Asking all over-65s to shield to slow the transmission of the second wave of coronavirus would be “age-based apartheid” and would not work, the boss of the NHS in England has warned.
Sir Simon Stevens, the organisation’s chief executive, rejected the idea being proposed by some scientists that only certain groups most at risk from the virus should stay at home.
While it may be wise for those with medical conditions that make them more vulnerable, it is not appropriate for the elderly as a group to isolate, said Stevens. His remarks contradict the argument that a more targeted lockdown would reduce the death toll while also protecting the economy.
Asked what the biggest mistake of the pandemic had been, Stevens cited the failure to realise that in February and March the virus was circulating more freely than was known, “in part because of the absence of testing”, which delayed the lockdown on 23 March and led to people dying.
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Seven out of 10 people of working age who died after catching the coronavirus became infected “before early March, before the full lockdown, so that will turn out to be a crucial period”.
Stevens said that the dynamics of family life meant that blanket shielding by older people would not be effective.
“If you look at the way in which infections are spreading across the north-west of England right now, you can see them beginning to ripple up the age curve. So the idea that you could, you know, completely separate, the fifth of the population who are aged over 65, say, I think is implausible, not least, because for some of the most vulnerable, they will be getting help from working-age adults, some of whom will be younger, and some of whom will be living in households with younger people, and so forth,” Stevens told an online event held by the Spectator magazine.
“And in any event, there would be legitimate concern about the social isolation that, you know, is giving rise to this very understandable discussion of how much visiting you can do in care homes, for example. So I think that, in a nutshell, extra precautions for those at greatest risk is clearly a sensible part of the mix. But by itself, we’re not going to have age-based apartheid across this country.”
Scientists are divided over whether asking certain groups to stay indoors or further national restrictions that affect everyone are the best course of action.
Last week a group of 32 scientists, including Carl Heneghan, a professor of evidence-based medicine at Oxford university, published a letter advocating a targeted approach. However, a rival group, led by Prof Trisha Greenhalgh, another leading Oxford academic, published its own letter arguing against quarantining by certain groups.
England is facing a second surge of Covid-19, albeit at the moment only in the north-east and north-west, but which, if unchecked, may claim many lives, Stevens added.
“We are certainly seeing that [resurgence] in a number of regions across the country. In that sense it is closer to the situation that France and Italy saw in their first waves as against our first wave, which was much more broad-based across the country as a whole.
“But obviously the concern is that if that picks up momentum across the country, then we will see a lagged effect between community infections then showing up as hospital admissions, then showing up as intensive care and then showing up as mortality.”
Stevens also warned that the NHS not receiving proper funding in the future because of the pandemic’s damage to the British economy was “a huge concern” and underlined that the government’s NHS test-and-trace programme was a standalone initiative run by the Department of Health.