The UK has now been experiencing COVID-19 restrictions for over a year, as part of the government’s attempt to control the infectious disease which has had a drastic impact on lives across the globe. Each nation has had its own way of dealing with the pandemic, but the British government’s constantly changing response has arguably contributed to 149,968 people who have COVID-19 written on their death certificates (at the time of writing). It has been filled with mistakes and delays (some of which were admitted by the government themselves) and now at least 0.22% of the population have died (compared to 0.17% in the US and 0.0005% in New Zealand) from this disease. But the vaccination program here is the fastest in Europe, and the government on the 22nd of February this year announced a roadmap out of lockdown, announcing plans to remove many restrictions on or shortly after June 21st. Having now spent more time in my childhood bedroom than in Oxford since starting my course, I can’t help but ask: should we forgive the government’s initial mistakes and errors in light of the new vaccine success and limited knowledge we had of COVID a year ago? Is forgiveness even possible?
The story of COVID-19 in Britain still has no clear starting point, but let’s start with the first known COVID case, which wasn’t discovered until relatively recently following a post-mortem test. Peter Attwood of Chatham, Kent (84) was admitted to hospital on the 7th January 2020, and passed away the day before the announcement of the two Chinese nationals testing positive at a hotel in York – at the other end of the country – on January 31st. It would be another 9 weeks until the announcement of the first national lockdown, where the whole of the UK seemed to come to a pause. Coronavirus ripped through the population in every second of those 9 weeks.
The story of COVID-19 in the UK may appear to start with Mr Attwood, but to understand why COVID was so bad here, we need to look at the frontline defence – the National Health Service. The UK holds up poorly compared to the health services of Western countries in the global North in terms of its healthcare capacity. Germany is the best in Europe in this area, with 33.8 ICU beds per 100,000 people, and the US has 34.3 (although southern California was at 100% capacity at the end of last year). So, how does the NHS compare? According to NHS reports, England had 7.9 ICU beds per 100,000 in January 2020 and averages about 7.3 across the UK as of March 2021.
What’s worse is that the government was fully aware the NHS was not equipped for a pandemic. In 2016, a report into Exercise Cygnus (a war game of how Britain would respond to a flu pandemic), warned that “the UK’s preparedness and response, in terms of its plans, policies and capability, is currently not sufficient to cope with the extreme demands of a severe pandemic that will have a nationwide impact across all sectors”. The government insisted it had acted on the report’s recommendations, but senior figures in the care sector claimed the findings of the report had never been shared with them. With a government tied up in Brexit negotiations, at the beginning of 2020 the nation and its ministers had their focus elsewhere.
Let’s come back to early 2020 and the disease’s movement towards the West. We saw footage from other nations. The dystopian lockdowns in Wuhan and Beijing, Australia’s and New Zealand’s closing of the borders in March of that year (the irony of an increasingly isolationist government failing to keep non-UK citizens from entering the nation is not lost on me), and later the circuit-breaker lockdown in France which was copied after a lot of fuss in November 2020 in the UK. In March 2020, the UK was still operating as normal and insisting on “wash[ing] your hands and business as usual” as the Prime Minister said in a BBC interview on March 5th , trusting his own advice so much he bragged about shaking hands with COVID patients in an attempt to disperse the public’s fear of the disease, before ending up in ICU with it himself. The chief scientific advisor, Sir Patrick Vallance, saw the same footage we all did, and acknowledged in an interview for Sky News in mid-March 2020 that the government’s plans to suppress the virus would involve allowing “enough of us who are going to get mild illness to become immune to this to help with the sort of whole population response which would protect everybody”. Over a year later with countless new variants of the original strain, some of which threaten the government’s last hope by possibly being resistant to some key vaccines, we now know this was an unfortunate and deadly mistake, and one most of the global East and South managed to avoid. More, what’s worse in an attempt to free up hospital beds, many elderly patients were discharged into care homes without coronavirus tests up until mid-April, so 4,210 of the most vulnerable people were moved from hospitals treating COVID patients into care homes, untested, between March 19th and April 15th 2020, which may have contributed to the massive death rates as the virus was easily able to spread amongst elderly residents.
The UK would finally go into a full national lockdown on March 23rd, not a moment too soon. Dr Walter Ricciardi, an Italian government scientific adviser, said in a Sky News interview on the 26th March 2020 that the “UK lockdown was 10 days too late” and the nation would “pay the price” for not acting sooner. Most of Europe locked down more than 12 days before the UK. Yet the government did not heed the warnings of other European nations to introduce a lockdown (or at least some clear and useful advice) at the same time they did. In fact, an Italian health official in Lombardy (Europe’s first COVID epicentre) was asked by The Telegraph if he had any British requests for information during the initial phases of the pandemic, he replied: “no” – the British government failed to observe and learn from the situation in Europe first. Unlike now, there was public support for a lockdown (93% supported the first lockdown), lockdowns had proven effective in the global East, and, despite insistence on being weeks behind the continent, the state of the health services in Europe (especially Italy) it seemed so strange to wait, due to being “two weeks behind” them.
At the time of writing, the government has just announced that anyone over the age of 18 in England can get a free rapid coronavirus test without symptoms (after being available for healthcare workers, teachers, and students for months). But on March 14th a year ago a government press release stated, “people who are in the community with a fever or cough do not usually need testing” and would prioritise those in hospital with pneumonia, flu or acute respiratory distress syndrome (ARDS). Even at the time, this was a strange and criticised move as it was clear testing people with symptoms was (and remains) the most effective way to gather data on the spread of the virus in the community.
Speaking of testing, another key response to dealing with infectious diseases is effective contact tracing after a positive test. NHS Test and Trace was launched at the end of May 2020, but had no contact tracing app as seen in other parts of Europe and in China, and the service was not expected to be fully operational until September. Even then, the system was not perfect, or even effective enough to contain the virus effectively. At the end of August it consistently took over 24 hours to produce a result and by the end of October, less than 60% of close contacts were reached (the target is over 80%). I was part of the untraced group. Following my positive test through the Oxford University Early Alert Service (OUEAS) I never received any contact from the service until a member of my household tested positive nearly two days later, and even then the health service never asked for the contact details of my close contacts. This was especially concerning as at the time, the OUEAS was incompatible with the NHS contact tracing app. I contacted the OUEAS to ensure my details had been passed on, and in a response they said, “[a]lthough we pass results on to PHE, there is clearly a problem sometimes with them passing things on to Track and Trace; possibly to do with postcodes”.The two-year budget for the service is £37bn (most of it being spent on the testing side), but the contact tracing company Serco obviously wasn’t meeting the demands of the task. £37bn is a huge sum of money for any public service, let alone a system that much of the public have written off as a total failure.
Finally, giving into the pressure of ensuring the economy remains as open as possible within the pandemic’s context. The economy suffered hugely, as has the health service and the nation as a collective to try and balance the two. An attempt to allow for a relaxation in restrictions over Christmas with a circuit-breaker lockdown was one replicated by other nations, but again this one too came too late (by the government’s own admission) and was insufficient to contain the virus strain originally discovered in Kent.
But there is a saving grace – the vaccines. At the time of writing, over 31.9 million NHS users have had the first dose of a coronavirus vaccine, and 6.5 million have been fully vaccinated. The government gambled on this and invested heavily in the Oxford/AstraZeneca vaccine and then got a deal for 100 million doses of it, on top of 90 million doses coming from Pfizer with other vaccines planning to be produced in the UK. The gamble finally seems to be paying off. But we are now in the position where so many people have contracted COVID and it is so deeply rooted within our population, even a permanent extreme lockdown with a fully vaccinated population would not be able to completely kill this disease. The government in 2020 seemed like it would only introduce more restrictions only if local NHS services could become overwhelmed. Now, the government recognises letting the virus spread through the population is dangerous and poses a threat to even those with immunity.
Moreover, it is not like the government did nothing with respect to the NHS. ICU capacity was massively increased with the Nightingale hospitals, but these efforts were undermined when it became clear due to government cuts these immense intensive care units would never be able to open fully due to staff shortages. The vaccine will save lives, and is now seemingly our only hope for us to return to our lives in a pre-COVID world (which, as a first year, could not come soon enough).
So now we need to ask the question I opened with: “should we forgive the government, if we even can?”. I’m not convinced that anyone could think the government has done an effective, or even adequate, job here. There have been too many restrictions for too long, too much money spent, too many mistakes and an overall arrogance and British stiff upper-lip attitude in assuming incorrectly that the problem would simply fix itself. The promise of a third wave coming to the UK is concerning, as this will result in more cases and even more deaths, but it is now far too late to stop that (hopefully final) wave. The UK government are not solely responsible, a global pandemic needs a global response (which, a year and a half in, we are still not seeing), but the risks taken, and plan to push for herd immunity on its own population (assuming a 1% death rate this would mean around 666,500 deaths), the constant reassurance that environments were COVID-Secure (which were obviously not due to their need to be closed in lockdowns following the initial national lockdown) and inability to control a deadly wave with lockdowns and vaccines is beyond words.