Will people be able to afford to isolate when mandatory Covid restrictions are dropped?

For Elena Tayleur, owner of London’s Linnaean cafe, the planned ending of Covid restrictions in England is good news.

She’s already seeing an increase in bookings and hopes this will continue as workers return to their desks in surrounding Battersea. But that doesn’t mean Elena and her business no longer take the virus seriously.

“I feel very excited but it’s also a mixed feeling because at the same time there’s responsibility for the team and for our clients. As excited as we are to build up the business and focus on growth, we feel extra responsibility,” Elena told ITV News.

But some have expressed fears that people will feel pressured to come back to work by their employers.

Professor Thomas House, a member of the government’s SPI-M panel of advisers, says that - even during mandatory isolation - some employers were not letting staff in public facing jobs who were ill stay off work and isolate.

And people in public health say that just because isolation will no longer be a legal requirement, good infection control means staying off when infectious.

Earlier in the pandemic, isolation was not mandatory. And there are many other countries where people were not legally bound to stay at home after a positive Covid test or upon coming into contact with others. Yet people stayed off when ill.

Prof House says that it’s going to be hard to predict what will happen. Many people will still be cautious, not wanting to infect others, and will stay at home if symptomatic.

But he says the way people behaved early in the pandemic isn't going to be the same as how they behave now. People are vaccinated and have been infected already. There may be reluctance to stay at home if not particularly unwell, he says, particularly if restrictions have adversely affected their lives.

Throughout the pandemic, public health experts warned that people’s inability to isolate was a key driver in the spread of Covid.

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Along with cramped housing and poor working conditions for those who had to continue to work, a reason for this was a lack of easily accessible sick pay. This meant people who were infectious were more likely to pass it on to others.

Prof House says that while there was a lot of focus on the ‘rule of six’ or curfews in some countries, “much more important issues” to the trajectory of the pandemic, such as rights at work, weren’t always given the same attention.

He says it's “very, very unclear” what the impact of rules of six or curfews are - whether it’s those restrictions themselves or the timing that matters.

“But on the other hand, we've seen the most enormous outbreaks associated with workplaces where people are not empowered to stay home,” he says.

This, he says, is what’s clear from data from all sorts of countries.

For some, however, isolating wasn’t an easy choice.

“People are simply not able to take appropriate sick leave,” Prof House says.

Put bluntly, people simply couldn’t afford to isolate if they tested positive for Covid or were a contact of someone who had. For much of the pandemic, Covid cases and deaths were higher in poorer people.

Paul Nowak, deputy general secretary of the Trades Union Congress said that Covid highlighted the inequalities in the labour market. Two million people currently don't qualify for sick pay because they don't earn enough and the payment of £96 a week isn’t enough for people to live on, he said.

During the pandemic, the government in England put in a £500 payment scheme for those on low incomes who had to isolate. With isolation no longer being mandatory, there are fears that this will be dropped, meaning people will feel compelled to work to cover their bills.

The Department of Health and Social Care told ITV News that “further detail will be set out in due course”.

How much difference dropping mandatory isolation will have on the pandemic is yet unclear. It’s estimated that hundreds of thousands of infections have not been picked up and a survey last year suggested one in four people between the ages of 35-54 did not isolate.

But for some in public health, the pandemic has shown the importance of staying off with infectious illnesses when you’re ill.

Mr Nowak says he knows what a tough time businesses have had but people coming in when they’re ill is a false economy - it spreads infection around the workplace, he says.

The cost of living crisis will bring its own challenges in following public health guidance, he says.

Doing the right thing and staying away from work might conflict with paying bills, feeding the kids and paying the rent, Mr Nowak says.

But will the pandemic change behaviour going forward - people staying off when they’re ill?

Only time will tell and some experts say that change will only happen if people can afford it.