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Sir Simon Stevens
Sir Simon Stevens said the biggest failure of the pandemic had been not realising the virus was circulating more freely in February and March. Photograph: James Veysey/REX/Shutterstock
Sir Simon Stevens said the biggest failure of the pandemic had been not realising the virus was circulating more freely in February and March. Photograph: James Veysey/REX/Shutterstock

Asking over-65s to shield is 'age-based apartheid', boss of NHS England says

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Sir Simon Stevens rejects idea proposed by scientists to contain Covid second wave

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.

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UK quarantine rules explained

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What are the quarantine rules?

Anyone entering England, Scotland, Wales and Northern Ireland from somewhere that is not on that country’s list of exempt travel corridors is required to go into self-isolation for 14 days.

What if the rules are not the same between the different countries of the UK?

You can’t get round the rules by using a different airport. For instance, as of 4 September travellers returning to Wales and Scotland from Portugal are required to quarantine. This is true even if they fly into an English airport, despite Portugal still being on England’s green list.

How are the rules enforced?

Everyone entering the UK, including British nationals, must fill in a passenger locator form, regardless of whether or not they need to quarantine. The form asks travellers to provide their contact details and UK address.

If someone who is required to self-isolate does not provide an address, the government will arrange accommodation at the traveller’s expense.

What does quarantine mean you can’t do?

For 14 days, starting from the day after arrival, people who are quarantining should not:

  • Go to work, school, or public areas.
  • Have visitors, except for essential support.
  • Go out to buy food, or other essentials, if they can rely on others to do this for them.
  • Use taxis or public transport to reach their destination on arrival in the UK, if possible.
  • Use public transport or taxis once at their destination.

The quarantine rules apply to everyone apart from selected groups of people such as freight drivers, very regular business travellers, and politicians or other dignitaries.

How do I find out which countries are on the list?

The travel restrictions are being frequently updated, and are available on the relevant government and administration websites linked to here, with separate lists covering England, Scotland, Wales and Northern Ireland

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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.

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.

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