Could we be asked to self-isolate if we catch flu?

How will coronavirus change our approach to seasonal illnesses? We are heading into the NHS's most difficult months as winter flu season is upon us, and ministers have been urging people to get a flu jab in order to keep demand in the health service down. Matt Hancock, meanwhile, has been justifying the enormous expense of the beleaguered test and trace system by suggesting that it could continue once the pandemic dies down, being used 'for everything'. He also told MPs last week that he wanted to end the culture of presenteeism in Britain, saying: 'If you have flu-like symptoms you should have a test for it and find out what is wrong with you and stay at home. We are peculiar outliers in soldiering on and going to work and that culture, that should change.'

This hasn't had as much attention as it perhaps deserves. If there is to be a test and trace system for seasonal flu and other illnesses, then it may well follow that there will still be a call — even if informal — for people to self-isolate when they have symptoms. Protecting the NHS has been the core argument throughout the pandemic, but it is not only relevant in a pandemic. Every winter, politicians brace themselves for a difficult flu season where higher-than-usual numbers of cases lead to a cash-strapped NHS struggling to cope. It does not require a huge leap of the imagination to envisage test and trace asking people to stay at home when they or close contacts have contracted the flu — not least because the NHS is going to be struggling for a good few years as a result of the backlog in elective cases delayed from the first lockdown. There are 4.7 million people who have not been referred for treatment compared to last year. They will join the 4.35 million people already on the NHS England waiting list, over a million of whom have been waiting for more than 18 weeks for treatment. The number of people waiting for more than 12 months for surgery is now at its highest since 2008.

The NHS has never really had much surge capacity built into it. Now it is having to find capacity to recover from the pandemic. Would it be sensible, therefore, for seasonal illnesses, which will undermine that capacity further, to be contained better once Covid has become something the system can cope with, largely through vaccines?

Even if this does make sense in policy terms, this is the sort of thing that would leave Tory MPs incandescent. But even if ministers won't admit that they are considering this sort of shift in approach to flu and other conditions, it would be a surprise if they weren't.