If there is one thing we have learnt from the pandemic over the past year, it is that social isolation works. This is, however, an inconvenient truth in the lead up to Christmas.

At the time of writing, approximately 633,000 people in England are estimated to have had Covid-19 in the past week. This is one of the highest positivity rates recorded, equivalent to one in 85 people. Mortality statistics paint a similarly grim picture, with just under 2,700 deaths in the week prior, the highest figure since May.

This week also marks the end of the national lockdown. Over the next three weeks, there is expected to be intense retail and social activity, as people make preparations for Christmas and start the annual travel exodus to be with close members of their family.

This poses a significant challenge for a Covid responsible Christmas, not least as the nation is lulled into a false sense of security by the promise of the impending vaccine roll-out.

At a time when infection rates are some of the highest they have ever been, people are permitted to have three weeks of heightened social activity, which will inevitably lead to a further spike in covid cases. This will be swiftly followed by five days of intense indoor social interactions, as small family groups are allowed to celebrate Christmas together.

Complacency with regard to social distancing is also likely to increase, both due to the news of the vaccine and the inebriating effects of festive celebrations. 

Christmas has the potential to become a national super-spreader event, leading to a catastrophic rise in cases at the start of the New Year. The effect of Thanksgiving in the United States proves testament to this.

Moreover, these celebrations are likely to represent the most significant exposure to covid for many of the most vulnerable members of the population who have been shielding over the past year. This is particularly true for the older generations, who are likely to come in contact with younger members of the family household who may be asymptomatic carriers. 

The consequences of this nationwide exposure could be devastating. 

Each year, there is a recognised increase in hospital respiratory related admissions and deaths in the weeks following Christmas. This is thought to be due to increased social interaction, time spent indoors and reluctance to seek medical advice over the festive period.

As a result, the NHS experiences a surge in demand at a time when it is already buckling under winter pressures. The pressure for bed space this year will likely be dire, with covid patients already accounting for almost 10% of capacity.

The NHS will also be hit at a time when it desperately needs to recover. The past year has put enormous strain on already stretched staff and resources, already exhausted from the immense pressures of dealing with covid. There is dangerously little capacity in the system to cope with any further infection spikes.  

Overall then, the current Christmas plans may represent the most significant super-spreader event this year, and the single greatest exposure to covid for the most vulnerable members of the population. Together with an overly stretched and exhausted NHS, a social festive period could spell one the biggest disasters for this country at a time when the covid era shows signs of resolution. 

So what should we do this festive period? It’s imperative we delay a social Christmas, at least until the vaccination has been more extensively rolled-out and immunity has had an opportunity to take hold. We also need to give the NHS this vital time to recover from winter pressures already exacerbated by covid.

Without sounding too much like a politician, we have all adapted enormously since the start of the covid pandemic, and it is important to maintain this discipline in order to see it to an end.

We must realise that by filling chairs at our tables for this year’s Christmas, we risk many more empty chairs next year. 

Felix Brewer is a surgical trainee in the East of England. He is part of the Doctors Association UK Editorial Committee.