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British Prime Minister Boris Johnson, 22 March 2020 @ Prime Minister’s Office, 10 Downing Street

“A National Scandal”: a timeline of the UK government’s response to the Coronavirus crisis

Ian Sinclair
Apr 28 · 104 min read

by Ian Sinclair and Rupert Read

Speaking on BBC Question Time on 26 March 2020, Richard Horton, the editor-in-chief of the Lancet medical journal, described the government’s response to the Coronavirus pandemic as “a national scandal”. A look through the key moments in the crisis explains why (timeline updated on 4 July 2020).

2010–20: “Several emergency planners and scientists said that the plans to protect the UK in a pandemic had once been a top priority and had been well-funded for a decade following the 9/11 terrorist attacks in 2001”, the recent expose in the Sunday Times reports. “But then austerity cuts struck. ‘We were the envy of the world,’ the source said, ‘but pandemic planning became a casualty of the austerity years when there were more pressing needs’” (Sunday Times). “It goes right back to 2010, when the government came in with a very clear policy to reduce public spending across the board, including the National Health Service”, Sir David King tells LBC Radio when asked about the UK’s response being slower than in other countries. “I’m afraid these austerity measures did lead to the cutting back on the risk management programmes”. Presenter Nick Ferrari asks whether “austerity measures cost lives”. Professor King replies: “Absolutely. That is what I’m saying” (Independent). “Bill Morgan, an adviser to then-health secretary Andrew Lansley, who sat in on many pandemic planning discussions in the UK’s 2010–15 coalition government, said: ‘I can’t recall anyone raising the possibility of a non-flu pandemic, and we need to understand why that was because our future contingency plans need to cover everything with pandemic potential’” (Financial Times). Commenting on the challenge of Covid-19 to the NHS, Dr Samantha Batt-Rawden, co-founder of the Doctors’ Association, says “we cannot ignore the state the NHS has been left in by this government. After years of short-staffing, our health service is much less equipped to deal with this pandemic while continuing to provide care for non-Covid-related illness or injury” (Guardian). After interviewing dozens of public health directors, politicians, experts in infectious disease control, government scientific and political advisers, NHS leaders and emergency planners, a Guardian investigation reveals that in the years leading up to the pandemic the “infrastructure that was once in place to respond to public health crises was fractured, and in some places demolished, by policies introduced by recent Conservative governments, with some changes going as far back as Labour’s years in power.” Approximately 32,000 overnight beds had been taken out of hospitals in England in just over a decade, including some lost under Labour. This number is roughly the same as the beds the NHS had to scramble to free up for Covid-19 patients, Allyson Pollock, Professor of Public Health at Newcastle University, notes. (Guardian)

October 2016: Exercise Cygnus, a three-day training on how to deal with a pandemic, is carried out, involving all major government departments, the NHS and local authorities. “It showed gaping holes in Britain’s Emergency Preparedness, Resilience and Response plan.” A report on the exercise has never been published, with a senior former government source with direct involvement saying the findings were deemed “too terrifying” to be revealed. “There was not enough personal protective equipment (PPE) for the nation’s doctors and nurses. The NHS was about to “fall over” due to a shortage of ventilators and critical care beds”, the Telegraph explains about the exercise. A senior academic directly involved in Exercise Cygnus and the current pandemic said: “These exercises are supposed to prepare government for something like this — but it appears they were aware of the problem but didn’t do much about it” (Sunday Telegraph). Publishing the report — which had been circulated within Whitehall — on 7 May 2020, the Guardian notes “it contained 26 key recommendations, including boosting the capacity of care homes and the numbers of staff available to work in them. It also warned of the challenge facing homes asked to take in patients from hospitals.” Martin Green, the chief executive of Care England, which represents the largest independent care home providers, commented: “It beggars belief. This is a report that made some really clear recommendations that haven’t been implemented. If they had put in place a response to every one, we would have been in a much better place at the start of this pandemic.” (Guardian)

June 2017: “The Department of Health rejected high-level medical advice about providing NHS staff with certain protective equipment during an influenza pandemic because stockpiling it would be too expensive”, the Guardian reports. “Documents show that officials working under former health secretary Jeremy Hunt told medical advisers three years ago to ‘reconsider’ a formal recommendation that eye protection should be provided to all healthcare professionals who have close contact with pandemic influenza patients. The expert advice was watered down after an ‘economic assessment’ found a medical recommendation about providing visors or safety glasses to all hospital, ambulance and social care staff who have close contact with pandemic influenza patients would ‘substantially increase’ the costs of stockpiling.” (Guardian)

14 September 2017: National Risk Register Of Civil Emergencies published by the Cabinet Office. The report notes “there is a high probability of a flu pandemic occurring” with “up to 50% of the UK population experiencing symptoms, potentially leading to between 20,000 and 750,000 fatalities and high levels of absence from work.” (Cabinet Office)

2018: The Association of Directors of Adult Social Services (Adass) warns the government, in a series of reports, about care homes’ exposure to a pandemic, the Guardian reports. “They called for better supply plans for personal protective equipment — warning that ‘demand for PPE could rapidly outstrip supply’ — plus improved infection control and a system to enlist volunteers to help services expected to be stretched to breaking point.” Adass comments: “We are not aware of whether government departments picked up on any of the recommendations set out.” (Guardian)

30 July 2018: UK biological security strategy published, addressing the threat of pandemics. It “was not properly implemented, according to a former government chief scientific advisor… Prof Sir Ian Boyd, who advised the environment department for seven years until last August and was involved in writing the strategy, said a lack of resources was to blame.” (Guardian)

2019: “Ministers were warned… the UK must have a robust plan to deal with a pandemic virus and its potentially catastrophic social and economic consequences in a confidential Cabinet Office briefing leaked to the Guardian.” The report’s recommendations included “the need to stockpile PPE (personal protective equipment), organise advanced purchase agreements for other essential kit, establish procedures for disease surveillance and contact tracing, and draw up plans to manage a surge in excess deaths.” (Guardian)

July 2019: “Boris Johnson scrapped a team of Cabinet ministers tasked with protecting the UK from a pandemic six months before coronavirus arrived”, the Daily Mail reveals. The group, officially known as the Threats, Hazards, Resilience and Contingency Committee, a sub-committee of the National Security Council and attended by senior ministers including Michael Gove, Matt Hancock and Gavin Williamson, was “disbanded without discussing virus control plans… as part of a vow to streamline Whitehall.” (Daily Mail)

January-February 2020: Boris Johnson misses five emergency Cobra meetings on coronavirus (Sunday Times). Responding to the story on 19 April on the BBC’s The Andrew Marr Show, senior government member Michael Gove says missing Cobra meetings is normal for a Prime Minister. The Guardian notes “Gove is correct in that prime ministers do not always, or even routinely, chair Cobra meetings. But it is common for them to do so during a major crisis.” (Guardian)

2 January 2020: “Chinese authorities have launched an investigation into a mysterious viral pneumonia which has infected dozens of people in the central city of Wuhan.” (BBC News)

Mid-January 2020: “From about mid-January onwards, it was absolutely obvious that this was serious, very serious”, notes John Edmunds, a professor of infectious disease modelling and a key adviser to the government. (Reuters)

17 January 2020: Writing for Byline Times, Nafeez Ahmed and Rupert Read reveal an official Government document published on 17 January confirms that, by delaying action in response to the Coronavirus, officials breached their own internal cross-government standards concerning risks to “human, animal or plant health”. According to the “internal guidance on assessing risks to health, the demand for scientific consensus or certainty sets the bar too high. In a situation where there is a potentially severe threat, the ‘precautionary principle’ indicates the need for a determination to act rapidly in taking far-reaching precautions against a threat.” (Byline Times)

21 January 2020: “China’s health ministry has confirmed human-to-human transmission of a mysterious Sars-like virus that has spread across the country and fuelled anxiety about the prospect of a major outbreak as millions begin travelling for lunar new year celebrations.” (Guardian)

23 January 2020: China implements a lockdown in Wuhan province, the centre of the outbreak. All transport into and out of the city is stopped (with no exceptions even for personal and medical emergencies), shops, schools and universities are closed, public transport halted, and private vehicles barred from the roads without special permission. (Guardian)

24 January 2020: A group of Chinese doctors and scientists publish an article in the Lancet medical journal titled ‘Clinical Features of Patients Infected With 2019 Novel Coronavirus in Wuhan, China’ (Lancet). According to Devi Sridhar, chair of global public health at the University of Edinburgh, the study showed “that a third of patients require admission to intensive care, and 29% get so bad that they need ventilation” (Guardian). “The risk to the public remains low” from coronavirus, Health Secretary Matt Hancock explains after the day’s Cobra meeting (Reuters). Professor Neil Ferguson, from Imperial College’s School of Public Health, submits a report to ministers and officials estimating infectivity at 2.6 and possibly as high as 3.5. “The Spanish flu had an estimated infectivity rate of between 2.0 and 3.0, so Ferguson’s finding was shocking.” Ferguson’s report also said “there needed to be a 60% cut in the transmission rate — which meant stopping contact between people. In layman’s terms it meant a lockdown”. (Sunday Times)

26 January 2020: Nassim Taleb and two colleagues publish a note with the New England Complex Systems Institute urging a robust precautionary response to the outbreak. “Policy- and decision-makers must act swiftly and avoid the fallacy that to have an appropriate respect for uncertainty in the face of possible irreversible catastrophe amounts to ‘paranoia,’ or the converse a belief that nothing can be done”, they conclude. (New England Complex Systems Institute)

30 January 2020: The World Health Organization (WHO) declares Coronavirus a “public health emergency of international concern” (Guardian). “That is the highest level of alert that WHO can issue, and it issued it on January 30. It made it very clear then — to every country in the world — that we were facing something very serious indeed”, says David Nabarro, Professor of Global Health at Imperial College, London, and an envoy for the WHO on Covid-19 (Guardian). The Government raises the threat level from low to moderate. (Sunday Times)

31 January 2020: Professor Joseph Wu, from the School of Public Health at the University of Hong Kong, co-authors an article in the Lancet medical journal about the Coronavirus outbreak in China. The authors note “Independent self-sustaining outbreaks in major cities globally could become inevitable because of substantial exportation of presymptomatic cases and in the absence of large-scale public health interventions. Preparedness plans and mitigation interventions should be readied for quick deployment globally” (Lancet). “British officials took part in four meetings where EU projects to bulk-buy medical kit were discussed — the earliest in January, according to official minutes … At this [31 January 2020] meeting, four EU member states said the virus could require increased stocks in Europe of personal protective equipment (PPE) such as gloves, masks and goggles, and the commission said it was ready to help if asked… the UK had decided not to participate in any of four EU procurement schemes to buy medical equipment in response to the coronavirus crisis” (Guardian). “By this time… scientists at the London School of Hygiene and Tropical Medicine had confirmed to [Chief Medical Officer Chris] Whitty in a private meeting of the Nervtag advisory committee on respiratory illness that the virus’s infectivity could be as bad as [Professor Neil] Ferguson’s worst estimate several days earlier [on 24 January]”. (Sunday Times)

End of January 2020: A senior politician tells the Sunday Times: “I had conversations with [Chief Medical Officer] Chris Whitty at the end of January and they were absolutely focused on herd immunity. The reason is that with flu, herd immunity is the right response if you haven’t got a vaccine.” (Sunday Times)

3 February 2020: Speaking in Greenwich, the Prime Minister says there is “a risk that new diseases such as coronavirus will trigger a panic and a desire for market segregation that go beyond what is medically rational to the point of doing real and unnecessary economic damage”. At this moment, “humanity needs some government somewhere that is willing at least to make the case powerfully for freedom of exchange, some country ready to take off its Clark Kent spectacles and leap into the phone booth and emerge with its cloak flowing as the supercharged champion, of the right of the populations of the earth to buy and sell freely among each other… I can tell you in all humility that the UK is ready for that role”, the Prime Minister says (Prime Minister’s Office, 10 Downing Street). “Papers published by the SAGE group of scientific experts… showed that its modelling group SPI-M-O suggested… that restricting travel from badly hit areas, including China, could delay the onset of the disease in the UK by up to a fortnight.” (Guardian)

6 February 2020: A businessman from Hove is identified as the source of the second UK outbreak. Public Health England failed to take advantage of our early breakthroughs with tests and lost early opportunities to step up production to the levels that would later be needed”, the Sunday Times reports. “This was in part because the government was planning for the virus using its blueprint for fighting the flu [rather than a coronavirus]. Once a flu pandemic has found its way into the population and there is no vaccine, then the virus is allowed to take its course until ‘herd immunity’ is acquired. Such a plan does not require mass testing.” (Sunday Times)

10 February 2020: The Scientific Pandemic Influenza Modelling committee (SPI-M) warns there is “a realistic probability that there is already sustained transmission in the UK, or that it will become established in the coming weeks.” (Times)

11 February 2020: Robert Peston, ITV News’s Political Editor, reports that he emailed colleagues telling them a senior government source had told him “we should know within a fortnight or so if we are looking at a pandemic in the UK…The risk is 60% of population getting it. With mortality rate of perhaps just over 1%, we are looking at not far off 500k deaths” (Robert Peston). Steve Oldfield, Chief Commercial Officer at the Department of Health and Social Care, writes a letter reassuring staff that the “NHS and wider health system are extremely well prepared for these types of outbreaks”. (Financial Times)

12 February 2020: “A report presented to the government’s Scientific Advisory Group for Emergencies (SAGE)… when the UK was still actively tracing contacts of those infected with Covid-19, recommended a 10-fold increase in Public Health England’s test-and-trace capacity in order to extend the number of cases that could be managed”, the Guardian reports. “Scaling this response up, using for example a call-centre type system to support the local PHE teams, should be possible and feasible,” the experts from Public Health England and the University of Cambridge recommended. The Guardian notes “this suggestion does not appear to have been pursued and contact tracing was abandoned in March. (Guardian)

13 February 2020: Between 13 February and 30 March the UK misses a total of eight conference calls or meetings about Coronavirus between EU heads of state or health ministers. (Reuters)

18 February 2020: Minutes from the day’s SAGE meetings note “Currently PHE [Public Health England] can cope with five new cases a week (requiring isolation of 800 contacts). Modelling suggests this capacity could be increased to 50 new cases a week (8,000 contact isolations) but this assumption needs to be stress tested with PHE” (SAGE). An NHS briefing for primary care workers obtained by the Financial Times says that PPE “should not be needed” when dealing with Covid-19 patients, who would be isolated as part of a strategy to contain the spread of the disease. The briefing added that there was a “large stock of face masks” and that “additional orders for PPE” had been placed with wholesalers. (Financial Times)

21 February 2020: A “key government committee, the new and emerging respiratory virus threats advisory group (NERVTAG), concluded on 21 February, three weeks after the World Health Organization had declared a public health emergency of international concern, that they had no objection to Public Health England’s ‘moderate’ risk assessment of the disease to the UK population”, Richard Horton, editor-in-chief of the Lancet journal, notes in the Guardian. “That was a genuinely fatal error of judgement” (Guardian). Minutes of the NERVTAG meeting suggest “that up to 1.3 million people could die in a ‘reasonable worst-case’ scenario from the COVID-19 pandemic — yet no lockdown was declared until three weeks later”, Nafeez Ahmed reveals. (Byline Times)

24 February 2020: At a press conference in Beijing the WHO-China Joint Mission on Covid-19 highlights how China “rolled out probably the most ambitious, and I would say, agile and aggressive disease containment effort in history” to fight the spread of Coronavirus (WHO). PHE National Infection Service issues guidance for coronavirus “suggesting it was not safe to discharge untested individuals to care homes from hospitals where there was an outbreak of 5–25 cases”, the Telegraph reveals. The guidance advises there should be “no discharges to care or residential homes”, adding “Patients who are not cases, do not have Covid-19 compatible symptoms and are medically fit for discharge could be discharged to own home with isolation/household quarantine” (Telegraph). Rupert Read sends a briefing to a senior member of the government, urging the adoption of the kind of strong precautionary measures laid out in Taleb et al’s 24 January note. The government response to Read is non-committal.

25 February 2020: Public Health England issue advice to care homes about the spread of coronavirus, noting “It remains very unlikely that people receiving care in a care home or the community will become infected.” The advice is later withdrawn (Mirror). The PHE advice also notes “there is currently no transmission of COVID-19 in the community”. (PHE)

26 February 2020: A memo from the government’s National Security Communications Team warns that in a worst-case-scenario half a million Britons could die from Coronavirus (Mirror). John Edmunds, one of the country’s top infectious disease modellers, and his team from the London School of Hygiene and Tropical Medicine, present their “latest ‘worst scenario’ predictions to the scientific pandemic influenza group on modelling (SPI-M) which directly advises the country’s scientific decision-makers on Sage”, the Sunday Times reports. “It warned that 27 million people could be infected and 220,000 intensive care beds would be needed if no action were taken to reduce infection rates. The predicted death toll was 380,000. Edmunds’s colleague Nick Davies, who led the research, says the report emphasised the urgent need for a lockdown almost four weeks before it was imposed” (Sunday Times). A paper — titled ‘Potential effect of non-pharmaceutical interventions (NPIs) on a Covid-19 epidemic in the UK’ — prepared for the Scientific Advisory Group for Emergencies (SAGE) highlights a strategy of shielding vulnerable groups from the virus: “The majority of the population would then develop immunity, hopefully preventing any second wave, while reducing pressure on the NHS. However, SPI-MO [Scientific Pandemic Influenza Group on Modelling — Operational sub-group] has not looked at the likely feasibility or effectiveness of such methods.” (SAGE)

Late February 2020: According to a Sunday Times report, at a private event Dominic Cummings, the Prime Minister’s Chief Advisor, outlined the government’s strategy at the time in a way that was summarised by someone present as “herd immunity, protect the economy, and if that means some pensioners die, too bad.” (Guardian)

29 February 2020: First recorded case of local transmission in the UK. (BBC News)

2 March 2020: The SPI-M committee, an official committee set up to model the spread of pandemic flu, publishes a report noting up to four-fifths of the population could be infected and one in a hundred might die — “that was a prediction of over 500,000 deaths in this nation of nearly 70 million” (Reuters). After chairing his first emergency COBRA meeting (the government’s emergency response committee) on Coronavirus, Prime Minister Boris Johnson says the country is “very, very well-prepared” (Sky News). “I wish to stress that, at the moment, it’s very important that people consider that they should, as far as possible, go about business as usual”, the Prime Minister says. (Sunday Times)

3 March 2020: “The government pursued its contain and delay strategy in the first two weeks of March despite strong warnings from its two main modelling teams that it could lead to a catastrophic number of people being killed”, the Sunday Times reports. “The teams from Imperial College London and the London School of Hygiene & Tropical Medicine concluded separately that if the mitigation measures under the delay strategy were followed, about 250,000 deaths could result. They delivered papers detailing those findings to a meeting of SAGE, the scientific advisory group for emergencies, on March 3 attended by government officials” (Sunday Times). The Government’s action plan is set out in a document from the Department of Health and Social Care that introduced its “contain, delay, research, mitigate” strategy. The document notes “if the disease becomes established in the UK … it may be that widespread exposure in the UK is inevitable” (Sunday Times). The SPI-B committee — the Scientific Pandemic Influenza Group on Behaviours — tells the Scientific Advisory Group for Emergencies (SAGE) “There was agreement that Government should advise against greetings such as shaking hands and hugging, given existing evidence about the importance of hand hygiene” (SPI-B committee). “Prime Minister Boris Johnson said… that coronavirus would not stop him greeting people with a handshake, adding that he had shaken the hands of everyone at a hospital where infected patients were being treated” (Reuters). “I was frankly horrified”, Professor Susan Michie, Director of the UCL Behaviour Change and member of SPI-B, told Channel 4 Dispatches. “It seemed very odd for somebody who is in a position of power and a position of influence to be stating something that is so much at odds with not only with common sense but also scientific evidence about transmission.” (Channel 4 Dispatches). The Prime Minister’s advice was: “We should all basically just go about our normal daily lives.” He also advised: “The best thing you can do is to wash your hands with soap and hot water while singing Happy Birthday twice” (Guardian). During the press conference the Prime Minister said “Our country remains extremely well prepared. We already have a fantastic NHS, fantastic testing systems and fantastic surveillance of the spread of disease.” However, “the upbeat tone of that briefing stood in sharp contrast with the growing unease of many of the government’s scientific advisers behind the scenes. They were already convinced that Britain was on the brink of a disastrous outbreak” (Reuters). The WHO Director-General announces “globally, about 3.4% of reported COVID-19 cases have died.” (WHO)

4 March 2020: “The government has been accused of withholding information about the spread of coronavirus after a 70% increase in confirmed cases prompted health officials to stop providing daily updates on the location of new infections.” (Guardian)

5 March 2020: The Prime Minister floats the idea of “herd immunity” on ITV’s This Morning, saying “one of the theories is, that perhaps you could take it on the chin, take it all in one go and allow the disease, as it were, to move through the population, without taking as many draconian measures” (This Morning). Minutes from the day’s meeting of SAGE note “SAGE agreed there is no evidence to suggest that banning very large gatherings would reduce transmission. Preventing all social interaction in public spaces, including restaurants and bars, would have an effect, but would be very difficult to implement” (SAGE). Professor Chris Whitty, the Chief Medical Officer, tells the Commons Health Committee “One of the things which is clear, if you model out the epidemic, is you will get 50% of all the cases over a three-week period and 95% of the cases over a nine-week period, if it follows the trajectory we think it’s likely to.” One scenario could involve a “huge number” of cases “overtopping the ability of the NHS realistically to put everybody in beds” (Guardian). The first official report of somebody dying in hospital having tested positive for Covid-19 caught in the UK came on 5 March. “Still, elderly and vulnerable people were not given any advice to shield themselves”, the Guardian reports. “A member of one SAGE advisory committee said that around this time there was a gap between the scientific advice and political messaging. ‘The prime minister was going around shaking people’s hands to demonstrate that there wasn’t a problem. There was a disconnect at that point. We were all slightly incredulous that that was happening’” (Guardian). Professor Chris Whitty, the chief medical adviser, said it’s “highly likely” the coronavirus is being transmitted in the community. (BBC News)

7 March 2020: The Prime Minister joins the 81,000-strong crowd that watched the England rugby team beat Wales at Twickenham, posting a video on Twitter of himself eagerly shaking hands with five female rugby players (Sunday Times). Rupert Read publishes a briefing setting out what a precautionary approach to the outbreak would look like, having sent it to a senior member of the government on 24 February. The briefing urges immediate implementation of measures such as shutting down of most air travel, treating cold and flu symptoms presumptively as Coronavirus symptoms and shutting down places where the old or medically-vulnerable are likely to exposed to the virus. (Rupert Read)

8 March 2020: “On Sunday, March 8, France banned public gatherings of more than 1,000 people but that same day thousands of French fans were allowed to mingle in the 67,000 crowd at Murrayfield, Edinburgh, for their [rugby] team’s game with Scotland.” (Sunday Times)

Early-mid March 2020: In the face of government inaction, large numbers of institutions, organisations and individuals across the UK move to cancel or postpone public events, or hold them remotely, including the Six Nations Championship and the Premier League. (Independent)

9 March 2020: “There is a risk if we go too early [with more measures to fight the virus] people will understandably get fatigued and it will be difficult to sustain this over time”, Chief Medical Officer Chris Whitty says, speaking at a Downing Street press conference. “There was talk of behavioral fatigue, as if we have only got, psychologically, a certain span when we will put up with these things and therefore there is no point putting them in place early… it was just plain wrong”, comments Stephen Reicher, Professor of Social Psychology at the University of St Andrews and member of SPI-B (Channel 4 Dispatches). A report from the government’s Scientific Advisory Group for Emergencies, SAGE, recommends, with no dissension recorded in its summary, that the UK reject a China-style lockdown. (Reuters). Helen Ward, Professor of Public Health at Imperial College London, notes the 9 March government report ‘Potential impact of behavioural and social interventions on an epidemic of Covid-19 in the UK’ “did not consider the impact of case-finding and contact-tracing, but it did suggest that the biggest impact on cases and deaths would come from social distancing and the protection of vulnerable groups. And yet social distancing was not recommended then.” The government waited seven days before recommending distancing on 16 March. “But there was still no enforcement, and it was left up to individuals and employers to decide what to do”, Ward notes. (Guardian)

10–13 March 2020: The government allows the Cheltenham Festival to take place, with over 60,000 people attending each day. Since then a number of racegoers have been diagnosed with Coronavirus (Guardian). The Cheltenham area ends up being one of the worst-affected parts of the whole UK with the coronavirus (Metro). “If you think of the best way to spread a virus, it would be bring 250,000 people together from around the country, get them crowding together to watch a horse race”, Sir David King, former Chief Scientific Adviser, tells BBC File On 4. He describes the decision to allow the festival to go ahead as “reckless” and “foolhardy”. (BBC File On 4)

10 March 2020: “The government was accused of playing roulette with the public by the editor-in-chief of the Lancet medical journal. Dr Richard Horton called for the ‘urgent implementation of social distancing and closure policies’” (Guardian). The minutes of the day’s SAGE meeting notes “SAGE advised that special policy consideration be given to care homes and various types of retirement communities.” (SAGE)

11–15 March 2020: The All-England Badminton Championships are held in Birmingham, attracting 300 players and more than 25,000 spectators from around the world, including China, Malaysia, Denmark, Taiwan, India and Indonesia. (BBC File On 4)

11 March 2020: WHO declares a Coronavirus pandemic. The government allows the UEFA Champions League football match between Liverpool and Atlético Madrid to go ahead at Anfield stadium in Liverpool. 54,000 people attend the game, including 3,000 fans from Spain. Spain closed its schools on 10 March 2020 (Guardian). NHS England says there are plans to increase Coronavirus testing to 10,000 a day (NHS England). Dr David Halpern, the Head of the Number 10 ‘Nudge Unit’, tells the BBC “There is going to be a point, assuming the epidemic flows and grows as we think it probably will do, where you’ll want to cocoon, you’ll want to protect those at-risk group so that they basically don’t catch the disease and by the time they come out of their cocooning herd immunity has been achieved in the rest of the population” (Guardian). “The [unpublished] modelling from Imperial College that underpinned the government’s belief that the nation could ride out the epidemic by letting the infection sweep through, creating ‘herd immunity’ on the way, was… troubling”, the Guardian’s Science Editor noted. “The model, based on 13-year-old code for a long-feared influenza pandemic, assumed that the demand for intensive care units would be the same for both infections. Data from China soon showed this to be dangerously wrong, but the model was only updated when more data poured out of Italy, where intensive care was swiftly overwhelmed and deaths shot up”. (Guardian)

12 March 2020: The Strategic Advisory Group of Experts meet to examine modelling from experts at Imperial College London and other institutions. “The results were shattering”, according to the Times. “A week earlier, councils had been warned to expect about 100,000 deaths from Covid-19. Now Chris Whitty, the chief medical officer, and Sir Patrick Vallance, the chief scientific adviser, realised the estimates were wrong.” The Times quotes a “senior figure”: “Unmitigated, the death number was 510,000… Mitigated we were told it was going to be 250,000” (Times). Addressing the “question of banning major public events such as sporting fixtures” the Prime Minister says “The scientific advice as we’ve said over the last couple of weeks is that banning such events will have little effect on the spread” (Prime Minister’s Office, 10 Downing Street). “The government moved the UK from the ‘containment’ phase into ‘delay’, accepting the inevitability of millions of infections”, the Guardian reports. The government announces it will “no longer try to ‘track and trace’ everyone suspected of having the virus. Instead, under plans outlined by the Prime Minister and his medical and scientific advisers, testing would be limited to patients in hospital with serious breathing problems” (Guardian). The WHO’s director-general makes his opening remarks at the mission briefing on Covid-19: “We are deeply concerned that some countries are not approaching this threat with the level of political commitment needed to control it. Let me be clear: describing this as a pandemic does not mean that countries should give up. The idea that countries should shift from containment to mitigation is wrong and dangerous” (WHO). “We think that the peak may be something like 10 to 14 weeks away — it could be a bit longer”, says Chief Scientific Adviser Sir Patrick Vallance (Reuters). “That evening, the former health secretary Jeremy Hunt spoke on the BBC, saying he was concerned Britain had become an ‘outlier’. Hunt says now he became worried that [Chief Medical Officer Chris] Whitty was too resigned to the virus spreading: ‘I couldn’t understand why they were so certain that nothing could be done to stop nearly 60% of our population becoming infected, when I had figures showing that even in Wuhan, the centre of the outbreak in China, less than 1% of the population actually became infected’” (Guardian). “I’m embarrassed by the situation in this country… We haven’t taken the action we should four or five weeks ago”, says Professor John Ashton, a former regional director of public health for north-west England, on BBC Question Time. “Boris Johnson should have convened Cobra at the outset when it became clear what was cooking up…. we have lost control here… for reasons that are totally obscure to me we have taken it as policy not to track the people who have come back from Italy, not to test the people who have come back from Italy. So the virus will now be amongst us” (BBC Question Time). The Guardian reports that as of 12 March “almost every country [in Europe] had deployed nationwide or regional school closures”. The UK’s schools remain open. (Guardian)

13 March 2020: “Mass gatherings are to be banned across the UK from next weekend, the government has announced after Boris Johnson’s cautious approach to the coronavirus outbreak was overtaken by care homes, sporting bodies and even the Queen taking matters into their own hands” (Guardian). The government’s chief science adviser, Sir Patrick Vallance, tells BBC Radio 4 Today programme that one of “the key things we need to do” is to “build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission” (Vox). Interviewing Sir Patrick on Sky News about the herd immunity strategy, presenter Stephen Dixon says “even looking at the best case scenario… 0.5–1 percent fatality in something like this, that’s an awful lot of people dying in this country” (Sky News). Professor Graham Medley, who leads the government’s disease modelling team, tells BBC Newsnight “We are going to have to generate what is called herd immunity… and the only way of developing that in the absence of a vaccine is for the majority of the population to become infected” (BBC Newsnight). “According to Italian health minister Pierpaolo Sileri the UK Prime Minister told his Italian counterpart Giuseppe Conte in a call on March 13 that he wanted herd immunity in the UK”, the Mirror reports, citing the 3 June 2020 Channel 4 Dispatches documentary (Mirror). “The health secretary dialed into a conference call for Group of Seven countries as governments across the world sought to coordinate their responses and share their experiences”, according to Bloomberg. “[Matt] Hancock asked the Italian representative if Italy was also working on a herd immunity plan” (Bloomberg). Minutes from the day’s meeting of SAGE note “SAGE was unanimous that measures seeking to completely suppress spread of Covid-19 will cause a second peak. SAGE advises that it is a near certainty that countries such as China, where heavy suppression is under way, will experience a second peak once measures are relaxed” (SAGE). The WHO’s director general says all possible action should be taken: “Not testing alone. Not contact tracing alone. Not quarantine alone. Not social distancing alone. Do it all” (Guardian). “Anthony Costello, a paediatrician and former World Health Organization director, said that the UK government was out of kilter with other countries in looking to herd immunity as the answer. It could conflict with WHO policy, he said in a series of Twitter posts, which is to contain the virus by tracking and tracing all cases” (Guardian). “At the start of the Covid-19 emergency, the UK imposed self-isolation on travellers from Hubei province in China, Iran, parts of South Korea and northern Italy”, the Financial Times reports. “That guidance was withdrawn on March 13.” (Financial Times). BBC News reports on a new study of more than 44,000 cases of Covid-19, based on data from the Chinese Centre for Disease Control and Prevention. The study puts “the overall death rate of the Covid-19 virus at 2.3%.” (BBC News)

14 March 2020: WHO spokeswoman, Margaret Harris, questions the UK government’s decision to follow a herd immunity response to the outbreak, telling BBC Radio 4’s Today programme: “We don’t know enough about the science of this virus, it hasn’t been in our population for long enough for us to know what it does in immunological terms” (Guardian). More than 200 scientists sign an open letter to the government urging them to introduce tougher measures to tackle the spread of Covid-19, noting the UK’s current approach will put the NHS under additional stress and “risk many more lives than necessary” (BBC News). Six senior health experts, including Richard Horton, the editor-in-chief of the Lancet, and Devi Shridhar, professor public health at the University of Edinburgh, publish a letter in the Times, noting there is “no clear indication that the UK’s response is being informed by experiences of other countries”. The letter urges the government to share the scientific evidence being used to inform policy, rather than acting on the basis of modelling that is being kept secret (Times). The British Society for Immunology publishes an open letter to the government with “significant questions” about the herd immunity plan: “this strategy only works to reduce serious disease if, when building that immunity, vulnerable individuals are protected from becoming ill, for example through social distancing… we don’t yet know if this novel virus will induce long-term immunity in those affected as other related viruses do not”. (British Society for Immunology)

15 March 2020: “When I first heard about this, I could not believe it… my colleagues here in the US… assumed that reports of the UK policy were satire”, notes William Hanage, a professor of the evolution and epidemiology of infectious disease at Harvard University, writing in the Guardian about the UK government’s herd immunity plan. “The UK should not be trying to create herd immunity, that will take care of itself. Policy should be directed at slowing the outbreak to a (more) manageable rate. What this looks like is strong social distancing… All this and more should have started weeks ago” (Guardian). Writing in the Sunday Telegraph, Health Secretary Matt Hancock states “Herd immunity is not a part of it [the government’s plan to deal with coronavirus]. That is a scientific concept, not a goal or a strategy. Our goal is to protect life from this virus, our strategy is to protect the most vulnerable and protect the NHS through contain, delay, research and mitigate.” (PoliticsHome)

Mid-March 2020: A Reuters investigation into the government’s response notes that “Interviews and records published so far suggest that the scientific committees that advised [Prime Minister] Johnson didn’t study, until mid-March, the option of the kind of stringent lockdown adopted early on in China” (Reuters). “According to several care home managers… in mid-March” the NHS made a decision “to transfer 15,000 patients out of hospitals and back into the community, including an unspecified number of patients to care homes”, Reuters reports. “These were not only patients from general wards. They included some who had tested positive for COVID-19, but were judged better cared for outside hospital.” (Reuters)

16 March 2020: The Imperial College team advising the government publishes a report that predicts “unconstrained, the virus could kill 510,000 people” and “even the government’s ‘mitigation’ approach could lead to 250,000 deaths and intensive care units being overwhelmed at least eight times over”, Reuters reports. “Imperial’s prediction of over half a million deaths was no different from the report by the government’s own pandemic modelling committee two weeks earlier” (Reuters). According to the Guardian, the report “indicated that, in effect, the virus had to be allowed to spread initially, so that over time people would become infected, recover, and attain immunity: ‘Introducing such interventions too early risks allowing transmission to return once they are lifted (if insufficient herd immunity has developed)’” (Guardian). The Prime Minister urges the public to avoid all unnecessary contact and travel and to not visit pubs and theatres, “following expert modelling which suggests the approach could cut the estimated coronavirus death toll from 260,000 to 20,000” (Guardian). “According to SAGE it looks as though we are now approaching the fast growth part of the upward curve, and without drastic action cases could double every five or six days”, the Prime Minister announces (BBC More Or Less). The Guardian reports on the government’s partial U-turn: “What changed was new data on the impact of Italy’s out-of-control epidemic on its health service. Basically, it is catastrophic, with 30% of hospitalised patients having to be admitted to intensive care” (Guardian). Channel 4 Dispatches notes “Professor [Neil] Ferguson and other scientific advisers had been issuing similar warnings for weeks.” Professor Graham Medley, a SAGE member and the chair of SPI-M, comments “We had been saying it on SAGE from the end of February. It was a public perception that something changed on the 16th [March], but nothing changed within SPI-M or within SAGE” (Channel 4 Dispatches). “We have a simple message for all countries: test, test, test. Test every suspected case” and “if they test positive, isolate them and find out who they have been in close contact with… and test those people too”, says the WHO Director General (BBC News). After speaking to some members of the SPI-M group, Dr Kit Yates, a Senior Lecturer in the Department of Mathematical Sciences and Co-Director of the Centre for Mathematical Biology at the University of Bath, tells the BBC’s More Or Less programme that in March 2020 SPI-M, and the SAGE group it fed into, underestimated the size and growth of the virus in the UK. The 16 March Imperial College model relied on “really early calculations” based on data from Wuhan to calculate the doubling time of the virus in the UK, which they estimated to be more than five days, Yates notes. However, the Imperial College model ignored data from the UK which showed the doubling time of the virus to be around three days. Yates continues: “Using only data available at the time… by the 14 March it should have been clear already that the doubling time was way shorter than the five day doubling period that was being used in the Imperial College model” (BBC More Or Less). “While the UK has carried out about 44,000 tests, South Korea had by Saturday tested more than 248,647 people — one in every 200 citizens — and Italy 86,011, including anyone who might have been exposed to the virus, as well as those with symptoms.” (Guardian)

17 March 2020: Sir Simon Stevens, the NHS Chief Executive, writes to every NHS Trust instructing them to “urgently discharge all hospital inpatients who are medically fit to leave” (NHS). As of 17 March the Guardian reports “only the UK and Belarus [in the whole of Europe] had held off implementing full or partial closures” of schools. The UK’s schools remain open (Guardian). An open letter organised by Rupert Read is published in the Daily Mail, co-signed by 26 people including former House of Commons Select Committee Chair Ian Gibson, George Monbiot, Chris Packham and Peter Tatchell, urging the government forthwith to institute quarantining policies, compel most firms to ensure workers work from home, introduce physical distancing policies, roll out mass testing and give sick pay to those on zero hours contracts. (Daily Mail)

18 March 2020: “Dr Tedros Adhanom Ghebreyesus, the WHO’s director general, has again called on every country to adopt its recommended strategy. The only way to slow the pandemic sufficiently to give time for treatments and a vaccine to become available is to test everyone who has symptoms and track and isolate their contacts, he said” (Guardian). “The UK’s best scientists have known since that first report from China that Covid-19 was a lethal illness. Yet they did too little, too late”, Richard Horton, editor-in-chief of the Lancet, writes in the Guardian. “Something has gone badly wrong in the way the UK has handled Covid-19… there was a collective failure among politicians and perhaps even government experts to recognise the signals that Chinese and Italian scientists were sending” (Guardian). The Prime Minister announces the ambition of carrying out 25,000 tests per day. 5,779 tests are carried out on 18 March (Guardian). The Department of Health and Social Care confirms the target of 25,000 tests a day, adding “the increased capacity is expected to be ready within 4 weeks.” (Full Fact)

19 March 2020: “The status of covid-19 was downgraded from level 4, the highest threat level, to level 3 by the four nations group on high consequence infectious diseases and the Advisory Committee on Dangerous Pathogens”, the British Medical Journal notes. “This enabled the required standard of personal protective equipment to be lowered for staff in hospitals and to nurse patients in non-infectious disease settings” (BMJ). “The NHS was ordered… to discharge 15,000 patients to free space for people with Covid-19”, the Times reported on 15 May. 95% were to be sent home, which meant 600 people going to care homes. “Providers said the number was higher and that they were put under pressure by the NHS to accept people at short notice. People were not tested before being moved” (Times). The PHE National Infection Service guidance on discharging patients from hospital is changed “so that hospitals no longer needed to avoid sending patients to care homes, a decision which was heavily criticised and which was reversed by the government later on in the epidemic.” (Telegraph)

20 March 2020: All schools are closed by the government (Guardian). The Prime Minister announces all cafes, pubs, bars, clubs, restaurants, gyms, leisure centres, nightclubs, theatres and cinemas must close tonight (Guardian). Deputy Chief Medical Officer Jenny Harries says “The country has a perfectly adequate supply of PPE [Personal Protective Equipment]” and that supply pressures had now been “completely resolved” (Pulse). A “critical incident” is declared at Northwick hospital in Harrow after the hospital runs out of intensive care beds because of a surge in coronavirus cases. (ITV News)

23 March 2020: The Prime Minister announces a national lockdown, with people ordered to stay at home, except for shopping for basic necessities, one form of exercise a day, medical need, to provide care or travelling to and from work if it is absolutely necessary (Guardian). Construction work is allowed to continue (INews), including the building of the HS2 rail line (Guardian). “The inclusion of ‘targeted herd immunity’ as a possible UK government response to the Covid-19 pandemic — in a list of possible interventions considered for analysis by a contractor — appears to contradict strong denials by the health secretary 10 days earlier that it was any part of government policy”, reports the Guardian. “A proposed computer simulation of the impact of ‘targeted herd immunity’ was contained in a planning document, used by NHSX [the NHS’s digital planning department] and a technology contractor to map out the data response to the pandemic, around 23 March. While it does not appear the herd immunity simulation took place, its inclusion in a list of possible interventions raises questions about the government’s stance on the policy.” (Guardian)

24 March 2020: BBC presenter Victoria Derbyshire speaks to the director of a UK company that makes protective equipment who said they’re exporting all over the world but haven’t had orders from the UK government. “We actually offered our services [to the UK government] when this first happened and unfortunately our services wasn’t taken up, but the rest of the world did take it up”, the director notes. (Stefan Simanowitz)

25 March 2020: BBC Newsnight interviews Andrew Raynor, CEO of a ventilator manufacturer. “You got in touch with the government as soon as they put out the call for help a few weeks ago. What happened then?”, asks presenter Emily Maitlis. “Nothing quite honestly”, the CEO replies (Stefan Simanowitz). The Prime Minister states “We are going up from 5,000 to 10,000 tests per day, to 25,000, hopefully very soon up to 250,000 per day.” 6,583 tests are carried out on 25 March 2020. (Guardian)

26 March 2020: Speaking about why the government has eased up on what initially seemed to be a concerted contact tracing and quarantining effort, Deputy Chief Medical Officer Jenny Harries tells reporters “There comes a point in a pandemic where that is not an appropriate intervention”, and that the testing focus would shift to patients and health workers (Financial Times). Responding to the WHO’s “message for all countries: test, test, test”, Harries says “We need to realise the clue for WHO is in its title. It is a world health organisation. And it is addressing all countries across the world with entirely different health infrastructures, and particularly public health infrastructures. We have an extremely well-developed public health system… the point there is they are addressing every country, including low and middle income countries” (BBC News). The National Care Forum writes to Matt Hancock and Boris Johnson warning that care homes were being pressured into taking patients discharged from hospital who had not been tested for the virus, even though they were exhibiting symptoms. (Telegraph)

29 March 2020: Rupert Read releases a video calling for a public inquiry into the government’s handling of the crisis. Within days the video had nearly half a million views; by June the video had over 600,000 views. (Rupert Read)

1 April 2020: Speaking from isolation in 11 Downing Street, the Prime Minister says “I want to say a special word about testing, because it is so important, and as I have said for weeks and weeks, this is the way through. This is how we will unlock the coronavirus puzzle. This is how we will defeat it in the end” (BBC News). Interviewed on ITV News Deputy Chief Medical Officer Jonathan Van Tam says that testing “is a bit of a side issue to be truthful with you” (ITV News). The government confirms that only 2,000 people out of 500,000 frontline NHS England workers had been tested for Coronavirus so far — 0.4%. 9,793 tests are carried out on 1 April 2020 (Guardian). According to the Sunday Times, Doris-Ann Williams, chief executive of the British In Vitro Diagnostics Association, which represents over 100 companies that make up most of the UK’s testing sector, said “her organisation did not receive a meaningful approach from the government asking for help until April 1 — the night before Hancock bowed to pressure and announced a belated and ambitious target of 100,000 tests a day by the end of this month” (Sunday Times). “The British Healthcare Trades Association was ready to help supply PPE in February — and throughout March — but it was only on April 1 that its offer of help was accepted”, the Sunday Times reveals. Dr Simon Festing, the organisation’s chief executive, said: “Orders undoubtedly went overseas instead of to the NHS because of the missed opportunities in the procurement process.” (Sunday Times)

2 April 2020: The Department of Health and Social Care, Public Health England and NHS England publish the guidance document ‘Admission and Care of Residents during COVID-19 Incident in a Care Home’, “intended for care homes, local health protection teams, local authorities, clinical commissioning groups and registered providers of accommodation for people who need personal or nursing care”. Noting the care sector “plays a vital role” accepting patients discharged from hospital and home settings, the briefing explains “ Some of these patients may have COVID-19, whether symptomatic or asymptomatic” before noting “All of these patients can be safely cared for in a care home if this guidance is followed.” The briefing also notes “Negative tests are not required prior to transfers / admissions into the care home” (Department of Health and Social Care, Care Quality Commission, Public Health England, and NHS England). The Department of Health and Social Care announces “family and friends should be advised not to visit care homes, except next of kin in exceptional situations such as end of life” (BBC News). “Dr Chaand Nagpaul, chair of council at the British Medical Association, said the doctors’ union had heard concerns from physicians in more than 30 hospital trusts about [Personal Protective Equipment] shortages… Reports have been rife of shortages and large variations in the level of PPE available. Pictures of healthcare workers who have created their own makeshift protective equipment out of bin bags and other materials have proved embarrassing for the government and NHS leaders. Staff have also improvised masks out of snorkels, bought kit from hardware stores, and used school science goggles to protect themselves” (Guardian). Admitting the government has made mistakes on testing, Health Secretary Matt Hancock announces the government is aiming to carry out 100,000 Coronavirus tests a day in England by the end of April (BBC News). “It is good to finally hear the explanation from the minister of health about the difficulties in scaling up testing. This is down to a lack of preparedness in advance of a pandemic, which then impacts upon the ability to greatly and rapidly increase a national response”, notes Michael Head, a senior research fellow in global health at University of Southampton. (Guardian)

3 April 2020: “Hospitals could be left without enough medical ventilators at the height of the UK coronavirus outbreak, with manufacturers struggling to build thousands of new machines in time for the likely mid-April peak in cases.” A source tells the Guardian that it was impossible to “produce into the peak… we should have started doing this weeks ago” (Guardian). In a joint press release from the British Medical Association, Royal College of Nursing (RCN), Unite and UNISON, RCN chief executive and general secretary Dame Donna Kinnair notes “Weeks into this crisis, it is completely unacceptable that nursing staff, wherever they work, have not been provided with PPE. I am hearing from nurses who are treating patients in Covid-19 wards without any protection at all. This cannot continue” (BMA). A BMA survey of its members finds “more than half of doctors working in high-risk environments said there were either shortages or no supply at all of adequate face masks, while 65% said they did not have access to eye protection” (BMA). Writing in the Guardian, Anthony Costello, a paediatrician and former World Health Organization director, notes the “The government and its advisers are now committed to their strategy of delaying the spread of coronavirus, which they hope will eventually lead to herd immunity” (Guardian). An Ipsos MORI poll finds 56% of respondents believe that the Government’s social distancing measures were taken too late, whilst only 4% of people felt that they were taken too soon. (Ipsos MORI)

5 April 2020: 13,069 tests are carried out in the UK (excluding Northern Ireland) on 5 April (Department of Health and Social Care). The UK has carried out 195,524 tests, in contrast to at least 918,000 completed a week earlier in Germany. (Reuters)

6 April 2020: “The government has been accused of missing an opportunity after it failed to deploy 5,000 contact tracing experts employed by councils to help limit the spread of coronavirus. Environmental health workers in local government have wide experience in contact tracing, a process used to prevent infections spreading and routinely carried out in outbreaks such as of norovirus, salmonella or legionnaires’ disease… PHE’s [Pubic Health England] contact tracing response team was boosted to just under 300 staff, deemed adequate for the containment phase of handling the Covid-19 virus up to mid-March… tracing was scaled back when the UK moved to the delay phase of tackling coronavirus in mid-March… in Germany, thousands of contact tracers are still working — with more being recruited”. (Guardian)

7 April 2020: “Lack of personal protective equipment continues to be a critical issue. It is heartbreaking to hear that some staff have been told to simply ‘hold their breath’ due to lack of masks”, says Dr Samantha Batt-Rawden, president of the Doctors’ Association UK (Guardian). “World-leading disease data analysts have projected that the UK will become the country worst hit by the coronavirus pandemic in Europe, accounting for more than 40% of total deaths across the continent. The Institute for Health Metrics and Evaluation in Seattle predicts 66,000 UK deaths from Covid-19 by August, with a peak of nearly 3,000 a day, based on a steep climb in daily deaths early in the outbreak” (Guardian). “Leaked recordings of a Home Office conference… reveal that the Government has all but given up in its fight against the Coronavirus and is intent on simply finding ‘a method of managing it within the population’. The recordings show Home Office Deputy Science Advisor Rupert Shute stating repeatedly that the Government believes ‘we will all get’ Covid-19 eventually. The call further implied that the Government now considers hundreds of thousands of deaths unavoidable over a long-term period consisting of multiple peaks of the disease.” (Byline Times)

8 April 2020: The UK reaches the highest number of recorded daily deaths from Coronavirus: 938 (Guardian). The government’s published figures are certainly an underestimate, as they exclude those dying at home and in care homes (Times), as well as the likely large increase in indirect deaths (“excess mortality”) resulting from a significant drop in the number of people attending A&E (Independent) and the unavailability of doctors, beds and vital treatment for those suffering from other conditions besides coronavirus (Guardian). The UK media coverage of the crisis however is dominated by none of this but rather by the Prime Minister’s own hospitalisation (ITV News). Three NHS nurses forced to wear bin bags due to a lack of PPE test positive for coronavirus. (Telegraph)

9 April 2020: “Hospitals across England are running out of the surgical gowns needed to treat patients with Covid-19 and do not know when fresh supplies will arrive, two secret NHS memos reveal”. The memos “contradict repeated assurances by ministers and NHS bosses that they are getting on top of the widespread shortages of PPE that have produced panic and fear among frontline staff” (Guardian). UNISON reports that “thousands of people working in the NHS, social care and local services have contacted a UNISON hotline in the last week expressing anxiety at the lack of gloves, masks, eye protectors and gowns where they work.” The union passes these testimonies onto the Health Secretary (UNISON). In a briefing to its members, the RCN notes it “is acutely aware that members have reported a lack of adequate personal protective equipment in all health and social care settings during the crisis.” (Royal College of Nursing)

10 April 2020: The UK reaches a new record high 980 recorded daily deaths from Coronavirus from those tested and dying in hospitals. This number is higher than any daily maximum recorded in Italy (or any other European country other than France, though France’s figures include deaths in care homes) during the entire pandemic to date, and places the UK’s per capita death rate from Coronavirus as one of the highest in the world (Statista). Most of the media coverage leads with Boris Johnson’s recovery after being in intensive care (ITV News), while the BBC website main headline is about the Government’s supposed “herculean” efforts to secure enough PPE for the NHS frontline staff who are becoming infected with Covid-19 in record numbers (Jack Seale). Health Secretary Matt Hancock urges NHS staff not to overuse Personal Protective Equipment: “We need everyone to treat PPE like the precious resource it is. Everyone should use the equipment they clinically need, in line with the guidelines: no more and no less” (Guardian). The BMA says PPE supplies in London and Yorkshire “are running at dangerously low levels” and “that some pieces of equipment are no longer available — forcing doctors into impossible situations, and ultimately, putting their lives at risk” (BMA). Following its 26 March letters to the Health Secretary and Prime Minister, “the National Care Forum writes again to the Government, urging once more for discharged patients to be tested or risk litigation over the ‘avoidable deaths’ of residents who subsequently became infected.” (Telegraph)

11 April 2020: A leaked letter from the Association of Directors of Adult Social Services (Adass) to the Department of Health and Social Care notes the handling of PPE for care workers has been “shambolic”, with delivery of equipment “paltry” and “haphazard” (BBC News). The Adass letter says “there is a risk that there are greater levels of deaths in social care and in the community than in hospitals” (Guardian). “A US institute that predicted deaths from Covid-19 in the UK would be the highest in Europe at 66,000 has revised down its forecasts as a result of new data. The Institute for Health Metrics and Evaluation, based at the University of Washington in Seattle, now predicts 37,494 deaths in the UK by 4 August, although it said the figure could be between 26,000 and 62,500. Despite the lower figure, it still predicts the UK will have the highest death toll in Europe.” (Guardian)

12 April 2020: “UK government stockpiles containing protective equipment for healthcare workers in the event of a pandemic fell in value by almost 40% over the past six years, the Guardian has found. Analysis of official financial data suggests £325m was wiped off the value of the Department of Health and Social Care emergency stockpile, reducing it from £831m in 2013 under the Conservative-led coalition government to £506m by March last year” (Guardian). A survey across the UK by the Royal College of Surgeons of England finds “a third of surgeons and trainees say they do not believe they have an adequate supply of PPE in their Trust, enabling them to do their jobs safely.” 57% say there have been shortages in the past 30 days. (Royal College of Surgeons)

13 April 2020: The New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG) warns that “particular caution should be exercised in Covid-19 patients discharged from hospital to nursing homes, homeless shelters, or other institutions where there are vulnerable individuals” (Guardian). The Alzheimer’s Society, Marie Curie, Age UK, Care England and Independent Age co-write an open letter to the Health Secretary: “We urgently need testing and protective equipment made available to care homes — as we’re seeing people in them being abandoned to the worst that coronavirus can do… A lack of protective equipment means staff are putting their own lives at risk while also carrying the virus to highly vulnerable groups” (Alzheimer’s Society). Robert Kilgour, owner of Renaissance Care which runs 15 care homes in Scotland, says “There are instances of ambulances taking residents to hospital and returning and coming straight back”, noting a “huge discouragement by the authorities to hospitalise, a wish to keep them where they are and look after them where they are” (Times). The Guardian reports “Britain missed three opportunities to be part of an EU scheme to bulk-buy masks, gowns and gloves and has been absent from key talks about future purchases, the Guardian can reveal, as pressure grows on ministers to protect NHS medics and care workers on the coronavirus frontline”. (Guardian)

14 April 2020: “Public Health England did not increase testing for Covid-19 as quickly as was needed to control the spread of the virus, the government’s chief scientific adviser has suggested. Sir Patrick Vallance’s comments echo those of Chris Whitty, England’s chief medical officer, who said a week ago that Germany ‘got ahead’ in testing people for Covid-19 and that the UK needed to learn from that” (Guardian). Interviewed on BBC Newsnight, Clare Wenham, Assistant Professor of Global Health Policy at the London School of Economics, says “I don’t know why the UK government haven’t been listening to the guidance coming out of the World Health Organization. [WHO Director-General] Dr Tedros was very clear that it was ‘test, ‘test, test’. And the countries we have seen getting out of this situation and the lockdown sooner than others, or in fact never going into a full lockdown, they have followed a very simple strategy of testing, isolating those who are infected, and then contact tracing who they have been in contact with” (BBC Newsnight). 15,994 tests are carried out in the UK (excluding Northern Ireland) on 14 April. (Department of Health and Social Care)

15 April 2020: “The Government published its adult social care action plan which announced that trusts would need to test every single patient prior to discharge back to their care home or new admission to a care home whether they had symptoms or not” (Telegraph). Health Secretary Matt Hancock tells the BBC Today programme 15% of care homes have two or more cases of coronavirus, noting “that is a robust figure that we have high confidence in” (Telegraph). Of those NHS staff who have downloaded the Doctors’ Association UK app to track the availability of PPE in the NHS, 38% report no eye protection, and only 52% report having a gown for high-risk procedures (Doctors’ Association UK). Dr Bharat Pankhania, a senior clinical lecturer at the University of Exeter medical school with field experience in the Sars and Ebola epidemics, is quoted in the Guardian about the possibility of lifting the lockdown. “Keep the shutdown until we know we can cope with patients”, he said. “Use the opportunity to scale up manufacture of PPE and ventilators. When you feel you have amassed your PPE, test kits, the army needed to do the tests and army of contact testers, that is when you lift the shutdown. But you only do that when you know the test numbers are in a sustained downward trajectory. In an emergency you can recruit many people and get them to help you under supervision…There is no indication we are preparing for that now” (Guardian). “The death toll among people being looked after in care homes in England has risen to 1,400, care leaders have said, as NHS England and the Care Quality Commission finally started rolling out testing of staff and residents.” Care home deaths are not included in the Government’s daily death figures (Guardian). Analysis of data released by the Office of National Statistics by statistician David Spiegelhalter suggests there has been a “massive rise” in “excess mortality” due directly or indirectly to Covid-19 (David Spiegelhalter), with very few Covid-19 deaths being registered outside hospital (David Spielelhalter).

16 April 2020: Speaking on the BBC Today programme Health Secretary Matt Hancock says “this core goal of making sure the NHS isn’t overwhelmed, which everybody was telling me a month ago was impossible to achieve, that has been achieved thus far” (BBC Today). Dr Rachel Clarke, a doctor specialising in palliative medicine, said the government responded to the threat to care homes “absolutely woefully inadequately, I’m afraid”, on BBC Question Time. “The point at which the government decided to change its testing policy [on 12 March] so that every possible case was being tested to one in which only cases in hospitals were being tested was the point at which residents of care homes and people receiving care in their own homes were thrown under a bus. They were being abandoned.” (BBC Question Time). The New York Times reports the UK government paid $20 million for coronavirus tests that didn’t work. “Within days of the deal, enthusiastic health officials back in London were promising that the new tests would vault Britain into the vanguard of international efforts to combat the virus”. However, after a laboratory at Oxford University found the tests to be inaccurate “half a million of the tests are now gathering dust in storage” while “another 1.5 million bought at a similar price from other sources have also gone unused” (New York Times). The Financial Times notes “The UK is setting itself apart from the rest of the world by maintaining loose border controls even as dozens of countries continue to clamp down on international travellers” to reduce the coronavirus outbreak. “The UK is an outlier,” say Professor Gabriel Scally, President of Epidemiology and Public Health at the Royal Society of Medicine. “It is very hard to understand why it persists in having this open borders policy. It is most peculiar.” 15,000 passengers are still arriving each day to UK airports, with no routine testing (Financial Times). Anthony Costello, a paediatrician and former World Health Organization director, describes the UK government as a “one-club golfer” for using only one strategy to deal with coronavirus — lockdown — when “it should be combined with testing, tracing and digital apps that have been used so successfully in South Korea.” He adds: “It is a total mess and we have been wrong every stage of the way. We have to change our policy and at the current moment I don’t hear anything to suggest we are. They keep talking about flattening the curve which implies they are seeking herd immunity, but what we should have done is crush the epidemic and then keep it down” (Telegraph). The government announces NHS patients being discharged into care homes would be first tested for Covid-19 — “by which time almost 1,000 homes in England had suffered outbreaks. The guidance still allows discharges pending test results”. (Guardian)

17 April 2020: “NHS bosses have asked doctors and nurses to work without protective full-length gowns when treating Covid-19 patients, as hospitals came within hours of running out of supplies”, the Guardian reports. “The guidance is a reversal of Public Health England guidelines stipulating that full-length waterproof surgical gowns, designed to stop coronavirus droplets getting into someone’s mouth or nose, should be worn for all high-risk hospital procedures” (Guardian). “Britain is to restart tracing the contacts of people who have had coronavirus symptoms, the health secretary has said, reverting to a policy recommended by the World Health Organization but abandoned by the UK [on 12 March] as the numbers of cases and deaths began to rise in early March” (Guardian). A Cabinet source is quoted in the Telegraph about exit plans from the lockdown: “They are waiting for the public to change their minds. We didn’t want to go down this route in the first place — public and media pressure pushed the lockdown, we went with the science” (Telegraph). “The Good Law Project says it has seen leaked hospital guidance telling doctors there was no need to write Covid-19 on death certificates and that it may be mentioned in another part of the form relating to indirect causes ‘should the doctor wish’”, the Times reports. The Good Law Project notes “If doctors are being discouraged from reporting deaths as Covid-19 we have no way of knowing if government figures on deaths from coronavirus — the daily in hospital figures as well as the weekly ONS figures — are accurate” (Times). “Operators said the infection rate in care homes was far higher than the 15 per cent acknowledge by the government [on 15 April]”, the Times reports. “Peter Calveley, chief executive of Barchester Healthcare, said that half its care homes had suspected or confirmed cases, while Jeremy Richardson, chief executive of Four Seasons, said around 60 per cent of its care homes had suspected cases. Methodist Homes has also said more than half its resident homes have confirmed or suspected cases” (Times). Health Secretary Matt Hancock announces the UK will restart tracing the contacts of people who have had coronavirus symptoms “reverting to a policy recommended by the World Health Organization but abandoned by the UK as the numbers of cases and deaths began to rise in early March” (Guardian). Of those hospitalised in the UK who tested positive for coronavirus, 15,464 have died. (Department of Health and Social Care)

18 April 2020: Data collated by Care England, the country’s largest representative body for care homes, suggests the number of care home residents who have died of suspected coronavirus may have reached 7,500 (Telegraph). Dr Alison Pittard, the dean of the Faculty of Intensive Care Medicine, the professional body for intensive care practitioners, “said her faculty had been warning for years about a shortage of intensive care capacity and intensive care nurses in hospitals. Normally each intensive care patient would have one intensive care nurse in attendance all the time, she said. Now there was one nurse to six patients, although other staff had been redeployed to intensive care units to plug the gaps and the new system was working because of heroic efforts” (Guardian). “There is no question that we were insufficiently prepared,” Paul Nurse, Nobel laureate and head of the Francis Crick Institute, tells the Guardian about the government’s response to the outbreak. “We had been warned a few years ago when reports made it clear that the UK was not ready to combat a major flu pandemic and we did not take up that warning. As a result, we were caught out.” (Guardian)

19 April 2020: Speaking at the daily government press conference the deputy chief medical officer Dr Jenny Harries says the UK “Has been an international exemplar in preparedness. So the fact that there is a pandemic stockpile is considered a very high quality mark of a prepared country in international terms” (Sky News). Richard Horton, the editor-in-chief of the Lancet medical journal, tweets in response: “When you see supposedly independent medical advisors to government tell what are manifest untruths to shore up a political regime whose credibility is rapidly collapsing, you have to say that those advisors have lost their integrity and our trust” (Richard Horton). “Data on patients with confirmed Covid-19 from the Intensive Care National Audit and Research Centre suggested ethnic minorities were overrepresented compared with the general population”, the Guardian reports. “Figures released on Friday showed that of 4,873 patients with Covid-19 in critical care, 1,681 were from the BAME community, accounting for 34.5% of cases” (Guardian). Deepti Gurdasani from the William Harvey Research Institute at Queen Mary, and Hisham Ziauddeen at the University of Cambridge, publish a paper highlighting how the government’s decision to stop mass testing and contact tracing on 12 March was based on erroneous modelling assumptions about the speed of receiving test results. (Deepti Gurdasani and Hisham Ziauddee)

20 April 2020: “Figures verified by Nursing Notes, a website representing nursing professionals, and shared with Byline Times reveal that 100 frontline health, care and related staff have now lost their lives during the pandemic. The list includes 19 medical professionals (such as doctors), 49 nursing and midwife staff, nine allied health professionals, nine social care staff, 13 ancillary staff and a student nurse volunteer” (Byline Times). “An NHS trust has been accused of ‘gagging’ its staff by asking them not to tweet about ‘political issues’ such as ‘PPE, testing and exit strategies’”, the Independent reports. “Acceptable tweets included praising staff for their hard work, volunteering to move departments, working over the weekend and keeping people safe” (Independent). “Senior intensive care consultants in London have told this programme they regard the original model of Nightingale [hospital] as unsafe because it ‘grossly underestimates the complexity of the disease’. They warn it could drain away resources from other hospitals at what is a most critical time”, the BBC World Tonight programme reveals. (BBC World Tonight)

21 April 2020: “Dozens of patients with Covid-19 have been turned away from the NHS Nightingale hospital in London because it has too few nurses to treat them”, the Guardian reveals. “The hospital has been unable to admit about 50 people with the disease and needing ‘life or death’ care since its first patient arrived at the site, in the ExCeL exhibition centre, in London’s Docklands, on 7 April. Thirty of these people were rejected because of a lack of staff” (Guardian). The Trades Union Congress calls for the government to set up a public inquiry into the “grotesque” failure to provide frontline workers with adequate Personal Protective Equipment (TUC). Joanna Cherry MP, the Scottish National Party’s Home Affairs spokesperson, writes to Home Secretary Priti Patel urging her to introduce screening for all travellers arriving at UK airports. Cherry had previously pressed Patel on this on 11 April (National). New figures published by the Office for National Statistics shows 13,121 of deaths in England and Wales up to 10 April involved COVID-19–41% more than the government’s official figure of 9,288 by 10 April. (Office for National Statistics)

22 April 2020: A Financial Times analysis of data from the Office for National Statistics suggests the coronavirus pandemic has already caused as many as 41,000 deaths in the UK — more than double the official figure of 17,337 released by the government, which only counts people who died in hospital and who tested positive for coronavirus (Financial Times). Writing in the Guardian, Devi Sridhar, professor public health at the University of Edinburgh, argues some “countries chose to treat” the coronavirus outbreak “like a bad flu strain that would be unstoppable and spread across the population until some kind of immunity was reached.” In the UK this was “the assumption until quite recently”, she notes (Guardian). “Some of the scientists advising the UK government on its handling of the coronavirus pandemic fear they will be used by ministers as ‘human shields’ at a future public inquiry, and they have privately discussed how to protect themselves from any attempted blame game, BuzzFeed News reports. “Members of the Scientific Advisory Group for Emergencies (SAGE), and other experts who advise them, have become nervous about senior ministers, including first secretary Dominic Raab and chancellor Rishi Sunak, deflecting criticism this week by saying they had been ‘guided by the scientific and medical advice’.” (BuzzFeed News)

23 April 2020: “Experts have voiced growing frustration over the UK government’s claim that it is ‘following the science’, saying the refrain is being used to abdicate responsibility for political decisions.”, the Guardian reports. “They also raised concerns that the views of public health experts were being overlooked, with disproportionate weight given to the views of modellers.” Professor Devi Sridhar, chair of global public health at the University of Edinburgh, “said the failure to fully consider the perspectives of experts beyond epidemiology may have contributed to misguided decisions” (Guardian). “Government pandemic planning should have focused more on the threat of a new respiratory virus rather than an influenza outbreak, Jeremy Hunt, the former health secretary, conceded”, the Times reports. “He said he regretted that Britain had not learned more from how countries in Asia had responded to the Sars virus in planning for a health emergency” (Times newspaper, 24 April). “The chief executive of Heathrow airport has called on the government to introduce mass health screening checks at airports following criticism of Britain’s loose border controls during the worst global pandemic for a century”, the Financial Times reports. “These could include measures such as temperature checks, antibody tests and a requirement to carry a health certificate. Downing Street rejected the call for checks at airports, saying the government’s position was ‘based on medical and scientific advice’” (Financial Times). Professor Azeem Majeed, head of public health at Imperial College London, is quoted in the Telegraph: “We need to use this lockdown to recruit large numbers of contact tracers, get them in post, get them working with local public health teams so we have a large scale programme in place as soon as possible. If for example you look at Wuhan in China, they recruited 9,000 contact tracers for 11 million people. That’s around 50,000 people for England. So we need to look at large volumes of contact tracers, not just a few hundred or a few thousand. We need tens of thousands, maybe even 100,000 people to do contact tracing.” (Telegraph)

24 April 2020: “The prime minister’s chief political adviser, Dominic Cummings, and a data scientist he worked with on the Vote Leave campaign for Brexit are on the secret scientific group [SAGE] advising the government on the coronavirus pandemic”, the Guardian reveals. Former Chief Scientific Advisor Sir David King notes political advisers were never on the equivalent committees of SAGE when he chaired them (Guardian). The government is not testing sick care home residents for coronavirus 10 days after Health Secretary Matt Hancock promised that anyone in residential care would be checked if symptomatic, the Guardian reports, citing a leaked email. “I’m convinced the loss of life in care homes could have been limited”, says Labour MP Peter Kyle. “They could have tested, got the right PPE, and stopped workers working between multiple homes. They put the NHS on battle stations but they left social care as business as usual … It has been criminal neglect” (Guardian). “Staff at care homes, GP surgeries and hospices will have to wait at least a month for government-supplied personal protective equipment, prompting criticism that they are being treated as second-class citizens. An online portal allowing primary and social care providers to order PPE, which had been due to start operating early this month, is now not expected to be in full operation for another five weeks”, the Times reveals. “A similar marketplace used by the French government was built in 48 hours and has been running for nearly a month” (Times). The Financial Times reports Chris Whitty, the Chief Medical Advisor, “made it clear the government’s 100,000 testing target had not been based on scientific advice, while endorsing the broader goal of an increase in testing.” (Financial Times)

26 April 2020: “The involvement of the prime minister’s chief political adviser, Dominic Cummings, in meetings of the scientific group advising the UK government’s response to the coronavirus has left other attendees shocked, concerned and worried for the impartiality of advice”, the Guardian reports. “One attendee of the Scientific Advisory Group for Emergencies (SAGE) said they felt Cummings’ interventions had sometimes inappropriately influenced what is supposed to be an impartial scientific process.” The Guardian notes “a second SAGE attendee said they were shocked when Cummings first began participating in SAGE discussions, in February” (Guardian). After reviewing all publicly available minutes of SAGE meetings over the last decade, the Guardian reports Downing Street political advisers have never before attended SAGE meetings (Guardian). The UK’s death toll could reach 100,000 if the lockdown is lifted too early, warns Imperial College’s Professor Neil Ferguson, who is a member of SAGE (Mirror). Out of 210 care home providers spoken to by the BBC, 159 said none of their workers had had a test. “The government said all symptomatic staff, residents and their families would be tested” (BBC News). Dominic Raab, the Foreign Secretary who has been standing in for the Prime Minister, said the Government was “on track” to hit the target of 100,000 daily tests by 30 April (Telegraph). “The opportunities presented by technology should be fully investigated, but seeking quick solutions in surveillance tools that rely on our personal data creates serious long-term threats to our rights and ways of life”, comments Clare Collier, the advocacy director at civil rights group Liberty, on government plans for a contact tracing app. “Contact-tracing technology will only work if 60% of people use it. But people will only use it if they trust their rights are being protected. For this approach to have any hope of helping us beat the virus, privacy safeguards must be hard-wired into the design from the outset.” (Guardian)

27 April 2020: The BBC Panorama programme ‘Has the Government failed the NHS?’ is broadcast. The investigation finds the Government “failed to buy crucial protective equipment to cope with a pandemic… there were no gowns, visors, swabs or body bags in the government’s pandemic stockpile when Covid-19 reached the UK.” Covid-19 was officially designated a High Consequence Infectious Disease (HCID) in January, the programme explains, a decision made in consultation with a group of British experts. On 13 March the Government downgraded its guidance on PPE and told NHS staff they were safe to wear less protective aprons and basic surgical masks in all but the most high risk circumstances. “Panorama understands that on the same day, the government took steps to remove Covid-19 from the list of HCIDs. But the experts who had recommended the coronavirus be put on the list in the first place were not consulted” (BBC News). A self-selecting survey undertaken by the Royal College of Physicians (RCP) of 2,129 hospital doctors found 27% said they could not get the protective kit they needed to keep them safe while treating patients with Covid-19, up from 22% who said the same when the RCP conducted the same survey at the beginning of April. “We’re living through the darkest times the NHS has ever faced… and it is truly terrible that supply has worsened over the past three weeks rather than improved”, said Professor Andrew Goddard, the college’s president (Guardian). Speaking outside Downing Street the Prime Minister says “this is the biggest single challenge this country has faced since the war and I no way minimise the continuing problems we face.” He adds “There will be many people looking now at our apparent success and beginning to wonder whether now is the time to go easy on those social distancing measures.” (Mirror)

28 April 2020: Asked on LBC radio why the recommendations of Exercise Cygnus in 2016 were not implemented, Health Secretary Matt Hancock says he checked with “his officials” and was assured “everything that was recommended was done” (LBC). Health Secretary Matt Hancock announces government policy is to test care home staff and residents only once unless the person subsequently develops symptoms. “The early weeks of the new testing regime were mired in ‘a complete system failure’, care operators complained”, the Guardian reports. “At one point we got the results after 24 hours, some we never get back and some we get back a week later. That’s not helpful when they come back positive. In that week they have been happily spreading the virus around”, said Anita Astle, the manager at Wren Hall nursing home in Nottinghamshire. (Guardian)

29 April 2020: Research from University College London and Data-Can, a health data research hub for cancer diagnosis and treatment in the UK, shows “Almost 18,000 more people with cancer in England could die after the coronavirus pandemic led hospitals to suspend treatment and deterred patients from seeking NHS care” (Guardian). Based on interviews with sources in or close to Downing Street, the Department of Health and Social Care, the Cabinet Office, Cobra and SAGE, as well as other advisers and experts, a Guardian investigation reveals “some experts believe Britain’s exceptional response arose in part because government preparations for a pandemic were so weighted to a flu outbreak.” Professor Graham Medley, a SAGE member and the chair of SPI-M, which stands for scientific pandemic influenza — modelling: “Everything — government preparedness, the modelling — was based on pandemic influenza. And that’s not because of lack of awareness on our part, that’s because that got the government attention and the funding. We could persuade them that flu was important” (Guardian). “Inquests into coronavirus deaths among NHS workers should avoid examining systemic failures in provision of personal protective equipment (PPE), coroners have been told, in a move described by Labour as ‘very worrying’”, the Guardian reports. “The chief coroner for England and Wales, Mark Lucraft QC, has issued guidance that ‘an inquest would not be a satisfactory means of deciding whether adequate general policies and arrangements were in place for provision of PPE to healthcare workers’” (Guardian). “26,097 people died across the United Kingdom after testing positive for COVID-19 as of April 28 at 1600 GMT, Public Health England said, citing daily figures that included deaths outside of hospital settings for the first time”, Reuters report. “That means the United Kingdom has suffered more COVID-19 deaths than France or Spain have reported, though less than Italy, which has Europe’s highest death toll and the second worst in the world after the United States” (Reuters). The Financial Times estimates the real UK death toll to be 47,100. (Chris Giles)

30 April 2020: Leading the Government’s daily press briefing, the Prime Minister says “We have so far succeeded in the first and most important task we set ourselves as a nation — to avoid the tragedy that engulfed other parts of the world” (Prime Minister’s Office, 10 Downing Street). Speaking on the BBC Today programme, Saffron Cordery, the Deputy Chief Executive of NHS Providers, the membership organisation for hospitals, the mental health community and ambulance services in England, calls the Government’s 100,000 testing target “a red herring” because “it is not actually meaningful in anyway.” She continues: “What it doesn’t show is who has been tested and to what end… What we need to do is focus on testing key groups of NHS staff, care worker staff, social care staff and key workers in a systematic way” (BBC Today). Speaking on BBC Question Time, Sir Paul Nurse, chief executive of the Francis Crick Institute and former director of the Royal Society, describes the Government’s 100,000 daily testing target as “a bit of a PR stunt which has gone a bit wrong… testing was absolutely critical. It hasn’t been handled properly” (BBC Question Time). “By the end of April, 6,500 care home residents in England were dead from Covid-19” (Guardian). An Ipsos MORI poll finds “there has been a significant rise in the number of people that think the Government acted too late in taking stricter measures, up 9 percentage points, from 57% to 66% in the last two weeks.” (Ipsos MORI)

1 May 2020: Heath Secretary Matt Hancock announces the Government has exceeded its goal of 100,000 tests a day by the end of April, with 122,347 tests carried out on 30 April (Matt Hancock). However, BBC Reality Check explains “this figure includes home testing kits which are counted when they are sent out — so it does not mean the test was actually completed or returned to a lab” (BBC Reality Check). In addition, the number of people tested on 30 April was 73,191, probably because some people are tested twice for clinical reasons (BBC Reality Check). The BBC’s Andrew Neil describes the Government announcement as “a propaganda figure rather than a reliable guide” (Andrew Neil). MHA care homes, which has 222 facilities in the UK, said the Prime Minister was being “at best disingenuous” when he told yesterday’s Downing Street press briefing the UK had come through the peak and there was sunlight ahead. Sam Monaghan, the chief executive of the network, said: “We are now 43 days in from lockdown, yet still our residents and staff have not received the enhanced level of protection that they need. The government will be held to account for this” (Guardian). The Office for National Statistics reports those living in the poorest parts of England and Wales were dying at twice the rate of those in the richest areas. (Guardian)

3 May 2020: A new poll from Opinium suggests there is a broad public opposition to lifting the lockdown, with 67% of respondents opposed to opening schools, 78% and 81% opposed to opening restaurants and pubs respectively, and 84% against allowing mass gatherings at sports events or concerts to resume. The poll also “shows the government struggling to hold on to public support over its handling of the coronavirus crisis”, the Observer notes. “The percentage of people who approve of its management of the crisis has fallen from 61% three weeks ago to 47% now, with the proportion of those who disapprove up from 22% to 34% (Observer). 48% of doctors have sourced their own personal protective equipment or relied on a donation when none was available through normal NHS channels, according to a survey by the British Medical Association of more than 16,000 doctors in England. (Guardian)

4 May 2020: The Guardian notes “Ministers face ongoing criticism over coronavirus testing, as the number of daily tests dropped below 80,000, care home staff reported difficulties in getting checked and home kits were delivered without return envelopes” (Guardian). Announcing the setting up of an independent Scientific Advisory Group for Emergencies group on the BBC Today programme, Sir David King, a former Chief Scientific Adviser, is asked to confirm if he thinks the government’s current science and medical advisers “are not free to speak their minds” in the daily press conferences and “when they answer… questions they are deferring to ministers”. King answers: “I believe that is the case, yes”. (BBC Today)

5 May 2020: Speaking to the Health Select Committee about testing, England’s deputy chief medical officer Jenny Harries admits “the UK’s decision to stop community testing and contact tracing for covid-19 in early March was partly driven by a lack of testing capacity”, according to the British Medical Journal. “The issue here is what capacity do we have to undertake testing and where should that be prioritised,” Harries says. “If we had unlimited capacity and the ongoing support beyond that then we would perhaps choose a slightly different approach” (BMJ). “Policies designed to prevent hospitals from being overwhelmed pushed a greater burden onto care homes”, a Reuters investigation reveals, after studying documents from government agencies and interviewing five leaders of local authorities and eight care home managers. “With hospitals given priority by the government, care homes struggled to get access to tests and protective equipment. The elderly were also put at potentially greater risk by measures to admit only the sickest for hospital treatment and to clear out as many non-acute patients as possible from wards” (Reuters). “The Government share with employers and unions its draft guidance on how to get employees back to work”, the Telegraph reports. The Trades Union Congress “cannot support” the current plans, general-secretary Frances O’Grady says. “The union accused ministers of failing to increase enforcement to prevent companies flouting the law. The Government’s guidance says that ‘employers should consider’ action such as enabling social distancing or providing handwashing facilities, but also states employers can decide to ignore the suggestions, according to the TUC” (Telegraph, 5 May). Speaking to the Health Select Committee, Chief Scientific Adviser Sir Patrick Vallance says the evidence available shows “the risk at one metre is about 10–30 times higher than the risk at two metres, so social distancing is an important part of this” (PoliticsHome). The Government reports the UK death toll is now 29,472, meaning the UK now has the highest number of coronavirus deaths in Europe, according to government figures. (BBC News)

6 May 2020: The Prime Minister and his senior ministers — Michael Gove, Rishi Sunak, Matt Hancock, Dominic Raab — meet to approve the plan to start lifting the lockdown. They approved “a less aggressive plan than many ministers had been calling for”, the Sunday Times reports. “They did so after being told that the real rate of new Covid-19 infections was 18,000 a day when the government target rate is 4,000 a day” (Sunday Times). “[Health Secretary] Matt Hancock’s claim to have triumphed in meeting his goal of 100,000 tests a day appears in serious doubt after the government failed for the fourth time in a row to hit the target they believe is crucial for exiting the lockdown”, the Guardian reports. Just 69,463 tests were carried out or posted to recipients on 5 May (Guardian). “The NHS’s contact-tracing app will fail unless sufficient numbers of Android phone users sign up, experts who have examined its trial use on the Isle of Wight have said”, the Guardian reports. This is because the NHS’s app “cannot use tools built by Apple and Google for the purposes of contact tracing.” (Guardian)

7 May 2020: Sir Ian Diamond, head of the Office for National Statistics, estimates there are at least three times as many new cases every day as recorded by official statistics, the Times reports. “He agreed with estimates that daily cases were running at about 20,000, while it is understood that cabinet has been told the figure is between 16,000 and 18,000” (Times). Sam Monaghan, chief executive of MHA, the UK’s largest charitable provider of care homes, tells the Guardian “Given the perilous state the social care sector continues to find itself in, easing restrictions, which will no doubt lead to greater spread of Covid-19 in the general population, will inevitably increase the risk of infection to our staff and our homes … without a comprehensive plan for the care sector, easing restrictions would be a reckless move” (Guardian). The Times reports “Patients being tested for Covid-19 are being told it will take up to ten days to get results because of delays in samples being processed” (Times). Richard Horton, editor-in-chief of the Lancet medical journal, tweets: “Dear Prime Minister — Please don’t dilute your policy of lockdown. Not yet. We have come so far. We need 3 more weeks” (Richard Horton). The House of Commons Joint Committee on Human Rights publishes a report on the government’s proposed contact tracing app “concluding that if effective, the app could pave the way out of the current lockdown restrictions and help prevent the spread of Coronavirus, but there are significant concerns regarding surveillance and the impact on other human rights which must be addressed first.” In addition “The Committee were also highly concerned that the app had not been subject to in-depth parliamentary scrutiny, as previous extensions of state powers of surveillance and data collection for terrorism prevention, had been in the past” (Joint Committee on Human Rights). The Financial Times estimates the real UK death toll to be 55,000. (Chris Giles)

8 May 2020: Professor John Edmunds of the London School of Hygiene and Tropical Medicine, who sits on the government’s Scientific Advisory Group for Emergencies, warns the present level of cases made it “probably impossible” to control the outbreak through contact tracing (Times). A YouGov poll finds 75% of respondents believe it would be wrong for the government to start loosening lockdown now, with 46% of respondents saying it would be right for the government to start loosening lockdown in three weeks. (YouGov)

9 May 2020: Home Office figures show that just 273 of about 18.1 million people arriving in the UK in the first three months of the year had to spend time in isolation (Guardian).“More people in this country now believe the UK has performed worse than Italy, Spain and France in the Covid-19 crisis than say it has done better than its European neighbours, according the latest Opinium poll”, the Observer reports. “It appears that the rise of the UK death toll above those of other nations has shifted public opinion about the effectiveness of the UK response” though “Overall more people still approve of the way the UK has handled the crisis (48% approve against 36% who disapprove)”. (Observer)

10 May 2020: In a televised address the Prime Minister announced an easing of the lockdown, urging people in jobs such as construction and manufacturing to return to work and giving permission for unlimited outdoor exercise, the i newspaper reports. “He raised the prospect of some primary school lessons resuming and shops beginning trading next month… The Government replaced it’s ‘stay at home’ instruction to the public with a plea to ‘stay alert’ to the dangers of the virus” (i). The Prime Minister announces the Government will soon be introducing a 14-day quarantine for travellers arriving at UK airports (Mirror). Scotland, Wales and Northern Ireland all reject the Prime Minister’s new “stay alert” slogan and said they will continue to stress the “stay at home” message of the lockdown (Financial Times). Britain could suffer more than 100,000 deaths by the end of the year if the government relaxes the lockdown too fast, a scientific adviser to the Government tells the Sunday Times. “Warnings about the potential death toll were sent to the government’s SAGE advisory committee early last week by researchers from the London School of Tropical Hygiene, Imperial College London and other centres. They modelled different lockdown exit policies… the source said more than one model had put the death toll in six figures in some scenarios” (Sunday Times). Speaking on Sophy Ridge on Sunday Dr Michael Veale, Lecturer in Digital Rights and Regulation at University College London said the UK was, in effect, the only country in the world to use self-reporting, rather than tests, to trigger contact tracing. “That appears to stem from, not a lack of number of tests potentially, but really something that hasn’t been focused on enough — the tests aren’t fast enough in the UK compared to other countries”, he explains. “And so the UK seems to claim it’s stuck using self-reporting because it can’t get a test turned around within a few hours” (Times). Interviewed on the BBC’s Andrew Marr Show, British statistician and Winton Professor of the Public Understanding of Risk in the Statistical Laboratory at the University of Cambridge Sir David Spiegelhalter describes the government’s daily press briefings as “completely embarrassing”. Noting the government has downplayed the number of deaths and exaggerated the number of tests, Sir David says “this is actually not trustworthy communication on statistics”. The general public is “feed what I call number theatre, which seems to be coordinated really much more by the Number 10 communications team rather than genuinely trying to inform people about what’s going on.” (BBC Andrew Marr Show)

11 May 2020: Writing in the Guardian David Hunter, Professor of Epidemiology and Medicine in the Nuffield Department of Population Health at the University of Oxford, argues “If we take the prime minister’s advice and return to work in large numbers now — and without the ability to test, trace and isolate — then virus spread will increase, there will be super-spreader events and local or regional lockdowns will have to be reconsidered” (Guardian). Speaking on BBC Newsnight, former Chief Scientific Adviser Sir David King says “I think it would be foolhardy to go back to work now… we should be considerably more cautious about undoing the lockdown” (BBC Newsnight). “A system of testing, tracing, and isolating is still not in place”, write KK Cheng, Professor of Public Health and Primary Care and Director at the Institute of Applied Health Research, University of Birmingham, and Wenjie Gong, Associate Professor at the Xiangya School of Public Health, Central South University, China, on the British Medical Journal blog. “Adequate provision of high quality PPE is not secure. Transmissions in care homes, hospitals, and households are far too high. Of course, the Government needs to balance health, wealth, and public acceptance of lockdown in making decisions. In this case, however, the health implications are so overwhelming that loosening the lockdown too much now will not do the economy and people’s livelihoods any good” (BMJ). Speaking in the House of Commons “former health secretary, Jeremy Hunt, has said lives could have been saved if the UK had ramped up coronavirus testing sooner, as he attacked ‘one of the biggest failures of scientific advice to ministers in our lifetimes’” (Independent). Speaking to Double Down News, Professor John Ashton, a former regional director of public health for north-west England, says “I don’t think herd immunity has ever gone away in all of this. It has been lurking in the background as a fall-back position for a failure to get to grips with this, to do the testing and control it.” (Double Down News)

12 May 2020: After raising the issue with the Prime Minister in the House of Commons, Conservative MP Kevin Hollinrake tells BuzzFeed News it is taking up to five days to get tests results turnaround in some settings, such as care homes, and even longer in other instances. Singapore provides patients with results in hours, while in South Korea patients are usually informed of their test result within a day. (BuzzFeed News)

13 May 2020: Downing Street stops publishing graphs which compare the UK coronavirus death toll to the total in other countries (Huffington Post). “International comparison charts were shown at the Downing Street daily briefing until England’s death rate from Covid-19 hit a trajectory set to take it above other European nations”, the Guardian reports on 17 May. “Ministers have said comparisons are not accurate because countries collect their data in different ways” (Guardian). During Prime Minister’s Questions, Labour Party leader Keir Starmer reads out testimony from a cardiologist: “We discharged known, suspected and unknown cases into care homes which were unprepared with no formal warning that patients were infected, no testing available and no PPE to prevent transmission. We actively seeded this into the very population that was most vulnerable” (carehome.co.uk). The Alzheimer’s Society warns the “lives of people with dementia continue to be put in danger” and calls for weekly testing of all care home staff and residents. A survey of 105 care homes finds over half of care homes can’t isolate residents, and 43% are still not confident of their PPE despite nearly a third taking Covid-19 positive patients from hospital (Alzheimer’s Society). “UK & US challenge is govt & scientists flying blind”, tweets Devi Sridhar, professor public health at the University of Edinburgh. “No good data on community transmission, no real-time surveillance in place, testing barely established. If data reveal few cases in certain part of country then much safer to open schools & resume activity. We just don’t know” (Devi Sridhar). “Central government excluded local partners from key intelligence and failed to share enough information, hampering the response to coronavirus”, the Municipal Journal, an online management journal for local authority business, reveals after receiving a leaked interim operational review. One contributor to the review by the C-19 national foresight group, a cross-government and partnership team created to support local resilience forums “described information sharing by central government as ‘woefully lacking’ while another said the process was ‘peppered with surprise announcements at various tiers of government, resulting in partners being on the back foot and having to plan/communicate live rather than prepare (and with stretched resources)’.” (Municipal Journal)

14 May 2020: Former Health Secretary Jeremy Hunt discusses testing on the BBC Today programme: “If you call up because you have got Covid symptoms, you really need test results back in 48 hours. Within that window, we need to contact everyone who you have been near in the last three or four days. That’s really got to happen very, very fast, otherwise there’s no point” (Times). “Is it safe currently to go on public transport? I don’t think so. Is it safe to open schools? I don’t think so”, Professor Devi Sridhar, chair of global public health at the University of Edinburgh, says on BBC Question Time about lifting the lockdown. “Because we don’t have in place the basic building blocks of surveillance to actually know who has the virus. And if the lockdown starts opening up now before we have the infrastructure in place, it’s basically pointless… what we are going to see is cases are going to go up… the virus is going to continue spreading and in a few weeks we are going to have this exact same debate again” (BBC Question Time). An Ipsos MORI poll finds “the majority of Britons (53%) think the Government should prioritise peoples’ health, with more restrictions on public events, workplaces and travel, compared to just 11% who think it should prioritise economic health by having less restrictions. Whilst three in ten say it should be both equally.” (Ipsos MORI). The government publishes new guidelines stipulating that staff and agency workers should work in only one care home ‘wherever possible’ (Guardian). “Sources close to Downing Street say the target for new daily infections is 5,000 before the lockdown can ease, but other more cautious voices in government are understood to be pushing for fewer than 4,000 new cases a day”, the Guardian reports. “There is scepticism within the government that the UK will have reached that figure before 1 June, the first possible date for easing the lockdown.” With the latest figures suggesting a “crude estimate” of 10,000 new cases each day, Paul Hunter, Professor in Medicine at the University of East Anglia, says the figures show that “we’re still some way off getting to a point where we can relax restrictions a lot”. (Guardian)

15 May 2020: During the daily government briefing, Health Secretary Matt Hancock says “Right from the start we’ve tried to throw a protective ring around our care homes. We set out our first advice in February… we’ve made sure care homes have the resources they need to control the spread of infection” (Sky News). Palliative care doctor Rachel Clarke tweeted in reply: “This is categorically untrue. Care homes were left without testing. Without contact tracing. Without PPE. Without support. You can deny it all you like, @MattHancock, but we were witnesses — we ARE witnesses — and believe me you will be held to account” (Rachel Clarke). The Health Secretary also announces “we’ll test every resident and every member of staff in our elderly care homes in England between now and early June” (BBC Reality Check). “A care home owner has told how he was forced to take in infected hospital patients, which led to seven of his residents dying of Covid-19”, the Telegraph reports. David Crabtree, who manages two care homes in Bradford commented: “The irony is that discharging without testing will put more people in more hospital beds — not empty them.” Nicola Richards, Director of Palms Row Health Care which operates three nursing homes in Sheffield, notes “We are aware that patients are being discharged without tests, or have been tested but the results are not available yet. This should have been thought about months ago” (Telegraph, 15 May). The British Medical Journal publishes an editorial: “the UK’s response so far has neither been well prepared nor remotely adequate”, it argues, noting the “reckless policy of discharging older patients from hospitals to care homes without testing allowed the virus to spread and kick start a second epidemic of community infection”. The editorial continues: “By the time the UK formally announced a lockdown with a huge package of economic support measures, almost two months of potential preparation and prevention time had been squandered. The delay in the face of emerging evidence that the Italian lockdown reduced viral transmission by about half looks likely to have cost many lives” (BMJ). “Only 1,500 of the 18,000 people the government wants to recruit as contact tracers have been appointed, a cabinet minister has admitted”, the Guardian reports. “The Northern Ireland secretary, Brandon Lewis, told Sky News… there had been 15,000 applications, but only 1,500 had been hired by the start of the week” (Guardian). According to Reuters, Dr Helen Carter, Public Health England’s deputy director in the Midlands, sends a memo to Birmingham councillors explaining “the government had initially ordered the agency not to share with local councils its surveillance reports containing data about notified cases from local hospital emergency rooms and general practitioners” (Reuters). The Financial Times estimates the real UK death toll is 61,200. (Chris Giles)

16 May 2020: The Observer reports a new poll “shows that approval for the government over its handling of the pandemic has plummeted by nine points in the last week… For the first time since Opinium began tracking views on the pandemic in March, more people disapprove of the government’s handling than approve.” (Observer)

17 May 2020: “Support for the government’s handling of coronavirus has dropped sharply since the prime minister’s address to the nation last weekend”, Sky News reports. “For the first time, more people think the government’s approach to the epidemic is going badly than is going well”, with 49% of people polled by YouGov saying the government was doing badly, and 47% that it was doing well (Sky News). In several hospitals up to a fifth of patients with Covid-19 contracted the disease on site after being admitted for another illness, the Guardian reports. “Senior doctors and hospital managers say that doctors, nurses and other staff have inadvertently passed on the virus to patients because they did not have adequate personal protective equipment (PPE) or could not get tested for the virus. (Guardian)

18 May 2020: Writing in the Guardian, Professor of Global Health at UCL and an ex-WHO director Anthony Costello, argues “the government’s decision [to abandon the community test, trace and isolate strategy on 12 March… led to the uncontained explosion of the Covid-19 epidemic” (Guardian). Speaking to the Telegraph, former Health Secretary Jeremy Hunt say “It is absolutely essential that test, track and trace is up and running before we start sending people back to school, so time is very tight.” Hunt added the UK needed to be performing 500,000 tests a week to meet the demands of a national test-and-trace programme (Telegraph, 18 May). “Temporary care workers transmitted Covid-19 between care homes as cases surged, according to an unpublished government study which used genome tracking to investigate outbreaks”, the Guardian reveals. “In evidence that raises further questions about ministers’ claims to have ‘thrown a protective ring around care homes’, it emerged that agency workers — often employed on zero-hours contracts — unwittingly spread the infection as the pandemic grew, according to the study by Public Health England (PHE).” (Guardian)

19 May 2020: The Deputy Chief Scientific Adviser acknowledges the Government’s decision to abandon its initial coronavirus test and trace policy was influenced by a lack of available tests, PoliticsHome reports. Professor Dame Angela McLean said “The advice that we gave certainly took account of what testing was available. It was the best thing to do with the tests that we had. Asked if the advice given was based on the capacity at the time, Dame Angela says “I think that’s what I just said, yes” (PoliticsHome). “The government’s ability to test people for coronavirus has been ‘inadequate’ throughout the pandemic, a committee of MPs has said”, BBC News reports. The Science and Technology Committee said capacity had not been increased “early or boldly enough” and that a lack of capacity had driven initial decisions in mid-March to reduce contact tracing and largely restrict tests to hospital patients. In a letter to the Prime Minister Committee chairman Greg Clark, a Conservative Party MP, said capacity “drove strategy, rather than strategy driving capacity” (BBC News). “The first national review to capture the UK’s response to coronavirus has… warned that failing to seek an extension [to Brexit] threatened to ‘compound COVID-19 with a second UK societal-wide, economic and social, chronic threat’”, the Municipal Journal reports. Contributors to the leaked report by the C-19 National Foresight Group, a cross-government team supporting local resilience forums, said preparations for a no-deal Brexit threatened to ‘overwhelm’ and ‘burnout’ local disaster planning capacity. (Municipal Journal)

20 May 2020: “We have growing confidence that we will have a test, track and trace operation that will be world-beating and yes, it will be in place by June 1”, the Prime Minister says during Prime Minister’s Questions in the House of Commons (BBC News). “Boris Johnson should resist calls to ease the lockdown including reopening schools until a new system to trace the spread of coronavirus is a proven success, according to two members of the government’s scientific advisory council”, Sky News reports. Professor John Edmunds, dean of the faculty of epidemiology and population health at the London School of Hygiene and Tropical Medicine and a member of SAGE, said a “well functioning track and trace system” was needed before lifting lockdown further. “Without that, we would return to a situation where the epidemic is increasing”, he noted (Sky News). “A programme to train thousands of contact-tracers to help control the spread of coronavirus has been described as shambolic and inadequate by recruits”, the Guardian reveals. People hired “have reported spending days just trying to log into the online system, and virtual training sessions have “left participants unclear about their roles”. When “someone taking part in a training session… asked for guidance on how to speak with somebody whose loved one had died of coronavirus, they were reportedly told to look at YouTube videos on the topic” (Guardian). “Fully reopening schools without substantial improvements in the performance of the test-and-trace system could risk a new surge in cases of Covid-19, according to calculations by the government’s scientific advisers”, the Guardian reports. “A report presented to the Scientific Advisory Group for Emergencies (SAGE) on 20 May, at a time when the government was weighing up the impact of school reopening in England, indicated little leeway for increasing school attendance and relaxing other physical distancing measures without a test-and-trace system that reaches 80% of contacts within 48 hours.” (Guardian)

21 May 2020: “Tens of thousands of Covid-19 tests have been double-counted in the Government’s official tally, public health officials have admitted”, the Telegraph reports. “Diagnostic tests which involve taking saliva and nasal samples from the same patient are being counted as two tests, not one. This inflates the daily reported diagnostic test numbers by over 20 per cent” (Telegraph). “Sars-CoV-2 causes mild disease in most cases, and gives rise to antibody responses in nearly all cases”, Rupert Beale, clinician scientist group leader at the Francis Crick Institute, notes in the London Review of Books. “We don’t know how long these responses will last, but it is likely that people who suffer only mild disease will be susceptible to reinfection after a few months or years. Humanity has never developed ‘herd immunity’ to any coronavirus, and it’s unlikely that Sars-CoV-2 infection will be any different.” (London Review of Books)

22 May 2020: Around 30,000 deaths could have been prevented if the government had put the UK into lockdown just a week earlier, according to modelling by British scientist James Annan from Blue Skies Research. The death toll would be around the 8,000 mark — similar to Germany — and would likely have been shorter and caused less damage to the economy. “This is all quite simple maths that every single modeller involved in SAGE was fully aware of at the time”, Annan notes (Mirror). Sir Ian Boyd, a professor of biology at St Andrews University and member of the government’s SAGE committee, tells the BBC Coronavirus Newscast he “would have loved to have seen” the government “acting a week or two weeks earlier and it would have made quite a big difference to the steepness of the curve of infection and therefore the death rate” (BBC News). The ‘Independent SAGE’ committee, which is separate from the government’s official advisers and is chaired by the former chief scientist Sir David King, warns that 1 June is too early to reopen schools. “It is clear from the evidence we have collected that 1 June is simply too early to go back”, Sir David says. “By going ahead with this dangerous decision, the government is further risking the health of our communities and the likelihood of a second spike” (Guardian). The Guardian reports Patrick Vallance, the government’s chief scientific adviser, says SAGE has “been very clear that an effective ‘test, track and trace’ mechanism was necessary in the event of schools reopening, and the sooner in place the better in order to make changes to England’s lockdown” (Guardian). “The UK’s contract tracing plan has two more fundamental flaws that threaten to undermine its effectiveness”, Wired reports. “The app is unusual in that it does not send alerts based on confirmed cases of coronavirus. Instead, in its current iteration, it asks users to report whether they have coronavirus symptoms and if they do, an alert may be sent to other app users with whom they have been in contact.” This approach makes the UK an outlier compared to other countries, with proposed or active contact tracing apps in Germany, Australia, Austria, France, Iceland and Singapore all relying on testing, rather than symptoms. Second, an effective app requires testing to be done quickly, and currently it is “impossible to say whether the UK is testing people quickly enough to support an effective contact tracing system” (Wired). Home Secretary Priti Patel announces that from 8 June almost everyone arriving at ports and airports, including British citizens, will have to quarantine themselves for a fortnight (Guardian). Commenting on 9 May, Gary McLean, professor in molecular immunology at London Metropolitan University, said: “This initiative to require all UK visitors to enter a 14-day quarantine is really what should have been done two months ago, and should also remain in place for at least another two months from when it is finally implemented” (Yahoo! News). The Financial Times estimates the number of UK excess deaths linked to coronavirus is 63,600. (Chris Giles)

24 May 2020: Responding to the Prime Minister’s defence of his adviser Dominic Cummings after reports he ignored the lockdown, Stephen Reicher, Professor of Social Psychology at the University of St Andrews, tweets: “As one of those involved in SPI-B, the Government advisory group on behavioural science, I can say that in a few short minutes tonight, Boris Johnson has trashed all the advice we have given on how to build trust and secure adherence to the measures necessary to control COVID-19” (Stephen Reicher). Two other members of SPI-B committee — Robert West, Professor Of Health Psychology at UCL, and Susan Michie, Professor of Health Psychology and Director of Centre for Behaviour Change at UCL — tweet in agreement (Robert West and Susan Michie). Anthony Costello, professor of global health and sustainable development at UCL and a former director at the WHO, tweets: “The huge problem for PM Johnson is that he has driven a cart and horses through any contact tracing programme. Why will contacts contacted by SERCO call centres self-isolate for 14 days rather than ‘follow their instincts’?” (Anthony Costello). The Insight team at the Sunday Times publish their latest investigation: “According to the data, no other large European country allowed infections to rocket to such a high level before finally going into lockdown. Those 20 days of government delay are the single most important reason why the UK has the second highest number of deaths from the coronavirus in the world.” Back-dated modelling done by Imperial College and Oxford University estimates there were around 14,000 people infected in the UK on 3 March. By the time lockdown was announced on 23 March this had soared to 1.5 million infected people. (Sunday Times)

25 May 2020: “They [the government] are treating the whole health crisis as though it were a political crisis. If it’s a political crisis, what you do is try to manage your reputation. If it’s a health crisis you focus on saving lives, at whatever cost to your political reputation”, Robert West, professor of health psychology at UCL’s Institute of Epidemiology and Health, who sits on the advisory group on behavioural science for SAGE, tells the Guardian. “The worry is that the government has said from the beginning it is following the science, and that was never true.” (Guardian)

26 May 2020: King’s College London and Ipsos MORI publish the results of a poll taken from 20–22 May. “54% think the government is relaxing the lockdown measures too quickly, twice as many as the 27% who think they are being eased at about the right pace”, while 68% said the government acted too slowly to control the spread of coronavirus, up 6 points from 62% from a 1–3 April poll. (Kings College London)

28 May 2020: Up to six friends or relatives will be able to meet in parks and gardens from Monday, two metres apart, the Prime Minister announces. Dentists will be able to reopen from 8 June, and it was confirmed that schools can go ahead with plans to reopen next week. The Prime Minister also confirmed that outdoor retail, such as markets and car showrooms, will be allowed to open from Monday, and all other shops a fortnight later (Guardian). “The number of people with Covid-19 has remained stable for the third week in a row, according to the Office for National Statistics, with an estimated 133,000 people infected in England in the last two weeks”, the Guardian reports. “The findings raise questions about whether community transmission rates are low enough to avoid a second surge in infections as lockdown measures start to be lifted.” The study found that just one in 15 (6.8%) of those tested carried antibodies for Covid-19, suggesting the vast majority of people in England have not been infected and are not immune (Guardian). “The government’s target of hitting 200,000 Covid-19 daily tests by Monday has been described as ‘meaningless’ by senior scientists, who say that the published data on testing does not adhere to the basic rules of statistics”, the Guardian reports. Experts said “the published daily testing figures appeared ‘almost designed to confuse’ and made it impossible to judge whether current levels of testing are adequate to support the track, trace and isolate programme that is said to be essential for easing lockdown. Concerns included the failure, for the past five days, to release data on how many people have been tested, the reported double-counting of multiple swabs (nose and saliva) from the same individuals, and the inclusion of tests that have been mailed out to homes and satellite labs, but not returned, in the daily tally.” Former Chief Scientific Adviser Sir David King comments “We’re opening up from the lockdown without having the test, track and trace process fully operative…We’re much more likely to go into a second peak in the outbreak unless we have test, trace, isolate fully in place” (Guardian). The coronavirus test and trace system will not be fully operational until the end of June, Baroness Dido Harding, the head of the programme, is said to have told MPs, according to ITV News. “The Government launched its tracing system in England on Thursday with the help of the newly hired 25,000 contact tracers, however the accompanying app to go with the programme has been delayed by several weeks” (ITV News). The UK has suffered the second-highest rate of deaths from the coronavirus pandemic after Spain, according to per capita excess mortality figures (Financial Times). According to the Financial Times a cautious estimate of the number of UK excess deaths linked to coronavirus is 64,000. (Chris Giles)

29 May 2020: “Lockdown restrictions are being lifted in England before experts are ready to cut the threat level from coronavirus from ‘high’, No 10 has admitted”, the Independent reveals. “Boris Johnson had been expected to lower the alert level from 4 to 3 when he gave the go-ahead for groups of 6 to mix in gardens and parks [on 28 May], but failed to mention it…The government’s own rules state that a ‘gradual relaxation of restrictions and social distancing measures’ should only happen when the alert level is lowered to 3” (Independent). “Government advisers have voiced unease over the decision to lift England’s lockdown while thousands of people a day are still becoming infected with the coronavirus, warning that loosening restrictions could easily lead to a second wave”, the Guardian reports. John Edmunds, a professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine and member of SAGE, says “I think many of us would prefer to see the incidence driven down to lower levels because that then means that we have fewer cases occurring before we relax the measures… think at the moment, with relatively high incidence and relaxing the measures and also with an untested track and trace system, I think we are taking some risk here.” Edmunds noted there were 8,000 new infections every day in England without counting those in hospitals and care homes: “If there’s a 1% fatality rate, that’s about 80 deaths a day. If there’s a 0.5%, that’s 40 deaths a day. So that’s the number of deaths per day that we might expect to see going forward.” Jeremy Farrar, director of the Wellcome Trust and also a member of SAGE, tweets: “Covid-19 spreading too fast to lift lockdown in England. Agree with John & clear science advice. TTI has to be in place, fully working, capable dealing any surge immediately, locally responsive, rapid results & infection rates have to be lower. And trusted” (Guardian). “Right now, looking at the numbers in England it is a big risk and gamble”, Professor Devi Sridhar, chair of global public health at the University of Edinburgh, says on the BBC Today programme about the easing of the lockdown. “Deaths are up this week from last week and you are still facing roughly 8,000 new infections a day, from the ONS [Office for National Statistics] survey. So to not have a functioning test-trace system, and to start opening up schools and shops, this could trigger an increase in cases, and therefore an increase in deaths in a few weeks’ time” (BBC Today). Though the government initially said people instructed to quarantine after arriving in the UK would be subject to spot checks in person at their given address, Metro reveals the spot checks will be done over the phone. (Metro)

30 May 2020: Peter Horby, Professor of Emerging Infectious Diseases at University of Oxford, a member of SAGE and Chair of the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG), tells the BBC Today programme he shares the concerns of Professor Edmunds and Jeremy Farrar. He notes the UK still has 8,000 new cases a day, the R-number is between 0.7 and 0.9 and that the Test, Trace and Isolate system is not fully operational. “We still, really, don’t have a great handle on the role of children in schools on transmission, so we are not entirely sure what the effect of relaxing the social measures will be”, he notes (BBC Today). Calum Semple, Professor in Child Health and Outbreak Medicine at the University of Liverpool and a member of SAGE, comments “Essentially we’re lifting the lid on a boiling pan and it’s just going to bubble over… we need to get it down to simmer before we take the lid off, and it’s too early.” (BBC News)

31 May 2020: The government announces that the two million extremely vulnerable people who have been “shielding” in England can now safely spend time outdoors from 1 June (ITV News). Commenting on the announcement, Dr Stephen Griffin, an Associate Professor at the School of Medicine, University of Leeds, said it “seems to lack any obvious rationale other than to add to an ongoing ‘good news’ narrative that appears to have little grounding in reality”. According to the Guardian, “GPs also criticised the advice, saying that it was changed without consulting them and did not make clear whether vulnerable people could now receive treatment in surgeries” (Guardian). “Jeanelle de Gruchy, president of the Association of Directors of Public Health (ADPH), says her colleagues across England are ‘increasingly concerned that the government is misjudging the balance of risk between more social interaction and the risk of a resurgence of the virus, and is easing too many restrictions too quickly’”, the Guardian reports. “Let’s be clear, the NHS ‘Test and Trace’ programme is currently far from being the robust operation that is now urgently required as a safeguard to easing restrictions”, de Gruchy noted. According to the Guardian the ADPH has “called on ministers to postpone the easing of restrictions until more is known about the infection rate, the test-and-trace system is better established and public resolve to maintain physical distancing and hygiene can be reinforced” (ADPH). Peter Openshaw, Professor of Experimental Medicine at Imperial College London and a member of NERVTAG, is interviewed on the BBC Andrew Marr Show. “I share with all my scientific colleagues, or virtually all my scientific colleagues, a deep concern that we need to go with great caution”, he says. “At the moment we still have quite a large number of cases out there in the community. And I think unlocking too fast carries a great risk that all the good work that has been put in by everyone to try to reduce transmission may be lost…. We need the numbers [of cases] to be much lower, and also we need to gear up the ‘test and trace’ in order to be able to cope with the many thousands of cases which are now being seen” (BBC Andrew Marr Show). Dame Donna Kinnair, the chief executive and general secretary of the Royal College of Nursing, says staff are “anxious that easing lockdown could undo the progress we’ve made as a country in combatting this virus” (Guardian). “Too much of April was wasted by focusing on the 100,000 tests by 30 April target at the expense of other aspects of a clear strategy,” Chris Hopson, the chief executive of NHS Providers, which represents foundation trusts in England, says. “The testing strategy, if there was one, got hijacked on the basis of just meeting that target when there were lots of other things that needed to be done” (Guardian). “Only 15 per cent of care home staff have been tested for coronavirus since the start of the outbreak, according to data which suggests the government is failing to meet a key target”, the Independent reports. Health secretary Matt Hancock pledged on 15 May that every elderly resident and member of staff in England would be tested by “early June”. The research by the Data Analysis Bureau and Person Centred Software revealed that by 27 May nearly two-thirds of homes had still not had any staff members tested. (Independent)

1 June 2020: The University of Oxford’s Blavatnik School of Government publishes a ‘Lockdown rollback checklist’, which analyses whether countries meet WHO recommendations for rolling back lockdown. The UK appears in 167th place in a league table of 170 nations (University of Oxford). Professor Martin Green, the spokesman for Care England’s larger care companies, speaks to Guardian columnist Polly Toynbee: “From the start the NHS was prioritized… PPE was redirected away from care homes. Managers were told by suppliers their orders were requisitioned by the NHS.” Green says some areas had “blanket policies not to admit residents to hospital. I’ve seen the letters from GPs saying they will not admit residents, putting DNR (do not resuscitate) on their notes. Some refused to visit… There was a clear instruction to empty hospitals in March and send people to care homes despite no testing for infection. I’ve seen patient notes altered to disguise infection.” Toynbee writes: “The NHS was only saved, Green alleges, because hospitals dumped the crisis on care homes” (Guardian). “Public trust in the UK government as a source of accurate information about the coronavirus has collapsed in recent weeks, suggesting ministers may struggle to maintain lockdown restrictions in the aftermath of the Dominic Cummings affair”, the Guardian reports. “According to surveys conducted on behalf of the University of Oxford’s Reuters Institute by YouGov, less than half of Britons now trust the Westminster government to provide correct information on the pandemic — down from more than two-thirds of the public in mid-April.” The Institute’s director, Rasmus Kleis Nielsen, comments: “I have never in 10 years of research in this area seen a drop in trust like what we have seen for the UK government in the course of six weeks”. (Guardian)

2 June 2020: “Chief medical officer Chris Whitty made the decision not to lower the coronavirus alert level last week, Downing Street has confirmed”, the Independent reports. “A cut from Level 4 — meaning transmission is ‘high or rising exponentially’ — to 3, where the virus is ‘in general circulation’, had been widely expected after Boris Johnson signalled his plan to relax lockdown restrictions in England at the start of this week.” Instead ministers said the pandemic in the UK was at Level 4, but “transitioning towards Level 3” (Independent). Sir David Norgrove, Chair of the UK Statistics Authority, writes an open letter to the Health Secretary about the government’s reporting of statistics on Covid-19. “The aim seems to be to show the largest possible number of tests, even at the expense of understanding”, he notes (UK Statistics Authority). Speaking on the Politics At The Edge podcast, Ian Harvey, Emeritus Professor of Epidemiology and Public Health at the University of East Anglia, says the UK government “could and should” have locked down 10 to 12 days earlier, having seen what was happening in other European countries: “I think, if you’d locked down 10 days earlier, it’s quite likely that the number of cases and hence the mortality would have been around about one-eighth of the eventual size of the problem” (Eastern Daily Press). Speaking to the Guardian, Professor Neil Ferguson, head of the outbreak modelling group at Imperial College London and a former member of SAGE, says “I suspect that under any scenario, the level of transmission and number of cases will remain relatively flat between now and September, short of very big policy changes or behaviour changes in the community” (Guardian).

3 June 2020: The UK reports 359 people have died after contracting COVID-19. “The daily number is higher than the combined total of COVID-19 deaths that the 27 countries in the European Union reported to the World Health Organization (WHO) for its June 3 situation report on the pandemic” (Newsweek). Rupert Read and Tara Greaves publish an article highlighting how a new report from the Office for National Statistics (ONS) shows fewer than 7% of people in England have been infected with the virus. As well as underscoring how dangerous and unrealistic a ‘herd immunity’ strategy is, the ONS research debunks the March 2020 study from Oxford University’s Evolutionary Ecology of Infectious Disease Group which estimated as much as half of the UK population had already been infected with the Coronavirus (this study was neither peer-reviewed nor published in any scientific journal, but received much positive attention in certain parts of the media at the time). (Byline Times)

4 June 2020: “The NHS coronavirus test-and-trace system designed to prevent a second deadly wave is not expected to work at full speed until September or October”, the Guardian reports. “Tony Prestedge, the chief operating officer of the NHS scheme, admitted in a webinar to staff that the programme would be ‘imperfect’ at launch, adding that he hoped it would be operational at a world-class level within three to four months.” (Guardian)

5 June 2020: Noting it “seems probable” there will be a second wave this winter “unless we find quick, practical solutions to some of the structural problems that have made implementing an effective response so difficult”, 27 leading experts, of which over half are professors in virology, public health, epidemiology and other relevant fields, call on the Prime Minister to order a public inquiry into the government’s response to coronavirus (Guardian). According to the Financial Times a cautious estimate of the number of UK excess deaths linked to coronavirus is 65,000. (Chris Giles)

8 June 2020: “Almost two-thirds of Britons with common life-threatening conditions have been denied care by the NHS because hospitals have focused on fighting Covid-19, new research has revealed”, the Guardian reports. Seven out of 10 people with diabetes, 65% with high blood pressure and 64% suffering from breathing problems have had care cancelled by the NHS during the pandemic, an Essex University study has found (Guardian). “Ministers are facing a high court legal challenge after they refused to order an urgent investigation into the shortages of personal protective equipment faced by NHS staff during the coronavirus pandemic”, the Guardian reports. The case is being brought by the Doctors’ Association UK, the Good Law Project and the charity Hourglass, which campaigns on issues involving care homes (Guardian). “More than half of Boris Johnson’s cabinet are pushing for Downing Street to cut the two-metre social distancing rule to contain coronavirus, in a move that would provide a huge boost to the hospitality industry”, the Financial Times reports. This “would involve overriding the government’s Scientific Advisory Group for Emergencies”, the newspaper notes. “One government figure” Is quoted: “The scientists have been quite firm on this. At the moment SAGE is definitely not inclined to reduce the guidance.” (Financial Times)

9 June 2020: Representing the Independent SAGE group of 12 leading scientists, Sir David King, former Chief Scientific Adviser, says “The government has placed huge emphasis on their test, track and trace system in recent weeks, even labelling it ‘world-beating’. It is clear from our research that this simply isn’t the case — indeed, the system as it stands is not fit for purpose” (Guardian). The Office for National Statistics estimates the number of excess fatalities in the UK to be more than 63,000. (Guardian)

10 June 2020: “Flights in and out of Britain are a major factor in the spread of coronavirus, a new report has confirmed”, the Evening Standard reports. The Institute for Economics and Peace (IEP) study noted the UK is an example of where a large number of domestic and international flights “facilitated contagion” of the virus (Evening Standard). “Coronavirus was brought into the UK on at least 1,300 separate occasions, a major analysis of the genetics of the virus shows”, BBC News reports. The Covid-19 Genomics UK consortium (Cog-UK) study shows China, where the pandemic started, had a negligible impact on cases in the UK with most of the initial cases coming from European countries. BBC News notes “there were 20,000 people flying in from Spain every single day in mid-March.” (BBC News). Speaking to the House of Commons Science and Technology Committee, Professor Neil Ferguson, from Imperial College’s School of Public Health and an ex-SAGE member, said: “The epidemic was doubling every three to four days before lockdown interventions were introduced. So had we introduced lockdown measures a week earlier, we would have reduced the final death toll by at least a half.” (Imperial College). Speaking on the BBC Today programme, Michael Baker, Professor of Public Health at the University of Wellington in New Zealand, said he is “really surprised” the UK didn’t follow the “Asia model” of treating the virus like a SARS virus and “going for elimination.” He also noted the UK could eliminate the virus, as New Zealand seems to have done, by implementing an “intense lockdown for 4–6 weeks, maybe a little longer”, followed by contact tracing, testing and border management. (BBC Today). “Problems with the UK government’s coronavirus testing regime must be ‘urgently addressed’ if the country is to develop an effective strategy for combating the disease, the Royal College of Pathologists has warned”, the Financial Times reports. “The Royal College warns of an array of problems that need to be fixed, including the slow turnaround of test results, a failure to inform patients’ doctors when they test positive for coronavirus and workforce shortages” (Financial Times). The Organisation for Economic Co-operation and Development notes “the UK has been relatively hard hit by the Covid-19 crisis,” with the lockdown “introduced on March 23, somewhat later than in neighbouring countries”. (Financial Times)

11 June 2020: Analysing new data released by the government, the Independent SAGE group says it is “extremely concerned” the government’s test & trace system is picking up contacts from only 25% of estimated symptomatic infections. “The government’s own SAGE committee says that 80% of the contacts of all symptomatic cases must be found and isolated in order to stop the virus spreading further”, Independent SAGE note. (Independent SAGE)

12 June 2020: National Audit Office data confirms that “25,000 hospital patients were discharged to care homes at the height of the pandemic before testing became routine.” (Guardian)

14 June 2020: “Senior scientists have reported flaws in an influential World Health Organization-commissioned study into the risks of coronavirus infection and say it should not be used as evidence for relaxing the UK’s 2-metre physical distancing rule”, the Guardian reports. “The analysis of infection risk at 1 metre versus 2 metre should be treated with great caution,” argues Professor David Spiegelhalter, a statistician at Cambridge University who has participated in the government’s SAGE group. Professor Kevin McConway, an applied statistician at the Open University, said the research “should not be used in arguments about how much greater the infection risk is at 1-metre minimum distance as opposed to 2 metres” (Guardian). “Care homes are receiving far more coronavirus testing kits than they order, raising concern that the extra supplies help the government inflate the number of people it claims have been tested”, the Guardian reports. After telephoning the company that had been contracted by the government to complete the testing, one care home manager said she was “told that they have been told to send out double the amount that has been requested, [and] they then record that number as daily tests completed”. (Guardian)

15 June 2020: “Shops in England, including those offering clothes, toys, books and electronics, are now throwing open their doors to customers again. Shops in Northern Ireland have already reopened” (BBC News). “England’s coronavirus lockdown should not be further lifted until the government’s contact-tracing system has proven to be “robust and effective”, the World Health Organization has said”, the Guardian reports. Dr Hans Kluge, the WHO’s director for Europe, cautioned that the UK remained in a “very active phase of the pandemic”. (Guardian)

16 June 2020: Writing in the Guardian, David McCoy, Professor of Global Public Health and Director of the Centre for Public Health at Queen Mary, University of London, argues “The government’s contact tracing shambles suggests… a disdain for evidence, an obsession with centralised control, and the privileging of private over public interests” (Guardian). More than 16,000 people have died from Covid-19 in UK care homes, according to the Office for National Statistics. (Guardian)

17 June 2020: “A government minister has said the NHS coronavirus contact-tracing app is ‘not a priority’ and he was not sure it would be out by winter”, BBC News reports. “Lord Bethell, the Minister for Innovation at the Department of Health and Social Care, said he was unable to give a date for its launch.” (BBC News). Independent SAGE note the latest Office for National Statistics surveillance figures estimate more than 4,000 infections per day in the UK (Independent SAGE). Analysing the government’s test and trace data, the BBC More Or Less programme notes the Office for National Statistics survey found “33,000 people with the virus in the community in England during the first week test and trace was running — late May and early June — plus more in hospitals and care homes. We [the government’s track and trace system] though we had found 12,600 of these cases, but we actually only found 8,100 of them. And if we don’t find them even the best contact tracing system in the world won’t be able to follow up.” (BBC More Or Less)

18 June 2020: “The government has been forced to abandon a centralised coronavirus contact-tracing app after spending three months and millions of pounds on technology that experts had repeatedly warned would not work”, the Guardian reports. “In an embarrassing U-turn, Matt Hancock said the NHS would switch to an alternative designed by the US tech companies Apple and Google, which is months away from being ready. At the Downing Street briefing, the health secretary said the government would not ‘put a date’ on when the new app may be launched, although officials conceded it was likely to be in the autumn or winter.” (Guardian). Speaking on BBC Newsnight Dr Michael Veale, Lecturer in Digital Rights and Regulation at University College London, said the government U-turn on the NHS app was “very predicable”, noting he had warned the UK government about the problem that led to the U-turn on 11 April 2020 (BBC Newsnight). The Independent SAGE group note the government’s contact tracing system “is not fit for purpose”. They note figures released by the government reveal “extensive data gaps” and “the actual number of daily and weekly cases in the community is unknown because testing has been chaotic and haphazard and the methodology is now being revised.” Therefore, “we do not know how many cases have been missed and have not been transferred for contact tracing — ONS survey data suggests there are very many missing cases.” Furthermore, they note “we have no idea how many people contacted are actually isolating and what health or other support they are receiving” (Independent SAGE). Data collected by the King’s College London’s COVID Symptom Tracker app suggests there are approximately 3,391 new cases each day in England. (Daily Mail)

19 June 2020: “Ministers have been accused of playing down the gravity of the coronavirus pandemic after it emerged that more than 1,000 people died every day in the UK for 22 consecutive days — in stark contrast with daily tolls announced by the government”, the Guardian reports. The gap between the government’s figures and the true toll was “an attempt to play down the adversity that the country was faced with”, Sir David King, the former Chief Scientific Adviser and chairman of the Independent SAGE group, said (Guardian). The world has entered “a new and dangerous phase” of the pandemic the World Health Organization’s Dr Tedros Adhanom Ghebreyesus tells a briefing: “Countries are understandably eager to open up their societies and economies but the virus is still spreading fast, it is still deadly and most people are still susceptible… We call on all countries and all people to exercise extreme vigilance.” (Guardian)

21 June 2020: The Independent SAGE group conclude the “Risk of transmission still too high to reduce social distancing rules indoors” and that the impending government announcement on relaxing the two metre rule means “Government ignoring advice of own SAGE committee which recommends keeping 2 metre rule”. Noting “There are more 1,000 new cases a day and still no functioning tracing system”, the group states the “daily number of new cases still too high” and that “evidence [is] needed that it has dropped to much less than 1,000 a day before relaxing rules.” (Independent SAGE)

22 June 2020: The MRC Biostatistics Unit COVID-19 Working Group at the University of Cambridge estimates there are 4,300 new cases a day in England. (MRC Biostatistics Unit)

23 June 2020: The Prime Minister announces pubs, restaurants, hotels and hairdressers can open from 4 July in England and that people should remain two metres apart where possible but a “one metre plus” rule would be introduced (BBC News). “The easing of multiple lockdown measures in England at once risks Covid-19 gaining a fresh foothold, scientists advising the government have warned”, the Guardian reports. Professor John Edmunds, an epidemiologist at the London School of Hygiene and Tropical Medicine and a member of SAGE warns: ““Relaxing the 2-metre rule at the same time as opening bars and restaurants does run the risk of allowing the epidemic to start to regain a foothold. These changes will have to be very carefully monitored and the NHS track-and-trace system will have to be working properly to help keep us safe.” Susan Michie, Professor of Health Psychology at University College London and a member of SPI-B, comments: “The key thing is that we don’t have a [digital] test, trace, isolate system in place,” said Michie, who is also a member of Independent SAGE. “And I think that’s the reason that the World Health Organization said last week that they thought the UK should not lift any more restrictions. It’s why other countries have 1 metre because they have other precautions and other systems in place that we don’t have.” She also noted “Hospitalisations are not coming down dramatically and the fact that we’ve just had opening of non-essential shops and a range of other things, I think, not the best time to reduce it [the 2-metre rule]” (Guardian). Professor Gabriel Scally, President of Epidemiology and Public Health at the Royal Society of Medicine, tweets: “The rules announced today are very complicated and potentially confusing. All at a time when the virus is not yet controlled and the Find,Test, Trace, Isolate, Support system is not running properly yet” (Gabriel Scally). “Local outbreaks of Covid-19 could grow undetected because the government is failing to share crucial testing data, council leaders and scientists have warned”, the Guardian reports. “More than a month after being promised full details of who has caught the disease in their areas, local health chiefs are still desperately lobbying the government’s testing chief, Lady Harding, to break the deadlock and share the data. The situation was described by one director of public health as a ‘shambles’, while a scientist on the government’s own advisory committee said it was ‘astonishing’ that public health teams are unable to access the information.” (Guardian)

24 June 2020: Citing a classified daily document released by Public Health England (PHE) dated 18 June, HuffPost UK report “The government is not certain that the coronavirus R rate is below 1 in England, meaning the disease may not be under control even as lockdown restrictions are being lifted.” The PHE document estimates there are 7,000 new cases every day in England alone (HuffPost UK). Former Chief Scientific Adviser Sir David King tells Sky News Former he thinks the easing of lockdown is happening “too quickly”, making the risk of a second wave “very significant”. He continues: “I don’t think there is anyone who could believe, from the scientific point of view, that this is a wise move.” (Sky News). “The 2 metre to 1 metre reduction and the other changes announced for 4 July won’t only lead to an increased physical transmission of infection at a time when we are far from being out of the woods”, Stephen Reicher, Professor of Psychology at the University of St Andrews and a member of SPI-B, writes in the Guardian. “They also undermine the psychological resolve we need to deal with the pandemic” (Guardian). “MPs have rejected a motion calling for NHS and social care staff to be routinely tested for covid-19 regardless of symptoms, as the country emerges from lockdown”, the British Medical Journal reports. “The motion, proposed by Labour’s shadow health secretary, Jonathan Ashworth, fell with 344 votes cast against and 198 for” (British Medical Journal). Former Health Secretary Jeremy Hunt voted down the proposal even though he called for a weekly testing himself on the same day in an article in the Telegraph newspaper. (Stroud News and Journal)

25 June 2020: “Europe has seen an increase in weekly cases of Covid-19 for the first time in months as restrictions are eased, the World Health Organization (WHO) says”, BBC News reports. “In 11 countries, which include Armenia, Sweden, Moldova and North Macedonia, accelerated transmission has led to ‘very significant resurgence’, said Regional Director Dr Hans Henri Kluge.” (BBC News). “Government figures… show that, of those who test positive, 70.3% were reached, with about three-quarters providing details for close contacts and the rest saying they had no recent close contacts. Of the contacts provided, 81.7% were reached”, the Guardian reports. “It is unclear what proportion are tracked within 48 hours or how many follow advice to self-isolate. The most optimistic estimate for current performance is that 57% of contacts are being traced rapidly and isolating, but the true proportion is likely to be lower” (Guardian). “The number of suspected coronavirus outbreaks in schools almost doubled last week, new Public Health England figures show”, Schools Week report. “PHE’s weekly COVID-19 surveillance report, published today, shows the number of “acute respiratory outbreaks” in schools rose from 24 to 44–16 more outbreaks than were recorded at hospitals.” (Schools Week)

26 June 2020: Independent SAGE says it “is extremely concerned by latest data which shows cases have stopped falling. At current rates, at least 20,000 more people will die in next 9 months. Even before pubs & restaurants re-open on July 4”. (Independent SAGE)

27 June 2020: “Blanket restrictions on non-essential overseas travel will be relaxed in the UK from 6 July, ministers have said”, BBC News reports. “Holidaymakers are expected to be allowed to travel to certain European countries without having to spend 14 days in quarantine when they return. They are thought to include Spain, France, Greece, Italy, the Netherlands, Finland, Belgium, Turkey, Germany and Norway — but not Portugal or Sweden” (BBC News). Speaking on Channel 4 News Devi Sridhar, chair of global public health at the University of Edinburgh, says the issue of travel bans and borders has been dealt with in a “random way” by the government. “When we actually did needed border restrictions early on in the pandemic borders were left wide open — one of the few countries in the world to have that arrangement… at each point it’s, I think, been led really more by the economics rather than by the public health imperative.” (Channel 4 News)

28 June 2020: In a YouGov poll 51% of respondents say the government is doing a bad job handling the crisis, while 44% said it was doing a good job. Sky News notes “This seven-point gap is smaller than the government’s worst moment — an 18-point deficit two weeks ago” (Sky News). “Care home residents were more likely to die of Covid-19 in the UK than in any of the major European countries apart from Spain”, the Guardian reports about analysis done by the London School of Economics as part of the International Long Term Care Policy Network. “The proportion of residents dying in UK homes was a third higher than in Ireland and Italy, about double that in France and Sweden, and 13 times higher than Germany.” (Guardian)

29 June 2020: A Reuters investigation reveals a series of failures by officials and government agencies, including Public Health England, in testing, tracking and tracing: “failure to build up capacity to perform mass tests for COVID-19; Deciding on a narrower definition of COVID-19 than used by the World Health Organization and other countries; a decision to abandon testing of most people who didn’t require hospitalization, and failure, early on, to create any way to track infection; a decision to abandon a programme of widespread ‘contact tracing’, in which people in contact with an infected person were traced and told to isolate to stop the outbreak spreading; deciding to share almost no details about the location of infections with local public health officials or the public; and fragmenting local responsibility for public health” (Reuters). “We all want this to be over”, Head of the World Health Organization Tedros Adhanom Ghebreyesus tells a press briefing. “We all want to get on with our lives. But the hard reality is that this is not even close to being over… most people remain susceptible, the virus still has a lot of room to move.” (Reuters)

30 June 2020: “Non-essential shops in Leicester have closed suddenly as the government imposed the first local lockdown in the UK”, BBC News reports. “Pubs and restaurants hoping to reopen at the weekend also have to delay plans for at least two weeks, while schools will be shut for most pupils” (BBC News). Dr Bharat Pankhania, a former consultant in communicable disease control at Public Health England, tells BBC Radio 4 the situation in Leicester is “a reflection of a premature lifting of lockdown measures” which were “not strict enough in any case” (BBC News). “The ability of local leaders to manage new coronavirus outbreaks in the UK is being hampered by gaps in the reporting of infection data for cities and regions”, according to the Financial Times. “The government publishes a UK-wide figure for Covid-19 cases every day that includes tests from hospitals and those processed by commercial laboratories, including samples taken at home. But at a subnational level the total of new daily cases contains only hospital tests. The result is that hundreds of local authorities across the country are unable to see a timely picture of what is happening in their communities or compare that with other cities and regions of the UK”. Peter Soulsby, mayor of Leicester, tells the BBC: “For weeks we have been trying to get information about the level of testing in the city and the results of that testing in the city”. (Financial Times). Parts of Kent, London, north Wales and Scotland are still battling significant Covid-19 outbreaks, sparking fears from scientists and public health directors that Leicester’s return to lockdown is set to be repeated”, the Guardian reports. “I am expecting there to be a number of Leicesters,” says Deenan Pillay, Professor of Virology at UCL and a member of Independent SAGE. “The base level of infections going on in the UK is still much higher than it was in other countries in Europe when they started to release their lockdowns” (Guardian). In Germany “any community with an infection level exceeding 50 people per 100,000 over the previous seven days must return to lockdown.” (Guardian)

1 July 2020: “Crucial data that could help prevent fresh local waves of coronavirus is being withheld from some of the places most in danger of further lockdowns”, the Guardian notes. “Council leaders said on Wednesday they were either not getting test results needed to prevent new outbreaks, or the results were incomplete and without sufficient detail to allow them to quell local surges in infection… Rochdale borough council, which has one of the highest levels of new infections in England after Leicester, told the Guardian the borough had not received any community testing results…. Barnsley, which after Leicester had the highest levels of infections recently alongside Bradford and Rochdale, only started getting community postcode-level testing data on Wednesday [1 July]”. (Guardian)

Parts of this timeline were originally published by Byline Times.

The timeline is co-authored by Ian Sinclair and Rupert Read. Follow Ian on Twitter @IanJSinclair and Rupert on Twitter @GreenRupertRead.

The timeline will be regularly updated (last updated 4 July 2020).

Ian Sinclair

Written by

Author of ‘The March That Shook Blair: An Oral History of 15 February 2003’

Ian Sinclair

Written by

Author of ‘The March That Shook Blair: An Oral History of 15 February 2003’

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