Covid-19: 'We'll be second-class citizens if self-isolation rules go'

Work-from-home guidance has been scrapped, mandatory mask-wearing will soon go and Health Secretary Sajid Javid has said compulsory self-isolation could be next. But what happens to people who cannot live with the virus, because their immune conditions mean vaccines may not work?

For nearly two years, Julie - not her real name - has worked from home and lived like "an absolute hermit", knowing that her condition means a coronavirus infection could be more deadly.

That didn't change even after her third jab, because she has to take medication to suppress her immune system, meaning her body may not be able to respond to the vaccine.

But as soon as Prime Minister Boris Johnson and the health secretary announced the end of Plan B measures in England, including the advice to work from home if possible, her manager called her, pressuring her to come back to the workplace.

"It's terrifying, absolutely terrifying," she says. Most of her job in customer service can be done online, but a small part involves sometimes managing the front desk of an organisation with thousands of people.

If coronavirus measures such as self-isolation come to an end, those people could pose a greater risk to her - along with the estimated 500,000 people who have conditions which mean vaccination may not work for them.

"People lean over the counter, they're in your face. My boss doesn't care that he will put me in an extremely risky position with hundreds or maybe thousands of people coming to the desk, vaccinated or not, and now not wearing any masks," she says.

"I understand that a lot of people are really fed up with all the restrictions. But I just feel like a second-class citizen now."

Susan Walsh, chief executive of Immunodeficiency UK, a charity which supports people affected by immune conditions, says the government's announcements about ending many Covid measures have caused "so much anxiety", with people calling her in tears.

"That's how this community has felt all along - abandoned," she says. "People are using terms like health apartheid. There's no real protection for these people."

One possible preventative drug, a long-lasting antibody treatment being developed by AstraZeneca, is still awaiting approval.

Other treatments have been approved, including retroviral drugs and short-term antibody treatments, but these must be given in a five-day window after someone has contracted Covid.

Fast-track procedures with special testing kits have been put in place to try to ensure the treatments reach people with weakened immune systems in time.

The health secretary said on Wednesday that "Omicron is in retreat" and the UK has delivered more booster doses and has more antivirals than any other European country.

He said he would set out a long-term plan for living with Covid in the spring. "We must learn to live with Covid in the same way we have to live with flu," he told a news conference.

But for many people with immune conditions, relying on antivirals feels like a big risk, leaving them with difficult decisions about everything from work to family life as the rest of society opens up.

"The likes of me will be wearing gloves and masks wherever we go, in the hope of not catching it," says Julie. "And how long before that becomes a problem? Oh, it doesn't look right in the workplace. The customers don't like it. That's my worry."

Margaret Bennett, a retired teacher from Birmingham who has a genetic condition which means she cannot properly make antibodies to fight infection, says she is still spending most of her life "locked away" after three jabs.

On the prospect of ending mandatory self-isolation, she says: "It's just terrifying from our point of view in the immunosuppressed community. The thought of people just wandering around and coughing and sneezing over everybody and it's just fine!"

Over Christmas, she says was able to take a calculated risk and hug her grandson Arthur - who was visiting with her daughter from Massachusetts in the US - for the first time since May 2019.

But that depended on the rest of her family taking extra care with lateral flow testing and cutting their other contacts, including her daughter cancelling a planned trip to London as the Omicron variant surged in the capital.

All this means the impact is even wider than the people directly affected by immune conditions, as family members have to be "very careful on your behalf", Margaret says.

"It's several million people's lives who've been blighted by this," she adds.

Angela Steatham, who is 54 and has chronic lymphocytic leukaemia, says a recent test showed even her third vaccine dose had produced no antibodies.

Although Wales is lifting restrictions more slowly than England and has not yet said it will remove requirements for face masks or self-isolation, Angela says society opening up will push her "deeper and further" into isolation in her cottage in Llanrhaeadr-ym-Mochnant, Powys.

Anxiety is also high among her family members. "My son is absolutely terrified of giving it to me, because he says, 'I'd never be able to live with myself, mum'," Angela says.

While many people are conscientious in trying not to spread the virus, she says others are unsympathetic, with some telling her on Twitter to "get on with your life" after she recently posted about her continued shielding.

People compare it to the risks of everyday activities like driving a car, Angela says. "It's like getting in a car with no brakes, ice on the roads and a blindfold on. I wouldn't do that, the risk is too high."

The ongoing isolation has been a drain on her finances, preventing her from resuming her international consulting work. And she says it has taken a psychological toll, undermining her sense of confidence.

"I feel very let down, very insignificant," she says. "There's no plan. I don't know the timescale for if, when and how I'll be able to come out of this."