Household Bubbles: Another COVID-19 failure by the UK Government?

A sequel to this post, describing the development of support bubbles and extended households up to August 2020 is here.

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This post discusses the continuing failure to introduce household bubbles as part of the UK Government’s COVID-19 recovery strategy.

It condemns the Government’s:

• Discrimination against non-cohabiting couples, unfairly prohibiting their intimacy during the COVID-19 lockdown period while not similarly prohibiting the intimacy of cohabiting couples.

• Failure to adopt household bubbles on the New Zealand model, in line with its own plan for easing the lockdown, as the means of removing this prohibition at the earliest feasible opportunity – and subsequently.

• Inability to engage with the public to develop, communicate and implement such an approach, or even to share the evidence it has considered and the basis for the decisions it has reached.

A precious opportunity was missed to introduce household bubbles when the country entered lockdown. The Government subsequently failed to meet its own commitment to introduce them within Step Two of the plan for easing it.

The Government must give this priority now, even within the limited headroom given by our slow progress in reducing the incidence of infection.

Human relationships should be a far more pressing priority than reopening non-essential shops, drinking in pub gardens, visiting zoos or the resumption of elite sport!

The comparatively limited risk of increasing infection rates is more than offset by the substantial benefits to mental health and wellbeing. 

This should now form part of a consistent shift away from the top-down imposition of national restrictions and crude distinctions of our relative vulnerability to COVID-19.

We need instead a model driven by personal risk assessment, as the basis for personal risk management.

This would be best supported at national level by: much greater transparency; the publication of timely, reliable, accessible evidence and data; a prompt, efficient and accurate test, track and trace strategy; and provision for targeted, localised lockdowns only as a last resort.

The Government’s handling of this crisis has been wayward, if not downright poor. If it persists with unfair top-down restrictions (and, now, even with criminalising human social interaction between non-cohabiting couples amongst others) it will alienate many and, increasingly, its various edicts and ordinances will be ignored.

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Living Apart Together

Several research studies explore relationships between couples who choose not to share a home.

In the UK (as elsewhere in Western Europe, the United States, Australia and New Zealand) approximately 1 in 10 of all adults are living apart together. In Great Britain research consistently places the figure at 9%. This accounts for up to 25% of all non-cohabiting British adults.

Assuming an estimated 48 million adults are resident in Britain, well over four million people are affected. While some will be living apart together across national boundaries, it is reasonable to estimate that some two million couples are doing so in Britain.

The phenomenon is most prevalent in younger age groups, but not exclusively so. A 2011-12 study found 43% of those in such relationships were aged 16-24, 33% were 25-44, 13% were 45-54 and 11% were 55 or older.

They were fairly evenly distributed across different socio-economic backgrounds, with 29% in managerial and professional employment and 41% in manual or routine employment or unemployed. Their ethnic background was broadly representative of the country as a whole. Three per cent were in same sex relationships.

Roughly one quarter were divorced or separated, 3% were widowed and 3% were married. About one quarter lived with children; about one third lived on their own. Four in five had never lived with their partner; the remaining fifth had done so previously.

Some 19% had been in their relationship for less than six months; but 22% had been with their partner for between three and five years and 19% had been together for six years or more.

These couples typically live close together: in this sample, roughly one in five lived within one mile of each other and two-thirds lived within ten miles.

More than one in five saw their partner at least once a day; almost half saw their partner several times a week. Eighty-six per cent were in daily contact.

Roughly one third felt that it was too soon to cohabit, they weren’t ready or they hadn’t thought about it. One third preferred not living together and the remaining third either couldn’t afford to cohabit, or were prevented from doing so by the location of their work or studies.

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What Are Household Bubbles?

Household bubbles are very small, exclusive groups of people who only have physical contact with each other while remaining socially distanced from everyone else.

They extend, only marginally, the concept of a household, extending it beyond nuclear families that live together to include other relationships, including those in close, loving, long-term relationships who live apart, whether by choice or circumstance.

Household bubbles may consist of two households, paired together in an exclusive relationship. This may be described as a ‘double bubble’ approach.

They may be confined initially to those living in relatively close proximity, but may also be extended as travel restrictions are eased, providing in themselves a justification for essential travel.

They should not exclude particularly subsets of people, for example those deemed particularly vulnerable to COVID-19, or those working in the health and care sectors: the state should never interfere with our choice of partner. Such matters are properly left to those involved, who will make their own risk assessment.

Household bubbles are always self-contained and exclusive. As with households, if one member of the bubble has COVID-19 symptoms, all must enter quarantine.

They do not create an extended chain of transmission. They permit continuing intimacy between non-cohabiting couples while minimising the risk to the remainder of the population.

In New Zealand, household bubbles were introduced at the earliest and strictest stage of lockdown – Level Four – and so helped from the outset to contain the very limited COVID-19 outbreak there which has now been eliminated. They did not generate any spike in cases.

Under New Zealand’s Level 4, a shared bubble arrangement was defined as:

‘…an agreement by all of the residents (other than children) of no more than 2 residences within the same or adjacent health districts to quarantine…as if they were 1 residence.’

Such agreements enabled New Zealand policy-makers to combat loneliness, improve mental health, facilitate childcare and extend support to those vulnerable to COVID-19.  

Initially, two households could pair into a single bubble provided that:

• At least one of them contained one person living alone, the other was relatively small and both were in the same local community; and/or

• The people living in one were deemed vulnerable, i.e. at significant risk if they contracted COVID-19.

This made it possible for many non-cohabiting couples to remain as couples despite not living together, so sustaining their relationships, protecting them against the negative consequences of forced separation and ensuring that they were not discriminated against relative to cohabiting couples.

Single parents could also choose to partner with a childcare provider, so releasing them to return to work.

As in the UK, there was provision for children to move between two households in the same community if each contained a ‘joint care giver’, and those in ‘unsafe or life-threatening circumstances could also leave their household.

When New Zealand eased its lockdown, shifting to Level 3, some limited expansion of household bubbles was permitted, but had to remain small, local and exclusive.

It was possible, for example, to add close family, someone needing care or a caregiver. Two small bubbles might merge, but no more than two.

Further relaxation was permitted when New Zealand shifted to Level Two in mid-May 2020.

Although New Zealand has a population of just five million people and has experienced a much less severe outbreak of COVID-19, there is no obvious reason why household bubbles could not be applied in the UK with much the same benefits.

But, despite appearing to embrace household bubbles as a means of easing the lockdown, the UK Government has preferred to use its limited headroom to prioritise less intimate social interaction between larger groups, exclusively outside, while maintaining social distancing.

Confusingly, these interactions are also often termed ‘bubbles’.

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COVID-19 Lockdown in the UK

COVID-19 lockdown was imposed in the UK on 23 March 2020. The Government banned almost all inter-household contact to slow the spread of coronavirus.

The most vulnerable were instructed to ‘shield’ at home; the remainder were permitted to leave their homes only for a handful of essential purposes. Planned face-to-face social interaction with those in other households was not one of these.

Moreover, all adults were told to maintain a distance of at least two metres between themselves and anyone in another household at all times.

One day after lockdown, on 24 March, Deputy Chief Medical Officer Harries was asked, at the Government’s daily press conference, whether this rule applied to couples living apart.

Her response (at approximately 21 minutes) was as follows:

‘I’m clearly going to start a new career here in relationship counselling, so I will tread very carefully as I work through this answer.

The principle is that we want people to stay in their household units primarily. The reason for that is because, if you have an infection, you are very close with your family members, so your risk of exposure to the virus is pretty similar usually across the family. We almost expect another member of the family to get that, unless they are applying very, very stringent precautions.

So if your two individuals, two halves of the couple, are currently in separate households, ideally they should stay in those households. The alternative might be that, for quite a significant period going forward, they should just test the strength of their relationship and decide whether one wishes to be permanently resident in another household. In which case, all of the decisions…you should be on your own or within your household unit, would apply.

So again the issue here is what we do not want is people switching in and out of households. It defeats the purpose of the reduction in social interaction and will allow transmission of disease.

So perhaps test really carefully your strength of feeling, stay with the household – either together or apart – but keep it that way while we go forward, because otherwise we will not all be working towards achieving our outcome.’

At a stroke then, some two million couples were forbidden all physical and intimate contact unless they moved in together for an indefinite period. This applied to all, regardless of their age, the size and structure of their household and the status of their relationship.

Strictly speaking, they couldn’t even arrange to meet each other outside to conduct their relationship from a distance of two metres or more. They could only meet virtually.

Harries implied, wrongly, that a decision to live apart must somehow be associated with being part of a relatively less strong relationship; that living together is necessarily a mark of progression in a relationship. That is both out-dated and discriminatory.

The practicalities, the feasibility of moving in together and the associated legal implications of cohabiting were completely ignored.

No such prohibition was imposed on couples sharing a household residence, regardless of the nature or status of their relationships, the nature of their households, their employment, or any other variable.

We do not know how many non-cohabiting couples have obeyed this injunction.

ONS surveys show that, throughout lockdown, well over 90% of respondents have claimed to be observing social distancing guidelines. However, another survey reported that much larger proportions of younger people were breaking these, especially males aged 19-24.

I have found no survey evidence specifically pointing to the infringement of social distancing by non-cohabiting couples though, anecdotally, one hears quite often that many couples, particularly younger couples, are refusing to comply.

The same surveys highlight the heavily negative impact of lockdown on people’s mental health. For example, ONS survey evidence shows that, in the period from 21 May to 23 May 2020, 28.5% of adults said their mental health was deteriorating.

Almost two thirds (64.6%) were concerned about their lack of freedom and independence. Almost half (46.9%) felt their well-being was affected.

Indeed, 35.9% reported feeling lonely, 29.1% said they were spending too much time alone and 23.8% felt their relationships were being affected.

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Household Bubbles are mooted in Scotland

The Scottish Government was the first to suggest applying something similar to the household bubbles pioneered in New Zealand.

In its Coronavirus (COVID-19) framework for decision making – further information, published on 5 May 2020, it said:

‘We are considering if and how we could make changes to allow people to meet with a small number of others (the number is under consideration) outside their own household in a group or “bubble” that acts as a single, self-contained unit, without connections to other households or “bubbles”. It is possible that this option would be introduced first for outdoor meetings, ahead of any change to permit indoor meetings of the bubble…

…Although similar approaches have been applied in other countries, each country’s experience of the virus may differ, and we have to be sure that this, or any other measure we consider, would fit Scotland’s particular needs and circumstances.’

The Scottish Government invited ideas and responses to its Framework and those who responded on household bubbles were overwhelmingly supportive, especially on behalf of non-cohabiting couples:

‘Two people in a relationship who are living in separate households should be allowed to meet. As long as they were not meeting with others. Currently children from separated families can move between houses to see separated parents, I think relationships in different houses should be the same as long as staying in the bubble?’

 ‘100% agree with this and it should come in to force asap. Loneliness kills and this can break relationships. A couple who do not live together but both live alone should be able to form a “virtual household” this would be much easier to implement than a social bubble (which is also a good idea but requires more thought). They should be allowed to meet freely just as a married or cohabiting couple do.’

‘I would like to be able to visit my partner who stays 70 miles away and he would like to visit me. We both have cars so would not need to use public transport. We haven’t seen each other since the lockdown. We have both been observing the lockdown rules. We are both educated as scientists so have quite a good understanding of the situation and believe ourselves to be sensible. We would like to create a bubble. I don’t see how this would be a problem unless we are unknowing carriers.’

‘I agree. My partner and I live 60 miles apart and have both followed the rules strictly, thus have not seen each other since lockdown began, other than by video call. We are both feeling isolated, lonely and struggling mentally. I don’t see how being able to spend time with my partner in either his or my home, just the two of us, could be any more dangerous than couples who live together full time and also go out to the supermarket? Loneliness and good mental health do not go hand in hand ….’

However household bubbles were entirely omitted from Coronavirus (COVID-19): framework for decision-making – Scotland’s route map through and out of the crisis which was published on 21 May.

An Overview of public engagement released on the same date faithfully recorded public support for household bubbles, not least for non-cohabiting couples.

But it continued:

‘However there were mixed views on whether social contact between households should ultimately be permitted as there were concerns with how the intricacies of physical distancing within ‘a bubble’ could be communicated, and who is permitted to be in a bubble. Many thought policing bubbles would be difficult.

There was divergence in views about how many could be in a bubble, and whether they should be selected on the basis of individuals or households. Many correspondents argued that the decision on who to include in a bubble might be particularly stressful if people with larger social networks need to choose between different friends and family members. Furthermore, clarity was required on how far away bubble members can live from each other.

Once a bubble is established, there were many suggestions about what they could be permitted to do together, whether they should still be required to maintain physical distancing from each other, and whether multi-household bubbles could meet up if distant from each other. In addition there were questions about length and frequency of visits and how long bubbles could interact. Children would benefit from social interaction, but might find it more difficult to maintain physical distancing. The location of where bubbles could meet was discussed, whether this was only permissible in public spaces like parks, or could take place in gardens or driveways, which were argued to be equivalent in safety and could help limit overcrowding.

Concern was expressed that opportunities to meet up would be an excuse for wider-scale socialising, in defiance of the rules and increasing risk.’

This is not a policy that lends itself to over-prescriptive rules and arbitrary distinctions, which would almost certainly be unfair and inequitable, nor should it require extensive ‘policing’. It should be permissive and flexible, unless it is being wilfully abused.

This commentary also suggests that the needs of non-cohabiting couples had been forgotten in the desire to shift immediately to a much wider-ranging reform enabling more people to engage in less intimate contact, typically outside.

A similar process has been evident in wider UK policy.

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Household Bubbles are mooted for the UK

On Sunday 10 May 2020, Prime Minister Johnson addressed the nation, outlining the Government’s plan to ease the lockdown, including the elements included in step one, to be taken the following week.

There were newspaper reports that Cabinet members Gove and Sunak were:

‘…arguing late into the night for the PM to include the provision for friends and family members to meet in ‘bubbles’ – but they were overruled by Mr Johnson and Mr Hancock

A Government source said: ‘Bubbles were in and out at different points of the weekend hence why it was so unclear after Sunday.’

It is not completely clear whether, in this context, ‘bubbles’ was being applied to all groups of people meeting together, or only to exclusive household bubbles. (But, given what the published document said, the latter is most likely.)

On 11 May 2020, the UK Government’s Our plan to rebuild: The UK Government’s COVID-19 recovery strategy was published and appeared supportive of a New Zealand-style household bubble approach:

‘Since 23 March the Government has asked people to only leave the house for very limited purposes and this has been extraordinarily disruptive to people’s lives.

In particular this has affected the isolated and vulnerable, and those who live alone. As restrictions continue, the Government is considering a range of options to reduce the most harmful social effects to make the measures more sustainable.

For example, the Government has asked SAGE to examine whether, when and how it can safely change the regulations to allow people to expand their household group to include one other household in the same exclusive group.

The intention of this change would be to allow those who are isolated some more social contact, and to reduce the most harmful effects of the current social restrictions, while continuing to limit the risk of chains of transmission. It would also support some families to return to work by, for example, allowing two households to share childcare.

This could be based on the New Zealand model of household “bubbles” where a single “bubble” is the people you live with. As in New Zealand, the rationale behind keeping household groups small is to limit the number of social contacts people have and, in particular, to limit the risk of inter-household transmissions.’

A footnote explains that it will not be possible to create a chain in which each household decides to link to a different household: the relationship must be exclusively between two households.

A second footnote explains that there will be an assessment of the potential effects on the rate of transmission (R) of the virus.

This section is included within ‘Step Two’ of the plan, which it says would be taken ‘no earlier than Monday 1 June’.

And:

‘The current planning assumption for England is that the second step may include as many of the following measures as possible…’

The text about ‘Step Two’ concludes:

‘Over the coming weeks, the Government will engage on the nature and timing of the measures in this step, in order to consider the widest possible array of views on how best to balance the health, economic and social effects.’

Only since step one of the recovery strategy was implemented on Wednesday 13 May has it been possible for non-cohabiting couples to arrange to meet each other outside, while maintaining a two-metre distance between them.

On 17 May, one newspaper reported:

‘At a virtual meeting of the 1922 Committee on Friday, one MP told the PM that he had ‘not hugged his girlfriend in seven weeks’ and asked when he would be able to. The PM replied ‘soon’.’

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Step 2 is implemented without Household Bubbles

At the time of writing there has been zero public engagement by the Government about household bubbles, or indeed bubbles of any kind.

When the Prime Minister formally announced step two on 28 May 2020, he made no reference to them.

Instead, he announced:

‘Lastly, I know the toll that lockdown has taken on families and friends who have been unable to see each other.

So from Monday we will allow up to six people to meet outside – provided those from different households continue strictly to observe social distancing rules by staying two metres apart…

…we will now allow people to meet in gardens and other private outdoor spaces.

These changes mean friends and family can start to meet their loved ones – perhaps seeing both parents at once, or both grandparents at once. I know that for many this will be a long-awaited and joyful moment.

But I must stress that to control the virus, everyone needs to…stay two metres apart from those who you do not live with…

…And it remains the case that people should not be inside the homes of their friends and families, unless it is to access the garden.’

The broader needs of friends and families had been prioritised over those of non-cohabiting couples and others who would have benefited directly from household bubbles.

There was no explanation of why the Government had decided not to proceed with household bubbles as described in the plan.

Nor has any substantive explanation emerged since.

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So what is the Government’s view?

Who knows?

The only information I can find in the public domain is the summary of a discussion by the Scientific Advisory Group for Emergencies (SAGE) at its 34^th meeting on 7 May 2020, the minutes of which were finally published on 29 May:

The minutes of the meeting say:

‘Bubbling

The concept of ‘bubbles’ has potential benefits, such as supporting mental wellbeing or allowing childcare to be shared between households. However there are also risks, particularly if bubbles were to be introduced alongside other changes or if there is poor adherence.

The effects of bubbles are complex. Introducing bubbles alongside other changes could reconstruct extensive networks, particularly when combined with any increase in contacts in other settings. These networks could enable transmission through the population. It will be difficult to assess the effects of individual policy changes on R if multiple changes are introduced together.

Mitigation of these risks would require very careful policy design. Key mitigations will include maximising adherence of those within bubbles to other messages and maintaining exclusivity of bubbles (which would be difficult to enforce). Size of bubbles will also be an important factor, with smaller bubbles being lower risk. There are many variables that would need to be considered to establish design principles.

A safe approach to bubbles would need to include isolation of all members of a bubble in the case of one member showing symptoms. This would lead to increased frequency of isolation for people, particularly in the winter months.

There are also equity considerations in the design of bubbles. Additional factors would need to be considered around vulnerable people, healthcare workers, and other groups who may be affected differently. The approach needs to consider the effects on households of different sizes, including those in HMOs [houses in multiple occupation]. Introducing bubbles may affect people in different cultural groups differently, for these reasons and others.

Further work is required to fully understand the potential impact of bubbles, which has not been possible to do in the timeframe or with the parameters given. Until a detailed approach is developed, it will not be possible to assess the level of risk with any degree of confidence.’

The conclusion is that introduction of bubbles is not straightforward and carries potential unforeseen risks. SAGE can undertake more work on this and would advise understanding this more to inform any decision.’

This discussion encounters many of the same pitfalls as the Scottish discussion reported above. SAGE seems to be attracted by a tightly prescriptive policy design that minimises risk, rather than broad design principles and exercising a degree of trust. There may also be evidence here of an unhelpful ‘not invented here’ mentality.

SAGE clearly parked the issue – refusing point-blank to consider whether or not the New Zealand approach could be adopted wholesale in the UK – and commissioned further work from its sub-groups for modelling (SPI-M) and behaviours (SPI-B) ‘to be based on further input from Cabinet Office’.

We do not know whether that work has yet been carried out, or whether it has specifically addressed the circumstances of non-cohabiting couples.

But, meantime, The Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 3) Regulations 2020 came into force on 1 June 2020, making it illegal for two partners not living in the same household to be indoors together.

Though this must be a temporary step, it is hardly consistent with the planned introduction of household bubbles.

It also sends unhelpfully negative messages that the Government will continue to impose universal and inflexible restrictions, rather than shifting gradually to a more flexible regime where greater responsibility is placed on the individual

Meantime, other lockdown relaxations mean we shall soon be able to buy shoes, or visit a car dealership, or pray alone in a place of worship. Elite sportspeople will be able to train together and (of course) the Premier League will recommence.

In what strange world have these things been prioritised ahead of loving human relationships?

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Research evidence

On 7 May 2020, the Parliamentary Office of Science and Technology (POST) published a piece about how social distancing might be lifted as part of the exit strategy from lockdown.

This explored two different approaches: intermittent ‘light switch’ arrangements where social distancing is switched on and then off for fixed periods and ‘cluster’ arrangements which restrict human interaction to small groups or bubbles.

The discussion of bubbles refers to modelling work undertaken by a group at Oxford University suggesting that repeated interaction with the same micro-community was the most effective strategy of those it modelled. This has subsequently received further publicity.

A rapid research report: Living in bubbles during the coronavirus pandemic: insights from New Zealand (Long et al), conducted by a joint UK-NZ team, was first made public on 13 May 2020. It is presumably informing UK policy development.

The report found that household bubbles supported effective public health messaging ‘foregrounding the importance of mutual care and support that might stretch beyond a single household or home’.

Compliance with the rules governing bubbles was high, even while those rules were being relaxed:

‘The concept of the bubble could be an effective policy in other countries to encourage compliance with social distancing regulations while meeting care and support needs.’

Unfortunately, the report provides no specific insight into benefits for non-cohabiting couples, but respondents of the survey underpinning it argued that the reconnection of households improved their quality of life more than reopening schools, shops or churches.

On 6 June 2020, the Centre for the Mathematical Modelling of Infectious Diseases (CMMID) published The effectiveness of social bubbles as part of a Covid-19 lockdown exit strategy: a modelling study (Leng et al).

At the time of writing this has not yet been peer-reviewed.

It models the effect on UK cases, fatalities and the R-number of several different strategies for combining exclusive pairs of households.

The central finding is that, if managed carefully, household bubbles are an effective means of extending human contact beyond a single household while limiting the increase in epidemic risk.

The modelling assumes that household bubbles are introduced when the R-number is 0.8 and then examines the impact on R of different forms of household pairing.

The full range of scenarios explored is:

Regrettably, non-cohabiting couples are once again sidelined.

The effect on R of differential take-up is relatively linear, i.e. 50% take-up has roughly half the effect of full take-up. The study fails to discuss the likely impact of risk-averse behaviour on take-up.

It does point out that, while all household bubbles will increase transmission of the virus to some extent, they offer a way of controlling the impact, so are preferable to a scenario in which the public increasingly tires of social distancing and takes matters into its own hands.

‘Hence social bubbles, if given as a guidance [sic] to households that are struggling to cope with the lockdown, may give these households a safer alternative and thereby help to reduce the epidemic and mortality risk.’

It notes that introducing household bubbles alongside other measures, such as reopening schools and non-essential retail is likely to affect the results.

But it makes no attempt to quantify the significant offsetting mental health benefits of household bubbles.

Although there is no estimate of the impact on R of provision for non-cohabiting couples, their numbers are relatively small compared with the total number of single occupancy households or households containing a child aged under 10 (unfortunately these figures are not provided in the paper). There will also be some overlap, particularly with single occupancy households.

Overall, the limited published research is much more favourable to household bubbles than SAGE appeared in its discussion on 7 May. Unfortunately though, none of this material explicitly addresses the circumstances of non-cohabiting couples.

And it should.

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Adoption elsewhere

The New Zealand model or variants upon it have been applied with apparent success in several other parts of the world while, in other settings, there has been alternative provision for non-cohabiting couples.

For example:

• Closest to home, the States of Guernsey introduced a household bubble arrangement from 2 May 2020, as part of its phased lockdown exit strategy. Each household was given the option to pair up with another, the two households then being able to socialise normally inside their homes, but not outside. Social distancing was no longer necessary. The over 65s were included. Two weeks later, these bubbles could be doubled in size by taking in two further households.

• In Victoria, Australia, an initial prohibition of interaction between non-cohabiting couples was quickly reversed on 1 April, as the Chief Health Officer tweeted:

‘Regarding ‘Stay at Home’ rules: We have no desire to penalise individuals who are staying with or meeting their partners if they don’t usually reside together. We’ll be making an exemption. Hope that helps.’

• A similar exemption was also made in New South Wales, and interaction was apparently permitted anyway in Tasmania, South Australia and The Northern Territory.

• In Canada, New Brunswick, Nova Scotia and Newfoundland have already introduced so-called ‘double bubbles’ and they are also likely to be introduced soon in Ontario, where infection rates are significantly higher.

• In the Netherlands intimacy is permissible with one’s regular partner, even if they do not live within the same household.

For many countries it is not straightforward to establish whether interaction between non-cohabiting couples is or is not prohibited.

One suspects that many governments prefer to ‘turn a blind eye’, refraining from laying down rules that interfere unnecessarily with the personal relationships of a relatively small proportion of their subjects.

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Conclusion

It was discriminatory for the UK Government to forbid non-cohabiting couples physical contact while continuing to permit such contact between cohabiting couples.

The line was drawn in the wrong place, assuming that cross-infection between cohabitees was all but inevitable, whereas between non-cohabiting couples it had to be avoided at all costs, even though the increased risk to the wider public was – and remains – limited.

Presumably it was influenced by an old-fashioned ‘one size fits all’ notion that cohabitation is a proxy for the strength and durability of relationships.

This misjudgement has almost certainly had a profoundly negative impact on mental health and wellbeing that more than outweighs any increased risk of infection.

Although there is some evidence that a proportion of cohabiting couples have also been refraining from physical contact, they at least had that choice.

Both the Scottish and the UK Governments have dangled the prospect of introducing household bubbles on the New Zealand model and both have then conveniently ‘forgotten’ them in favour of looser, socially distanced contact exclusively outside.

(The Northern Ireland Government is now the latest to express such interest.)

In the case of the UK Government, household bubbles were advertised as part of Step Two out of lockdown, but have apparently been parked for an indefinite period.

We know SAGE was less than enthusiastic when it discussed the matter on 7 May; we have not seen the outcome of the promised further work. The record of the 7 May discussion suggests that SAGE remains wedded to a centralised, paternalistic and overly cautious ‘command and control’ model of easing lockdown which is neither desirable nor sustainable.

As a first step, household bubbles should be permitted immediately for all non-cohabiting couples. No ifs, no buts.

They also have wider benefits for other lonely or vulnerable people and those with childcare needs. Those needs should also be met where possible, but non-cohabiting couples must not be squeezed out of consideration.

And we also need a wholesale shift towards a ‘new normal’ in which adults are encouraged to take responsibility for assessing their own personal risk, and acting accordingly.

Otherwise a sizeable minority of the population will remain overly risk-averse, shunning restored freedoms because they have been cowed by fear, unwilling to resume their former lives.

That is not in the best interests of a Government seeking to present the UK as ‘open again for business’.

Personal risk assessment must be properly informed.

As lockdown eases, it is no longer appropriate to categorise groups according to age, or to lump all the so-called ‘comorbidities’ into two broad categories – vulnerable and extremely vulnerable – regardless of severity or evidence of impact.

It stands to reason that one 71 year-old may be far healthier than another 69 year-old.

And it is neither sensible nor appropriate to consider someone with, say, mild asthma and someone else with end stage diabetes as equally vulnerable (not least since, in the United States, only those with moderate to severe asthma are advised to take extra precautions).

The Government’s role is to manage the phased reopening of services temporarily withdrawn as a consequence of lockdown; to publish the information and data required for personal risk assessment; and to secure the systems necessary for the regime to operate effectively.

These will include: consistent norms for social distancing and consistent safeguards where social distancing is impossible; universal on-demand testing; a rapid, responsive and efficient track and trace system; supported self-isolation where necessary; and localised lockdown as a last resort.

And the Government has to communicate so much more effectively. The public has a right to be engaged directly in the policy-making process, rather than being left waiting for tablets of stone to be handed down from on high.

The bottom line, though, is that non-cohabiting couples have been waiting some three months now for permission to once more kiss, cuddle and be intimate together.

And, given the arguments above, that is simply unacceptable.   

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A sequel to this post, about the development of support bubbles and extended households up to August 2020, is here.

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TD

June 2020