Politicians’ decisions must be based on evidence that infection rates are low enough, vaccines work and hospitals can cope

Throughout the pandemic, NHS trust leaders have argued for appropriate restrictions on social contact to bring Covid-19 under control. It is they and their teams who have to deal, in a distressing and direct way, with the daily death and harm that this dreadful virus brings. They know that, until we can vaccinate our population, restrictions on social contact are the only way to prevent unnecessary deaths, reduce patient harm and give the NHS the best chance to treat all the patients it needs to.

So it should be no surprise that, as discussions start on loosening the current round of restrictions, trust leaders remain deeply cautious. There can be no simple, blanket approach to decision-making here. Each phase of the pandemic has its own characteristics and dynamics. Any relaxation will need to be evidence-based and take account of significant local variations in infection rates. And trust leaders have always been clear that these must be decisions for elected politicians as only they can balance the complex and difficult trade-offs required using the evidence and advice they receive. But trust leaders believe there are a number of reasons to be very cautious at this point.

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