impacts more on vulnerable populations as do the measures used to control it. People on low incomes are more likely to lose jobs and suffer financially than the more affluent, many of whom have profited from this pandemic. The firm measures we propose here are both morally and practically untenable without enhanced support for individuals and local businesses that will be affected most.

At a time when the UK (population 67 million, Covid deaths 70,752) has been experiencing more than 30,000 new cases a day and prevaricating about what measures are needed, Australia (population 25 million, Covid deaths 909) instituted immediate and far-reaching restrictions in Sydney after an “outbreak” of 38 cases. One local person responded by saying: “Let’s go early, let’s go hard and let’s get this baby.” This makes a good mantra for the pandemic as a whole. Our plan is a minimum for what needs to be implemented – without delay.

Coronavirus: Hundreds of quarantined Britons flee Verbier ski resort

The fleeing Britons were criticised on social media as selfish or foolish. Jacqueline Hamilton, a professor of atmospheric chemistry at the University of York, said: “Why the hell are people going on skiing holidays in the middle of a pandemic? And then to run away, like the selfish idiots they are.”

Owl recalls reporting that last March, Devon had emerged as the worst affected area for coronavirus outbreak as the government released the first breakdown by local authority. These cases were linked to individuals returning from skiing trips.

So have all these escapees fled to their second homes, maybe in Devon?

Charles Bremner, Paris | Greg Wilford www.thetimes.co.uk 

Hundreds of British skiers who slipped out of the resort of Verbier and travelled home to escape a Swiss quarantine have been called selfish idiots.

Hoteliers alerted the local authorities on Sunday morning after half their British customers failed to pick up breakfast trays outside their doors, according to officials. Up to 200 skiers were said to have left.

A mandatory quarantine had been imposed on British arrivals after the announcement of a variant of the coronavirus in the UK.

Swiss officials blamed each other as anger grew over the disappearance of the skiers. The leaders of Valais canton said that the federal authorities had failed to notify them of the details of newly arrived Britons who were ordered to self-isolate under retroactive rules imposed on December 21. It applied to arrivals dating to December 14.

About 400 were traced to Verbier, a favourite Alpine resort for Britons. They were asked to stay in their chalets or hotel rooms, where meals were left at their door, but many opted for a quick getaway during a foggy night.

Jean-Marc Sandoz, spokesman for the Bagnes municipality, which includes Verbier, told ATS, the Swiss news agency: “It was when they saw the meal trays untouched that the hoteliers noticed that the customers had gone. Many of them stayed in quarantine for a day before they set off unnoticed under the cover of darkness.

“We can’t blame them. In most cases, quarantine was untenable. Imagine four people staying in a hotel room of 20 square metres.”

The fleeing Britons were criticised on social media as selfish or foolish. Jacqueline Hamilton, a professor of atmospheric chemistry at the University of York, said: “Why the hell are people going on skiing holidays in the middle of a pandemic? And then to run away, like the selfish idiots they are.”

Beatrice Bass, a spokeswoman for the Liberal Democrats, wrote: “I still hope the selfish reckless culprits get caught and fined.”

Hugh Risebrow, chief executive of Latchmore Associates, a healthcare company, said: “Love skiing but unnecessary travel seems very risky (to self and others) under the circumstances.”

Adrian Faiers, a former NHS worker, said: “Perhaps Verbier is just another example of the overlap between the arrogant and the ignorant classes? ‘Regardless of the cost to others, we’ll decide how, when and if rules apply to us.’”

After reports on the higher transmission rate of the “British variant”, people in Switzerland became wary of UK visitors, the SonntagsZeitung newspaper reported on Sunday. “Anyone who speaks English is suspicious,” it said.

Many of the tourists appeared to have driven across the border to France in search of return flights because there were almost no flights between Switzerland and Britain at the weekend. French ski slopes are closed but resort hotels are open, with visitors free to practise Nordic skiing or snowshoe walking.

However, a tourism official said that the figure of a 200-strong British exodus was exaggerated. Simon Wiget, Verbier’s director of tourism, said most of those who left over the past three days had obeyed the rules and were at the end of their quarantine or had obtained permission to leave for Britain.

Verbier, long a favourite with the royal family, usually fills up with British tourists for the Christmas break. Britons make up about a fifth of the visitors there in the mid-winter. The resort had been hoping to save its season because, unlike surrounding nations, Switzerland remained open to winter sports visitors.

Many in Switzerland blamed Christophe Darbellay, head of the Valais cantonal government, who had defied advice and pushed to keep the resorts open. Many of the 10,000 Britons who arrived just before the announcement of the Swiss quarantine had travelled to the canton. Mr Darbellay said the Federal Office of Public Health “had made our work unnecessarily difficult” but the federal government rejected the claim, saying it had fully informed the cantons on its quarantine policy.

Brexiteer compares escape to flight of the Von Trapps

Andy Wigmore, a spokesman for Arron Banks, the Brexiteer who co-founded Leave.EU, has denied breaking the rules after he joined hundreds of British skiers in rushing home to escape the Swiss quarantine (Charlote Wace writes).

Mr Wigmore, 54, had boasted of his escape on social media, comparing it to The Sound of Music. He had been staying in a chalet at a ski resort in Wengen about an hour from Verbier when he heard about an imminent quarantine for UK arrivals.

He said that he and his family crossed the Swiss border last Tuesday afternoon with 20 minutes to spare. After taking local trains they reached Paris at midnight and caught the last Eurostar to London “just in time for Christmas”.

Mr Wigmore told The Times that he had received a tip-off from a local about the new rules. “We made a dash for it on the 22nd and managed to get over the border with about 20 minutes to go before they locked down Switzerland,” he said.

“The Wiggy von Trapps, like The Sound of Music, escaped over the border before they shut it down, except that we were escaping from Switzerland rather than to Switzerland”.

He had posted details of his escape on Instagram six days ago but yesterday made his page private after receiving abuse when people assumed he had broken quarantine restrictions.

“I haven’t broken any rules,” he said. “Absolutely not. That’s why I did it. Because if I had done it after that, I would have broken rules and the Swiss would be chasing me. But they’re not because I didn’t.”

Mr Wigmore is one of the “lab rats” for the Oxford vaccine programme and claimed it had made him “fully aware of the issues surrounding spread and what you should do”.

He suggested that the Verbier crowd who escaped had “probably thought it would be over by Christmas” and had not realised how seriously the rules would be taken.

Some of his friends have stayed in Switzerland but he said he was not aware of anyone who had broken the quarantine rules.

“If you’re in a nice chalet, great, but you can’t go skiing, you can’t go out, you can’t go shopping, can’t do anything. By the way, even if you go on your balcony, they will go for you. That’s how seriously the Swiss take it,” he said.

Two thirds of England could be in Tier 4 Covid restrictions this week

Up to two thirds of England could be living under the toughest coronavirus restrictions this week, with “sizeable chunks” of the Midlands and the North expected to be put into Tier 4.

By Amy Jones, Political Correspondent www.telegraph.co.uk 

Whitehall sources suggested millions more people would fall under the toughest rules when area banding is reviewed on Wednesday.

It comes as the number of Covid cases recorded in a single day rose above 40,000 for the first time and Public Health England (PHE) warned that hospitals “are at their most vulnerable”.

Ministers are understood to be concerned about the spread of the new South African variant and the “mutant” Kent strain, which has been detected across the country.

The Government has not ruled out tougher new “Tier 5” restrictions, which could close schools and universities, or the prospect of a new national lockdown in January. However, a Whitehall source said that in the “immediate future” the expansion of Tier 4 was more likely.

A health official said: “Coronavirus cases are rising across the country fuelled by the new variant, which has spread far beyond London and the South-East.

“I would expect more than half of England to move into Tier 4, but it wouldn’t surprise me if two thirds end up in the top tier. There is also real concern about the South African variant which seems to be spreading fast. Unfortunately, more action is needed to combat rising cases across the board.”

More than six million people in east and south-east England went into the highest level of restrictions on Saturday. The Tier 4 measures now affect 24 million people, representing 43 per cent of the population.

On Monday, the Cabinet Office minister Michael Gove failed to dismiss the suggestion that the whole of England could be moved into Tier 4, saying: “We review which tiers parts of the country should be in on the basis of scientific evidence.

“The Joint Biosecurity Centre will be making a recommendation to ministers, but I can’t pre-empt that because it obviously has to be a judgment based on the medical situation. The NHS is under pressure and these are difficult months ahead.”

It comes after the Scientific Advisory Group for Emergencies (Sage) warned Boris Johnson that a New Year national lockdown would need to be tougher than that ordered in November in order to keep the virus spread under control.

The Black Country is understood to be an area of particular concern, with Wolverhampton driving up infection rates in Staffordshire.

The latest figures show that the West Midlands city has a case rate of 407.8 per 100,000 of the population, while cases have also been rising in Stoke-on-Trent, Rugby and Lincoln.

Meanwhile, Cumbria could jump from Tier 2 to Tier 4 as rates in the county soar. Lancashire could also move up a tier after the areas of Pendle and Burnley saw “alarming” rises.

East Devon shown with top ten hotspots for comparison

On Monday, the Government reported a further 41,385 lab-confirmed cases of coronavirus in the UK, while a further 357 people died within 28 days of testing positive.

Dr Yvonne Doyle, the medical director at PHE, said: “This very high level of infection is of growing concern at a time when our hospitals are at their most vulnerable, with new admissions rising in many regions.”

Experts have warned that the NHS is on track to have 20,000 coronavirus patients in its care on New Year’s Eve, surpassing April’s peak for cases in hospital.

Saffron Cordery, the deputy chief executive of NHS Providers, said: “We know that the rate of Covid-19 admissions is rising and some trusts are reporting up to three times the number of Covid patients than at the peak of the first wave.

“This means hospitals and also ambulance services in Tier 4 areas and beyond are incredibly busy, compounded by increasing staff absences due to illness and the need to self-isolate.”

Dr Katherine Henderson, the president of the Royal College of Emergency Medicine, described her experience of working in a hospital on Christmas Day as one of “wall-to-wall Covid”.

Storm Bella helps Great Britain set new record for wind power generation

More than half of Great Britain’s daily electricity came from wind turbines for the first time on Boxing Day, as the country headed for its “greenest year on record”, due in part to the coronavirus.

Rob Davies www.theguardian.com

As Storm Bella arrived, bringing gusts of up to 100mph, wind provided 50.7% of Great Britain’s electricity according to data charting the power generation mix.

While wind briefly hit 60% in August, it had not previously sustained such levels for 24 hours.

“Britain has experienced a renewables revolution over the last decade with the growth of biomass, wind and solar power,” said Drax Electric Insights, part of coal and biomass power company Drax, which tracks the data.

The milestone follows a string of new low-carbon records set in 2020, as Covid-19 restrictions depressed power demand, helping wind and solar to claim a larger share of the mix. Fossil fuels have increasingly been edged out as a result, helping Great Britain enjoy its longest coal-free period since the Industrial Revolution.

Gas and coal power plants made up 36% of the electricity generated in England, Scotland and Wales in the year up to 21 December 2020, according to data from National Grid’s electricity system operator (NGESO), down from 46% in 2019.

Wind and solar farms delivered 29% of the electricity mix, rising from 23% of electricity generated in Great Britain last year, according to the early data report.

While Boxing Day set a record for the highest share of power generated by windfarms, it was not a record for the most power they have ever supplied. That was set earlier this month, when windfarms delivered 17.3 gigawatts. Because overall demand was higher at the time, their percentage share of total power generation was lower than it was on Boxing Day, at 40%.

The larger role for renewables has caused the “carbon intensity” of Great Britain’s electricity to fall to its lowest level on record of 181g of carbon dioxide per kilowatt-hour of electricity, compared with an average of 215g last year and 248g in 2018.

Rob Rome, NGESO’s head of national control, said: “2020 has been a record-breaking year for Great Britain’s electricity system. The grid continues to transform at an astonishing rate as we harness the growth of renewable power sources.

“We saw the highest ever level of solar generation in April, the longest period of coal-free operation between April and June, and the greenest ever month in May,” and the wind record set earlier this month illustrated the “changing nature of electricity in Britain”.

There was a blip during August and September, when the electricity system bucked the trend of declining carbon intensity as emissions rose despite lower demand for electricity, suggesting a higher use of fossil fuels.

Tom Edwards, an analyst at the energy consulting group Cornwall Insight, said the electricity system operator increased its reliance on gas-fired power plants by 20% in September compared with the year before, amid a slump in renewable energy generation.

“To compensate for the lower wind speeds and dunkelflautes – dark, still periods – we turned to gas and coal,” he said. “It’s part and parcel of relying more on weather driven capacity and interconnector exports, which makes us more reliant on the vagaries of the wind and sun.”

Steve Jennings, a partner at the consulting firm PwC, said the “key challenge on our pathway to net zero” is what the electricity system does “when the wind doesn’t blow or the sun doesn’t shine”.

The falling cost of energy storage – such as batteries – is expected to play a major role in Great Britain’s ability to use more renewable energy, and less fossil fuel power, alongside a more flexible approach to when major energy users consume electricity.

But Jennings said nuclear power and gas-fired power plants fitted with carbon capture technology would still be required if Great Britain hopes to avoid unabated fossil-fuel generation.

“Everyone is very positive about the UK’s green energy records but I think the microscope will begin to turn to what is happening on a daily basis rather than simply a cumulative basis,” he said.

The coronavirus pandemic reduced electricity usage overall in 2020 compared with a normal year, as large swathes of the economy have been forced to shut their doors for extended periods. Average power demand across the course of the year has dropped from 32.58GW in 2019 to 30.6GW so far in 2020.

“Don’t take foot off covid pedal”

It was back in January when Devon’s public health teams first became aware of a mysterious virus in China. And while the rest of world was getting on with life and preparing for Brexit, they started planning to respond if coronavirus made its way to Devon.

Daniel Clark, local democracy reporter www.radioexe.co.uk 

Public health head reflects on story so far

Eleven months later, more than 10,000 Devon residents have tested positive for covid-19 and nearly 300 people have died. Thousands have ended up in hospital.

But Devon has fared far better than other areas, and remains the area in England with the lowest death rate. At 37 per 100,000 population, the only place in England below the 40 per 100,000 mark. The worst hit area – Tameside – has seen nearly ten times that proportion of deaths. Only Cornwall, the Isle of Wight, Dorset and Wiltshire have had lower infection rates than Devon throughout the entire pandemic, and for smaller council areas the South Hams, Torridge, Teignbridge, West Devon and Mid Devon are among the bottom ten in England.

This is the story of how Devon’s public health teams responded to and dealt with a year like no other.

“We have pandemic flu plans ready to go”, said Steve Brown, Devon’s public health director designate, who also led the response in 2009 for the swine flu outbreak, when one of the first places in England were cases were confirmed was at Paignton Community College. “So we always had plans in place and we test and learn from those plans for any novel virus. It was mid-January when we started to get some information flowing through the public health route about this novel virus coming from China.

“That’s not unusual. We have experience of novel viruses around the world, so we kept a watching brief around how it was developing, but our interest pricked up significantly at the end of January when the first case in the UK was confirmed, so once we saw that and transmission into the country, you start to think this could be something serious.

“It was the beginning of February we started to look back and reflect on the pandemic flu plan – and although we had a pandemic flu plan, we didn’t have a covid-19 plan, so any plan while providing a helpful framework, needed to be adapted and amended to the challenges.”

“So in February and March, we started in Devon to put in place some of the work that should stand us in good time going forward, around the incident management team, to include the public health expertise, those in health protection, and those around data and intelligence, which is fundamental to managing an outbreak, so we started to get the right people in the room as we were allowed to then”.

And just like in the 2009 swine flu pandemic, Devon was hit early by covid-19. On 2 March, two cases of the coronavirus were in the county – a pupil and family member at Churston Ferrers Grammar School – while two Torquay GP surgeries were closed following advice from Public Health England. There had been two cases confirmed in Teignbridge on 1 March that received less publicity, but closures of other schools quickly followed, with Galmpton Primary, Collaton St Mary Primary, Berry Pomeroy Primary and Brixham Primary, while cases began to crop up across the rest of the county.

In the early stages, everyone was hospitalised, not necessarily through sickness Mr Brown said, but through a lack of clarity and understanding of the disease. By the first time that coronavirus was discussed inside a council chamber on 11 March, Devon County Council’s cabinet heard there was a low risk for anyone attending schools. Face masks were not recommended and there was no need to close any settings or send anyone home.

Those measures and message swiftly changed, with schools shut within 10 days and the country into full lockdown shortly after. Mr Brown said that the toughest challenge throughout the last nine months has been the changing guidance and trying to answer people’s questions when there is not absolutely clarity.

“Back at the beginning were talking about it being okay to meet outdoors, schools can continue, a mild to moderate flu symptoms for most, no face coverings needed, and pretty quickly as the evidence developed, those messages changed.

“At the beginning it wasn’t framed as ‘face, space, hands’ but was about hand washing and doing that for 20 seconds and signing Happy Birthday, but a continuous updating of the messages and action is clearly not helpful but we had to change and adapt, but does make things difficult when you say one thing on Friday and another on the Monday.”

Asked why Devon did well, with cases and deaths among the lowest in the country, Mr Brown said it was never one thing, but Devon has some natural advantages. “Let’s reflect on the rurality of Devon,” he said. “A disease that transmits for person to person and mainly in indoor settings, so us not having mass infrastructure like the underground means that we are not bringing lots of people together into indoor spaces where transmission can happen freely.

“The geography of Devon has played to our benefit and the timeliness of the first lockdown was absolutely the right time, and we saw high compliance in Devon which helped reduce infections, and even now, even though one death is too many, we are on the of the lowest in the country for deaths and in care homes, and that speaks highly of the work of staff in care homes. These are all things that collectively play out to put in is a good position compared to the rest of the country.”

And as the summer came and the first wave ended, coronavirus in Devon almost became a distant memory, with cases low, deaths low, and life returning to normal. But Mr Brown’s team knew that their work wasn’t done and that they fully expected as the season’s turned and summer became autumn, that a second wave was likely to hit.

Cases initially started to rise in August – mainly linked to returning holiday makers bringing the virus back with them, before a huge explosion in Exeter in September linked to the university.

“For us, we always knew it was a question of when, not if, there would be a second wave,” he said. “The only way there wouldn’t be if a vaccination was developed over the summer and we knew that was not going to be the case. We always expected in September with the return of schools and universities, people going back to work, we would see a rise in cases. The question we had to think about was how bad it would be, who would it affect the most, and are we prepared from a health and care perspective. We always knew it would happen as it absolutely played out as expected, with cases initially in the younger population, the 0-19 and 20-39, the younger age groups we saw the sharpest peak in cases, which was to be expected.

“We then saw that develop into the older adults, 40-59, again to be expected. With children and young people getting it, one of the best places for transmission, primary places for transmissions is households, and families, so if pupils get it, then mum and dad may get it, so see some household transmission. And then the rise, a month later, in the 60+ and 80+, so the profile and pattern of the disease was to be expected, but we didn’t know what quick and steep the peak was going to be.

At one stage, more than half of the total cases in Devon were linked to the university, but wider community spread and outbreaks taking off across the county never happened, and the swift, decisive and perhaps harsh measures taken to ban students from mixing indoors with others meant that when the term ended, only two students tested positive for covid-19 before returning home as part of the travel window.

“We always expected something as you don’t bring 20,000 people together and not have some cases, but I’d be lying if I said we expected it to escalate quite as quickly as it did but the work we put in place, the work the university did, liaising with others, allowed us when I got the phone call about three or four cases to have a meeting about it, and we had daily meetings with partners to get on top of it.”

Mr Brown continued: “Much of our energy every day is looking at all the confirmed cases, identify where they live, how old are they, what’s their occupation, is it high risk, are they in hospital, how many people have died, so the data comes together which allows us to get a really clear picture of the transmission in Devon, where is it happening, and important to allow us to track the virus.

“We have to ask ourselves all the time ‘where did this person pick it up from?’ We look at information around their age, where they live, are they at home, in care home, a hospital?

“The virus spreads best indoors and if someone is sharing house, that’s a clear way it could happen, but we do see cases in health and care settings and in hospitals, so that’s people going into hospital with covid, but also people going into hospital for non-covid reasons, they get testing on entry, and are positive with no symptoms at all.

“So it’s really important that regardless if you have symptoms, you do the social distancing, wash hands, and when we do finds outbreaks, we will have an outbreak control team meeting and we will discuss cases and Identify how the individuals became positive, give advice and support to the settings, and agree a number of actions to help bring down infections in that setting, which is standard operating procedure.”

But despite the most recent doom and gloom with cases, hospitalisations and deaths rising across the county, there are some clear shoots of optimism around vaccines, which have begun to be rolled out across Devon, he said. “The virus hasn’t gone away and we do know indoors there is a risk, not just of going into a lockdown again, but people will be infected, become ill, end up in hospital, and there will be people who die as a result of it. So message is don’t let guard down when there is a light at the end of the tunnel.

“Each one of the vaccines comes with challenges and storage that we are working through and the undertaking cannot be underestimated as it’s vaccinating the population twice, as its two doses, and will take months to get through the process for everyone. A significant undertaking, not to be underestimated.”

Asked when he thought that some of the restrictions could be lifted, and life could begin to return to normal, he said: “There’s a lot of ifs and buts, but hopefully looking for late spring, that assuming vaccinations have been agreed, have been rolled out, people do adhere to the guidance.

“We saw throughout the summer when numbers were low and people were sensibly socialising, and I hope that by the end of spring, we should be in that position. What we do know in the summer is that the virus not as effective as transmitting from person to person, so we have reasons to be optimistic that next summer will be better than the current summer that we have had.

“But now is not the time to take the foot off the pedal. There are green shoots coming but we need to get through the next two of three months over the winter period as we need to all we doing the right things, keeping our social distancing, wearing the face coverings, washing our hands, and everyone has a role to play to protect the most vulnerable over this most challenging period.”