20 February 2022
Dear Sir Chris and Sir Patrick,
Re: Early End to England’s Isolation Rules
As members of the UK's science and medical community, we are writing this open letter to express our concern about Government plans to end testing, surveillance surveys and legal isolation of COVID-19 cases. We ask you to clarify the scientific advice underpinning these policy decisions.
We do not believe there is a solid scientific basis for the policy.
It is almost certain to increase the circulation of the virus and remove the visibility of emerging variants of concern. SAGE 105 minutes noted that:
"The emergence of new variants and a resultant wave of infections can occur very quickly, potentially within just several weeks. The ability to rapidly detect and characterise new variants and to scale up necessary responses (such as TTI and vaccinations) quickly will be very important. Considerations for future response preparedness and surveillance infrastructure should take this into account." 1
Further, SAGE’s “Viral Evolution Scenarios” document, dated 10 February, noted:
"higher global SARS-CoV-2 prevalence provides more opportunities for viral evolution, while new variants can drive higher prevalence". 2
We have no reason to assume that all future new variants will be mild. The SAGE document also noted that:
"higher transmissibility does not necessarily mean lower severity or vice versa." 3
Finally, in their consensus statement of 2 February 2022, SAGE SPI-M warned of increased transmission if self-isolation and testing are removed:
"Warwick’s estimates are equivalent to there being the potential for transmission to increase by between around 25% to 80% if the population were to return to pre-pandemic behaviours and no mitigations." 4
We believe humanity is in a race against the virus.
We believe the science strongly supports using vaccines combined with public health interventions to slow transmission and regain the upper hand on viral evolution. We must encourage vaccination in all demographics for which there is a medically approved vaccine and give a timely opportunity for vaccination.
Some form of surveillance must be continued to ensure the situation is well understood and new variants of concern identified. Lack of testing is not only detrimental to controlling the spread of SARSCoV2 and detecting new variants, it also puts people who develop Long Covid at a great disadvantage by not having a confirmation of their infection, which is integral to the diagnosis, support and care they need to receive. For the 1 in 4 people in the UK who are clinically vulnerable, the current approach appears a perilous and politicised pandemic response.
Continued and unopposed transmission is a recipe for further adaptation
by the virus.
Every strain of SARS-CoV-2 to date has failed to reach population saturation. Instead, each has been replaced by a new variant that is more transmissible, more immunity-escaping or both. This pattern will likely be repeated, and further reinfections will occur, with a continuing burden of disease and displacement in the healthcare system.
We urge you to clarify the extent to which the planned policies are consistent with scientific advice and what specifically that scientific advice contained. We feel that transparency on such matters is an essential requirement of your roles as Chief Medical Officer and Chief Scientific Officer, respectively.
We look forward to your response, with thanks for your hard work throughout the pandemic.
Professor Anthony Costello, University College London
Professor Trish Greenhalgh, University of Oxford
Dr Rochelle Burgess, University College London
Dr. Deepti Gurdasani, Queen Mary University of London
Professor Christina Pagel, University College London
Dr Stephen Griffin, University of Leeds
Dr Kit Yates, University of Bath
Dr Daniel Goyal, NHS Consultant Physician, Oban
Dr David Tomlinson, Consultant Cardiologist and Electrophysiologist, University Hospitals Plymouth NHS Trust
Professor Peter Boyle, University of Edinburgh
Dr Nisreen Alwan, University of Southampton
Dr Alison George, GP & GP in Emergency Medicine, Newcastle Upon Tyne
Dr Sarah Todd, GP, North Derbyshire
Dr Joe Pajak, FRSC CSci, NHS FT Governor
Dr Lucy Williams MRCA, Associate Specialist Anaesthetist, Great Western Hospital
Dr Katherine McConkey, GP, Cumbria
Dr Ian Jackson, Clinical Lead, Vaccination Hub, York & Scarborough Teaching Hospitals NHSFT
Dr Yvette Rean, GP in Kent
Dr Linda Dykes, Consultant in Emergency & Interface Medicine/GP, Herefordshire
Dr Kate Cushing, Newcastle upon Tyne.
Professor Colin Davis, University of Bristol
Dr Peter Dilworth, GP, Merseyside
Professor (Emeritus) Raymond Agius, The University of Manchester
Dr Simon Ashworth, Clinical Director Critical Care, Imperial College Healthcare NHS Trust
Anna Batchelor, Consultant ICM Newcastle upon Tyne, Clinical Lead for GIRFT