March 5, 2020

expert reaction to comments from CMO Chris Whitty about moving towards ‘delay’ phase of COVID-19 response

During a Health and Social Care Committee hearing this morning the Chief Medical Officer for England (CMO), Prof Chris Whitty, commented on moving towards the ‘delay’ phase of COVID-19 response.

Dr Tom Wingfield, Senior Clinical Lecturer and Honorary Consultant Physician, Liverpool School of Tropical Medicine, said:

“CMO Chris Whitty’s comments today about moving beyond the containment phase towards the delay phase of the COVID-19 UK outbreak are not surprising.

“Despite monumental contract tracing and screening efforts by PHE, and prompt isolation and first-rate care of people with COVID-19 by NHS specialist infection units, we have seen a continued increase in the number of COVID-19 cases in the UK.  This means that a strategy focusing resources on slowing down the spread of COVID-19 in the UK, in order to limit the strain and impact on our healthcare services, staff, and the public, has become the priority.

“A potential future mitigation strategy could involve things like some reorganisation of existing hospital services such as the creation of ‘cohort’ wards, which care solely for people with COVID-19, and also redefinition of admission criteria for people with COVID-19 whereby people with severe symptoms relating to COVID-19 are admitted to hospital for specialist care, and those with more mild symptoms may be managed at home.”

Prof Trudie Lang, Director of the Global Health Network, University of Oxford, said:

“The stages of contain, delay and mitigate don’t have to be separate – in fact, some countries are choosing to use parts of all three stages at the same time.  The steps don’t have to happen in isolation.  In some parts of the world containment is not practical or feasible.

“It is completely appropriate and expected to have elements of contain and delay at this stage, and in fact the steps are not that different.

“This is all perfectly reasonable and in practice the phases are not entirely different, and is in line with what is happening throughout the world.  It is important to keep looking at the global context – we are learning all the time from other countries.

“The government is quite rightly having to put steps in place continuously to prepare for the worst case scenario even though it may well never happen.  Research is essential because it allows us to put it in context – research is informing advice and decisions.

“Right now we are still not in an epidemic in the UK because we do not yet have widespread person-to-person transmission.  The government are getting ready to move in case it gets to that point.  If we were to get to that point there would be less to be gained by doing all contact tracing.

“We aren’t in the Italian situation yet, which is why we are not yet implementing social measures.

“The aim is currently still to try and contain the disease so we don’t get to the Italian situation.  If cases pick up, the aim is to delay in order to blunt the curve of cases so we don’t have lots of people unwell at the same time.  It is all still an IF – we’re not at that stage yet.  There are still only three countries other than China with high levels of person-to-person transmission.  Globally all countries are putting steps in place to combine contain and delay measures.”

All our previous output on this subject can be seen at this weblink:

http://www.sciencemediacentre.org/tag/covid-19

The SMC also produced a Factsheet on COVID-19 which is available here:

https://www.sciencemediacentre.org/smc-novel-coronavirus-factsheet/

Declared interests

None received.