9th May 2020 – Willfully inadequate measures have led to the UK becoming the worst in Europe.

A Blog by Dr David J Flavell PhD FRCPath & Dr Sopsamorn (Bee) Flavell BSc PhD
Scientific Directors of Leukaemia Busters

9th May 2020

COVID-19 Transmission

The UK government’s initial response to the COVID-19 pandemic at the beginning of the year was willfully inadequate leading to UK becoming the worst case in Europe.

  • Transmission of COVID-19 despite lock-down

  • New measures needed to reduce transmission rate further

  • Face mask use in public and work places set to be announced tomorrow

  • Airport quarantine procedures also to be announced but far too late in the day

  • Second wave & lockdown likely if appropriate measures not taken

The UK government’s announcement of 4,649 new cases of COVID-19 yesterday is shocking coming almost seven weeks after lock down began. In reality this means that despite this period of lock-down, quite high rates of transmission are still taking place in Britain regardless of what might be said by the government and its experts about the R value being below 1.

This means quite simply that there are people still milling around in the community transmitting infection to others (and we include care homes and other institutions here) where the lock-down measures currently in place are insufficient to contain the epidemic and inadequate to sufficiently curtail transmission rates. Yesterday at the No 10 briefing session The Minister for the Environment George Eustice hinted that future reports on the number of new daily cases would include a breakdown of the settings where new infections were occurring, for obvious reasons this will be vitally important for understanding the containment of any infection and what further needs to be done.

Who Is to Blame?

For those of you who have been reading our series of blogs you’ll understand some of the reasons behind this abject failure. We’ve been talking about some of these issues since the beginning of April. It is quite simply the laxity, procrastinations and subsequent delays of the government’s response from the beginning, led by the man at the top together with his chief advisers who are to blame. For those of you interested in reviewing the timelines (31st December 2019 to 5th May 2020) of failures and delays then follow this link to the Appeasement website that details these. We have personally fact-checked the claims made on this easy to follow timeline of events and they are all correct.

However, now is not the time for recriminations with so much urgent work needed to correct the situation, so let’s set this aside for now. We are where we are and more important is what we do from hereon. Much more pragmatic and dynamically rapid action is needed in the UK’s response to containment and ultimate defeat of an epidemic that is having dire consequences for our great nation. Our only hope is that this modest blog might in some small way nudge those at the top to do what is so obviously necessary and to do this in a timely manner without all the procrastinations and indecision we have seen over the past few months. We cannot afford to waste any more precious time.

If newspaper headlines are to be believed we are expecting Boris Johnson to announce amongst other things two very important new procedures tomorrow, things that we have been shouting about in our blogs from the beginning which we knew were almost certain to help reduce infection transmission rates within Britain. But it has taken them so long to move to this position despite the overwhelming evidence that they chose to ignore or procrastinate on, a laxity that contributed significantly to the difficult situation that the nation is now in.

Face Mask Use in the Workplace and in Public Spaces

The first of these we believe will be the Prime Ministers recommendation tomorrow to use face masks in the workplace and in public places including on public transport (see our previous blogs Unmasking the Myths, Facemask Dithering and More on Facemasks). This is not before time and should have come much sooner.

But we think that this doesn’t go far enough. If it is to be effective, it should not just be a recommendation to wear a mask, it should be mandatory under a new law fast tracked through parliament. From the information we have at the time of writing this blog, it seems that the government are suggesting that they provide a supply of non-surgical masks to employers and possibly the general public, the government having purchased the machinery to manufacture these. This hasn’t been confirmed officially yet as far as we know, so watch this space for further information as it becomes available.

Ports of Entry Quarantine Restrictions

The very first blog we wrote on the 3rd April questioned why our airports were still wide open for flights arriving from all over the world including COVID-19 hotspots at that time (see our blogs Flights of Fancy and Ports of Entry for Coronavirus). Nothing was done and nothing is still being done and all the while visitors have been pouring in carrying different strains of the COVID-19 virus to every corner of our islands. However, we expect the Prime Minister to very belatedly announce tomorrow that quarantine procedures will be introduced at ports of entry into Britain from the end of the month but as many will agree this has come far too late.

We now know from the genotypic analyses of the range of SARS-CoV-2 viruses circulating in Britain that many have been imported from around the world, carried by the several million airline passengers arriving here since January and yet they are still arriving without checks, albeit in smaller numbers than before.

As we currently understand it once the new regulations are in place at the end of this month, border control officers will require each arrivee to register electronically with an address at which they will self-isolate for 14 days from arrival. They will then be free to travel onwards to the address where they will be staying in the UK. This is woefully inadequate for at least two reasons.

  • Firstly they would be free to travel onwards using public transport systems and along the way unwittingly transmit infection to others if they themselves are asymptomatic or mildly/moderately infected. Who in their right mind would allow this to happen if the purpose is to contain infection?

  • Secondly, who is going to police whether these individuals comply and actually remain self-isolated? We have read that there will be spot checks but we suggest that this would be insufficient to guarantee that these travellers didn’t break the rules and fail to remain in their accommodation for the full 14 day quarantine period.

We say that there has to be a system of enforced quarantine, (i.e.not just voluntary quarantine) with the government setting up special centres and the means to securely transport travellers to these centres. There will be those who complain that this is too onerous and will deter people from travelling to the UK and we would say to them “so what”. Why should anybody who is not prepared to quarantine for 14 days want to visit the UK at this time anyhow?

If quarantine deters them from visiting the UK at this time then that’s just fine if it serves to protect the entire UK population from being exposed to a re-introduction of further COVID-19.

Then finally there’s the question of when enforced quarantine at ports of entry should be implemented? The answer to that is that it should have been done much earlier in the year but now the cat is out of the bag it’s far too late and mitigation is now the only option. We say that the end of this month is too late and implementation should be much, much sooner, how about tomorrow?

As per the Prime Ministers own admission, we are now entering a very dangerous phase as reversal of lock-down measures are considered and eventually implemented. Let us hope that Boris Johnson and his government takes these measures much more seriously than they did in February and March.

Failure to do so will lead to a second wave of infection and the doubly disastrous consequences that would impose on all of us in this country. They must get it right for all of our sakes.

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