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England's reopening provokes anxiety for some who have weakened immune systems

The relaxation of England's coronavirus restrictions is stirring concern among some people who have weakened immune systems and are more clinically vulnerable to the possibility of an infection.

Scientists also concerned as most COVID-19 restrictions are lifted

Hal Cohen, a double kidney transplant recipient living in north London who has a weakened immune system, is worried about the lessening of England's coronavirus restrictions on Monday. (Lily Martin/CBC)

It may be called "Freedom Day" in England, but some people who have compromised immune systems are counting on Monday being a day of fear, as the country proceeds with its plan to lift virtually all COVID-19 restrictions. 

"Feels really tough and definitely there's anxiety," Hal Cohen, a double kidney transplant recipient, told CBC.

"It's really very hard to know what we should do in this case and for how long to keep ourselves shielded away from the rest of the world." 

England is doing away with restrictions such as limits on how many people can meet at once, physical distancing rules and a blanket mandatory mask mandate. This comes even as daily new coronavirus infections in the U.K. are topping 50,000 — the highest levels since January. On Friday, there were 51,870 new cases.

Data released by the Office for National Statistics shows an estimated one in 95 people (or 1.06 per cent of people living in the community) had COVID-19 in the week ending July 10, up from one in 160 people the previous week, a resurgence in cases fuelled by the more contagious delta variant.

Countrywide regulations on mask-wearing are to be lifted in England on July 19, with an expectation that the public will continue to wear masks in confined spaces out of consideration for others, such as on public transport. (Henry Nicholls/Reuters)

Despite the data, nightclubs have also been allowed to reopen, and pubs and restaurants can return to operating normally without table limits or required face coverings, although Prime Minister Boris Johnson has recently urged people to opt for a mask in crowded indoor spaces. 

Scotland and Wales are not going as far as England in lifting pandemic restrictions, leaving the latter as one of the first countries in the world to lift legal restrictions while in the midst of a significant rise in COVID-19 cases. 

Cohen, 39, received his second transplant just months before the coronavirus pandemic hit and spent much of the beginning of last year confined to his north London home, even keeping his distance from his wife and two young daughters, before gradually resuming outdoor activities. 

As of Monday, capacity limits in pubs and restaurants in England will be lifted and physical distancing guidance removed. The hospitality sector was first allowed to open up in May, but with outdoor seating only. (Tolga Akmen/AFP/Getty Images)

He is fully vaccinated but he's uncertain whether he's protected, given the medication he takes that suppresses his immune system. Cohen has had antibody tests, which did not register any response to the COVID-19 vaccines he has received.

"I have to go on the basis that I don't have any protection at this point," he said, adding that the most recent government data shows that 40 per cent of unvaccinated transplant recipients who contracted COVID-19 died. 

This means the removal of a mandatory mask mandate across England is particularly worrisome for him and others who are immunocompromised, a number estimated at 500,000 by the charities that work with them. 

More calls for help

There has been a massive increase in calls to the helplines at charity Blood Cancer UK from blood cancer sufferers who are more at risk of being hospitalized after being infected with the coronavirus, even at this later stage in the pandemic when many have had two jabs. They are worried about what the easing of restrictions means for them.

"We've been completely overwhelmed," said Kate Keightley, the head of support services at the charity. "We've been receiving probably three or four times as many calls over the last couple of weeks than we have been throughout the pandemic." 

Most worrisome, she said, is that a number of people calling are only just hearing that the vaccine is likely less effective for them than it is for the general public. 

WATCH | Fears in England ahead of 'Freedom Day':

Caution urged as England prepares to lift most COVID-19 restrictions

3 years ago
Duration 2:02
England is set to lift most of its COVID-19 restrictions on Monday, including mask requirements and physical distancing. But with cases on the rise, some experts say the move is reckless.

Freedom Day means more of a free-for-all for blood cancer survivors, Keightley said. "They feel less safe and less free than they have done for a long time now." 

Cohen feels the same, particularly when he thinks of how easy it would have been for the U.K. government to keep a mandatory mask rule in public spaces. 

"We have been a bit forgotten," Cohen said, pointing to the government's emphasis on personal choice instead of forced mask mandates. 

"You do need certain rules in place. Things like masks on public transport and shops, they're really a mild inconvenience for people," he said. "I don't really see them being an issue of people's freedom and then they protect other people like me." 

'This is the right date'  

Johnson shifted his tone a week ago, emphasizing the need for caution in the face of a virus that isn't done spreading, even as he remained steadfast that England must reopen on July 19. 

The removal of the legal restrictions to distance and wear masks, said Johnson, was not a licence for people to have "a great jubilee [or] freedom from any kind of precaution or restraint."

British Prime Minister Boris Johnson says it's 'highly probable' the worst of the pandemic is over, but he has warned people not to 'throw caution to the winds.' (Daniel Leal-Olivas/Reuters)

The justification, presented time and again by his government, is that Britain's high rate of vaccination, with two-thirds of the adult population fully jabbed, has weakened the link between coronavirus infections and hospitalizations, even with the dramatic rise in cases linked to the delta variant. 

"I think what the scientists are saying is [that] this is the right date, or as good as any other date, to do this," Johnson said during a July 12 news conference. 

'Negligent and reckless' 

That is not the scientific consensus, according to Deepti Gurdasani, a clinical epidemiologist and senior lecturer at Queen Mary University of London who called the move "completely negligent and reckless."

She's one of the signatories to a letter from more than 100 scientists and doctors, published in the Lancet, that labelled the government's reopening plan a "dangerous and unethical experiment." 

It's also set to be a confusing experiment for those trying to navigate the rules. London Mayor Sadiq Khan announced last week he will keep the mandatory mask mandate for the city's subway, buses and trams, and other mayors across England are contemplating similar moves for local services. 

Gurdasani said other countries must be looking on in shock at what she called England's "let-it-rip policy," worried at the threat it could pose to global infection rates. 

"This is essentially herd immunity by infection for about half of the population," she told CBC, highlighting that a sharp increase in infections, even if it doesn't lead to as many deaths, would most certainly lead to a rise in sufferers of long COVID, a condition doctors still know very little about. 

"Why on earth we're exposing our young to those risks is very hard to understand or justify from any perspective, whether it's ethical or scientific." 

ABOUT THE AUTHOR

Salimah Shivji

Journalist

Salimah Shivji is CBC's South Asia correspondent, based in Mumbai. She has covered everything from natural disasters and conflicts, climate change to corruption across Canada and the world in her nearly two decades with the CBC.

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