How did Britain get its response to coronavirus
so wrong?
Britain’s
health secretary, Matt Hancock, speaks via video link during the official
opening of the NHS Nightingale hospital in Birmingham. Photograph: Jacob
King/AFP via Getty Images
As the warnings grew louder, the government was
distracted by Brexit. On testing, contact tracing and equipment supply, there
was a failure to prepare
by Toby
Helm, Emma Graham-Harrison & Robin McKie
Sat 18 Apr
2020 22.29 BST
By late
December last year, doctors in the central Chinese city of Wuhan were starting
to worry about patients quarantined in their hospitals suffering from an
unusual type of pneumonia.
As the
mystery illness spread in one of China’s major industrial hubs, some tried to
warn their colleagues to take extra care at work, because the disease resembled
Sars (severe acute respiratory syndrome), the deadly respiratory disease that
had killed hundreds of people across the region in 2002-03 after a government
cover-up.
One of
those who tried to raise the alarm, though only among a few medical school
classmates, was a 33-year-old Chinese ophthalmologist, Li Wenliang. Seven
people were in isolation at his hospital, he said, and the disease appeared to
be a coronavirus, from the same family as Sars.
In early
January he was called in by police, reprimanded for “spreading rumours online”,
and forced to sign a paper acknowledging his “misdemeanour” and promising not
to repeat it.
Many early
cases were linked to the city’s Huanan seafood and fresh produce market, which
also sold wildlife, suggesting that the first cases were contracted there.
Scientists
would discover the disease had probably originated in bats and had then passed through
a second species – in all likelihood, but not certainly, pangolins, a type of
scaly anteater – before infecting humans.
But the
infections were soon spreading directly between patients, so fast that on 23
January the government announced an unprecedented lockdown of Wuhan city and
the surrounding Hubei province.
Two weeks
later, on 7 February, Li, who had contracted coronavirus himself, died in
hospital from the condition about which he had tried to raise the alarm. He had
no known underlying conditions and left behind a wife and young child.
Li became
the face of the mysterious new disease. The story of his death and pictures of
him in a hospital bed wearing an oxygen mask made media headlines across the
globe, including in the UK.
The world,
it seemed, was slowly becoming more aware of how lethal coronavirus could be,
that it was not just another form of flu with fairly mild symptoms.
But while
UK scientists and medical researchers were becoming more concerned, and
studying the evidence from China, those among them who were most worried were
not getting their messages through to high places.
Distracted
by Brexit and reshuffles
The
Conservative government of Boris Johnson had other more immediate
preoccupations at the start of this year.
Johnson was
still basking in his general election success last December. After he returned
from a celebratory Caribbean holiday with his fiancee, Carrie Symonds, the political
weather for the prime minister seemed to be set fair. It was honeymoon time.
Three and a
half years on from the Brexit referendum, the UK was finally about to leave the
EU on 31 January. The fireworks and parties for the big night were being planned,
the celebratory 50p coins minted.
Minds were
certainly not on a developing health emergency far away, as Johnson prepared to
exploit the moment of the UK’s departure from the European Union for all it was
worth. “I think there was some over-confidence,” admitted one very senior Tory
last week.
The prime
minister and his chief adviser, Dominic Cummings, wanted to make an early
impression at home in other ways too, as domestic reformers. Cummings was
waging a war on civil servants in Whitehall, throwing his weight around and
deliberately upsetting the Westminster applecart.
While he
made the headlines, briefing about his iconoclastic ambitions, Johnson was
preparing a big Cabinet reshuffle to assert his own authority in other areas
now Brexit was done and dusted.
With Labour
effectively leaderless after its fourth consecutive election defeat, there was
little opposition to trouble Johnson on any front at all – and certainly no-one
of note asking tough questions about coronavirus.
The prime
minister duly recast his cabinet team on 13 February – five days after Li’s
death in Wuhan. He made big changes but unsurprisingly retained the hitherto
safe pair of hands of Matt Hancock as his health secretary.
In a sign
of where priorities lay – and the lack of concern that a potential crisis might
be heading our way from the east – Hancock wasted no time recording a video of
himself grinning with delight on reshuffle day.
He smacked
his right fist into his left palm saying he could not wait to “get cracking”
and that he relished the chance to deliver the Tories’ manifesto promises,
reform social care and improve life sciences. And lastly, in a more sombre
voice, he spoke of “dealing with coronavirus and keeping the public safe”
before adding, as the grin returned: “Now let’s get back to work!”
It is
perhaps too early to conclude for sure that Johnson, Hancock and the
government’s entire team of scientific and medical advisers were caught asleep
at the wheel. But the fact that Johnson and Hancock themselves, in common with
much of the Downing Street staff, would go on to contract the virus or suffer
symptoms, further suggests that people at the top had not been sufficiently on
their guard.
Now, 11
weeks on from the first cases being confirmed in the UK on 31 January – a
period during which more than 14,000 people (and probably several thousands
more once care home fatalities are counted) in the UK have died from Covid-19 –
and with the country in lockdown, the economy facing prolonged recession as a
result, schools closed, and no sign of an end in sight – hard questions have to
be asked.
We already
know with some certainty that other countries, such as Germany, South Korea,
Taiwan and New Zealand, will emerge from this crisis having performed far
better than the UK. A few weeks ago the government’s advisers crassly said that
fewer than 20,000 deaths would be “a very good result” for the UK.
As we fast
approach that grim tally, many experts now believe the UK may come out of this
crisis, whenever that may be, with one of the worst records on fighting
coronavirus of any European nation. Once the full tally is counted, few expect
the number of deaths to be below 20,000.
By
contrast, on Friday, Germany was saying it thought it had brought coronavirus
largely under control. It had had 3,868 deaths, less a third of the total in
the UK (and Germany’s population, at 83 million, is far higher), having
conducted widespread testing for Covid-19 from early on, precisely as the UK
has failed to do.
How, then,
did it come to this? How did coronavirus spread across the globe, prompting
different responses in different countries? Did the UK simply fail to heed the
warnings? Or did it just decide to take different decisions, while others
settled on alternative actions to save lives?
The
warnings grow louder
David
Nabarro, professor of global health at Imperial College, London, and an envoy
for the World Health Organization on Covid-19, says one thing is for sure. All
governments were warned how serious the situation was likely to become as early
as the end of January. Ignorance of the danger that was coming can be no
excuse. Yet it would not be until late March – later than many other countries
– that Johnson would announce a complete lockdown.
“WHO had
been following the outbreak since the end of December and within a few weeks it
called a meeting of its emergency committee to decide if this outbreak was a
‘public health emergency of international concern’,” said Nabarro.
WHO made it
very clear – to every country in the world – that we were facing something very
serious indeed
Prof David Nabarro, Imperial College, London
“That is
the highest level of alert that WHO can issue, and it issued it on January 30.
It made it very clear then – to every country in the world – that we were
facing something very serious indeed.”
Well before
the end of January, the WHO had been tracking the growing threat minutely: 14
January was a key day in the spread of the disease that would become known as
Covid-19. The first case was confirmed outside China, with a woman hospitalised
in Thailand.
A WHO
official warned then that it was possible that human-to-human transmission had
occurred in families of victims – a sign that the disease had potential to
spread far and fast – and, inside China, officials were quietly told to prepare
for a pandemic.
There was
little international attention on the day, though, because Beijing’s dire
warnings about a pandemic were made in secret, and a WHO spokesman rowed back
from his colleague’s claim.
Officially,
China had not seen a new case of the coronavirus for over a week; the outbreak
appeared to be fading. It took another six days for China to publicly
acknowledge the gravity of the threat, time that scientists believed meant a
further 3,000 people were infected.
But on 20
January, officials announced more than 100 new cases and admitted the virus was
spreading between humans, a red flag for concern to anyone who works on
infectious diseases. The virus could no longer be contained by finding the
animal source of the infection and destroying it.
Two days
later, the scale of the challenge was made clear to the general public when
Beijing locked down millions of people. All transport into and out of the
metropolis of Wuhan was cut off, an unprecedented modern quarantine that would
come at huge human and economic cost.
On 29
January, the UK would have its first two confirmed cases of the disease. There
was little sense that China’s dilemma and its approach – shut down life as we
know it or watch the death toll spiral out of control – might have to be our
nightmare within weeks.
In early
February, Donald Trump announced a ban on travellers who had passed through
China in the previous 14 days. Europe began focused testing of people with
symptoms and travel histories that linked them to the disease, but little else.
Johnson, it
seemed, still had Brexit and free trade much more on his mind. Any hint of
draconian action to fight coronavirus that might hurt the economy was the last
thing he was entertaining.
In a speech
on Brexit in Greenwich on 3 February, he made clear his views on Wuhan-style
lockdowns. “We are starting to hear some bizarre autarkic rhetoric,” he said.
”Humanity
needs some government somewhere that is willing at least to make the case
powerfully for freedom of exchange, some country ready to take off its Clark
Kent spectacles and leap into the phone booth and emerge with its cloak flowing
as the supercharged champion of the right of the populations of the Earth to
buy and sell freely among each other.”
‘Herd
immunity’: UK goes it alone
By early
March it was abundantly clear to many academics and scientists that the
approach being adopted by the UK was markedly different from those followed by
other countries. From South Korea to Germany, governments had invested heavily
in expanding testing capacity from the first weeks of the epidemic.
Hong Kong,
Taiwan and Singapore had brought in controls on travellers from infected
regions and strict contact tracing to help understand who could have been
exposed, inform them and require self isolation. Face masks became widespread
in east Asia, long before it was recommended elsewhere.
Testing and
contact tracing has been at the heart of the approach advocated by the WHO, so
that countries can establish how transmission chains were occurring, in order
to break them.
Many also
brought in some social distancing measures, banning large gatherings, closing
schools or extending holidays, and encouraged those who could do to work from
home. None were as extreme as China’s shutdown, or the European and American
lockdowns that would follow.
Writing in
the Observer last month, Devi Sridhar, chair of global public health at the
University of Ediburgh, noted the distinct UK approach. “Rather than learning
from other countries and following the WHO advice, which comes from experts
with decades of experience in tackling outbreaks across the world, the UK has
decided to follow its own path. This seems to accept that the virus is
unstoppable and will probably become an annual, seasonal infection.
“The plan,
as explained by the chief science adviser, is to work towards ‘herd immunity’,
which is to have the majority of the population contract the virus, develop
antibodies and then become immune to it. This theory has been widely used to
advocate for mass vaccination for measles, mumps and rubella. The thinking is
that, if most of the population is vaccinated, a small percentage can go
unvaccinated without cases emerging.”
It was not
just the UK whose politicians and scientific advisers were, arguably, slow to
act in the early stages. Others countries, including Spain and France, were
caught out too, but it was Italy’s tragedy that alerted Europe to the scale of
the threat it faced.
European
governments and citizens were forced to reckon with the reality that in an age
of global travel, the thousands of miles separating them from China meant
almost nothing at all. Thousands of Britons were holidaying in Italy the week
that it shut down. They were advised to go into self-quarantine on return, but
were not registered by the health authorities, nor were their contacts tracked.
Italy and
the UK had both had had their first case a day apart at the end of January, but
cases rose faster in Italy. The country may just have been unlucky that
carriers of the disease flew to its northern cities and ski resorts rather than
to other European capitals.
Whatever
the reason, cases and then deaths started climbing sharply in northern Italy in
late February. Dozens of towns were locked down from the 21st, but in the rest
of the country life carried on as normal.
It was soon
clear that the problem had not been contained. On 8 March, the prime minister,
Guiseppe Conti, quarantined 16 million people across the north of the country,
and the next day extended the lockdown to all of Italy.
The
measures saved lives, but came too late for thousands of Italians. The death
toll outstripped China, and the world looked on horrified as hospitals were
overwhelmed, doctors forced to choose who should have a chance on a ventilator
and who should die. On 11 March, the WHO declared a global pandemic. On 14
March, Spain went into lockdown, and three days later France did the same.
But in the
UK there appeared to be greater reluctance to act decisively with lockdowns:
the banning of mass gatherings and the closure of pubs and restaurants. The
government’s scientific and behavioural science advisers were warning ministers
that the public might react badly to draconian measures and would not tolerate
them for long.
In an
apparent show of defiance against the lockdowners, Johnson and Symonds attended
the England v Ireland rugby match at Twickenham on 7 March. The Cheltenham
Festival, attended over three days to 13 March by 250,000 racegoers, was
allowed to go ahead.
Shutdown:
Johnson changes tack
The tone
was about to change. In a Downing Street press conference on 12 March, Johnson,
who had said a few days before the first UK death that the disease was “likely
to spread a bit more” suddenly became the deliverer of grave warnings.
Previous
talk by his advisers of avoiding lockdowns and developing “herd immunity” had
been banished and replaced by a brutal honesty. “I must level with you,”
Johnson told reporters. “More families, many more families, are going to lose
loved ones before their time.” On 18 March – just days after Downing Street had
suggested it was not on the cards – the government announced the closure of all
schools until further noticed. Pubs and restaurants were ordered to shut on 20
March. The UK had come late into line.
One former
cabinet minister last week described the change of approach as a “screeching
U-turn”. Johnson and his ministers were now, even more than before, taking
cover behind, and advice from, their scientific and medical advisers. Many of
these advisers had become increasingly concerned that the UK had become out of
step with other countries because of political resistance from ministers to
measures that would hit the economy. The Observer has been told that at least
two senior government advisers were on the brink of of quitting before Johnson
switched his approach.
The
government has found itself unable to escape the consequences of a wider
failure to prepare. As hospitals threatened to be overwhelmed before orders
were given to massively expand capacity, ministers came under intense criticism
over the lack of protective equipment for frontline NHS staff, over the lack of
ventilators for patients in intensive care, and for a failure to test more
widely for Covid-19, particularly among NHS workers.
The lack of
preparedness and instances of chaotic planning has shocked many in and outside
the NHS.
Last week,
Dr Alison Pittard, the dean of the Faculty of Intensive Care Medicine, the
professional body for intensive care practitioners, said the minimum
specifications for the government’s own homegrown ventilator scheme would
produce machines that would only treat patients “for a few hours”. “If we had
been told that that was the case… we’d have said: ‘Don’t bother, you’re wasting
your time. That’s of no use’,” she told the Financial Times.
Last month
the government missed an EU procurement deadline for ventilators because,
minister said, an email went unnoticed. The NHS had said 30,000 more would be
needed, Hancock reduced this to 18,000. Pittard said her faculty had been
warning for years about a shortage of intensive care capacity and intensive
care nurses in hospitals.
Normally
each intensive care patient would have one intensive care nurse in attendance
all the time, she said. Now there was one nurse to six patients, although other
staff had been redeployed to intensive care units to plug the gaps and the new
system was working because of heroic efforts. Although she was reluctant to
criticise the government, she said that if the faculty had been listened to,
“we wouldn’t be starting from this place”. Germany, she pointed out, has 29
intensive care beds per 100,000 people, compared with six in the UK.
The Tory MP
and former health minister Dan Poulter, who works part-time in the NHS, said
that given the enormity of the challenge facing government “it almost seems
wrong to be critical”.
But he
believes part of the problem is that insufficient advice has been sought from
experienced NHS clinicians who would have warned of problems with PPE early on,
of the shortage of ventilators and would have told ministers of the urgent need
to test NHS staff.
“An early
over-reliance on academic modelling also resulted in a lack of experienced
frontline NHS clinicians – in other words, the people who really understand the
day-to-day challenges our hospitals and health service face – from feeding into
the initial Covid-19 action plan,” he said. “This has manifested itself amongst
other things in the slowness of providing adequate PPE for frontline NHS staff
and in the lack of virus testing for healthcare staff in the earlier part of the
outbreak.”
How the
scientists reacted
When the
investigations into the UK’s response to Covid-19 come to be written, there is
widespread recognition among experts that this lack of long-term strategic
planning will be at the centre of it. So too should be the need to ensure that
the views of experts are fed into government more efficiently and widely. The
prospect of a previously unknown disease spreading catastrophically around the
globe and infecting millions is, after all, not a new one.
Indeed,
many warnings have been given in the past about the viral dangers facing
humanity. “Given the continual emergence of new pathogens ... and the
ever-increasing connectedness of our world, there is a significant probability
that a large and lethal pandemic will occur in our lifetime,” Bill Gates
predicted several years ago. “And it will have the impact of a nuclear war,” he
warned, while urging nations to start stockpiling antiviral drugs and
therapies. If only.
For its
part, the WHO prepared – several years ago – a list of viruses with no known
treatments or vaccines, illnesses that could one day trigger that pandemic and
kill hundreds of thousands. Prospective killers included nipah disease and
lassa fever as well as an ailment it simply called “disease X” – “a serious
international epidemic caused by a pathogen currently unknown”.
As to the
most likely nature of that mysterious virus, most modelling assumed that
disease X would be flu-like in behaviour, says Dr Josie Golding, the epidemics
lead at the Wellcome Trust. After all, influenza had caused so many deadly
global outbreaks in the past. As a result, a lot of investment went into making
influenza vaccines in preparation, she says. “But have we been thinking about
diseases other than influenza that might become pandemics? I don’t think we
have. There has been a real gap in our thinking.”
Then came
the appearance of Covid-19 – caused not by a strain of influenza but by a
coronavirus – in November. Initially, only a few cases were highlighted, a
trend that began to change early this year with a rise in numbers of infected
ill people.
“The report
that really grabbed my attention came out in mid-January,” says epidemiologist
Professor Mark Woolhouse at Edinburgh University. “It said 41 cases of this new
respiratory illness had now been diagnosed in one small area of China, around
Wuhan. And that set the alarm bells ringing for me.”
For
Woolhouse, the cluster of cases in one place showed this was not a matter of a
few people scattered around China picking up an occasional infection from an
animal such as a bat or a chicken. “Forty-one cases in one small area at the
same time could not be explained that way. People are not picking this up from
animals, I realised. They are actually spreading it to each other. It was
already heading out of control.”
Ewan
Birney, head of the European Bioinfomatics Institute in Cambridgeshire, also
noted the significance of the new disease at the time. “I presumed, at first,
that this one would also burn itself out, probably somewhere in Asia,” he says.
His
reasoning was straightforward. The outbreak of Sars that appeared in 2003 in
China was caused by a coronavirus and killed more than 10% of those it
infected. “In fact, it killed or hospitalised so many of those it infected the
chain of transmission from one person to others was cut. It was too lethal for
its own good. So I thought this might happen with this new disease. But it
turns out Covid-19 is much milder and incapacitates fewer individuals, so there
is no cut in its transmission. When that became apparent – around mid-January –
I became very worried.”
Then there
was the infectiousness of the new virus. A person with Sars generally starts to
display symptoms before they infect other people. That makes it much easier to
contain. But this was not the case with Covid-19. Early data from China – again
released in January – showed the virus was being spread from people who were
displaying only the mildest symptoms, or in some cases no symptoms. This was
making the condition very difficult to track, says virologist Professor
Jonathan Ball of Nottingham University.
“At that
point I realised this outbreak was going to be very serious,” he added. “I sent
a tweet to a colleague in Australia. It simply said: ‘This one is out of the
bag properly’. He sent one back agreeing with me.”
Around this
time, Paul Nurse, Nobel laureate and head of the Francis Crick Institute,
recalls attending a conference where he met Mark Wolpert, head of UK Research
and Innovation, the organisation that funds a vast slice of British scientific
research.
“He had
just received a text message from a colleague about the outbreak and we started
to discuss the implications,” Nurse recalls. “It did not take us long for us
both to realise this was going to be very significant. It took another two or
three weeks to confirm these worst fears – by mid-February.”
By this
time, Birney had realised the virus had a real sting in its tail and could
cause serious illness among the elderly and those with other underlying serious
ailments. “It was half-term and I was on holiday with my parents. All I wanted
to do was to get the holiday over and then get them back to their house in the
country where they could keep themselves isolated.”
In
February, sporadic cases of Covid-19 were appearing round the country, recalls
Tom Wingfield, a clinician and infectious disease expert based at the Liverpool
School of Tropical Medicine. “These were cases that had been brought into the
country, mainly from China or Italy. Then there was an outbreak in Brighton and
I realised that the virus had established itself in a community there. It was a
turning point.”
Britain was
still doing quite well in containing the disease by testing, tracing contact
and setting up quarantine for those suspected of being infected with Covid-19
at this time. “Then, in March, the government decided to abandon this approach
and shift from containing the disease to delaying its progress,” says
Wingfield. “I would really like to know why the decision to give up testing and
contact tracing was taken.”
Many other
researchers also question why the government took so long to react to their
warnings. “Part of the trouble was there were other virologists who were saying
this was going to be like Sars or flu and there was not too much to worry
about,” says Ball. “But Sars happened in 2003. The world is much more connected
now than it was then. More to the point, Covid-19 was also much more infectious
than Sars. And so it started appearing in lots of other countries.
Perhaps some of
us should have got up in front of BBC News and said you lot ought to be
petrified because this is going to be a pandemic that will kill hundreds of
thousands of people
Professor Jonathan Ball
“Perhaps
some of us should have got up in front of BBC News and said you lot ought to be
petrified because this is going to be a pandemic that will kill hundreds of
thousands of people,” adds Ball. “None of us thought this was a particularly
constructive thing to do, but maybe with hindsight we should have. If there had
been more voices, maybe politicians would have taken this a bit more
seriously.”
“There is
no question that we were insufficiently prepared,” Nurse says. “We had been
warned a few years ago when reports made it clear that the UK was not ready to
combat a major flu pandemic and we did not take up that warning. As a result,
we were caught out.”
He and many
others say an inquiry into Britain’s Covid-19 preparedness will have to be held
at some point but stress that this should not be started until the crisis has
been dealt with in the UK.
Professor
Ian Boyd, a former chief scientific adviser at the Department for Environment,
Food and Rural Affairs, agrees. “There is a great danger there will be a lot of
looking back with the benefits of hindsight and poking fingers of blame,” warns
Boyd. “But when you are in the middle of things you have to make a lot of very
hard 50-50 decisions, and sometimes you make the wrong call. On the other hand,
there is no harm in making sure that we learn as many lessons as we can.”
The lessons
from the rest of the world …
Boris
Johnson, after his own brush with death at the hands of Covid-19, will
presumably no longer take the gung-ho attitude to illness that he has always
has. A former Tory minister said: “If Boris had any sense he would take control
of the inquiry and lead it.”
One
conclusion that experts are already drawing is that it was those countries
close to China, with memories of Sars, or cultural ties to their neighbour,
which were much faster to act in response to Covid-19. Perhaps most notable in
its success was Taiwan. Closely linked by economic and cultural ties to
mainland China, Taiwan could have been at high risk of a major Covid-19
epidemic. Tourists and business people travelled regularly back and forth.
But helped
perhaps by having an epidemiologist as vice-president, the government set up a
gold standard regime of testing and contact tracing that means that nearly
three months on from its first confirmed infection, it has registered fewer
than 400 cases and six deaths.
Taiwan’s
extensive testing and thorough contact tracing are precisely the kind of action
that the former health secretary Jeremy Hunt is demanding before the UK
lockdown is lifted. Hunt points out that it is one of the essential conditions
set by the WHO to avoid a second wave resulting from an easing of restrictions.
Hong Kong,
which also suffered from the Sars crisis, also moved early to enforce
quarantine and social distancing, as well as widespread mask wearing, and today
has registered just over 1,000 cases and only four deaths.
In late
February, South Korea looked like it was on a trajectory to disaster, with the
highest number of confirmed cases outside China, and numbers rising rapidly.
But after the country’s first infection, the government met medical companies
and urged them to start developing coronavirus test kits on a massive scale.
The results
were impressive. When the epidemic hit, it was ready to deploy largescale
testing. Its measures allowed South Korea to become the second country to
flatten its coronavirus curve, without the sweeping shutdowns of society and
economic activity that China had pioneered and the west would be forced to
adopt.
China’s
experience should have provided a grim template for western countries to use to
prepare. The speed with which Wuhan’s crisis had intensified showed that a
relatively advanced medical system could be swamped. Within three weeks there
were over 64,000 people infected and 1,000 dead.
The pleas
for help from Wuhan’s residents and doctors were to be echoed by those from
Italy a few weeks later, and soon after the UK.
Look back
three months, and in China there were not enough tests to work out who had
coronavirus, there was not enough protective equipment for medical staff
treating patients, and then, soon, tragically there were not enough hospital
beds and ventilators for sick patients. These are exactly the challenges faced
by authorities from New York to Rome, London to Madrid.
… and the other country that didn’t listen
If the UK
has serious questions to answer, the country that so far has seen the worst of
the outbreak, the United States, was slowest of all to act. Trump for months
ignored, played down or lied about the threat posed by coronavirus, leaving
individual states to act unilaterally as it became clear it had already taken
hold on US soil.
On 17 March
parts of California issued “shelter in place” orders, effectively a lockdown.
By the end of that week New York City had also shut down, along with a dozen
states, and the majority of the rest of the country had put some restrictions
in place. Only five states had few or no controls.
There have
now been nearly 700,000 confirmed cases in the US and over 33,000 deaths;
actual numbers are likely to be higher for both. The economy has also been
devastated, with more than 22 million out of work as businesses collapse or
shrink under the strain.
The US was slowest of all to act, but Donald Trump is
ready to lift restrictions already.
Trump
insists the US is turning a corner, and has tried to blame – among other
targets – the WHO for failing to fully raise the alarm, and has stripped it of
its US funding.
There have certainly
been questions about the organisation’s strong praise for China and the
exclusion of Taiwan, which may have contributed to the delay in recognising
human-to-human transmission was occurring. But it began daily briefings on 22
January and had declared a global health emergency by the end of that month.
While
initially sceptical about China’s distancing measures, it urged other countries
to adopt them once there was evidence they were working. It warned about
shortages of PPE over a month ago, and since the beginning of the outbreak has
urged countries, including the UK, to “test, test, test” to contain the virus –
a strategy followed by almost all countries that have managed to suppress it.
All the
government’s pandemic planning was based on a flu scenario. And then it turned
out to be something different and far, far worse and the response was
completely inadequate
Senior Whitehall source
A senior
Whitehall source with detailed knowledge of the UK’s response and those of
other countries said: “The fact is that those countries who knew a lot about
Sars quickly saw the danger. But in the UK the attitude among politicians and
also scientists was that it was really just some form of a flu. All the
government’s pandemic planning was based on a flu scenario. And then it turned
out to be something different and far, far worse and the response was
completely inadequate.”
And we are
going to be living with the consequences for a long time. Don’t expect a
vaccine to come to the rescue in the short term, says Nabarro. “For the
foreseeable future, we are going to have to find ways to go about our lives
with this virus as a constant threat to our lives. That means isolating those
who show signs of the disease and also their contacts. Older people will have
to be protected. That is going to be the new normal for us all.”
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