If we are to protect the vulnerable, we still need social distancing | thearticle

Britain is on the verge of relaxing the social distancing that has almost certainly prevented a much higher death toll from Covid-19. As we move into this new phase, it is vital that we

avoid the mistakes that were made during the initial stages of the pandemic. Beginning next week, the official mantra is to change. At present the public has been told: “Stay home, protect

the NHS, save lives.” In future, we will reportedly be told: “Stay safe, save lives.” This new advice is meant to encourage people to go back to work. It also reflects the fact that the NHS

now has enough spare capacity to cope, if a second peak can be avoided. That “if”, however, is crucial. Britain has already suffered more than most other countries, though in deaths per

million it still ranks below Italy, Spain and Belgium. With fewer than 1 per cent of the world’s population, the UK has some 12 per cent of recorded deaths from Covid-19 — over 30,000 out of

a global total that has now passed the 250,000 mark and is still rising. We cannot afford to risk a second wave of coronavirus on this scale. While the debate will continue about precisely

why the British ordeal has been so much worse than others, the more urgent question is: how can we manage lifting the lockdown without a major surge in new infections? In Germany, the

federal and regional authorities are taking this danger very seriously. Any district where the rate of infection goes above 50 per 100,000 inhabitants must return to lockdown. So far, only

two towns (Greiz in Thuringia and Rosenheim in Bavaria) face such a return. We are closely monitoring the German experience. The choice of which restrictions to ease, together with the

timing and manner of the unlocking, will determine the success of our risk management. We are learning more about one of the main risk factors for Covid-19: obesity. Those who are obese are

twice as likely to need hospital treatment, which in turn greatly increases the likelihood of death. Britain has one of the highest levels of obesity in the developed world: nearly one in

three adults (27.8 per cent) have a BMI above 30, the clinical definition of obesity. This means that as a nation we are significantly more vulnerable than, say, Germany or France, where

about 22 per cent are obese. A separate study suggests that ethnic minority groups are two or three times more likely to die of Covid-19 than the general population. There are likely to be a

number of factors involved here, including urbanisation, family structure and poverty. But obesity may also be relevant. According to the 2011 NHS study of _Obesity and Ethnicity_, “there

is no straightforward relationship between obesity and ethnicity.” However, for complex reasons some ethnic minorities — South Asian communities, in particular — do have high levels of

obesity. This may help to explain their higher mortality from Covid-19. The steady fall in the daily death toll means that the country has indeed flattened the curve. It is most important

that we keep our eye on one particular ball, however. This is the numbers and rate of infection. While the R (reproduction rate) has remained well below 1 for some weeks, the number of new

cases has not significantly fallen. Many more tests are being carried out, so more cases are being identified outside a hospital setting. Even so, it is worrying that 6,111 new cases were

recorded on Wednesday, almost as many as at the peak in early April. What this could mean is that while older, more vulnerable groups have observed social distancing, thereby bringing down

the death toll, other groups are taking the rules less seriously. Anecdotal evidence suggests that those who consider themselves less likely to die from the virus are also more likely to

risk being infected. So far, 52 per cent of those who have died have been aged 80 or more, with 39 per cent in the 60-79 age group. Just 1 per cent were 20-39 year olds. When more data

becomes available, it is likely to show that younger people are more likely to be taking liberties with social distancing and hence keeping the virus circulating in the community. The

Government and especially Public Health England need to target these younger groups in their messages as we emerge from the lockdown. The new official slogan may no longer need to mention

the NHS, but it ought to remind the young and healthy that, even if they may not feel vulnerable, other people still are. Perhaps it should read: “Stay safe, PROTECT THE VULNERABLE, save

lives.” If we are to protect the old and vulnerable, we will still need social distancing. Staying safe means sticking to the rules.