‘Living with Covid-19’: what next?

The Government has announced its plans for ‘living with Covid-19’ in England. We summarise some key points and our response below.

As we move forward towards living with Covid-19, Kidney Care UK has consistently asked the Government for a plan for people at highest risk to live safely with Covid-19. The Prime Minister has said that the majority of people previously considered clinically extremely vulnerable are now advised to follow the same general guidance as everyone else as a result of the protection they have received from vaccination.

Specific guidance for people who are immunosuppressed will be published alongside the new plan and we are asking that it explains the government’s strategy for ensuring this high-risk group have adequate protection as the newly announced plan leaves many questions unanswered. Infection levels are still high and the Chief Medical Officer has said new variants are to be expected, with no guarantees on severity.

Kidney Care UK has been speaking up about these plans to BBC and ITV News.

Kidney Care UK's response to the ‘Living with Covid’ plan

Access to clear and timely information

We are told that the Government and UK Health Select Agency will continue to communicate to people most vulnerable to Covid-19. Yet we have seen consistent failures in communication with vulnerable kidney patients. We await updated communications & are calling on the government to work with charities like ourselves to ensure that those who will be most acutely affected by these changes receive information that is timely, clear and reassuring. This should be sent directly to people’s homes, rather than online only.

Access to free lateral flow and PCR testing for highest risk people and their contacts

From 1 April, free universal testing will end with limited symptomatic testing to be made available for a small number of at-risk groups. We are urging Government to allow immunosuppressed people to access free testing for asymptomatic friends and family that they choose to spend time with, as well as colleagues with whom they have regular close contact. Without free asymptomatic testing many people will feel forced to reduce their contact with other people, to the detriment of their mental health and wellbeing. Charging for tests would put a costly burden on those immunocompromised people live and work with, and risks creating greater inequalities for people who will not be able to afford tests.

Testing must be affordable for people who are not eligible for free tests. This may be through capping the cost of tests or a scheme for low cost testing for people with a lower income. A policy which meant access to the protection offered by testing was determined by income would not be acceptable.

To support prompt access to Covid treatments, all those eligible for assessment for antiviral or antibody treatments must have access to a free test to keep at home and for replacements as and when necessary.

We also need more detail about whether people who are currently eligible for access to the studies such as PANORAMIC, which you need to be clinically vulnerable or over 50 to access. This study relies on positive tests – so it is not clear how people will be able to take part in such studies if they cannot access free testing.

Continued workplace protection for people who are immunosuppressed

From Friday 1 April the legal requirement for employers to explicitly consider Covid-19 within their risk assessments will be removed in England, although the general duty for employers to keep employees safe remains. The Government will replace the existing set of ‘Working Safely’ Covid guidance for employers with new public health guidance which explains what they should do to keep employees safe.

Employers will be told they should continue to consider the needs of employees at greater risk from COVID-19, including those whose immune system means they are at higher risk of serious illness from COVID-19. We believe this should include a specific duty to carry out COVID-19 risk assessments for immunocompromised employees.

Without this requirement it would be left to employers to decide whether to support their vulnerable staff members. It has been encouraging to hear that some employers have been very supportive, but we know that this is not always the case.

Explaining why it is safe to end the self-isolation rules

We would like the Government to publish the scientific basis for the decision to end the legal requirement to self-isolate following a positive test and for close contacts to test daily, as well as removing support to enable people to stay at home if they develop Covid. We are concerned this could potentially increase the risk for those who are immunocompromised.

Many people who have been living with the risk of Covid will find it difficult to make the shift to ‘living with Covid’. Providing more detailed background and rationale for decision making may be particularly helpful to higher risk individuals.

Access to vaccinations

The JCVI recommendation for a spring vaccine dose reflects the ongoing vulnerability of higher risk people to Covid. We need far easier access and online booking available as soon as the rollout commences, unlike that for primary and booster doses.

Access to treatments

Therapeutics are also very welcome but easier access is needed, especially at the weekend, because they must be given with 5 days of a positive Covid-19 test. Despite multiple requests, we have yet to see what any plan for preventative treatments.

Thanks to all of you for writing to us with your thoughts and for writing to your politicians.

• Our advocacy and counselling services are there for you.
• Take a look at the updated letter for everyone who is at highest risk from Covid-19 to use in discussion with their employers about how to keep safe at work.
• Current guidance for people who are immunosuppressed is subject to review but is currently unchanged since 24 December.
• See our joint campaign for 5 tests for living with Covid-19.

Self isolation rules in other UK nations:

• In Scotland, people who test positive must self-isolate for up to 10 days. Self-isolation has always been “very strong guidance” rather than law. Any changes to the recommended period of self-isolation will be considered on an ongoing basis.
• In Wales, people who test positive must self isolate for up to 10 days. The rules will be reviewed on Thursday 3 March.
• In Northern Ireland, people who test positive should self isolate for up to 10 days. Self-isolation has always been “very strong guidance” rather than law.