Health experts want the U.K. to bring back covid restrictions. Government says we dont want to go back

British Prime Minister Boris Johnson ended the lockdown in England on July 19, declaring it "Freedom Day." Since then, the country has lifted most restrictions, with no legal mask requirement in most settings, including schools, and nothing approaching a universal vaccine mandate, in sharp contrast with some other European countries.

In a speech in September laying out his government's plan for autumn and winter, Johnson said he would like things to continue that way, with an emphasis on promoting vaccinations, booster doses, and frequent testing, rather than reintroducing covid restrictions. However, he outlined a pandemic "Plan B" that he said could be necessary if the publicly funded National Health Service became overwhelmed. Some restrictions could then be introduced, including advising people to work from home, legally mandating face coverings in certain settings again, and bringing about mandatory covid passports.

Now, as the United Kingdom this week recorded its highest number of deaths from the coronavirus since March, health experts are warning of a potential "winter crisis," and have begun urging the government to not just implement "Plan B" - but to go further with "Plan B Plus."

"We are right on the edge - and it is the middle of October," Matthew Taylor, Chief Executive of the NHS Confederation, a group representing the health care systems in England, Wales and Northern Ireland, told The Guardian newspaper Tuesday. "It would require an incredible amount of luck for us not to find ourselves in the midst of a profound crisis over the next three months."

The government should ensure "clear communications to the public that the level of risk has increased," his organization said, and call on the public to "mobilise around the NHS and do whatever they can to support front line services this winter," including by getting booster shots and volunteering.

"Many of these measures, particularly around mask-wearing and COVID-19 certification, are already common in parts of Europe where the prevalence of the disease is lower," the group added.

However, the government, which has been keen to reopen the economy, has insisted that its current approach is working. Business Secretary Kwasi Kwarteng said Wednesday that it was not the time for Plan B, adding: "What we want to do is manage the situation as it is - we don't want to go back into lockdown and further restrictions. I would rule that out."

The Cabinet Office said in an emailed statement: "The vaccination programme has significantly weakened the link between cases, hospitalisations and deaths and will continue to be our first line of defence against COVID-19."

"We always knew the coming months would be challenging, which is why we set out our plan for Autumn and Winter last month."

Daily case numbers are the highest they have been since July - 49,156 people were reported to have tested positive for the coronavirus in Britain on Oct. 18. And "the problem is a lot worse than the daily figures suggest," says Robert West, a Professor of Health Psychology at University College London who is part of the government's Scientific Pandemic Insights Group on Behaviors.

This is because not everyone who has covid-19 is aware of it, particularly if they do not have symptoms, and some people may test positive but not report their result to public health bodies. The Office for National Statistics estimates that the true number of infections in England, in the week ending on Oct. 9, was closer to 1 in 60 people in the country, or about 127,000 new cases per day.

And while hospitalizations and deaths remain low, they are climbing. According to the government, in the United Kingdom as a whole, 954 people were recorded to have died of covid-19 in the past seven days, a 21% week-on-week increase, while 6,074 people were reported to have been admitted to a hospital due to covid-19 in the seven days up to Oct. 16, an 11% week-on-week increase.

Experts say three major trends may have led Britain to this point: Loosened public health restrictions, the relative success of different vaccination campaigns and the natural evolution of the virus.

The government went into "an explicitly post-pandemic mode" and did not do enough to mitigate risks after Johnson ended lockdown, says Danny Altmann, Professor of Immunology at Imperial College London. This created a "perfect storm" once the more contagious delta variant began to spread, while schools reopened, immunity from the coronavirus vaccines began to wear off and the weather got cooler.

The success of the country's vaccination program may, ironically, also be a factor in the rising number of cases right now. While much is still unknown about how coronavirus vaccines work, studies suggest their efficacy could be reduced over time. Because many people were vaccinated early, immunity to infections could be going down around now, says UCL's West, just as people begin to spend more time indoors, potentially increasing transmission.

The virus mutates naturally over time, so some of the rising cases could also be explained by "basic biology and timeline," says Altmann. "Not only were we early, we were also at the front of the queue for importation of delta variant so we've had much longer for it to percolate," he said, adding that the same is true for AY4.2, a new variant sometimes known as "delta plus" that is "expanding" in England, according to the latest official analysis.

And while nearly 79% of those aged above 12 have been fully vaccinated, efforts to vaccinate school-aged children have progressed more slowly - even though infections are rising in that age group. The latest official data shows an estimated 8.9% of children in England in what roughly translates to sixth to tenth grade were infected.

"They get sick, they miss school, they spread it to their mates and teachers and family, they get long covid," Altmann adds.

While the government has remains reluctant to reintroduce covid restrictions, it has said it will be keeping "a very close eye" on case numbers.

It has delayed implementing covid measures in the past, partly out of concern that the British public would not comply, according to a recent scathing review of the British response to the pandemic. In that review, lawmakers concluded that the government underestimated people's willingness to comply with restrictions and erred in delaying a lockdown as a result.

Now, some health experts believe that the public would be willing to accept more restrictions again if they are sold as common-sense measures.

Research shows most people would be willing to start wearing masks again "if you make it very clear in your communications why and when to do it," West says.

Meanwhile, Altmann has a more blunt assessment: "I don't understand how people can get bored of avoiding death."