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POLICY ANALYSIS

One Year On: analysing the UK’s COVID-19 response

The UK has recently passed a grim milestone: 100,000 deaths – ONS predict that it is even higher. Here, we take a look at the UK’s COVID-19 response to see what it is getting wrong and what it is getting right.

Almost one year ago to the day, the first two cases of COVID-19 were detected in the UK. It was the positive test of two Chinese nationals on January 29th 2020 which marked the nation’s fight against the disease.

One year on, the UK’s fight against COVID-19 looks very different: since then, over 100,000 people have died, while over 3.6m have tested positive, as per the John Hopkins University.

We analyse the government’s performance over the last year, outlining five things it has got right, and five things it has got wrong.

Let’s focus on the negatives first.

Five things the government has got wrong:

Lockdown(s) timing

I am not here to scream ‘LOCKDOWN’S DO NOT WORK!!!’ – I hate them as much as the rest of you. They are a disaster for the economy and for people’s health; however, they have been shown to be effective in bringing down cases and consequently, hospital admissions and deaths.

Whether the trade-off between COVID-19 and other health conditions, mental and physical, as well as the damage to economy is justified, will be saved for another article.

What we do know, however, is that all three of Britain’s lockdown’s have come too late.

The government’s initial lockdown advisor, Neil Ferguson, stated that locking down just seven days earlier in March may have halved deaths [granted, this is the same advisor who flouted his own recommendations mid-lockdown to stay over a woman’s house].

Yet, his point stands: the government’s persistence at delaying the inevitable is not an isolated incident; when cases started to rise again around mid-September, leader of the opposition Keir Starmer called for a two-week ‘firebreaker’ to be implemented around half-term week.

In avoiding the opportunity of half-term, Boris delayed the inevitable and ultimately plunged the country into a second national lockdown at the beginning of November.

This lockdown was in place for just four weeks. Cases had started to come down but by mid-December, they were on the rise once again.

What is different about this third national lockdown was the looming prospect of a COVID-Christmas: cases were rising at a commensurate rate, yet government policy still remained that up to three households could mix for five days over the festive period.

Just days before the government eventually reduced the period to one day and to only two households, Boris claimed that cancelling Christmas would be inhumane. And yet, Boris cancelled Christmas for many.

Unsurprisingly, cases surged and this was quickly reflected in hospital admissions. As things stand, the NHS is on the brink of being overwhelmed.

You cannot help but think that had the government acted sooner and more decisively over Christmas, the NHS would not have entered this place of panic. After all, the sooner cases come down, the sooner we can all be free from this horrendous situation.

No doubt, it is easy to look from afar and accuse the government of acting too slowly – we are talking about shutting down the entire nation. It’s certainly not an easy decision to make.

Exactly why Boris and his government have dithered and delayed is unknown. There are rumours around Westminster that Boris delays the inevitable in order to demonstrate his reluctance to more hard-line, anti-lockdown Tory MPs.

In this attempt, the government appears to have allowed this pandemic to be worse than what was necessary, with lives being lost in the process.

Testing

Another one of the government’s initial failures was testing. Again, as with the lockdowns, it is easier to sit from afar and scream about what the government should and could be doing.

But testing was far too slow and too meagre at the start of this pandemic. During the first wave, daily positive cases peaked at around 7,000. To put this into perspective, the highest daily case rate during the current wave is over 68,000. Can you imagine how many more cases would have been uncovered had testing capacity been in place?

It has also failed to properly utilise one of the greatest tool’s at its disposal: mass community testing. The mass testing pilot in Liverpool was deemed a success; indeed, case rates came right down and ultimately, it was one of the last region’s to remain in Tier 2 prior to the third national lockdown.

But why has this programme not become a national one? Why is it not now the gold standard? There are many logistical challenges associated with testing an entire region, with a large number of volunteers and much of the army needed.

Liverpool’s experience cannot be considered a total success, either: in particular, the government’s programme failed to reach young, digitally-excluded males, a group thought to be prominent spreaders of the virus.

All of this is bad enough on its own, but is made significantly worse by the UK’s ineffective track and trace system.

NHS track, trace & isolate

The government ultimately succeeded on getting testing capacity up [more on that below]. One thing it has simply failed to get on-lock is an effective test and trace system – the city of Leicester can attest to that.

As Leicester left the national lockdown with the rest of the country, cases continued to surge. This is no surprise given that just 53% of contacts are being traced within the national system.

As per Gian Volpicelli from WIRED, the city has since set up its own localised test and trace system. And the contract-tracing success rate? Over 90%.

This success is not only testament to the tireless work of local officials but exposes the ineffectiveness of the government’s own national test and trace system.

The NHS test & trace app has not been much of a success, either. Over ten million people have downloaded the app, which is well below what is needed for the system to work comprehensively.

Downloading the app is also entirely optional and users can simply ignore any notification ordering them to isolate.

At this stage of the game, COVID-zero is not a possibility and would not be achieved even with a fully-functioning test and trace system; however, it would serve to break chains of transmission and bring case rates under control as the vaccine roll-out continues.

And if a failing test and trace system is not enough to dishearten you, then the isolation system might: back in September, SAGE warned the government that just 20% of people who test positive for COVID-19 fully isolate for the full duration of their period. That is up to 80% of people knowingly leaving the house with COVID-19.

Some of those people are undoubtedly ignorant, underestimating the impact of the disease and how quickly it can spread to those with certain vulnerabilities. Others, however, seem to be left with little choice.

In particular, those on zero-hour and precarious work contracts who simply cannot afford self-isolation. For a large part of the pandemic, the self-isolation period was 14 days. – without a stable income, how are people meant to buy food or pay the bills?

The government states that those self-isolating should be given support from employers, but stops short of enforcing this support, or providing it themselves.

It is against the interest of the public and government policy to allow these systems to continue to fail.

Border control

You will have heard a lot about border control over the last few weeks. The fact that it has taken this long to dominate the public discourse is worrying enough, and it only highlights this gaping whole in the government’s policy.

It has come under greater scrutiny since the discovery of several significant COVID-19 variants across the globe, which pose a great threat to any vaccination roll-out programme.

It was only the start of this year when the government mandated that arrivals into the UK must provide proof of a negative test within 72 hours, a policy that has been adopted by many European nations for nearly six months – why have we waited until the variants are already here?

Self-isolation is also a requirement but it is rarely enforced – if people are coming into the UK without a test and without enforced isolation, how can we stop the importing of international variants? The answer is we cannot.

The UK government finally appears to be getting the message on border controls. We are expecting an announcement on the introduction of an Australian-style ‘quarantine hotel’ system for new arrivals in an effort to stop the introduction of even more variants.

This pro-Brexit government wanted greater border control powers – now, it needs to use them.

Education

This is one of the most difficult issues for the government to navigate. Whatever stance the government takes, it’s damned if it does, it’s damned if it doesn’t.

This has been highlighted by Labour’s continuously-shifting stance on the issue during the last year. For months and months, the opposition called for schools to close as infections rates sky-rocketed. When schools did close, the government was accused of acting too late. Now they are closed, Labour is pushing the government to publish a plan for schools to re-open. When schools do open, there will no doubt be people arguing that it is too soon, some too late.

As a result, it is difficult to determine whether the government has failed in terms of timing. But it has undoubtedly not protected students or teachers enough. Testing systems should have been set up in schools throughout the summer in readiness for the new academic year.

Students, at least those in secondary school, should be able to access tests readily and without stigma in an environment they are comfortable with. It is entirely unreasonable to expect children and teenagers to social distance at all times, and so transmission is inevitable. If an effective testing system can be set up prior to students returning before schools return, a huge amount of transmission will be avoided.

University students have also been neglected during this pandemic. I have a bit of a personal bias with this one, but let me tell you what is going on first hand.

Back in the summer, students were told to come back to university – we were promised an overwhelmingly-normal student experience. Six months later, we are all stuck in our accommodation, paying unnecessary rent, with little-to-no access to study spaces and just three hours of poor-quality online seminars per week.

Any prospect of a refund looks bleak, just like our futures in education.

Now, for something a bit more positive [sorry, I really cannot help myself].

Five things the government has got right:

Testing 2.0

Yes, the government has experienced successes and failures in relation to testing. Although the government was undoubtedly slow at increasing test capacity, it has improved impressively since.

The UK’s testing capacity is the relative highest in the world and is still growing by the week. From January 7th to 14th, nearly three million people were tested, a 14% increase from the week before.

This is particularly impressive given that 2.3m vaccine doses were also administered during the same period – that is over five million actions taken to try and control this deadly virus.

If the government can turn around testing, it can turn around tracing – let’s hope it succeeds.

The Furlough Scheme

This might be a bit of a controversial one. I have said it myself – those with precarious employment contracts have not been supported enough.

But the reality is that the majority of people are not in informal employment and so a huge portion of the population will have benefited from this scheme.

Paying 80% of people’s wages comes at great cost to the state and although it is largely to be expected, it is generous compared to similar schemes in other European nations: France covers 70% of its workers salaries, while Germany covers 67%.

Unemployment has just hit 5% in the UK for the first time since 2016, so the furlough scheme has not saved every job – but, it was not expected to.

One thing the furlough scheme has exposed, however, is the UK government’s policy on sick pay. Workers in Sweden are entitled to sick pay is worth 80% of workers’ salary [the same as the UK’s furlough scheme] – for comparison, in UK sick pay sits at just £95,85 per week.

Given that a huge number of people knowingly go to work with COVID-19, the UK government seriously needs to re-consider its policy on sick pay, especially during a health crisis.

Compliancce

Disclaimer: the public should take the overwhelming majority of praise when it comes to compliance during the COVID-19 crisis. The government does deserve some praise, though.

The average level of compliance has remained stable throughout the crisis, sitting at just above 90%, with a small dip in summer.

Its messaging on the tier system is perhaps the most confusing and some of the rules are definitely too vague.

But the overall severity of its messaging relative to the risk that is posed has been, on the whole, a resounding success.

The governent’s use of word-play rivals that of a GCSE student in an English language exam: ‘Hands, Face, Space’; ‘Stay at Home, Protect the NHS, Save Lives’. These catch-all, memorable phrases are ingrained into the public psyche; when they are uttered by ministers, the public know exactly what to do.

Seemingly, the impact of messaging is huge and the overall level of compliance reflects the effectiveness of government messaging.

Brexit

It is bad enough doing an article on the issue that everybody’s most sick of hearing about, but forcing in the second most despised issue is pretty shameless. Nonetheless, it is relevant to the UK’s COVID-19 response.

Another disclaimer: I am not a fan of Brexit. Yet, I accepted it as the UK’s reality long before many of the remainers who still think that Keir Starmer will save their European dream.

It was meant to be the nation’s biggest event of the 21st century. And yet, it does not even compare to the scale of the COVID-19 crisis. The two culminating at the exact same time could have been a total disaster for the government.

Though the COVID-19 response has been far from perfect, Boris did a very good job at navigating Brexit – it was in the public consciousness enough to be scrutinised, but not to detract from the ongoing public health crisis.

His deal also appears to have appeased large sections of both sides. Those who wanted a No-Deal were happy to see us leave the single market and customs union; those who wanted to remain are happy to see a deal; those wanting a soft-Brexit are probably most pleased.

Thankfully, to the surprise of absolutely nobody, Britain has not magically turned into a third-world country.

Vaccines

I am aware that I may be speaking too soon when it comes to vaccines. A lot could still go wrong and I do not want to doom the nation by jinxing anything. But, as things stand, the vaccine roll-out is going extremely well.

Well over 2.3m vaccines were administered last week, bringing the total to over 7 million. This means that 10.4 people have been vaccinated per 100 – by comparison, the highest in Europe is 5.4 [Malta].

There has been some criticism over the decision to delay people’s second dose of the Pfizer vaccine. I cannot say I am a science man, but the notion that a single dose of a vaccine could be rendered ineffective within three short months seems extremely unlikely.

Not only does this decision allow for a greater number of people to be vaccinated, it also buys manufacturers time to scale up production.

Which country is vaccinated first is not a competition, as the government seems to be presenting it, since the vaccination of the entire planet is in the interests of the UK.

But the UK is doing an excellent job at covering its own base first. Long may it continue.

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