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A goal that will draw headlines to conduct 100,000 daily tests of Covid-19 by the end of April is unlikely to be achieved, and the government says only 52,429 were performed on Tuesday, two days before the deadline. Capacity is available for about 73,000, says Downing Street. Government sources argue, with some justification, that the target, compared to 10,000 a day earlier in the month, was always incredibly ambitious, and the fact that capacity has expanded so rapidly is a great achievement.
But, critics say, that only serves to illustrate the shortcomings of Britain’s testing regime in the first place.
“This is an unprecedented global pandemic and we have taken the right steps at the right time to combat it, guided by the best scientific advice,” a government spokesperson told CNN, in response to a request to address the criticism raised in this article. . Ministers and officials have been “working day and night to fight the coronavirus, delivering a strategy designed to protect our NHS and save lives,” the spokesperson said. “We have provided the NHS with all the support it needs, [and] made sure that everyone requiring treatment has received it. “
But could more have been done to prevent the scale of loss of life? Should ministers have acted earlier? And could there be more transparency in the overall strategy?
A crucial date
Historians may look back on March 12 as the most significant date in Britain’s coronavirus response. This was the day the UK formally abandoned the “containment” phase: an attempt to stop the virus on its way by tracing each outbreak and tracing its origins; and went into the “lag” phase, an effort to “flatten the curve” and prevent the health service from becoming overloaded.
As he spoke, tens of thousands of people gathered at Cheltenham Racecourse for their annual festival, one of the first elements of England’s social calendar. Was he wise, they asked him? “It is very important that science guides us,” Johnson said, using a phrase that would become a favorite of government ministers. “There is very little epidemiological or medical reason at the moment to ban such events.”
Johnson’s medical director, Professor Chris Whitty, admitted that even people with “really mild symptoms” could be contagious. Despite this, chief scientific adviser Patrick Vallance agreed with Johnson that canceling major events “was not an important way to tackle this epidemic.”
In fact, the next day, Vallance told the BBC Radio 4 flagship news program, in an now infamous interview, that a “key” goal would be “to develop some form of collective immunity so that more people are immune to this disease. and we reduce transmission. ” Government sources have told CNN that herd immunity was never an official policy.
Three key questions
Critics focus on three key areas as they seek to find out what went wrong in the UK.
First, there was an abandonment of mass testing.
At the start of the outbreak in the UK, public health officials tracked and tracked every known case. Ministers have never offered a clear reason why that policy was abandoned. Was it because the testing capacity had been reached? Was it because the system was unable to cope with the expected rebound in demand? Was it structural, as the public health system in England has gradually become centralized over the years?
“The abandonment tests gave the green light for the virus to spread uncontrollably,” says Gabriel Scally of the Royal Society of Medicine. “If you don’t have access to the tests, you won’t know you have an outbreak until many people are sick.”
Some members of the scientific community say an obsession with central control led officials to establish the testing regimen initially in a few laboratories, rather than allowing local hospitals to do it themselves.
“Unfortunately, it seems likely to me that once government models showed just how severe the crisis would be, our testing capacity would not be able to cope with the surge,” a leading microbiologist told CNN on condition of anonymity to describe confidential discussions. “God only knows what his thinking wasn’t telling hospitals to get ready. It was a mistake.” Downing Street declined to provide an official explanation to CNN on this matter.
The second crucial question is whether the government did not order a closure early enough.
Although the government did not know at that March 12 briefing how many people were infected, Whitty said it was still too early to close the door because “if people go too early, they become very fatigued.” If the harsh restrictions came too early, according to theory, the British public would begin to tire of it just as they began to take effect, and demands for them to be lifted would be impossible to resist.
Government sources defended that course of action before CNN, noting that some mitigation measures were implemented between March 12 and the total closure on March 23, such as advising vulnerable groups to stay in their homes and demanding that people with certain symptoms they are quarantined.
The third big question is the search for the so-called “collective immunity”.
“It is not possible to prevent everyone from understanding it,” Vallance said at the March 12 briefing. However, the experience of countries such as South Korea and Germany, where testing and monitoring systems have been significantly more stringent, and in New Zealand, where blocking measures were taken at a much earlier stage, suggest that it has been possible stop a fairly large process. number of people to get it.
Medical experts, both inside and outside the circle of trusted government advisers, have admitted to CNN that they believe the government waited too long to enter the shutdown. “Many of the government’s decisions ignore the basic science of public health,” says Dr. Bharat Pankhania, a clinical professor at the University of Exeter. “From abandoning the trail and the trail, to closing time, to providing the right protective gear, ignoring the basic science of public health may have led to more deaths than necessary.”
Pankhania believes that despite government claims that it has been guided by science at every step, the decision to delay the blockade is likely “governed by economic consideration, rather than by public health science.”
This conflict between the government’s claim that it has followed science from day one, and some in the scientific community’s skepticism about how good that evidence is, has become a key battleground between those inside and outside the UK government.
Following the science
This secrecy has led to speculation by prominent members of the public health community about the quality and breadth of evidence that is reaching the highest levels of government. “Government decisions show no characteristics of public health contributions. I would not be surprised if the public health voice was marginalized both within SAGE and in the government,” says Scally of the Royal Society of Medicine.
It is “driving the boys out of public health,” said another scientist who has contributed to the UK National Register of Risks, an overview of the potential threats the UK faces.
Another criticism of the process has been that the government has sometimes even circumvented normal groups of scientific advisers. “Things are moving so fast that they prefer to go directly to the modelers,” Openshaw said. “Epidemiological modelers have a very direct line with the government.”
As trivial as it may seem, disagreements between public health experts and scientific modelers are an important part of the story. “We are seeing a fight that has been going on for about 20 years between modelers and epidemiologists,” said a scientist who advises SAGE on CNN on condition of anonymity to discuss confidential government matters.
It is no secret that Dominic Cummings, Johnson’s top advisor, has a vested interest in scientific modeling. It comes as no surprise, therefore, that public health experts were furious when the government was forced to admit last week that Cummings had attended SAGE meetings, which are supposed to be independent advisory forums. The government said it attended to understand the scientific debate about the virus and its behavior.
Multiple SAGE members and advisory groups defended his impartiality on CNN. “The debate is strong, and everyone presents their case clearly and articulately,” said one member, requesting anonymity to discuss sensitive issues. “There are a lot of people criticizing from the sidelines, but I think those people may be angry that they have been left out.”
A source advising SAGE said: “Frankly, I find it difficult to see that Cummings’ presence makes much difference. We are not talking about reducing violets.”
However, the source continued to express concern over the way the scientific evidence is presented. “Science is not homogeneous … The best that SAGE can do is present imperfect material. The government has been able to take advantage of the public view of science as a voice of certainty, and present some of its decisions as being made more concretely. Certainty than they have. “
This has raised fears that at some point in the future, the government could try to hide behind the science for the decisions they have made, or worse yet, throw SAGE members under a convenient bus. “It certainly seems to be anxiety for some of my colleagues, but I am less concerned. Many politicians are not exceptional thinkers. If a public investigation is conducted, I would be surprised if scientists are doing a bad job doing their job.” case, “said a SAGE member.
Whats Next?
That public investigation seems inevitable, once the worst of the crisis has passed.
And when it comes down to it, the government will stick to its line that the decision to prioritize NHS protection was the right course of action, and that it was successful. While it is true that the NHS did not crash during what appears to be the worst weeks of the crisis, a cynic might claim that focusing on hospitals ignores what was happening in the broader community.
“People might well respond that it protected the NHS at the expense of moving deaths elsewhere. Not to mention the physical and mental suffering experienced across the country,” said one of the scientists who advised SAGE.
In the short term, the government is under pressure to tell the public how the blockade will end. It will not be simply a matter of facilitating social distancing measures.
Pankhania says the government should not be too influenced by economic pressures to regain normalcy. “It is important to note that the economy can be rebalanced, but lost lives cannot be bought back.” He emphasizes that even if the blockade is lifted, the government must be prepared to “close it again.”
Robert Dingwall, professor of social sciences at the University of Nottingham Trent and member of NERVTAG, says: “The biggest challenge for the government is the levels of fear and anxiety in the general population, which can make people reluctant to accept the release of the confinement “.
The history of the UK coronavirus has been dramatic, even by international standards. While Johnson was ill, legitimate questions were asked about his government’s handling of the pandemic with few satisfactory answers from those who intervened to fill his shoes.
Johnson’s inner circle hopes that his return to work will produce a renewed sense of energy and urgency. But many key irreversible decisions have already been made. When, how, and why will determine the next phase in this story, and how successful the Johnson administration was in facing the nation’s worst crisis in decades.
