At a time of steep rise in Covid infections, with one in 20 people in England testing positive in recent weeks and hospital admissions going up, William Hanage is right to remind us all that measures in addition to vaccination have a vital role to play (From ‘herd immunity’ to today, Covid minimisers are still sabotaging our pandemic progress, 29 March). Unfortunately, the government is in denial about this and has withdrawn free lateral flow tests for most people, while also reducing funding for community surveillance studies. This is part of a dangerous narrative from the prime minister that we got the big calls right. Tell that to the relatives of the 175,000 who have died.
Wearing masks and providing clean air inside buildings are important public health measures. As Hanage points out, the scourge of epidemic cholera and typhoid was not removed by giving individuals personal responsibility for protecting themselves against enteric fevers, but through clean water and effective sewerage. A “head in the sand” approach has deadly consequences. While aerosol spread is now widely recognised as the principal mode of Covid transmission, it is astonishing that government guidance still means health and care workers are not being provided with the protection they need.
Dr John Puntis
Co-chair, Keep Our NHS Public
• William Hanage highlights several measures to blunt future waves of Covid-19. But these will be inadequate without the direct involvement of local communities. A community-centred approach is crucial to disseminating public health messages relating to Covid. Mobilising community participation will be vital to support mutual aid groups in neighbourhoods, provide resources to voluntary groups, and work through existing neighbourhood networks. Working with informal leaders in communities can assist the continued uptake of vaccines. Ensuring more diverse forms of communication about Covid-19 is also vital. Current methods are overreliant on access to the internet (which many individuals and groups may not have) as a medium for transmitting public health messages. Non-digital approaches are equally important, eg leaflets through doors, advertising in shops and local newspapers and work with faith-based organisations. Covid hit some communities far worse than others, and living with Covid is likely to perpetuate such inequalities. Doing something about Covid must involve embedding community-based approaches as a key part of any pandemic strategy.
Chris Phillipson
Professor of sociology and social gerontology, University of Manchester
• Frances Ryan is right to regard the end of free Covid tests as “an act of national sabotage” (31 March). She mentions the burden this places on, among others, those who wish to check that they are not asymptomatically infected before visiting vulnerable loved ones. But, like the government, she makes no mention of those of us who are living with vulnerable loved ones. My wife is immunosuppressed and among those recognised as eligible for free tests and for urgent anti-viral treatment in the event of a positive test. But I who share a home – bed, meals, kitchen and bathroom – with her am not even advised to test myself to ensure that I can safely do so without risk to my wife.
Hartley Dean
St Albans, Hertfordshire
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