LONDON – On May 5 the United Kingdom became the country with the worst coronavirus death toll in Europe – according to official figures, almost 42,000 Britons have died because of this disease so far.
In early March the situation was quite different.
The virus was already spreading across Europe with Germany, France and Spain passing 1,000 total cases. The worst hit country was Italy: it was the first Western nation to enter a full lockdown, reporting 366 coronavirus-related deaths and 7,380 total cases.
At that time, the situation in the United Kingdom was not that worrisome with only two deaths and 352 confirmed cases. But everybody knew the virus would eventually get into the UK. Nevertheless, the government led by Boris Johnson waited until March 23 to shut all non-essential shops, while the number of cases and deaths had become worryingly closer to those reported in Italy.
“You want some immunity in the population”
In fact, No.10 first decided to “delay” the spread of the virus and pursue herd immunity.
Sir Patrick Vallance, the Government Chief Scientific Adviser, as late as March 12 said: “It’s not possible to stop everybody getting it and it’s also not desirable because you want some immunity in the population”.
The government’s aim at the time was to avoid the NHS becoming overwhelmed, as Downing Street believed that infections were doubling every four to six days. However, a later published research from Imperial College London and Oxford University estimated that the doubling of the infection rate was happening within just three days. The government’s plans were, therefore, based on figures that were significantly wrong.
In mid-March, when most European countries had already curbed public life, tube carriages in London were still packed with people, there was no sign of social distancing at all and it was basically business as usual.
Reports of two parliamentary committees have found that the UK government made major mistakes in handling the spread of the virus.
The Public Accounts Committee reported that around 25,000 patients were discharged into care homes in England between mid-March and mid-April to free up hospital beds without CoViD–19 tests. MPs have described this as “an appalling error”.
The Home Affairs Select Committee has also concluded that No.10 did not “recognise soon enough” the risk of importing the virus from continental Europe. Although all passengers arriving from Hubei Province, certain areas of South Korea, Iran and Italy were initially asked to self-isolate, this guidance was ‘inexplicably’ withdrawn between March 13 and March 23.
MPs have concluded that thousands of new infections were brought in from Europe during this period. They added: “The failure properly to consider the possibility of imposing stricter requirements on those arriving – such as mandatory self-isolation, increased screening, targeted testing or enforceable quarantine – was a serious error”.
Only 273 out of the 18.1 million people who entered the UK by air in the three months prior to the lockdown were quarantined.
“It’s not possible to stop everybody getting it and it’s also not desirable because you want some immunity in the population”
— BBC News (UK) (@BBCNews) March 12, 2020
Not only did the government pursue a wrong strategy – at first the Prime Minister also underestimated the issue. As revealed by the Times (paywall), Mr Johnson went on a 12-day holiday during the half-term recess from February 13. He then missed five consecutive Cobra meetings while he “had found time […] to join in a lunar-new-year dragon eyes ritual as part of Downing Street’s reception for the Chinese community”. The first emergency meeting about coronavirus attended by the PM was on March 2.
At the same time, the government was also busy drawing post-Brexit plans, as the country had just left the EU.
When Boris Johnson eventually announced that the United Kingdom was going into lockdown – on March 23 – it was admittedly too late, as the virus had already spread across the country. London hospitals became rapidly overwhelmed, while the NHS experienced the very same situation Italy had gone through just days earlier.
Over the following weeks the virus then moved from London to the north of England, affecting especially the areas of Greater Manchester and Leicester.
PPE nowhere to be seen
Even when a lockdown in the UK was announced, the government decided to follow a very different path from the one chosen by Italy two weeks earlier, even though the two countries were in a similar situation.
In the UK, all non-essential shops were closed and people were advised to work from home. However, face coverings were not made compulsory on public transport until June and until the end of July in enclosed spaces. The Chancellor was seen serving tables in a restaurant – in a PR stunt – without wearing PPE as late as July 8.
Enforcing social distancing or stopping people from gathering in parks became almost impossible, as outdoor activities such as runs and walks were still allowed and take-away coffee shops in residential areas remained open.
It got even worse when, in early May, No.10 hinted that the lockdown could be loosened the day after the May bank holiday weekend when a heatwave was starting to hit the UK. This might have given the impression that the emergency was over.
The PM also explained that this lockdown review would be announced on Sunday night in order to have the most recent data available. Problematically, however, it was known that weekend figures at the time were not reliable. In fact, as a smaller number of people work in hospitals and labs during weekends, there are less people being tested and fewer deaths being processed.
Eventually, when Johnson addressed the country, he revealed that very few changes would be made to the restrictions that were already in place.
Adding to Johnson’s poor handling of the crisis, a recent research from the University College London has also revealed a significant decrease in public confidence in the government after the scandal over Dominic Cummings’ trips to and around Durham in May. The report also says that willingness to adhere to lockdown guidelines dropped in England. In fact, although the chief adviser to the PM broke lockdown rules, he was never sanctioned.
On the contrary, the Italian government handled the pandemic differently.
In Italy, wearing PPE was made compulsory since the very beginning of the lockdown in early March, both indoors and on public transport; people were allowed to leave their homes once a day only to buy groceries or to go to work – where necessary. People had to carry a self-declaration form justifying their movements. The police also had the powers to enforce social distancing and to stop people in the street.
By comparing the trend of the first ten weeks of lockdown in Italy (March 9 – May 17) and in the United Kingdom (March 24 – June 1), it is clear that, at the beginning, the two countries had a similar number of daily new cases. This number reached the peak after three weeks into lockdown both in the UK and in Italy respectively.
However, while Italy’s figures decreased after three weeks into lockdown – one might suggest as a result of the restrictions – in the UK this did not happen. In fact, it took an additional month for the number of daily new cases to decrease.
A larger number of new daily cases contribute to more direct as well indirect deaths due to the lack of ventilators or beds in intensive care units.
CoViD–19 in England has hit, in particular, BAME communities and the most deprived areas, according to official figures.
However, the best measure of the impact of coronavirus on a country are excess deaths: recent data shows that England had the highest levels of excess deaths in Europe in the first half of 2020. This means that the official number of CoViD–19-related deaths should be revised upwards.
Edwin Morgan, from the ONS, has said: “While none of the four UK nations had a peak mortality level as high as Spain or the worst-hit local areas of Spain and Italy, excess mortality was geographically widespread throughout the UK during the pandemic, whereas it was more geographically localised in most countries of Western Europe.”
He has also added: “Combined with the relatively slow downward ‘tail’ of the pandemic in the UK, this meant that by the end of May, England had seen the highest overall relative excess mortality out of all the European countries compared”.
This is not a drill
Thousands of lives could have been spared had the UK government not wasted weeks pursuing a herd-immunity approach even when it was clear that this would result in millions of infections.
If No.10 had followed Italy’s example before and during lockdown, by imposing stricter rules and not undermining regulations already in place, the country could be in a better place now.
For instance, the PM decided not to sanction his chief advisor when it was revealed that he had broken lockdown. Mr Johnson also briefly let people believe restrictions were ending in May.
A simulation of the impact of a flu outbreak in the UK was carried out in 2016.
“Exercise Cygnus” showed that the country lacked PPE, medical ventilators and critical care beds. Further planning was also required to understand how to improve capacity within the social care system in order to clear hospital beds by moving patients into care homes.
“The UK’s preparedness and response, in terms of its plans, policies and capability, is currently not sufficient to cope with the extreme demands of a severe pandemic that will have a nationwide impact across all sectors”, the report concluded.
The delay and hesitance shown by the Downing Street played a crucial role in the United Kingdom becoming the worst-hit European nation – not to mention the fact that the government failed to roll out its own contact tracing app and did not stress the importance of wearing face coverings until the summer.
However, the impact of coronavirus on the United Kingdom was also caused by long-standing issues, such as a decade of underfunding and cuts to the NHS by the Tories.