March 2020

2nd March

Boris Johnson attended his first COBRA meeting on the coronavirus (having missed the previous five) and acknowledged for the first time that it was “more likely than not that the UK will be significantly affected”. [Appendix 2]

 

3rd March

The Prime Minister announced a four-stage “battle plan” on how the UK would tackle COVID-19.

Stage 1 – “Contain” – had three parts: (1) detect and isolate early cases; (2) trace people who have been in contact with those affected; (3) screen travellers to and from high-risk areas.

• part 1 was implemented; part 2 took many weeks to be effective; part 3 was almost completely ignored.

Stage 2 – “Delay” – had four parts: (1) slow the spread of virus and push it away from the winter season; (2) encourage closure of schools and more working from home; (3) launch public awareness campaign for personal hygiene; (4) ban large-scale gatherings such as sporting events.

• most of the “delay” was inaction on the part of the government and, in particular, the Department of Health and Social Care; action on all four parts was too slow and frequently muddled.

Stage 3 – “Research” – was back to three parts: (1) constant monitoring and research of virus with the aim of reducing its impact; (2) look for new diagnostic tests, drugs to treat patients, and preventative vaccines; (3) prepare for multiple waves of the virus.

• this was the most successful part of the strategy but is not a stage in the handling of the crisis; rather it is a continuous process.

Stage 4 – “Mitigate” – had a further three aspects: (1) cancel all but essential care and support at hospitals; (2) army on the street and police concentrating on serious crime; (3) hospital staff leavers and retirees could be called back to duty.

• part 1 turned out to have horrendous effects on the elderly and vulnerable, people with various other diseases including cancer with millions of treatments suspended as the NHS focus was almost entirely on COVID-19; part 2 proved largely unnecessary; and part 3 was implemented well much earlier on.

The plan was included in a 27-page document, published as the number of confirmed cases in the country jumped to 51. As well as detailing possible measures to be taken, it warned that in a worst-case scenario up to 80% of the population could become infected (it didn’t point, however, that in that case herd immunity – which turned out to be a contentious issue – would have ben achieved).

Outlining the “contain, delay, research, mitigate” plan, Mr Johnson said he had “no doubt at all that the country is going to get through coronavirus, and get through it in good shape”. The report noted how the country had “strategic stockpiles” of medicines and protective equipment – the latter proving to be grossly inadequate.

Action the public could take in the “delay” phase, the report said, included hand-washing and following the “catch it, bin it, kill it” strategy for sneezing and coughing. The delay phase also included the possibility of closing schools, people working from home and cancelling large gatherings.

The “research” phase would, among other things, aim to come up with the best course of care for people affected.

Finally, in the event of the outbreak escalating, the response would be ramped up from “contain” and “delay” to “mitigate”. This last phase set out plans to minimise the impact of the virus on society, public services and the economy and gave details on how the health and social care systems had plans in place to ensure people received essential care and support but might mean that other services were reduced temporarily.

 

3rd March

WHO called on industry and governments to increase manufacturing of personal protective equipment (PPE) by 40 per cent to meet rising global demand, warning that severe and mounting disruption to the global supply – caused by rising demand, panic buying, hoarding and misuse – was putting lives at risk from the new coronavirus and other infectious diseases.

“Without secure supply chains, the risk to healthcare workers around the world is real. Industry and governments must act quickly to boost supply, ease export restrictions and put measures in place to stop speculation and hoarding. We can’t stop COVID-19 without protecting health workers first,” said WHO’s director-general. [Appendix 8]

 

3rd March

SAGE said that official advice should warn against handshaking “for hygiene reasons” and ministers should instead promote an alternative greeting. Later that day, Mr Johnson told a Downing Street press conference that he had not ditched the traditional form of greeting. “I can tell you that I’m shaking hands continuously,” he said. “I was at a hospital the other night where I think there were actually a few coronavirus patients and I shook hands with everybody, you’ll be pleased to know, and I continue to shake hands.”

SAGE said: “There was agreement that government should advise against greetings such as shaking hands and hugging, given existing evidence about the importance of hand hygiene. Promoting a replacement greeting or encouraging others to politely decline a proffered handshake may have benefit.”

 

5th March

Professor Chris Whitty, the chief medical officer, told the House of Commons Health Committee that the UK was moving into the next stage of its response to the coronavirus outbreak. “We have moved from a situation where we are mainly in contain, with some delay built in, to where we are now mainly delay.” Efforts had initially been made to try and contain the spread of the disease, but he said it was now “optimistic” to believe this could be a success. He added that it was now “more likely than not” that the UK would see an epidemic.

A spokesman for the Prime Minister stated shortly afterwards that the UK was still in the contain phase and if a decision was made to move to the delay stage, it would be announced publicly. Boris Johnson told ITV: “Things like closing schools and stopping big gatherings don’t work as well as people think in stopping the spread.” [Why he said this is a mystery: there was certainly no scientific, or any other, basis for the claim.]

• The first death from the virus in the UK was recorded when a woman in her 70s with an underlying health condition passed away at the Royal Berkshire Hospital in Reading (see entry for 9th September when earlier death reported). This lady was among 116 UK cases confirmed by the Department of Health that day, with all seven NHS regions reporting at least one instance.

• The New England Journal of Medicine listed examples of asymptomatic infection in Germany when the UK’s infection total stood at 114.

 

7th March

The PM and his fiancée were among the 80,000-strong crowd that watched the rugby international between England and Wales at Twickenham and he put a video on Twitter of him shaking hands with five female rugby players.

 

10th-13th March

The Cheltenham Festival went ahead at Cheltenham Racecourse with crowds totalling more than 250,000 over the four days.

 

11th March

Nearly 3,000 football fans travelled from Madrid – one of the worst affected cities in Europe and where schools had already been closed – to watch Atletico Madrid play Liverpool at Anfield in the European Champions League. It was the last match the Spanish fans could attend for many months.

 

11th March

Stating that it was “deeply concerned” both by the alarming levels of spread and severity, and by the alarming levels of inaction, WHO declared COVID-19 to be a pandemic. At this time more than 118,000 cases of the illness had been identified in over 110 countries and territories and, according to the organisation, there was sustained risk of further global spread.

The WHO director-general stated: “If countries detect, test, treat, isolate, trace and mobilise their people in the response, those with a handful of COVID-19 cases can prevent those cases becoming clusters and those clusters becoming community transmission.”

He also said: This is not just a public health crisis, it is a crisis that will touch every sector, so every sector and every individual must be involved in the fight.”

 

12th March

The four chief medical officers of the UK raised the perceived risk level in the UK from medium to high.

 

13th March

The PM announced that large public events including concerts and sports matches would be banned by the following weekend. This announcement came barely a day after he said that banning mass gatherings would not be an effective way to tackle to spread of the virus. Several countries, including Denmark, Italy, Switzerland and France, had already implemented similar measures with a number shutting down cinemas, theatres, pubs and clubs along with schools, colleges and universities. The Prime Minister’s move was made after England’s football authorities postponed all professional fixtures until at least 3rd April.

At a press conference Mr Johnson said he did not want to ban mass gatherings too early to “maximise the benefit” of such measures [whatever that might mean]. He said it was something the government had up its sleeves for when the time was right.

The announcement followed a call from the WHO director-general for governments to take more action: “Not testing alone. Not contact tracing alone. Not quarantine alone. Not social distancing alone. Do it all,” he said.

• The government’s chief scientific adviser, Sir Patrick Vallance, speaking on the BBC Radio 4 Today programme, said: “Our aim is to try and [sic] reduce the peak, broaden the peak, not suppress it completely; also, because the vast majority of people get a mild illness, to build up some kind of herd immunity so more people are immune to this disease.” This prompted 229 scientists to sign an open letter stating that going for herd immunity was not a viable option. [Appendix 7]

 

14th March

The government announced it would be prioritising “the most vulnerable individuals” for testing, including those in hospitals and care homes. If an outbreak was suspected, a small number of residents in a care home could be tested. It was reported that a number of care home providers found access to testing to be very limited.

 

16th March

Social distancing [WHO preferred the term “physical distancing”] guidelines were published by the government. [Appendix 4]

 

18th March

WHO and partners launched the Solidarity Trial, an international clinical trial that aimed to generate robust data from around the world to find the most effective treatments for COVID-19.

 

19th March

NHS guidance said that “unless required to be in hospital, patients must not remain in an NHS bed”. The policy, which sounded perfectly reasonable, was implemented to free up beds in advance of an expected surge in COVID-19 cases. It was, essentially, targeted at “bedblockers” – elderly patients with nowhere to go – and the NHS put strong pressure on care homes to take these patients. [Appendix 5]

 

22nd March

Downing Street denied claims that Boris Johnson had been advised to follow a policy of “herd immunity”. According to The Sunday Times, Dominic Cummings urged the policy of “herd immunity” amid fears that a large-sale shutdown would wreck the economy. Mr Cummings is quoted as saying: “Herd immunity, protect the economy and if that means some pensioners die, too bad.”

Number 10 issued a statement dismissing the claims that Mr Cummings made the comments at a private engagement at the end of February. A Downing Street spokesman said: “This is a highly defamatory fabrication which was not put to No. 10 by The Sunday Times before publication. The article also includes a series of apparent quotes from meetings which are invented.”

Downing Street also dismissed a report that Mr Johnson had only introduced tougher measures to prevent the spread of the disease, such as ordering the closure of pubs and restaurants, after French President Emmanuel Macron threatened to block all travellers coming from the UK if he did not act. The French newspaper Liberation said the president had warned that the rest of the EU would follow suit unless Mr Johnson abandoned his policy of “benign neglect”. A No. 10 spokeswoman responded: “These new measures were taken based on scientific advice and following the government’s action plan set out two weeks ago.”

• “Herd immunity” is defined as “the resistance to the spread of a contagious disease within a population that results if a sufficiently high proportion of individuals are immune to the disease, especially through vaccination”. It is the end-point to aim for with an epidemic or pandemic and it would be nonsense for anyone to suggest it as something that could be achieved at an early stage. [Appendix 7]

 

23rd March

The Prime Minister, in an address to the nation, said that the coronavirus was the biggest threat the country had faced for decades and announced a “complete lockdown” of the UK, banning people from leaving their homes or meeting in groups of more than two people. He said the public would not be allowed to leave their homes except for a few specific reasons: shopping for basic necessities, as infrequently as possible; one form of exercise a day – for example, a run, walk, or cycle – alone or with members of your household; any medical need, to provide care or to help a vulnerable person; and travelling to and from work, but only where this was absolutely necessary and could not be done from home. People could be fined £30 for meeting outside in groups of more than two.

To ensure compliance with the government’s instruction to stay home, he said the following would close: all shops selling non-essential goods, including clothing and electronic stores and other premises including libraries, playgrounds and outdoor gyms, and places of worship; in addition gatherings of more than two people in public – excluding people you live with – would stop; as would all social events, including weddings, baptisms and other ceremonies, but excluding funerals. Parks would remain open for exercise but gatherings would be dispersed.

“Without a huge national effort to halt the growth of this virus,” he continued, “there will come a moment when no health service in the world could possibly cope; because there won’t be enough ventilators, enough intensive care beds, enough doctors and nurses.”

Mr Johnson said the government would keep the restrictions under constant review: “We will look again in three weeks and relax them if the evidence shows we are able to.”

 

26th March

The PM’s chief political adviser, Dominic Cummings, in a clear breach of the guidelines, took his spouse, Mary Wakefield, who was feeling ill at the time, and son on a drive to his father’s property in Durham. Mr Johnson had said people must stay home for seven days if they believed they had symptoms of COVID-19 and if one member of a household had symptoms the whole family had to stay put at their primary residence for 14 days. On 30th March Downing Street said Mr Cummings was self-isolating and he was apparently ill for about 10 days. On 2nd April, the son was taken to hospital but released a day later. On 12th April Mr Cummings was seen at Barnard Castle, 30 miles from the Durham property; he said later that he had driven there to see if his eyesight was good enough to allow him to drive back to London. On 14th April he was seen back in London. Ministers claimed the law allowed him to make this trip, despite it being in breach of the guidelines and for which others had been fined. The PM defended his aide and, preposterously, said he had acted with integrity. Mr Cummings held a press conference in the garden at 10 Downing Street on 25th May in which he gave a rambling and rather unconvincing account of his actions. However, despite being the butt of many jokes over his eyesight-testing trip to Barnard Castle, he kept his post. The Times devoted its second leading article soon afterwards to declaring that Boris should not sack him because he needed him – probably the silliest leading article in the paper for many a day.

• At the Downing Street briefing on 26th May, Health Secretary Matt Hancock was asked by a clergyman whether people who had been fined for doing the same thing as Mr Cummings could have their fines refunded. Mr Hancock pledged to look into it. Said he, somewhat naively: “I will have to talk to my Treasury colleagues before I can answer it in full, and we’ll look at it. And if we can get your details, we’ll make sure that we write to you with a full answer and make an announcement from this podium. I think we can make this commitment.” He was quickly slapped down by Downing Street and no refunds were made; nor did that clergyman ever get to ask another question. The making of refunds would, of course, have amounted to an admission of Mr Cummings’ guilt.

• A survey later found that Mr Cummings’ action at the height of the lockdown “drastically undermined public trust in the government’s handling of the pandemic”. Analysis, conducted by University College London and published in The Lancet, found the actions of the aide reduced people’s willingness to follow social distancing rules. The research analysed 220,000 survey results from 40,000 participants in UCL’s COVID-19 Social Study between 24th April and 11th June. Respondents were asked how much confidence they had in the government’s handling of the pandemic. Among participants living in England, confidence dropped sharply between 21st and 25th May but there was no comparable drop in confidence in the leaders of Scotland and Wales at the same time. The research also found that adherence to lockdown, which was already starting to decline, dropped more rapidly in the following weeks, particularly in England.

 

27th March

It was revealed that Boris Johnson, Matt Hancock and Professor Chris Whitty had all tested positive for COVID-19 and all were self-isolating. Up to this point they had pointedly ignored their own advice on social distancing (standing shoulder-to-shoulder at the earlier press briefings) and physical contact. Downing Street insisted the advice on social distancing had been observed in Number 10 but some scientists were critical of the fact that the House of Commons had largely stayed open, enabling the virus to spread.

Professor Susan Michie, director of the Centre for Behaviour Change at University College London, said: “Whilst the PM was telling people to stay at home and keep at least two metres apart from each other, the House of Commons was open for business and face-to-face parliamentary activities were carrying on. Given the transmission routes of touching contaminated surfaces and breathing in virus-laden droplets, it should not come as a surprise to hear that the PM and Health Secretary have tested positive for coronavirus.”

She added: “There are many reasons why those in leadership positions, including in government, should practise what they preach.”

• On 17th June, Mr Hancock was seen in the House of Commons putting his arm on the shoulder of a fellow MP. He later apologised for breaking the social distancing and physical contact rules and said he had made a “human mistake”.

 

<< FEBRUARY  |  APRIL >>