Ending England’s Covid restrictions was divisive – but the data shows we were right | Raghib Ali

More than 30 million people in England have been affected by the Omicron variant, which was first detected in the UK five months ago.

Behind these headline figures lies a more complicated reality, yielding important lessons about the impact of government-mandated restrictions that could help end disagreements between some scientists and help us deal with future waves.

The first Omicron wave showed us that it was possible to get over a peak without being locked up. The second wave peaked in England without any government-mandated restrictions, as all legal mandates ended on February 24.

England chose a different path for restrictions to the other home nations and other western European countries during the Omicron waves. Natural experiments can be used to compare the UK home nations, which have similar populations, age structures, climate/seasons, healthcare systems and population-level immunity.

It was perfectly reasonable for the home nations to choose different paths, and the extra restrictions outside England had widespread public support. England has had a similar rate of infections and a lower rate of Covid deaths during the Omicron wave. Having more mandates did not lead to better outcomes.

There was no significant difference in excess mortality across the home nations by the end of the year. The Omicron wave has negative excess mortality in England so far, which is the lowest age-standardised mortality rate in the country.

Data on excess deaths tends to be a better guide as there are variations in how testing regimes operate in western Europe. Although the UK did the third most tests, it had the lowest number of cases in western Europe. Despite having few restrictions, the UK has had the lowest excess deaths in Europe from January to date.

There has been no clear relationship between levels of excess mortality and the intensity or longevity of mandatory restrictions across western Europe. Lower levels of vaccination are to blame for the higher Covid death rates in central and eastern Europe.

Many were calling for England to follow the example of Germany and other European countries when it came to bringing back mask mandates, vaccine passports and other restrictions, as they had lower case rates at the time. I and many others pointed out that once vaccine programmes were complete, these strategies were likely to be simply postponing infections to the winter, when health systems would have been less able to cope. Since last July, Germany has had more infections and excess deaths than the UK has.

Voluntary changes to behavior are as important as the government mandated ones, even though a majority of people in England still self-isolated and wore masks when the mandates ended. The level of deaths due to Covid is determined by population levels of immunity, either through vaccinations or natural infections. There is little difference in a highly immune population.

Measures of personal wellbeing, economic performance and unemployment have all improved since the removal of restrictions in England.

There is no guarantee that the new variant will be milder than Omicron. We need to be prepared for this and use this time to establish the evidence for the effectiveness of restrictions in the future. We need those asking the public to follow the guidance to be credible because the focus is more likely to be on persuasion and relying on people to continue taking personal responsibility rather than mandates. Politicians must follow the rules they make and scientists must accept their mistakes in order to regain trust.

We owe it to those who have died and their loved ones to have a proper public inquiry that looks at all the decisions made over, because those countries that have had much lower excess death rates than ours have lessons we can learn from.

• Raghib Ali is a clinical epidemiologist at the University of Cambridge and a consultant in acute medicine at the Oxford university hospitals.