Pushing our luck with Covid-19 this Christmas will cost lives in January

As with speed limits and the guidelines for weekly consumption of units of alcohol, the difficulty with the Covid-19 restrictions is that they soon become targets to aim for, rather than the maximum that should be safely tolerated. Or, as the chief medical officer Chris Whitty put it the other day, just because you can do something, such as hugging Granny, it doesn’t mean that you have to do it, or even that you should do it.  

So it is, yet again, with the national Covid Christmas guidelines. Rather than being taken to be the absolute limits of what might be done in exceptional circumstances and with other appropriate social distancing and ventilation in place, the three households rule is regarded as an invitation to “get this party started” for five days of officially sanctioned “normality”.  

As the powerful joint warning from the British Medical Journal and the Health Service Journal makes clear, this public habit of gaming the system and pushing its luck threatens to overwhelm hospitals during January and after. It will cost lives.  

The guidelines were drawn up some weeks ago during one of the government’s periodic episodes of unwarranted optimism. Ignoring the hard lessons about doing too little too late to curb past waves, the Christmas “truce” was designed on the assumption that the November lockdown and the tougher tier system would get the infection levels down in time for a relaxation at Christmas. There was political calculation at work, naturally; no doubt ministers like to play Santa and look kind as much as anyone else. The move was also well meaning, though. The country is fatigued from the pandemic, and no one wants to criminalise Christmas. Besides, too rigid and Scrooge-like a regime risks being ridiculed and ignored. Usually it is wise to go with the grain of public opinion when the public can make a mockery of your rules.  

So the government is in a difficult position, clearly. Yet the BMJ/HSJ warning is credible; that as many as 19,000 Covid patients will be in hospital in January, as many as at the peak of the first wave in the spring. Hospitals, including the Nightingale units, will be overwhelmed and urgent non-Covid treatments disrupted.  

Ministers and the scientists are already trying to stress that the public should err on the side of caution, have “minimalist” celebrations and generally take personal responsibility in a situation where even pre-testing (with high false negatives or results slow to arrive) is little defence against inter-generation infection. As people will travel cross-country and return to households, universities, schools, public transport and workplaces, Christmas 2020 has the capacity to be the mother of all superspreader events.  

Neighbours such as the Netherlands and Germany have already scrapped Christmas. The “freedom loving” British, as Boris Johnson describes them, may press on regardless, but they should not be surprised when things turn very nasty indeed in mid to late January.