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July 13, 2021
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Presidential blog: Living with COVID-19 is not the same thing as letting it rip

Dr Jeanelle de Gruchy, President, Association of Directors of Public Health

The Association of Directors of Public Health started advocating for a ‘living safely with COVID-19' approach from February of this year. The objective of keeping cases of COVID-19 as low as possible whilst moving closer to normality is a pragmatic, rather than a perfect, strategy. Nobody wants endless cycles of restrictions and lockdowns but the idea of being relaxed about rising case numbers is wrong and damaging to public health. 

We should be heartened by the enormous steps we have made thanks to inspiring colleagues working across our public services, the incredible scientific progress epitomised by the development and rollout of vaccines, and the compassion and caution of everyone in society. Why put all that at risk? 

Let us be honest about where we are, the challenges ahead and what we can do to stay safe.

One of the most divisive debates of the COVID-19 era has pitted public health and the economy against each other. For Directors of Public Health, who care passionately about creating a thriving and fair economy, this was always a false choice. As we cast our gaze beyond the 19th July, we should be guided by a simple reality: there is no health without wealth and no wealth without health. 

Of course, the primary purpose of the restrictions since March 2020 has been to limit illness and death from COVID-19. There were other motivations too. The social, economic, educational and cultural life of the UK cannot succeed if a virus runs unchecked through the population. As we have seen from other parts of the world, decisive public health action suppresses cases and limits transmission to manageable levels, enabling economic recovery. 

The prospect of reaching 100,000 cases per day is of deep concern, but we acknowledge that easing restrictions – whenever it is done – will cause an exit wave of infections. Our efforts should be directed to how we exit and the actions necessary to minimise infections. 

Even though the vaccines are highly effective they are not perfect and there are still millions of people not fully protected. The current wave will cause significant illness, including Long COVID, hospitalisations and deaths. More cases lead to more children missing school and recreational activities, more people off work – with the impact that has on public services and businesses - and more uncertainty for the economy. 

We should proceed carefully not recklessly. 

Creating a workable ‘living safely with COVID’ strategy for the medium term is a tough task. For the Association of Directors of Public Health, there are three areas of focus right now: continued implementation of public health measures, maintaining the momentum of the vaccination programme and renewed collective spirit. 

We need to challenge an unhelpful assumption – public health is an enabler of recovery, not a roadblock. Public health interventions can boost public confidence and create safe public spaces for everyone. Many older people and vulnerable groups will understandably be anxious about the easing of restrictions, they deserve guidance and support. Polling shows strong backing for keeping some of our tried and tested approaches in place for the time being. 

So, we should continue to draw from our toolbox of public health measures and messages that work – handwashing, testing, contact tracing, economic support for isolation and quarantine, physical distancing, wearing a face covering and strict border controls. We believe it is right for the Government to promote working from home, insist on face coverings in crowded and high-risk situations such as on public transport and in health settings and encourage outdoor socialising. The Government also needs to collaborate on robust plans for the safe return of schools in September and to invest in ventilation for public buildings. 

The vaccination roll out has been a fantastic achievement that the nation should be proud of. It is essential to keep up the pace, reaching out to the significant number of adults who are yet to receive the protection of two jabs.

Common purpose and clear leadership are vital. The sense of collective spirit throughout COVID-19 has been amazing. Councils and partners are well placed – and trusted – to communicate effectively with their local communities, it is disappointing when these efforts are hindered by irresponsible national messages. 

Directors of Public Health are working hard with council colleagues, their communities and partners to support a more open economy and society. Public health measures and looking out for one another will put us in the best possible position to weather a difficult Autumn and Winter. We should not risk the gains we have made or push public services to the brink unnecessarily. Living with COVID-19 is not the same thing as letting it rip. 

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