Politics & Policy

Why Is the U.K.’s Response to COVID-19 Such an Outlier?

Commuters wait to board a Northern Line tube at Clapham North underground station during rush hour in London, England, March 17, 2020. (Hannah McKay/Reuters)
The contrast with other countries is baffling.

It is absolutely baffling. Last Tuesday, with lockdowns spreading throughout the world as the extent of the threat posed by COVID-19 became clear, videos circulated of tens of thousands of people at a Stereophonics gig in Cardiff, Wales, jumping up and down, singing along to their favorite songs.

France, Belgium, and Ireland had all canceled sporting events. English soccer authorities would eventually follow suit, suspending the Premier League by themselves. But the U.K. government had not banned — and, as of now, still only discourages — mass gatherings. Many are left wondering: What does the British government know that the rest of the world doesn’t? How can its approach be so different from that of other countries’ governments?

On Friday, Britain’s chief scientific adviser, Patrick Vallance, said that 40 million people would need to catch the coronavirus to build up “herd immunity.” He said that the government’s approach could help “reduce the peak of the epidemic, pull it down, and broaden it” while protecting the elderly and vulnerable. “If you suppress something very, very hard, when you release those measures it bounces back, and it bounces back at the wrong time,” he told the BBC. This suggested that the government considered mass infection to be inevitable.

Jenny Harries, England’s deputy chief medical officer, emphasized the continued importance of proper handwashing and other hygienic measures. The country’s chief medical officer, Professor Chris Whitty, said measures to tackle the spread of the disease would need to be in place for a “prolonged period,” and thus the government was introducing them more gradually so they could be sustained. Whitty also confirmed that the National Health Service would no longer test those with mild symptoms, reserving tests for those who present at hospitals with respiratory problems. This was in contradiction with the World Health Organization’s advice to keep testing.

On Saturday, Britons over 70 were told to stay in strict isolation in their homes until July, in a “wartime-style” mobilization effort that will also see the requisitioning of hotels and other buildings as temporary hospitals and the emergency manufacturing of respirators for the critically ill.

A shift didn’t appear to come until yesterday, when Prime Minister Boris Johnson all of a sudden announced that “now is the time to stop all non-essential contact with others,” advising Britons to avoid pubs, clubs, theaters, and travel when at all possible. He also emphasized that anyone living in a household with a person who has a persistent cough or fever must self-isolate for 14 days.

Coincidentally or not, yesterday was also when a report by the Imperial College COVID-19 Response Team was published, calling the government’s slow response into question. The authors explain that there are two main approaches to COVID-19: mitigation, “which focuses on slowing but not necessarily stopping epidemic spread — reducing peak healthcare demand while protecting those most at risk of severe disease from infection,” and suppression, “which aims to reverse epidemic growth, reducing case numbers to low levels and maintain that situation indefinitely.”

Crucially, they warned that if the former option was chosen, “the resulting mitigated epidemic would still likely result in hundreds of thousands of deaths and health systems (most notably intensive care units) being overwhelmed many times over. For countries able to achieve it, this leaves suppression as the preferred policy option.”

Some have argued that it was this warning that spurred the Johnson government to take a more aggressive approach, shifting from mitigation to suppression. But the government maintains that it has been following the experts’ advice all along, and the shift announced yesterday was always part of its “action plan.”

It’s impossible to tell which side is telling the truth. But the U.K.’s approach thus far remains glaringly out of step with those seen around the rest of the world. Singapore and Taiwan, two of the countries that have most successfully contained the virus, adopted stringent “social distancing” measures early on in their outbreaks. South Korea realized that it had gone from a handful to hundreds of new cases in a few days due to two main clusters from a church in Daegu city and a nearby hospital. This was caused by one patient, who came into contact with over a thousand people. What if one of the attendees at that Stereophonics concert had the virus? In a crowd of tens of thousands, that seems likely.

A Liberal Democrat spokesman put it well when he said that the issue is, at least partially, one of clear communication:

We maintain our confidence in the CMO [chief medical officer], the experts, and the decisions we are making. What we are disappointed with is the way Conservative ministers have communicated that information. We feel they haven’t really made a clear enough case as to why our position is so radically different to other countries. We aren’t saying it’s the wrong advice, it’s just that we feel there is increasing concern that people don’t know what’s going on.

So far, one government health minister, Nadine Dorries, has tested positive for the virus. Another, Edward Argar, was filmed coughing over the dispatch box while addressing Parliament. That is not a good look, to say the least. If the government is correct in its strategy, it likely won’t be vindicated until after this is all over. In the meantime, it ought to be very conscious of optics, and more clearly communicate its response to the virus.

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