Why is the UK not taking action as drastic and quickly as other countries to tackle the coronavirus? Yesterday, the UK government issued new guidance, telling people with a cough to stay home. But it stopped short of more extreme measures such as banning big gatherings and school closures, which some neighbouring countries have done.
The approach has drawn criticism in some quarters, but Patrick Vallance, the UK’s chief scientific adviser, took to TV and radio studios this morning to explain the strategy’s two main goals. His office told today that it is working to make the models behind the reasoning available for public scrutiny.
Vallance said the first goal was: “To reduce the peak of the epidemic, flatten it and broaden it, so you don’t end up with so much intense pressure on healthcare systems at one time.”
The second is to protect the most vulnerable people while the virus spreads through the population. He said the approach would help build up herd immunity as people recover from the disease and become immune, reducing transmission.
This stance appears at odds with the World Health Organization (WHO), which has called on countries to “take urgent and aggressive action”.
“That to me translates into hit hard, early,” says Mark Woolhouse at the University of Edinburgh, UK.
But Woolhouse is broadly supportive of the UK government’s approach. That is partly because he believes it is more sustainable over time than that of the WHO, which he says appears to want to eradicate the virus entirely, like with SARS, rather than learning to live with a virus that may be here to stay.
“At some point, I suspect the WHO is going to have to change its position to something like the UK government’s, and not the other way around,” he says.
Many public health experts were expecting more dramatic interventions yesterday, says Helen Ward at Imperial College London. The talk of herd immunity is worrying and a distraction from the important vital goal of flattening the peak of the epidemic, she says.
“It’s very strange to use this [herd immunity] as a strategy for control without a vaccine,” she says. Even if older people are protected, it will still see millions of more resilient people hit by a severe disease.
“I think it’s a version of ‘take it on the chin’, get it over and done with,” she says, referring to a phrase previously used by prime minister Boris Johnson. “That will just collapse the healthcare system.” However, she adds: “It’s not that the government is being reckless but we are in a very uncertain situation.”
Devi Sridhar at the University of Edinburgh thinks the UK government’s approach is wrong. “Other countries have shown speed is crucial. There is a middle path between complete shutdown and carrying on as normal,” she tweeted, citing examples of stopping large public gatherings, stopping non-essential travel and urging employers to allow home working.
The government has defended holding back on stronger measures. Vallance said at a press conference at Downing Street yesterday that one reason is the public will get fatigued and compliance could drop off just as the epidemic’s peak nears.
Ward says it is true that people do get message fatigue. Her background in dealing with HIV has shown that people are more willing to take action when they are seeing impacts in their community. “When there is a real health crisis people’s ability to accept and act is greater,” she says.
Some have looked to China for how and when the UK should react with more draconian steps. A study published yesterday on social distancing measures imposed in Wuhan, where the coronavirus outbreak began, showed they worked.
But because of different demographics, it does not necessarily translate to other countries, says Petra Klepac at the London School of Hygiene and Tropical Medicine (LSHTM), one of the team behind the paper. “It’s really location specific. It is telling us in Wuhan the measures have worked,” she says.
Anthony Costello at University College London, who worked at the WHO between 2015 and 2018, says evidence from China and South Korea indicates that social distancing does work, and the UK should be doing much more. “We are going against every other countries’ policy, with no social distancing going on from the government,” he says.
There is also the question of how transparent the UK is being about the evidence underpinning its decisions. Adam Kucharski at the LSHTM tweeted that the UK government was working off multiple models from universities around the UK to create as “solid an evidence base as possible for very tough decisions”.
Still, Ward says she would like to see more openness. “I know people working to advise the government are restricted in what they are allowed to share and I think that is a problem. We need as much transparency as possible,” she says.
Asked why the government has not yet published the modelling its decisions have been made on, a spokesperson for the Government Office for Science says: “We respect and agree with the need to publish in line with scientific rigour and transparency and we are working towards making these public. ”
The number of positive cases in the UK jumped to 798 today, the biggest daily rise so far.