‘I would want to be vaccinated first’: Covid experts on England’s relaxed rules

With restrictions in England relaxing this week, we ask the experts about the risks involved with some of the main changes.

Groups of up to six people or two households can now meet indoors, with overnight visits allowed

Prof Susan Michie, a member of the government’s Covid-19 behavioural science team, and the Independent Sage group of scientists, said indoor meeting was riskier than outdoors.

“The scientific evidence over the last few months has been increasingly pointing to aerosols being the major route of transmission,” she said.

If people are planning to meet indoors, opening the windows or doors to improve ventilation is important.

But Michie cautioned against being lulled into a false sense of security around familiar faces, noting that while people tend to think that those they don’t know are more risky than people they do know, that is not necessarily the case.

David Heymann, a professor of infectious disease epidemiology at the London School of Hygiene & Tropical Medicine, said everyone had to weigh up the risks themselves. “I will go inside to visit friends who are vaccinated,” he said, adding he had been vaccinated. “I wouldn’t go into a place where people are not vaccinated myself, because that’s my own risk assessment.”

People can meet in groups of up to 30 outdoors

While meeting outdoors is, in general, lower risk that gathering indoors, there could still be a risk of spreading the virus – for example, if an infected person sneezes, speaks loudly or sings in the direction of somebody’s face, said Michie. “But mostly when you’re outdoors, the aerosol that’s coming out of an infected person’s mouth is quite quickly dispersed.”

Care home residents can have up to five named visitors (two at a time), provided the visitors test negative

Although there will be some risk of false negatives with lateral flow tests, people in care homes are likely to have had their vaccination, so the risk to them is greatly reduced, said Heymann.

“If I were going in to visit an elderly person in a care home, I would want a test,” he said. “If the test was negative, I would probably still wear a mask, just because I want to protect those others from getting infected should the test have been a false negative.”

Pubs, bars, cafes and restaurants can serve customers indoors

Drinking alcohol can reduce inhibitions – meaning it can make it harder to stick to rules one has made – and it can also make some people more likely to sit close, touch and hug. “So alcohol can be associated with increasing [the chance of] people being in a risky situation, even when their intentions are good,” said Michie.

“While there are concerns over variants, I wouldn’t go to the cinema or on holiday abroad or visit a care home.” Michie added. “But I would consider going to a restaurant or pub if well ventilated and not crowded – but infrequently, and not for a long period of time.”

Venues such as museums, galleries and cinemas can reopen

As with other contexts – ventilation is key. If you are at the Science Museum, which is huge and cavernous, people can wander around distanced from one other, so the risk of infection – should another visitor have Covid – is lower than in some other settings, said Michie. “If you think about a cinema, you’re sitting quite close to other people … you’re in an enclosed space with no obvious ventilation. And you’re there for two or three hours,” she said.

However, Gabriel Scally, a visiting professor of public health at the University of Bristol and a member of the Independent Sage committee, suggested cinemas might not be so risky. “Cinemas may well be safer than other indoor venues because of their ability to have effective social distancing and because they mostly have mechanical ventilation systems,” he said. “However, the quality of the ventilation system needs to be assured, in that it either needs to bring in a high proportion of fresh air source to change the air in the cinema regularly, or to have effective filters that will trap the virus if they have a recirculating air system.”

Organised adult sports, including gym classes, can begin again

Michie said it is difficult to make an informed choice about whether to go because it is hard to know how well ventilated gyms are, adding that when people exercise they do two problematic things.

“They exhale deeply, and so if you are infected you are more likely to spread the virus than if you are sitting in a theatre, and secondly, you inhale a lot, and so if there is any virus in the air, you are more likely to get infected,” said Michie.

Steam rooms and saunas can reopen

“I would want to be vaccinated before I went into a sauna; other people may feel that they want to take the risk, like they do when they smoke or do other things,” said Heymann. “It’s really individuals who need to be empowered to understand the risks and then just make their own decision.”

The virus is relatively sensitive to humidity and temperature, and so the likelihood is that in a sauna the virus will not survive very long, said Dr Julian Tang, a clinical virologist and honorary associate professor at the University of Leicester.

He added: “But of course, it depends on how close those people are sitting together, because the virus could transmit quickly before it has a chance to be impacted on by that heat and humidity.”

International travel

One problem with international travel is that even if people go to low-risk countries where Covid cases are scarce, they may end up in tourist hotspots and mingle with people from lots of different countries.

Complicating matters further, said Michie, is that people are being made to wait for hours at airports, which increases the risk of transmission between them.

“I think that it would be very good to … really encourage people to holiday within Britain this year,” she said.

Scally agreed. “This is not the summer for travelling abroad,” he said.