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expert reaction to new UK government interventions to tackle spread of COVID-19

The UK government announced on 23rd March 2020 much stricter restrictions on social gatherings and travel to tackle the spread of COVID-19.

 

Prof Sheila Bird, Formerly Programme Leader, MRC Biostatistics Unit, University of Cambridge, said:

“Once an epidemic takes hold, as it has now in UK, the country’s own data – properly reported and interpreted – take precedence over modelling.  This is because the data tell us the actual toll which the epidemic is exacting on a weekly basis – especially by age-group, and with special attention to healthcare workers – in terms of COVID-19 deaths per million of population and its impact on all-cause mortality per million of population compared to the weekly expectation based on the past 5-years.

“COVID-19 positive rates for hospital-based testing should be reportable by the week of sampling, but one week in arrears (e.g. we’ll know the results for hospital-based samples taken in the week to 20 March 2020 on 27 March 2020): the age-distribution of hospitalized COVID-19 positives, and the age-distribution of those COVID-19 cases admitted to intensive care units in any one week.

“These actual data are used as important inputs to inform or calibrate modelling for the critical purpose of projecting ahead by several months. But a huge amount can also be directly inferred from these key data about the immediately forthcoming weeks, including whether further policy-changes are needed to reinforce social-distancing: for example, in particular age-groups. This is the quintessential importance of reporting, in an epidemiologically-robust manner, these key data on how the UK’s epidemic is evolving.”

 

Prof Mark Woolhouse, Professor of Infectious Disease Epidemiology, University of Edinburgh, said:

“Yesterday’s escalation of the UK government’s social distancing policy was inevitable.

“We now enter a phase of careful monitoring. We are looking for indicators first that the epidemic is slowing down and then for numbers of new cases to start to fall. This is unlikely to become apparent in under 3 weeks, so 3 weeks will be an appropriate time to review the situation, as the government intends.

“After 3 weeks we will have to decide whether the restrictions need to be continued, can be relaxed, or can be relaxed temporarily with the expectation of imposing them again later. At that time I hope we will be guided not just by the state of the epidemic curve. We must also monitor the damage being that the lockdown is doing; damage to the economy, to education, to psychological well-being and to health and social care provision in the community. An informed decision on the best course of action in 3 weeks’ time must in my view, weigh the epidemiological benefits against societal costs.

“I speak as an epidemiologist when I say that the impacts of this epidemic are too far reaching for policy decisions to be driven by epidemiology alone.

 

Dr Andrea Collins, Senior Clinical Lecturer in Respiratory Medicine, Liverpool School of Tropical Medicine (LSTM), said:

I am delighted that the PM has put these measures in place. The levels of misunderstanding about how serious this situation is are still remarkable to me – for many this has finally made the penny drop. I believe that they have not quite gone far enough. The ‘absolutely’ necessary to go to work is still being used by some when it is not required – I think we need permits across controlled areas to go to a workplace. Home working is hard for many but it is possible, we just need to adapt to a new way of being.

“Shopping as infrequently as possible is also very valid & important but again possibly too vague as for some this may still mean popping to the shops every other day! This is too frequently. We must get more supermarket home delivery and click & collect slots available as soon as possible.”

 

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

“The measures announced by the government yesterday, to deal with the increasing number of COVID-19 cases and deaths in the UK, are proportionate. The main driver of the measures is to ensure that social distancing is occurring. It is essential that these measures are combined with a further large-scale increase in COVID-19 testing in the UK over the coming days and weeks in order to better understand our country’s outbreak and support those most in need.

“The effects of these measures in the UK is unlikely to be seen until a few weeks from now but it is hoped that they will be effective in reducing transmission of the coronavirus and, consequently, decreasing the number of cases and deaths to “flatten the curve”, as Professor Chris Whitty has noted. Such positive effects of similar measures have been shown in other countries, including China, Singapore and South Korea.

“It is clear that we all have a part to play in controlling COVID-19 and helping our NHS to deal with the ongoing increase in people being admitted to hospital with symptoms of COVID-19. We are urging everyone where possible to stay at home. This is something we can all do to help to protect ourselves and each other in these difficult times. Let’s act together as individuals, households, communities, and a country.”

 

Prof Robert Dingwall, Professor of Sociology, Nottingham Trent University, said:

“It would be irresponsible to encourage anyone to break the law and to  incur whatever penalties might be attached. However, these measures represent the third social epidemic that accompanies all outbreaks of infectious disease – the epidemic of action, however, pointless.

“In this case, it is another triumph of populism over science, of a capitulation to the demand to ‘do something’. Its approach reminds me of the line in Brecht about the failure of the people to live up to the expectations of the politicians – so we must dissolve the people. Specifically, we are still seeing some notion that ‘the people’ are selfish and must be bullied and disciplined. The people are not selfish: they have behaved in ways that are individually rational but have collectively irrational results. (This is a big problem for those economists and politicians who believe that unregulated individual decision-making will always produce optimal results – the ‘efficient market’ hypothesis). People are told that they should prepare to self-isolate for 14 days, so they transfer stocks from supermarkets to homes, if they can afford to, and expose the fragility of just-in-time supply chains.

 

“Last night’s injunction to shop less often simply reinforces that message! People are told they can go out as long as they maintain a degree of physical distancing that does not seem to have an evidence base for outdoors – so they do go out and then find that a lot of other people have had the same idea. Now they are told to stay at home, regardless of circumstances and at whatever cost to their mental and physical health. There are some very smart biomedical scientists and mathematicians advising government, who I respect greatly in their areas of expertise. However, the increasing intensity of control measures is a pretty good index of the naivete of policy elites about the real living conditions of many people in this country. It is unfortunate that the PM’s hero is Churchill rather than Disraeli, who did understand the gap between the two nations.”

 

Dr James Gill, Honorary Clinical Lecturer, Warwick Medical School, said:

“After a weekend where we’ve had reports of crowds flocking to Wales and the Brecon Beacons, the UK Government has taken the step of enacting much wider isolation instructions for the whole of country. If we look at the doubling rates of other countries, especially those who appear to have had more success in flattening to curve, these new restrictions are exceptionally welcome additions to UK response to COVID 19. Whilst these measures may seem extreme to some, this is a step which allow all people to contribute to this outbreak effort and protecting our most vulnerable

“By stopping free moment of all but essential key workers, the spread of COVID-19 should be damped, as all evidence indicates the greatest spread of the virus is within close contacts. Hence previous statements regarding two meters social distancing which will also remain in effect.”

 

Professor Sir Robert Lechler PMedSci, President of the Academy of Medical Sciences, said:

“I am fully supportive of the new measures announced tonight [Monday 23 March] by the Prime Minister. These interventions will not have been decided upon lightly. They are based on evidence and advice from world-leading experts who have been studying the best way to flatten the peak of the coronavirus outbreak and prevent the loss of thousands of lives.

“The time has come for everyone in the UK to play their part to protect their friends, families, neighbours and the fabric of our entire society, as well as crucially safeguarding NHS staff. I strongly urge all members of the public not to leave their house unless absolutely necessary and to model their behaviour on these new measures.

“If we do not act now then we risk pushing the NHS beyond its limits. We must all show our support for the huge number of doctors, nurses, scientific researchers and those that keep these workforces going by following the advice laid out by the Prime Minister tonight.”

 

Prof Rowland Kao, Sir Timothy O’Shea Professor of Veterinary Epidemiology and Data Science, University of Edinburgh, said:

“This change has been anticipated. It represents a severe and substantial ramping up of distancing measures. It is likely that this is at least in part, due to failure of the general public to adopt less restrictive measures in their entirety – in that sense, they may be measures that in themselves are more severe than absolutely necessary to restrict disease spread, but are necessary to ensure sufficient compliance. The reasons for reduced compliance are likely many, but major contributors are undoubtedly due to communication – both of the nature of the control measures themselves (for example anecdotal evidence of confusion of what is appropriate social distancing) and in some cases, poor appreciation of the urgency of the requirements.

“It must be hoped that such measures will only last a relatively short time. However, we must be prepared for this not to be the case, and for them to be in place for an extended period. If so, consideration of what are considered ‘essential’ will likely have to be broader than simply food and medical supplies.”

 

Dr Gail Carson, Head of the ISARIC Coordinating Centre and Consultant in Infectious Diseases, University of Oxford, said:

“None of us want to be in this situation but we are and I welcome the PM’s statement tonight as part of a series of measures. For example, he mentioned additional test kits as ‘locking us down’ alone is not a magic bullet.

“From someone who has been involved intermittently with pandemic preparedness since 2003, I still have to pinch myself.

“This is real, any of us is at risk of infection, some more than others for severe disease but together all of us can turn the tide of the pandemic in the UK. As the PM said, we are all enlisted in this fight. Please remain patient, kind and considerate. Some neighbours, friends, family and strangers will be confused and anxious. We are distant physically but remain in touch; phone, message them to make sure everyone is ok. Today the DG of WHO spoke of the acceleration of the pandemic. It is with grave concern we look to Italy. We see their grief & distress. Let’s stay home and healthy until advised otherwise.”

 

Prof Susan Michie, Director of UCL Centre for Behaviour Change, said:

“For these measures to work they need to be adhered to. Evidence suggests that perceived equity is an important influence on adherence to measures such as this. Currently there are two important areas of obvious inequity:

  1. “5 million self-employed people are being left potentially destitute by the Government failing to offer financial support as they have done for directly employed workers. Since £94 is not enough to pay rent, bills, food for a family etc, they will be forced to carry on as usual. Other countries have paid people to stay at home – everyone needs to be financially secure whilst staying at home if this is to work.
  2. “There needs to be a rapid injection of resources into communities to ensure that everyone is looked after – practically, socially and emotionally, especially those most disadvantaged.

“10 years of austerity has ended up with a severely diminished infrastructure for social and community support and a large number of people in precarious employment. These measures are hitting the already disadvantaged most, increasing inequalities, with all the health and social deleterious consequences outlined by Prof Michael Marmot and others.”

 

Prof Stephen Reicher, Professor of Social Psychology, University of St Andrews, said:

“The crucial issue is compliance which depends upon 3 factors:

“The first is legitimacy – and I think it is now clear why these measures are necessary, not so much to protect the individual as to protect the community. Anyone who goes out risks spreading the disease and endangers the lives of the most vulnerable.

“The second is clarity – and I think the requirements are now clear in a way they were not before.

“The third is practicality – and here I think there is still some way to go. In the simplest and most comprehensive way possible, we must make it possible for everyone – employed, self-employed or unemployed – to stay at home, be able to afford to feed themselves and their family, and light and heat their homes, and stay in touch with family and friends. No-one should be cut off from any of these essentials.”

 

Prof Sylvia Richardson, Director, MRC Biostatistics Unit, University of Cambridge, said:

“I believe the great majority of scientists will say the same, these measures are certainly appropriate and sensible and it was high time that they are taken by the government. Whether they are effective will depend on compliance and the PM message needs to be reinforced by a daily communication exercise targeting the general public as well as special groups like young people. Getting the reproductive number below 1 is hard and requires stringent compliance for a sustained period of time. The expected delay between these measures and their effect on the course of the epidemic has to be understood by the wider public. The increase in the death rate has to be monitored together with information coming from population level testing and other sources to evaluate whether additional measures, such as the ones recently taken in Italy, will need to be taken. Many countries are now imposing similar “lock down” measures and we will also learn by doing comparative studies between countries.”

 

Dr Rupert Beale, Group Leader, Cell Biology of Infection Laboratory, Francis Crick Institute, said:

“I agree with all the measures outlined by the Prime Minister this evening. They are absolutely required to save lives. Doctors and scientists are working flat out to deliver better testing and better treatments, but this will take time. Before then we will run out of capacity in intensive care units if we do not obey these instructions. These measures are therefore necessary to prevent thousands of deaths. I urge everyone to comply with them immediately.”

 

https://www.gov.uk/government/speeches/pm-address-to-the-nation-on-coronavirus-23-march-2020

 

All our previous output on this subject can be seen at this weblink: www.sciencemediacentre.org/tag/covid-19/

 

Declared interests

None received.

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