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‘Rollercoaster’ of UK Covid lockdowns blamed on initial delays to act [1]
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Date: 2023-10
The UK government’s delay in introducing Covid interventions and a lack of an effective contact tracing programme led to more severe restrictions than in other countries, the UK’s Covid inquiry has heard.
Countries such as Japan, South Korea and Vietnam were able to use testing and tracing measures to maintain low levels of spread and outbreak of Covid-19, said Thomas Hale, leader of the Oxford Covid-19 government response tracker, which monitored how 185 countries responded to the Covid-19 pandemic.
Keeping the virus at a lower level also meant these countries were able to avoid the more stringent measures required to deal with a more widespread infection, the professor added.
“Effective use of these testing measures was a nice way of maintaining a low level of spread and therefore not beginning the rise of the rollercoaster,” said Hale, referring to the trend in some countries – including the UK – to implement strict measures, ease them between waves, and reintroduce them later.
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“Countries riding the rollercoaster were suffering from a trifecta of large health impacts; high, long periods of stringency; and negative economic consequences,” said Hale. “Those that were able to maintain a low spread, perhaps through effective test, trace and isolate measures, were able to have a better outcome on all three of those measures.”
Asking Hale whether the UK government’s response to the pandemic resembled a rollercoaster, chief counsel to the inquiry Hugo Keith KC made particular reference to the government’s decision to close schools and workplaces in a more severe move than other countries early in the pandemic, before dropping to a low comparative level of restriction between waves.
Hale said that the UK’s ‘rollercoaster’ tendency could be seen in both the delay to introduce restrictions and the increased stringency of those restrictions because they were late.
“Sustaining high stringency for a long period comes with costs, there’s huge pressure to roll them [restrictions] back sooner rather than later, and that leaves, inevitably, some residual virus circulating in the population and lays the seeds for next week to emerge,” said Hale.
The government response tracker began in spring 2020 when the most prominent government responses to the pandemic were so-called ‘non-pharmaceutical interventions’ (NPIs) such as travel restrictions or requirements to stay at home, with vaccinations coming on line later.
In broad terms, Hale said the literature he and his team reviewed suggested that interventions such as masks, school and workplace closures, and other restrictions preventing people from meeting one another “are going to be the ones that have the greatest impact on cases, hospitalisations and eventually deaths”.
The hearing was shown a chart comparing the introduction of NPI or lockdown measures in different countries after they had identified 100 Covid cases. “It shows very clearly that, in relation to the spread of the virus, restrictive measures in the UK came into place much more slowly than in other groups of [comparable] countries,” said Hale, referring to regions with – for example – similar political systems or populations.
Elderly care and ‘working from home’ NPIs were the only two interventions where the UK was in line with comparative countries in terms of when it introduced measures.
The tracker team collated and reviewed thousands of studies and data relating to the actions taken by governments around the world in response to the pandemic. The review concluded that:
The speed and strength of interventions matters, in terms of the spread of the virus, health impacts and the cost of managing a disease outbreak;
Effective use of ‘test, trace and isolate’ measures limits health impacts and the need for more stringent measures to be introduced;
Economic support can bolster compliance with interventions or restrictions;
Prolonged restrictions can have economic and other costs.
Rapid introduction of interventions when faced with diseases such as Covid-19 are critical to reducing further spread, said Hale. One study suggested that a single day’s delay in implementing restrictions such as a ban on mass gatherings during a wave of the virus may have led to a 7% increase in the cumulative death toll.
Hale said the data and studies showed evidence of the cost of prolonged restrictions to mental health, learning outcomes for children, and domestic violence. Last week, the inquiry heard about a dramatic increase in calls and referrals to a leading UK domestic violence charity during the pandemic.
On average, the data reviewed by the tracker project suggested that more stringent restrictions on international travel were associated with reductions in the spread of Covid-19, he said. Less stringent measures, such as temperature checks at borders, were harder to enforce and did not show the same impact on transmission rates as stricter interventions, such as long quarantines in hotels on arrival or border closures, Hale added under questioning.
He referenced interventions that were aimed at bolstering compliance with Covid measures in other countries, including in India, where food was provided to those isolating. Earlier in the evidence session, Kamlesh Khunti – a professor who sat on the government’s Scientific Advisory Group for Emergencies (SAGE), said its ethnicity sub-group made recommendations about support for Bangladeshi and Pakistani communities disproportionately affected by the virus, including housing provision to help those in multigenerational households to isolate. He was not asked whether any of these recommendations were taken up.
Witness Mark Walport, a former government chief scientific adviser, later stressed in his evidence that non-pharmaceutical interventions work best in combination – for example test, trace and isolate alongside vaccinations. Social and cultural factors could also inform their effectiveness: for example, the preparedness of the South Korean government and public for a pandemic following its experience of the MERS outbreak in 2015.
When asked whether the UK would be able to introduce a better test and trace system today, Walport said the UK’s position was “not as strong as we would like it to be.”
“I think there is much more to do,” he said. “The disinvestment in public health, not just in the UK but in rich countries in the world, needs to be tackled.”
The inquiry continues.
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