On testing and tracing, the UK started the battle ahead of other countries, with a system enabling Public Health England to trace the first victims’ contact with the virus and thereby attempt to contain it, as planned in the first axis of the government's strategy. During February and until early March, nearly 4,000 people at risk of infection were warned, based on data collected from approximately 590 positive cases.
Despite the usefulness of the scheme, the testing capacity, which was restricted to eight Public Health England laboratories, was not increased and was quickly overloaded. Faced with this issue, on March 12, the government changed its approach to testing by deciding to abandon its strategy to track all symptomatic patients, choosing instead to restrict the use of tests to hospitals.
This change of strategy marked the transition to the second axis of the government's strategy: delaying the spread of the virus within the population by flattening the famous curve, without attempting to stop it.
This strategy wasn’t reviewed before April 2, when the testing capacity reached 10,000 tests per day, at which point the government decided to put testing back at the heart of its approach. The proposed plan aims to expand the number of testing centres beyond the eight Public Health England labs to the private sector and universities, to add serological tests on top of existing tests, and to ensure a capacity of 100,000 tests per day by May.
Unfortunately, the government was once more ill-prepared. Twenty million dollars’ worth of government-commissioned Chinese serological tests are found to be defective and by mid-April, the interim target of 25,000 tests per day is missed, with 18,200 tests delivered on April 22. While the target of 100,000 tests per day by the end of the month appears less and less achievable, other shortages persist, such as that of swabs needed to perform these tests.
The United Kingdom is currently running very late in the race for tests, with a total of 6.6 tests performed per 1,000 inhabitants on April 25, compared to 9.06 in France on April 21, and 25.11 in Germany on April 19.
End of lockdown: uncertain
With the imminent end of the UK's second lockdown period (on May 7), and while other European countries have announced their exit plans, the UK government has yet to discuss the end of its lockdown. Instead, it has indicated five criteria that will have to be met before the end of lockdown can be considered:
- ensure the NHS has sufficient capacity for intensive care and specialist treatment;
- record a "sustained and consistent fall" in daily death rates;
- observe a decline in infection rates to "manageable levels", well below 1;
- have sufficient testing kits and PPE to "meet demand"; and
- be certain that easing restrictions will not cause a second peak of infection that would overwhelm the NHS.
The first three criteria are moving in the right direction: the NHS has numerous beds available, the peak in the number of deaths was reached on April 8 and the R0 number, which measures the rate of infection, is estimated to be less than 1 since the beginning of April. However, the last two criteria are subject to more uncertainty. The NHS still faces a significant shortage of equipment, particularly gowns, and the provision of testing kits is behind schedule.
While it maintains its efforts to increase its testing capacity, the government is also developing a Bluetooth tracking application and aims to recruit 18,000 people to replicate on a large scale the efforts of the team of 290 people in charge of tracking at Public Health England.
As Boris Johnson resumed his duties on April 27 following his stay in intensive care, the UK's schedule with regard to the end of lockdown remains uncertain, with some predicting that it may not take place until late May.
While the United Kingdom appeared to be in a good position to deal with a national epidemic when the first case was detected at the end of January, the delay incurred by the government during February and early March in providing the necessary equipment, ventilators and testing kit, as well as in the implementation of restrictive measures to limit the spread of the virus, left the country in a poor position to control the accelerating death toll.
The UK’s lenient approach to this crisis highlights the importance of proactive management, both to secure medical equipment supply chains and to stop the spread of the virus.
Copyright: ISABEL INFANTES / AFP