Coronavirus: The U.K. Approach Explained

But Boris Johnson’s chief advisors, Chris Whitty and Patrick Vallance, supported by expert groups who meet regularly to consider the evidence, still think now is not the time to introduce deeper measures. There is no doubt such moves would slow the spread. But would the enormous socioeconomic impact be worth it at this stage? More importantly, the evidence from social scientists suggests people would soon tire of the imposition and start breaking the rules at a time when the outbreak is likely to be reaching its peak.

If such measures only work for a few weeks, they need to be implemented when they will have their biggest impact. If they worked for four weeks, and reduced the death rate by 20 percent, introducing them when you have 20 deaths per week will save 16 lives. The same measure introduced later in the epidemic, when there are 200 deaths per week, could save 160.

It’s not just the enormous social and economic impact which is holding the U.K. government back. One key question is, if such rules were introduced now, when would they be relaxed? They would not halt the spread of the virus completely, just slow it down. So, would Britons put up with major disruption for several months?

When a virus passes through most of the population, people acquire herd immunity. This means that enough people have been infected and developed an immune response so that there is nowhere left for the virus to go, and circulation stops. In theory, a prolonged lockdown, by slowing virus circulation, could mean a population never gets herd immunity, and so the lockdown has to continue indefinitely.

What Are Other Countries Doing?
Scandinavian countries have taken the opposite approach. Their case numbers are similar to the U.K.’s, and they have had few deaths, but they are introducing many of the lockdown regulations now. Ireland is also closing schools. Only time will tell which approach proves more successful. This comparison would be a fascinating social and medical experiment, were the situation not so grim.

The question around schools is informed by different evidence. While at first glance it seems obvious to close them, the data show that children are less likely to get infected with the coronavirus than adults, and less likely to get ill. So closing schools would not have a big impact on the epidemic overall, unless they were closed for several months. Many parents would have to stay home looking after the children, including the healthcare workers we need in hospital. Or children would be with grandparents, putting them at increased risk.

The U.K. strategy is to hold the drastic changes back until the epidemic is nearing its peak, when the changes will have maximum impact. With a respiratory virus which is so infectious, a large proportion of the population are going to get it sooner or later. Estimates range from 30 percent to 80 percent.

If 30 percent of the population get infected, and 5 percent of them are very unwell and need to be hospitalized, that is about a million people. If this all happens over just a couple of weeks, the NHS will struggle to cope. But if by social interventions, such as stopping mass meetings, closing workplaces, and reducing contact, this peak can be flattened and spread over several months, then the NHS will deal with it much better. If we can push this peak back to the summer, there will be less demand on the NHS anyway, and it also gives more time to develop treatments and vaccines.

Despite the U.K. government’s plans, many people and organizations are taking things into their own hands. We know the elderly and those with chronic illnesses are at increased risk, so it seems sensible for them to tuck themselves away as much as possible. It can only be a matter of weeks before my ageing mother cancels her bridge classes for her elderly neighbors.

The number of U.K. coronavirus patients will definitely increase. The number is doubling every few days. With fewer than 1,500 patients in the U.K., we are not quite at the point of introducing major social distancing. But it will not be long. And remember, although there will be fatalities, more than 99 percent of people recover completely.

Tom Solomon is Director of the National Institute for Health Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, and Professor of Neurology, Institute of Infection and Global Health, University of Liverpool. This article is published courtesy of The Conversation.