“Living with the virus” doesn’t mean “doing nothing about it”

A post suitable for April Fool’s day when lateral flow tests will no longer be provided free to everyone.

From ‘herd immunity’ to today, Covid minimisers are still sabotaging our pandemic progress 

Dr William Hanage is a professor of the evolution and epidemiology of infectious disease at Harvard and co-director of the Center for Communicable Disease Dynamics www.theguardian.com 

So, is that it? After wave upon wave of infections, the combination of vaccination and Omicron’s comparatively mild (though still serious) properties has led the UK to declare the pandemic, essentially, over.

After two lockdowns, a huge burden on healthcare and at last an extremely prompt and effective vaccination campaign, the UK has still registered more than 160,000 lives lost to the pandemic, roughly half of them in the Alpha wave.

And in case you hadn’t noticed, “herd immunity”, much like Godot, has stubbornly failed to arrive and expel the virus from the population. Nobody should be under any illusions that it could have been much worse. Poor Peru was hit by dreadful waves of infection before vaccines could be deployed; it has lost roughly three times as many people as the UK, accounting for population.

It should be astonishing given these facts, but some stubborn voices have continued to argue that in the autumn of 2020 we should have rushed to remove restrictions on all except those most at risk – who would be somehow saved by untested, implausible means gathered together under the heading of “targeted protection”. At that point no vaccines were widely available, and the effective therapies we now have against Covid were pie in the sky. Shockingly, there are now attempts to rehabilitate these ideas in parts of the media.

Reaching back to relitigate such already-discredited approaches is nonsense. And worse, it makes reasonable discussions about pandemic management that much harder. Distraction has always been the goal of such revisionism. We saw this around targeted protection, we saw it in early arguments that Covid was “just the flu”, we saw it when many people were still arguing that PCR tests were overcounting cases in the UK in the fall of 2020, even as hospital beds and ventilator wards filled up and the death toll steadily mounted.

The point of all those fights was to play down the seriousness of the disease and ultimately to blunt our response to it. It started with saying the pandemic wasn’t a real threat, and, when that became undeniable, it became about declaring it over or past, again and again. As I wrote in April 2020, instead of a single peak, we got a mountain range. Ultimately, these arguments – despite being lost individually – seriously hampered the possibility of a real, sustainable strategy emerging to help us handle the grim pandemic terrain.

To want a sustainable strategy is not about being a “Covid hawk”. March 2022 is very different from October 2020. To suggest that restrictions might be relaxed once vaccination has been deployed is a reasonable discussion. Before that point it was guaranteed to lead to more preventable transmission, more serious illness, more hospitalisations and more deaths.

How our pandemic response should change is a question I get asked all the time. And my answer is always the same: what do we want to achieve? The minimum is to avoid healthcare being overwhelmed. But healthcare gets compromised when things like elective surgeries and screening are delayed – which will happen if huge numbers of staff and patients are sick. And this has indeed happened, over and again, as a result of uncontrolled transmission of the virus in the community.

Here’s a basic pandemic strategy fit for 2022: maintain awareness of the situation with cross-sectional testing of the population to determine how much virus is around, and combine it with wastewater surveillance to spot any rapid changes. Aggressively investigate any new variants because we can expect them, and they could still make a lot of people sick, fast. Make sure people who are in a vulnerable category get treatment early in infection, when it is most likely to help. Above all, emphasise being “up to date” with your vaccination status rather than “fully vaccinated” or “boosted” because we don’t know what might be needed in future.

And we should not forget other effective measures that we have known about for ages. A century and a half ago, we started to think seriously about cleaning the water we drank, after repeated cholera epidemics that killed Queen Victoria’s Prince Albert, alongside many others, mostly poor and without a gaudy memorial on the south side of Hyde Park. We could do the same for the air we breathe now with better ventilation. What about improved sick pay? It enables people who are infectious with Covid or anything else to not infect people in the workplace, by staying at home.

These interventions would blunt future pandemics of respiratory infections. And they would help in the autumn and winter of this year, when Covid and influenza will be tussling for pole position. Hell, you don’t need to talk about future pandemics to advocate for the benefits of such structural change, it’s clear right now.

After almost all interventions were removed, the UK has been predictably buffeted by a wave of BA.2 infections. For now, it appears that the disease is comfortingly similar to BA.1, by which I mean readily handled by the great majority of vaccinated folks. But to insist that future variants will be similar is a gamble, not a policy. Rather than maintaining its world-beating scientific effort to understand the properties of the variants as they emerge, the UK is scaling back funding. It doesn’t end because you want it to. Every time you’ve heard a voice state it’s time to “live with the virus” remember that doesn’t mean doing nothing about it.

‘A vote for gender equality’: MPs vote to permanently allow at home early medical abortions in England

But Jupp votes against and Parish absents himself.

Maya Oppenheim www.independent.co.uk

MPs have voted to make at-home early medical abortions permanent in England after a lengthy campaign by pregnancy termination services to keep the measures in place.

After the pandemic hit the UK in March 2020, ministers permitted abortion pills to be sent via post to be taken at home after a phone consultation, in a new system referred to as “telemedicine”.

While new abortion measures were due to run out on 25 March, the government recently declared a six-month extension for at-home early medical abortions after lengthy delays to ministers clarifying their position.

After the extension period, women who ordered abortion medication to take at home would have been breaking the law and could therefore have faced criminal penalties.

But MPs on Wednesday voted to make at home early medical abortions permanent – with 215 politicians voting for the measure and 188 against.

Having a medical abortion involves taking two tablets. Prior to the pandemic, getting the first tablet, mifepristone, required a visit to an abortion clinic.

The vote on telemedicine for abortion comes after Baroness Sugg, a Conservative peer, proposed a new amendment to the government’s Health and Care Bill, to ensure at-home early medical abortions become a permanent measure.

Baroness Sugg’s amendment passed in the House of Lords earlier in the month.

Louise McCudden, of MSI Reproductive Choices, a leading abortion provider, said they are “delighted” the system of telemedicine for abortion is no longer set to be revoked.

She said: “MPs have voted to keep the option of at-home abortion care. This was a vote for evidence over ideology, a vote for reproductive rights, and a vote for gender equality.

“Making this safe and popular service a permanent option will particularly benefit those who struggle to attend face-to-face appointments, including those in abusive relationships, those with caring responsibilities, and those without transport.”

Ms McCudden noted people decide to have an abortion for a range of reasons and in very different personal situations as she warned it is imperative to be able to provide a range of options.

“It is important that we can offer options that take into account personal circumstances – and that includes taking both pills at home,” she added. “Trusting people to make these choices for themselves is a vital part of how MSI delivers high quality, responsive care for anyone who needs us.”

The UK’s largest study into abortions previously found at-home early medical abortions pose no greater risk and allow women to have the procedure much earlier on in their pregnancy. Telemedicine for abortion has been permitted in Wales, France, America and New Zealand.

Some 150,000 women have had early medical abortions at home before they are 10 weeks pregnant since the provision was overhauled in the wake of the Covid crisis, MPs in the House of Commons heard.

Earlier in the week, The Independent reported women in the UK contemplated dangerous measures like scalding hot baths and hooks to terminate pregnancies before the government introduced telemedicine.

Clare Murphy, chief executive of the British Pregnancy Advisory Service, the UK’s largest abortion provider, said: “We are absolutely delighted that MPs followed the evidence and above all listened to women when they voted for the continuation of this service.

“Early abortion at home is safe, effective and an important option for women. We look forward to being able to provide this service into the future and are incredibly grateful to all the parliamentarians who championed it.”

George Eustice’s sewage discharge proposals are not tough enough

Proposals aim to cut 70% sewage discharges into bathing waters, but not until 2035, and eliminate 40% of discharges into rivers by 2040 rising to 80% by 2050.

At this rate it’s a toss-up whether we reach net zero carbon first. – Owl

Raw sewage discharged into English rivers 375,000 times by water firms

Sandra Laville www.theguardian.com 

Water companies discharged raw sewage into English rivers 372,533 times last year, a slight reduction on the previous year.

The water companies covering England released untreated sewage for a combined total of more than 2.7m hours; compared with 3.1m hours in 2020, according to data released by the Environment Agency (EA) on Thursday.

The data was published as the government announced what it said was the largest overhaul of the sewer system since the 1990s to tackle the problem of discharges.

The government said the Storm Overflows Discharge Reduction Plan was a step change in how water companies tackled the number of discharges of untreated sewage, which the government and the public have made clear are unacceptable.

The plan aims to eliminate 40% of raw sewage overflows into rivers by 2040. Untreated sewage and rainwater should only be released into rivers and coastal waters via storm overflow pipes in extreme weather to relieve pressure in the sewerage system. However, evidence over the last three years has shown water companies are routinely using the overflows to discharge untreated sewage rather than treating it.

The environment secretary, George Eustice, said: “We are the first government to set out our expectation that that water companies must take steps to significantly reduce storm overflows. Today, we are setting specific targets to ensure that those storm overflows are used only in exceptional circumstances – delivering on our Environment Act and building on wider work on water quality.”

However, critics said the plan, which was launched for consultation on Thursday, lacked urgency. Mark Lloyd, the chief executive of the Rivers Trust, said: “I’m disappointed that this plan lacks the urgency we so desperately need. This plan is going to need strong input from civil society and NGOs like the Rivers Trust if it is going to outpace the twinned climate and nature crises we are currently facing. We want to have rivers where people and wildlife can thrive, but the target timelines in the plan are far too slow – I want to see this in my lifetime!”

Data released by the EA on Thursday showed that 10 water companies covering England were releasing raw sewage into waterways for hundreds of thousands of hours in 2021. The 372,533 spills were recorded only on those overflows where event duration monitors were in place: 12,608 of the 14,707 overflows, or 89%.

More than 60 discharges a year from an overflow are considered too high and should trigger an investigation. On average, 14% of discharges from the 10 water companies passed that limit.

Water companies in England are under investigation by the regulator Ofwat and the EA after they admitted they may have illegally released untreated sewage into rivers and waterways. The investigation will involve more than 2,200 sewage treatment works, with any company found breaching their legal permits liable to enforcement action, including fines or prosecutions. Fines can be up to 10% of annual turnover for civil cases, or unlimited in criminal proceedings.

Hugo Tagholm, the chief executive of Surfers Against Sewage, said the government’s plan was not tackling the problem quickly enough.

“The level of public outrage on the sewage pollution scandal continues to grow by the day, yet we’re seeing a consultation today that provides us with targets and timeframes decades away,” he said.

“The water industry must surely be forced to act faster, with a greater urgency to tackle their woeful pollution record that is contributing to the destruction of our rivers and coastline. This industry has already had over 30 years to act; we need to make sure they don’t have the opportunity to put their profits before the planet for the next 30.”

Richard Benwell, the chief executive of the Wildlife and Countryside Link, said: “These figures show another year of our waterways being choked by sewage pollution. This must change, for our own health as well as that of plants and animals struggling to survive in our polluted waters.”

Benwell said if the government was serious about cleaning up rivers “we need a hard deadline set in law to improve the overall quality of our waters and strong enforcement measures. We must halt the most harmful pollution by 2030 and go further, faster to stem the flow of water pollution for people and wildlife.”

Recorded spills by water companies

United 81,588

Yorkshire 70,062

Severn Trent 59,684

South West 42,484

Northumbrian 36,483

Wessex 23,532

Anglian 21,351

Southern 19,077

Thames 14,713

Welsh Water (in England) 3,567

Council U-turn after ‘extortionate’ rent hike backlash

“Officers at East Devon District Council (EDDC) have now made a refreshed offer to businesses in The Strand who wish to trade on the land owned by the council this summer.”

Common sense seems to have prevailed, but VAT returns to the pre-covid level of 20%. – Owl

Anita Merritt www.devonlive.com 

Independent businesses on Exmouth Strand can now breathe a huge sigh of relief following a U-turn by East Devon District Council over ‘extortionate’ rent hikes for outdoor seating after a major backlash. Last year, bars and restaurants in the area were paying Devon County Council £100 to use the paved areas outside its premises and also the same amount to EDDC to also use its grassed areas to extend its seating area in good weather and the Covid pandemic.

However, this month traders were informed by EDDC that new charges were being brought in with increases being as much as 144 times more pro-rata. Traders also alleged they were told of they don’t pay the new rates, the grassed land will be offered to other businesses.

A collective protest against the new rents was made by five traders in The Strand. They unanimously agreed they should have to pay to have seating on the Strand, but they didn’t agree with how much the rents have been raised or that they were being charged different rates from each other. Support was received for their campaign from local councillors as well as East Devon MP Simon Jupp, and also local residents.

Earlier this week, the council said it had launched a ‘commercial negotiation’ with traders to see whether it is ‘appropriate’ for the council to ‘subsidise’ local businesses that adjoin the Strand in Exmouth, and that a similar consultation was successfully carried out at Queen’s Drive Space.

Yesterday, the council confirmed it has now ‘refreshed’ its rent charges, much to the delight of the Strand traders. George Nightingale, owner of Spoken, said he is happy to have ‘won’ their battle and has thanked all those who have helped them achieve a victory.

He said: “We have all reached mutually agreeable rents. We can now afford to be out here and can employ more staff and we can just ensure the vibrancy of the town. Let’s get back to business and doing what we should be doing and that’s providing good food and good drink.” He added: “Viva revolution and here’s to a better great Exmouth for the future.”

EDDC says it has reconsidered its position due to rents charged by DCC. A spokesperson for EDDC said: “Officers at East Devon District Council (EDDC) have now made a refreshed offer to businesses in The Strand who wish to trade on the land owned by the council this summer.

“The council has taken into consideration the views that have been expressed by traders over recent days and wants to find a positive way forward. EDDC has always wanted to enable the continued use of The Strand for hospitality businesses to place tables and chairs on council-owned land and to continue the café culture/ alfresco environment that has proven so popular.

Traders are uniting against rent hikes for outdoor space in The Strand

Traders are uniting against rent hikes for outdoor space in The Strand (Image: The Strand traders)

“The council had been seeking a fair commercial rent and had hoped the traders in this space would have entered into constructive negotiation with our agents as they had been encouraged to do. However, in light of the unique circumstances of this space with pavement licences also issued by Devon County Council, a refreshed proposal has now been made to traders for the 2022 and 2023 seasons – April 1 to September 30 – each year).

“EDDC will be embarking this summer on a significant and exciting piece of work around place making in Exmouth with the recent appointment of a dedicated project manager. This work will include extensive consultation and engagement on a range of projects and opportunities across the town including The Strand and how we can further improve the offering. We hope that the traders will engage constructively in those discussions when they take place.”

Before the council’s change of heart, Cafe and bar Franklins were told they would have to pay £1,007 for six tables (equivalent rent pro rata of £4,080 PA), whereas The Grapevine will have to pay £4,500 – an increase it says amounts to 45 times.

Bayleaf Cafe and Bar said they were being charged almost 80 times more than what it pays DCC for its pavement licence. Bar and restaurant Spoken said it was required to pay £6,000 for ‘a few months in the summer’ (equivalent rent pro rata of £14,400 PA) and – 144 times more valuable than the paved area.