Coronavirus: Doctors spell out how to exit England's lockdown

Lifting lockdown must be handled better this time round to avoid a surge in Covid that could overwhelm the NHS, doctors say.

The British Medical Association has published a blueprint for how it thinks England should proceed with any easing.

It includes replacing the "rule of six" with a two-households restriction to reduce social mixing and banning travel between different local lockdown tiers.

Government has yet to say if or exactly how England will exit on 2 December.

It will decide next week, based on whether cases have fallen enough and how much strain hospitals are under.

'Same mistakes'

Communities Secretary Robert Jenrick has said ministers want to see a "significant easing" of coronavirus controls.

But Public Health England medical director and NHS Test and Trace chief medical adviser Susan Hopkins said the government would have to look at "strengthening" the three-tier system introduced in October.

And now, the BMA, a trade union for UK doctors, has said robust measures to keep the virus under control must be in place before lockdown ends, including:

• giving local public health teams more of the oversight and budget of Test and Trace to ensure it is fit for purpose

• replacing the rule of six, which allowed up to six people from different households to meet with a two-households rule to reduce social mixing

• banning travel between different local lockdown tiers

• replacing guidance with rules to ensure workplaces and public areas such as shops and pubs are Covid-secure

• continuing to encourage people who can to work from home

BMA chair of council Dr Chaand Nagpaul said the government must learn from mistakes from the ending of the first lockdown - rapid relaxation and inadequate monitoring, while people had been encouraged to go to the pub and dine out.

"It is unthinkable that we make the same mistakes again," he said, "because this time, the impact will be far worse."

Prof Neil Ferguson, whose modelling led to the original lockdown in March, has said reopening pubs and restaurants in the run-up to Christmas would likely lead to rising infection levels.

He told BBC Radio 4's PM programme: "The big question in practical terms is can we reopen hospitality venues - pubs and restaurants - in the run-up to Christmas and still avoid infection levels increasing?

"I suspect we can't, but the decision may be made to do so anyhow on the basis that any increase will be slow and may be able to be counteracted later."

• THREE TIERS: How will the system work?

• JOBS: How will I be kept safe at work?

• LOCAL LOCKDOWNS: What happens if you have one?

• TEST AND TRACE: How does it work?

• VACCINE: How close are we to finding one?

The NHS was preparing to roll out Covid vaccinations should a jab become available soon, the BMA said.

But such a mass immunisation programme must be properly resourced and funded by government.

And all of that groundwork should be done now, rather than later.

The Department of Health and Social Care said it has invested over £230m into manufacturing any successful vaccine and there had been "an enormous amount of planning and preparation" for distributing it to the people who needed it.

A spokesman said: "As we've set out, we will seek to ease restrictions on Wednesday 2 December, going back into a tiered system on a local and regional basis according to the latest data and trends.

"Guidance on infection control measures such as returning to work, social distancing and household mixing are constantly under review to ensure we can visit loved ones and support the economy whilst controlling the spread of the virus."