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At a time of a sharp rise in Covid infections, with one in 20 people in England testing positive in recent weeks and hospital admissions on the rise, William Hanage is right to remind us all that measures in addition to vaccination have a vital role to play (From ‘herd immunity’ to now, Covid minimizers are still sabotaging our pandemic progress, 29 March). Unfortunately, the government denies this and has withdrawn free lateral flow testing for most people, while cutting funding for community surveillance studies.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 dead.

Wearing masks and bringing clean air indoors are important public health measures. As Hanage points out, the scourge of cholera and typhoid epidemics was not eliminated by giving individuals the personal responsibility to protect themselves against enteric fevers, but by clean water and an efficient sewage system. A “head in the sand” approach has deadly consequences. With aerosol spread now widely recognized as the main mode of transmission for Covid, it’s amazing that government guidance still means health and care workers don’t get the protection they need.
Dr. John Puntis
Co-Chair, Keep Our NHS Public

William Hanage highlights several measures to mitigate future waves of Covid-19. But these will be insufficient without the direct involvement of local communities. A community-centered approach is crucial in disseminating Covid-related public health messages. Mobilizing community participation will be key to supporting self-help groups in neighborhoods, providing resources to volunteer groups, and working through existing neighborhood networks. Working with informal leaders in communities can contribute to continued uptake of vaccines. Ensuring more diverse forms of communication about Covid-19 is also vital. Current methods rely too heavily on internet access (which many individuals and groups may not have) as a means of conveying public health messages. Non-digital approaches are equally important, for example flyers through doors, advertising in local shops and newspapers, and working with faith-based organizations. Covid has hit some communities far more than others, and living with Covid is likely to perpetuate such inequalities. Doing something about Covid must involve integrating 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 see the end of free Covid testing as “an act of national sabotage” (March 31). She mentions the burden this places, among others, on those wishing to check that they are not asymptomatically infected before visiting vulnerable relatives. But, like the government, she makes no mention of those of us who live with vulnerable loved ones. My wife is immunocompromised and among those recognized as eligible for free tests and 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 make sure I can do so safely without risk to my wife.
Dean Hartley
St Albans, Hertfordshire

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