'We're led by the science': UK's plan to delay coronavirus peak and pursue herd immunity triggers uproar
US President Donald Trump has extended his Europe travel ban to include Ireland and the UK. Spain — like Italy and France to varying degrees — is essentially on lockdown. But the UK, to the dismay of many, has taken what some have labeled a complacent approach.
On Thursday, UK Prime Minister Boris Johnson, flanked by Patrick Vallance, the government’s chief scientific adviser (and GlaxoSmithKline’s former R&D chief), and the UK’s chief medical adviser Chris Whitty, kicked off a press conference announcing the region was moving on from “contain” phase to the “delay” period of their action plan to tackle the epidemic on a somber note:
“I must level with you, level with the British public, many more families are going to lose loved ones before their time.”
These measures are being put in place to delay to the peak, and to push the peak down (or flatten the curve) — in an effort to reduce the burden on the National Health Service (NHS) at any given point and to protect the old and the vulnerable when they need it the most, the officials emphasized.
“It’s important to recognize it’s not to stop everybody from getting it, you can’t do that — it’s not possible to stop everybody from getting it. And it’s also actually not desirable, because you want some immunity in the population,” Vallance said.
Rough estimates indicate that herd immunity — a strategy designed to protect at-risk individuals from infection by being surrounded by people who are resistant to the disease — to Covid-19 could be achieved if about 60% of the population has been infected. While testing was broadly conducted at the start of the outbreak, the UK has now limited testing to patients that are presenting with severe symptoms in hospitals.
At the conference, Johnson asked patients with coronavirus symptoms, however mild — either a new continuous cough or a high temperature — to stay at home for at least a week and advised all citizens over 70 and those with serious medical conditions against going on cruises and recommended against international school trips. More serious measures, such as asking citizens to stay home if somebody in the household has symptoms will likely be taken in a few weeks, the officials said.
At this juncture, the region will not be shutting down schools or imposing a quarantine, the officials said, citing undisclosed scientific evidence that indicates such measures could do more harm than good at this time.
As of Monday, there were more than 1500 confirmed cases of Covid-19 and 35 deaths attributed to the disease. “Our top number for a reasonable worst-case scenario … is up to 80% of the population being infected,” Whitty said on Thursday.
Repeatedly, the officials said their actions were guided by the science — that in order to maximize the benefit of interventions, timing is crucial. When drastic measures are taken too soon, Whitty said, “people start off with the best of intentions, but enthusiasm at a certain point starts to flag.”
“It’s important to not do things that have a relatively small effect, but sound sensible because that puts people off from doing things that really matter. It’s also important to do things in a way that is sustainable because you’re not talking about measures that will there for a week or two,” Vallance added.
But an open letter from 500 behavioral scientists, expressed concern. “(W)e are not convinced that enough is known about ‘behavioral fatigue’ or to what extent these insights apply to the current exceptional circumstances,” it said. “Such evidence is necessary if we are to base a high-risk public health strategy on it.”
The UK government’s response to the burgeoning epidemic has triggered a spate of negative headlines with critics panning the approach as insufficient and dangerous. To add insult to injury, late on Thursday Arsenal Football Club manager Mikel Arteta announced he had tested positive for the virus, and soon after news that players from other clubs had been infected began to surface. Eventually, the Premier League said it would suspend games until April 3, amid other suspensions across other sporting events.
In an open letter published on Saturday from over 200 scientists, including PhD students, in disciplines ranging from mathematics to artificial intelligence (but no researchers who study the science of disease spread) suggested the UK government was doing too little and risking lives in its pursuit of ‘herd immunity,’ given that the current data on infections in the UK is in line with the growth curves already seen elsewhere, such as Italy, Spain, France and Germany.
“Under unconstrained growth, this outbreak will affect millions of people in the next few weeks. This will most probably put the NHS at serious risk of not being able to cope with the flow of patients needing intensive care, as the number of ICU beds in the UK is not larger than that available in other neighboring countries with a similar population,” they wrote.”Going for ‘herd immunity’ at this point does not seem a viable option, as this will put NHS at an even stronger level of stress, risking many more lives than necessary.”
Richard Horton, editor-in-chief of The Lancet, accused the UK government of playing roulette with the public. Another concerning letter also surfaced from the British Society of Immunology. Anthony Costello, professor of global health and sustainable development at University College London and a former director of maternal and child health at the WHO, told the Guardian that meanwhile, China mounted a “proper” campaign to stop the epidemic in its tracks, as laid out by the WHO — test intensively, trace contacts, quarantine and maintain social distancing.
“They didn’t leave it all to messages and nudge behavioral methods,” he wrote in a scathing editorial. “Without an all-out national mobilization for social distancing, are the behavioral and nudge strategies really evidence-based to flatten the peak? Or simply based on models? Why are we emphasizing herd immunity now? Does coronavirus induce strong herd immunity or is it like flu, where immunity remains weak and new strains emerge each year? We have much to learn about Covid-19 immune responses.”
Meanwhile, calls for transparency on the scientific advice and models the UK government is using to make its determinations gathered steam.
In an exchange with Secretary of State for Health and Social Care Matt Hancock, Sky News journalist Sophy Ridge said: “You said that this is based on the best scientific advice, so why don’t you transparently publish that advice and the government’s modeling … because if you’re so convinced you’re following the science, why don’t you publish it so that people can take it on their own knowledge, rather than trust?”
Hancock said the data would be published in the coming days, but appeared to back away from the goal of herd immunity, which had been alluded to by UK officials at the press conference days earlier.
“Herd immunity is not our goal or policy, it’s a scientific concept. Our policy is to save lives and beat this virus,” he said, adding that government is gearing up to ask Britons over 70 to isolate for “months,” within weeks.
The UK government has since also announced it will be conducting daily briefings to update the public.
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