The UK government should encourage people to spend more time in regulated environments to curb the second wave of the pandemic, rather than shutting them down as part of local lockdowns, according to HCM editor, Liz Terry.

In an open letter to Prime Minister Boris Johnson, Terry said regulated businesses with high levels of COVID-19 controls in place, such as gyms, are much safer than unregulated environments.

"The government has got itself into a tight corner when it comes to COVID-19 control," Terry said in the letter, which was published the day Johnson announced a new three-tier system of COVID-19 alertness for England.

"People spend their time in two basic types of environments:

1. Unregulated – homes and personal social situations etc

2. Regulated – tightly controlled environments such as schools, leisure facilities and supermarkets etc"

"This means the government has a limited number of levers it can pull to control transmission.

"We know from the scientific evidence that's being collected that transmission is not happening in regulated environments. This means it's happening in unregulated environments, so the more time people spend in regulated environments, the safer they will be.

"The government has been trying to impose controls on unregulated environments with interventions such as the Rule of Six, but the hard reality is that many people – including, for example, Jeremy Corbyn who was a guest at a dinner party for nine – are simply not complying, so these interventions are not working.

“Three quarters of people who know they've been exposed to COVID-19 are failing to self-isolate, according to research," she said.

"The initial lockdown saw the public displaying very high levels of compliance, but the failure of leaders to follow their own advice – such as Dominic Cummings' trip to Barnard Castle and Margaret Ferrier MP using public transport while knowing she had COVID-19 (and the lack of consequences for them) – mean many people have lost trust in the government.

“They are no longer prepared to follow the rules the government is imposing to try to control transmission in unregulated environments. As a result, transmission is increasing, in spite of local lockdowns.

"This leaves the government in a position where it believes the only lever it can now pull is closing businesses," wrote Terry.

"However, this is not logical.

"If we close regulated environments, we will be forcing people to spend more time in unregulated environments, where transmission is actually more likely.

"We need to do the opposite – encourage people to spend as much time as possible in regulated environments and work to ensure that they become even safer going forward.

"If we close businesses, we will increase transmission AND kill the economy, creating a catastrophic lose-lose situation," she concluded, "it's vital that we allow safe environments, such as gyms to remain open.

Terry also called for a greater focus on health, saying research has shown that people who exercise, have high levels of EcSOD and Vitamin D in their bodies and lower levels of body fat are less susceptible to COVID-19.

"Yet although these facts have been proven, we are still encouraging people to stay indoors and making it harder for them to exercise and raise their vitamin D levels, which means they'll be more likely to succumb to the virus, or to have it more seriously," she said.

"We should be pursuing the exact opposite tack and encouraging people to get outdoors, to get to the gym and to get fit. Prevention is better than cure – especially with COVID-19, which has been shown to have lingering aftereffects.

Terry's comments came on the day Dr David Nabarro, the World Health Organization's special envoy on COVID-19, appealed to all world leaders to "stop using lockdowns as your primary control method" – saying lockdowns will lead to a doubling of both poverty and child malnutrition globally by next year.

"Develop better systems for controlling COVID-19," he said, "lockdowns have only one outcome – making poor people an awful lot poorer."

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