COVID-19 pandemic in the United Kingdom
The COVID-19 pandemic in the United Kingdom is part of the worldwide pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus reached the country in late January 2020. As of 3 February 2021, there have been 3,871,825 confirmed cases[nb 3] and 109,335 deaths, the world's fourth-highest death rate per hundred thousand population[4][5] and the highest number overall in Europe.[6] There were 112,972 deaths where the death certificate mentioned COVID-19 by 22 January 2021 (see Statistics).[7][8] There has been some disparity between the outbreak's severity in each of the four nations. Health in the United Kingdom is a devolved matter, with England, Northern Ireland, Scotland and Wales each having their own systems of publicly funded healthcare, separate governments and parliaments, together with smaller private sector and voluntary provision.[9][10][11]
| COVID-19 pandemic in the United Kingdom | |
|---|---|
(clockwise from top)
| |
| Disease | COVID-19 |
| Virus strain | SARS-CoV-2 |
| Location | United Kingdom |
| First outbreak | Wuhan, China |
| Index case | York, North Yorkshire |
| Arrival date | 31 January 2020 (1 year and 1 week ago)[1] |
| Confirmed cases | |
| Hospitalised cases | |
| Ventilator cases | 3,726 (active)[2] |
Deaths | |
| Fatality rate | 2.85% |
| Government website | |
| UK Government[nb 2] Scottish Government Welsh Government Northern Ireland Department of Health | |
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On 22 February 2020, in Scotland, COVID-19 became a "notifiable disease",[12] and a surveillance network involving 41 GP locations was established to submit samples of suspected patients, even if they had no travel history.[13] The Department of Health and Social Care (DHSC) for England launched a public health information campaign to help slow the virus's spread, and began posting daily updates in early February. The HSC began testing for COVID-19 during February 2020, as of 19 February there were 35 completed tests all of which returned negative results.[14] Also in February, the Health Secretary, Matt Hancock, introduced the Health Protection (Coronavirus) Regulations 2020 for England, and hospitals set up drive-through screening. The Chief Medical Officer for England, Chris Whitty, outlined a four-pronged strategy, relevant to England, to tackle the outbreak: contain, delay, research and mitigate. In Wales, the Chief Medical Officer, Frank Atherton, said that the Government would be taking "all appropriate measures" to reduce the risk of transmission.[15]
In March, the UK governments imposed a stay-at-home order, dubbed "Stay Home, Protect the NHS, Save Lives", banning all non-essential travel and closing most gathering places. Those with symptoms, and their households, were told to self-isolate, while those with certain illnesses were told to shield themselves.[16] People were told to keep apart in public. Police were empowered to enforce the measures, and the Coronavirus Act 2020 gave all four governments emergency powers[17] not used since the Second World War.[18][19] The Chancellor of the Exchequer, Rishi Sunak forecast that lengthy restrictions would severely damage the UK economy,[20] worsen mental health and suicide rates,[21] and cause additional deaths due to isolation, delays and falling living standards.
All four national health services worked to raise hospital capacity and set up temporary critical care hospitals, including the NHS Nightingale Hospitals. By mid-April it was reported that social distancing had "flattened the curve" of the epidemic.[22] In late April, Prime Minister Boris Johnson said that the UK had passed the peak of its outbreak.[23] Daily cases and deaths slowly declined in May and June, and continued at a relatively low level in July and August. The total number of excess deaths in the UK from the start of the outbreak to mid-June was just over 65,000.[24]
Cases rose significantly from late August onwards (by a factor of 3.2 from 15 August to 15 September). From October onwards, varying levels of lockdown were imposed in England, including in many areas a complete ban on households mixing at Christmas,[25] in tandem with the discovery of a variant of concern which was blamed by Hancock for the rise in cases in the South East[26] and precipitated further suspensions of international travel from the UK.[27] A similar system was introduced in Scotland.[28] Circuit breaker lockdowns took place in Wales[29] and Northern Ireland.[30] In December, the UK became the first country to authorise[31] and begin use of the Pfizer–BioNTech COVID-19 vaccine in a mass vaccination programme throughout 2021.[32]
Background
On 12 January 2020, the World Health Organization (WHO) confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster of people in Wuhan City, Hubei, China, which was reported to the WHO on 31 December 2019.[33][34] The case fatality ratio for COVID-19 has been much lower than SARS of 2003,[35][36] but the transmission has been significantly greater, with a significant total death toll.[37][35]
Genetic sequencing has traced most COVID-19 cases in the United Kingdom to imported cases from Italy, France and Spain, rather than directly from China.[38]
Mathematical modelling and government response
Reports from the Medical Research Council's Centre for Global Infectious Disease Analysis at Imperial College, London have been providing mathematically calculated estimates of cases and case fatality rates.[39][40] In February 2020, the team at Imperial College, led by epidemiologist Neil Ferguson, estimated about two-thirds of cases in travellers from China were not detected and that some of these may have begun "chains of transmission within the countries they entered".[41][42][43] They forecast that the new type of coronavirus could infect up to 60% of the UK's population, in the worst-case scenario.[44]
In a paper on 16 March, the Imperial College team provided detailed forecasts of the potential impacts of the epidemic in the UK and US.[45][46] It detailed the potential outcomes of an array of 'non-pharmaceutical interventions'. Two potential overall strategies outlined were: mitigation, in which the aim is to reduce the health impact of the epidemic but not to stop transmission completely; and suppression, where the aim is to reduce transmission rates to a point where case numbers fall. Until this point, government actions had been based on a strategy of mitigation, but the modelling predicted that while this would reduce deaths by approximately 2/3, it would still lead to approximately 250,000 deaths from the disease and the health systems becoming overwhelmed.[45] On 16 March, the Prime Minister announced changes to government advice, extending self-isolation to whole households, advising social distancing particularly for vulnerable groups, and indicating that further measures were likely to be required in the future.[47][46] A paper on 30 March by the Imperial College group estimated that the lockdown would reduce the number of dead from 510,000 to less than 20,000.[48]
In April, biostatistician Professor Sheila Bird said delay in the reporting of deaths from the virus meant there was a risk of underestimating the steepness of the rising epidemic trend.[49]
Timeline
Winter 2019–20: Arrival and embedment
September 2019 - January 2020 : Suspected cases
In May 2020, the BBC reported that several members of a choir in Yorkshire had suffered COVID-19-like symptoms shortly after the partner of one of the choir members returned from a business trip to Wuhan, China, on 17 or 18 December.[52]
Earlier, in March 2020, it was reported that a 50-year-old man from East Sussex fell ill, also with COVID-19 symptoms, on 20 January after he returned from Ischgl in Austria, which is under investigation because it failed to report early cases on February. Also, the three other members of his family and two friends from Denmark and one from Minnesota, US had same symptoms.[53][54]
In June 2020 BBC reported it was found COVID-19 in UK had at least 1356 origins, mostly from Italy (late February), Spain (early-to-mid-March), and France (mid-to-late-March).[55] Same month, it was reported that 53-year-old woman fell ill on 6 January, two days after returning from Obergurgl resort in Austria.[56]
In August 2020 the Kent coroner reportedly certified that the death of Peter Attwood (aged 84) on 30 January had been related to COVID-19 ('COVID-19 infection and bronchopneumonia', according to an email on 3 September, after COVID-19 was detected in his lung tissue), making him the first confirmed UK victim of the disease. He first showed symptoms on 15 December 2019.[57] Attwood had not travelled abroad.[58]
In November 2020 it was reported that a 66-year-old had experienced symptoms shortly after returning from holiday in Italy in September 2019, and his 44-year-old daughter had experienced similar symptoms. Scientists had previously speculated about COVID-19 in Italy as early as September 2019.[59]
January 2020: First confirmed cases
On 22 January, following a confirmed case of COVID-19 in the United States the previous day, in a man returning to Washington from Wuhan, China, where there were 440 confirmed cases at the time, the DHSC and Public Health England (PHE) raised the risk level from "very low" to "low". As a result, Heathrow Airport received additional clinical support and tightened surveillance of the three direct flights from Wuhan every week; each was to be met by a Port Health team with Mandarin and Cantonese language support. In addition, all airports in the UK were to make written guidance available for unwell travellers.[60][61] Simultaneously, efforts to trace 2,000 people who had flown into the UK from Wuhan over the previous 14 days were made.[62][63]
On 31 January, the first UK cases were confirmed in York.[64][65] On the same day, British nationals were evacuated from Wuhan to quarantine at Arrowe Park Hospital.[66] However, due to confusion over eligibility, some people missed the flight.[66]
February 2020: Early spread
On 6 February, a third confirmed case was reported in Brighton – a man who returned from Singapore and France to the UK on 28 January.[67][68][69] Following confirmation of his result, the UK's CMOs expanded the number of countries where a history of previous travel associated with flu-like symptoms—such as fever, cough, and difficulty breathing—in the previous 14 days would require self-isolation and calling NHS 111. These countries included China, Hong Kong, Japan, Macau, Malaysia, Republic of Korea, Singapore, Taiwan, and Thailand.[70]
On 23 February, the DHSC confirmed four new cases from the Diamond Princess cruise ship.[71]
A Nike conference on 26–27 February in Edinburgh led to at least 25 cases, including 8 residents of Scotland. Health Protection Scotland established an incident management team at the time and traced contacts from delegates.[72] A report by Glasgow University on genomic epidemiology and the conference concluded this did not lead to further spread of the virus.[73][74]
On 27 February, the first cases were confirmed in Northern Ireland.[75][76]
On 28 February, the first case was confirmed in Wales, and a passenger on the Diamond Princess became the first Briton to die from the virus.[77]
Spring 2020: First wave
Early to mid-March: closures and cancellations
On 1 March, a further 13 cases were reported including new cases in Greater Manchester; bringing the total to 36, three of which were believed to be contacts of the case in Surrey who had no history of travel abroad.[78][79] First case of the virus reported in Scotland.[80]
On 3 March, the UK Government unveiled their Coronavirus Action Plan, which outlined what the UK had done and what it planned to do next.[81] Paul Cosford, a medical director at Public Health England, said widespread transmission of COVID-19 in the United Kingdom was "highly likely".[82]
On 5 March, the first death from COVID-19 (within the UK), a woman in her 70s, was reported in Reading,[83] and the second, a man in his 80s in Milton Keynes, was reported to have died later that day.[84][85]
On 12 March, the total of cases in the UK was reported to be 590.[3] On the same day, the UK CMOs raised the risk to the UK from moderate to high.[86] The government advised that anyone with a new continuous cough or a fever should self-isolate for seven days. Schools were asked to cancel trips abroad, and people over 70 and those with pre-existing medical conditions were advised to avoid cruises.[87][88]
On 13 March, the 2020 United Kingdom local elections were postponed for a year.[89]
On 16 March, Prime Minister Boris Johnson advised everyone in the UK against "non-essential" travel and contact with others, as well as suggesting people should avoid pubs, clubs and theatres, and work from home if possible. Pregnant women, people over 70 and those with certain health conditions were urged to consider the advice "particularly important", and would be asked to self-isolate within days.[47] On the same day, a second MP, Kate Osborne, tested positive after a period of self-isolation.[90][91][92][93]
On 17 March, NHS England announced that all non-urgent operations in England would be postponed from 15 April to free up 30,000 beds.[94] General practice moved rapidly to remote working. In March 2020 the proportion of telephone appointments increased by over 600%.[95] Also, the government provided a £3.2million emergency support package to help rough sleepers into accommodation.[96][97] With complex physical and mental health needs, in general, homeless people are at a significant risk of catching the virus.[96]
On 18 March, the UK announced schools would close at the end of Friday 20 March. First to announce was Welsh minister for education Kirsty Williams, this was followed closely by a similar announcement for Scottish schools by Nicola Sturgeon.[98] Arlene Foster and Michelle O’Neill jointly followed suit for Northen Ireland schools. Later the same day, Boris Johnson announced that schools in England would also close. He also announced that public examinations would not take place as a result.[99][100]
On 19 March, the UK Government downgraded the status of COVID-19 from a "high consequence infectious disease" (HCID) after consideration by the UK HCID group and the Advisory Committee on Dangerous Pathogens.[36][101]
On the same day, Boris Johnson, UK Prime Minister said "I do think, looking at it all, that we can turn the tide within the next 12 weeks, and I am absolutely confident that we can send coronavirus packing in this country but only if we take the steps, we all take the steps we have outlined."[102][103][104]
On 20 March, the government announced the closure of public venues, such as pubs, restaurants, gyms, leisure centres, nightclubs, theatres and cinemas.[105] The chancellor, Rishi Sunak also announced that the government would cover 80% of the salaries of retained workers until restrictions were over.[106]
Late March: Restrictions begin
On 23 March, having previously advised the public to avoid pubs and restaurants, Boris Johnson announced in a television broadcast that measures to mitigate the virus were to be tightened to protect the NHS, with wide-ranging restrictions on freedom of movement, enforceable in law,[17] under a stay-at-home order which would last for at least three weeks.[107] The slogan "Stay home, Protect the NHS, Save Lives" was introduced, often seen in capital letters, on a yellow background, with a red border.
The government directed people to stay home throughout this period except for essential purchases, essential work travel (if remote work was not possible), medical needs, one exercise per day (alone or with household members), and providing care for others.[108] Many other non-essential activities, including all public gatherings and social events except funerals, were prohibited, with many categories of retail businesses ordered to be closed.[17][109]
Despite the announcement, the Health Protection (Coronavirus, Restrictions) (England) Regulations 2020, which made the sweeping restrictions legally enforceable, did not take effect until three days later on 26 March.[110]
Operation Rescript and Operation Broadshare saw the deployment of the COVID Support Force, a military task force to support public services and civilian authorities in tackling the outbreak within the United Kingdom and overseas.[111]
On 26 March, the number of UK COVID-19 deaths increased by more than 100 in a day for the first time, rising to 578, while a total of 11,568 had tested positive for the virus.[112] At 8:00 pm that day, people from across the UK took part in applause in appreciation of health workers, later branded as Clap for Our Carers.[113][114] This gesture was repeated on the next nine Thursdays, up to 28 May.[115]
On 27 March, Boris Johnson and Matt Hancock announced that they had tested positive for the virus.[116][117] On the same day, Labour Party MP Angela Rayner, the Shadow Secretary of State for Education, confirmed she had been suffering symptoms and was self-isolating.[118]
Chief Medical Adviser Chris Whitty also reported suffering from symptoms and would be self-isolating, while continuing to advise the UK government.[119] That day also saw the largest increase in the number of deaths, with the figure rising by 181 from the previous day, bringing the total to 759, while 14,579 cases had been confirmed.[120]
On 29 March, it was reported that the government would send a letter to 30 million households warning things would "get worse before they get better" and that tighter restrictions could be implemented if necessary. The letter would also be accompanied by a leaflet setting out the government's lockdown rules along with health information.[121] Dr Jenny Harries, England's deputy chief medical officer, suggested it could be six months before life could return to "normal", because social distancing measures would have to be reduced "gradually".[122] The first NHS nurse died of COVID-19.[123]
On 30 March, the Prime Minister's senior adviser Dominic Cummings was reported to be self-isolating after experiencing COVID-19 symptoms. He had been at Downing Street on 27 March and was stated to have developed symptoms over 28 and 29 March.[124]
Also, transmission within the community was thought to be decreasing, and hospital admission data suggested cases were increasing at a slower rate.[125] The Foreign and Commonwealth Office repatriated tens of thousands of British nationals who had been stranded abroad by the coronavirus outbreak.[126]
April 2020: Lockdown continues
On 1 April, the government confirmed that a total of 2,000 NHS staff had been tested for coronavirus since the outbreak began, but Cabinet Office Minister Michael Gove said a shortage of chemical reagents needed for COVID-19 testing meant it was not possible to screen the NHS's 1.2 million workforces.[127] Gove's statement was contradicted by the Chemical Industries Association, which said there was not a shortage of the relevant chemicals and that at a meeting with a business minister the week before the government had not tried to find out about potential supply problems.[128]
On 2 April, Health Secretary Matt Hancock, after his seven-day period of isolation, announced a "five pillar" plan for testing people for the virus, with the aim of conducting 100,000 tests a day by the end of April.[129] The plan referred to ambitions to:
- scale up swab testing in PHE labs and NHS hospitals for those with a medical need and the most critical workers to 25,000 a day in England by mid to late April, with the aligned testing strategies of the NHS in the Devolved Administrations benefiting from PHE's partnership with Roche through a central UK allocation mechanism;
- deliver increased commercial swab testing for critical key workers in the NHS across the UK, before then expanding to key workers in other sectors;
- develop blood testing to help know if people across the UK have the right antibodies and so have high levels of immunity to coronavirus;
- conduct UK-wide surveillance testing to learn more about the spread of the disease and help develop new tests and treatments; and
- build a mass-testing capacity for the UK at a completely new scale.[130]
On 4 April, Boris Johnson was admitted to hospital as a "precautionary measure" after suffering from symptoms for more than a week with no improvement.[131] Catherine Calderwood, the Chief Medical Officer for Scotland, resigned from her post after it emerged she had been spoken to by police for visiting her second home during lockdown.[132] On 6 April, Johnson was moved to the intensive care unit at St Thomas' Hospital in London as his symptoms worsened. First Secretary of State Dominic Raab assumed Johnson's duties.[133]
On 7 April the UK Government Chief Scientific Adviser, Sir Patrick Vallance, said that death figures were not accelerating as had been predicted but it was too early to tell whether the outbreak was peaking.[134][135] On 9 April, the number of daily recorded deaths was 881, taking the total to 7,978. Dominic Raab said the UK was "starting to see the impact" of the restrictions but it was "too early" to lift them, and urged people to stay indoors over the Easter weekend.[136]
On 10 April, the UK recorded another 980 deaths, taking the total to 8,958. Jonathan Van-Tam, England's deputy chief medical officer, told the UK Government's daily briefing the lockdown was "beginning to pay off" but the UK was still in a "dangerous situation", and although cases in London had started to drop they were still rising in Yorkshire and the North East.[137] Johnson left hospital on 12 April.[138]
On 14 April, figures released by the Office for National Statistics indicated that coronavirus had been linked to one in five deaths during the week ending 3 April. More than 16,000 deaths in the UK were recorded for that week, 6,000 higher than would be the average for that time of year.[139] Several UK charities, including Age UK and the Alzheimer's Society, expressed their concern that older people were being "airbrushed" out of official figures because they focused on hospital deaths while not including those in care homes or a person's own home.[140]
Matt Hancock announced new guidelines that would allow close family members to see dying relatives to say goodbye to them. Hancock also launched a new network to provide personal protective equipment to care home staff.[141] On that day, NHS England and the Care Quality Commission began rolling out tests for care home staff and residents as it was reported the number of care home deaths was rising but that official figures, which relied on death certificates, were not reflecting the full extent of the problem.[142] Also on 15 April, Arlene Foster, the First Minister of Northern Ireland, extended the period of lockdown in Northern Ireland to 9 May.[143]
On 16 April, Dominic Raab revealed that lockdown restrictions would continue for "at least" another three weeks, and to relax them too early would "risk wasting all the sacrifices and all the progress that has been made". He set out five conditions for any easing of the lockdown .[144] On that day the number of recorded deaths increased by 861 to 13,729, while the number of cases of the virus passed 100,000, reaching 103,093.[145]
On 18 April, unions representing doctors and nurses expressed concern at a change in government guidelines advising medics to reuse gowns or wear other kits if stocks run low.[146] Robert Jenrick, the Secretary of State for Local Government, announced a further £1.6bn of support for local authorities, on top of £1.6bn that was given to them at the beginning of the outbreak.[147]
On 29 April, the number of people who had died with coronavirus in the UK passed 26,000, as official figures include deaths in the community, such as in care homes, for the first time.[148] On 30 April, Boris Johnson said the country was "past the peak of this disease".[23]
May 2020: Lockdown easing begins
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On 5 May, the UK death toll became the highest in Europe and second highest in the world.[149]
On 7 May, the lockdown in Wales was extended by the Welsh Government, with some slight relaxations.[150][151]
On 10 May, Prime Minister Johnson asked those who could not work from home to go to work, avoiding public transport if possible; and encouraged the taking of "unlimited amounts" of outdoor exercise, and allowing driving to outdoor destinations within England. In his statement he changed the "Stay at Home" slogan to "Stay Alert".[152] The devolved administrations in Scotland, Northern Ireland, and Wales did not adopt the new slogan as there had been no agreement with the UK government to change it, and because the announcement sent a mixed message to the public.[153][154]
On 11 May, Johnson published a 60-page document called "Our Plan to rebuild: the UK Government's COVID-19 recovery strategy", with details of the COVID-19 recovery strategy for the UK. In the report a new COVID-19 alert level system was announced.[155] At the same time the Cabinet Office published guidance on "staying safe outside your home", comprising eleven principles which "all of us" should adopt "wherever possible".[156]
In May a COVID-19 alert system was announced, to be run by a new joint biosecurity centre. When first announced, Johnson stated that the UK was on level 4, moving towards level 3.[157][155][158]
The Health and Safety Executive stated that from 9 March to 7 May they were contacted 4,813 times. Around 8% of the complaints related to Scotland. The executive managed to resolve 60% of them while another 40% needed further investigation, with some workplaces suspended whilst safety measures were put in place. As of 17 May the executive had not issued any enforcement notices in relation to COVID-19.[159]
On 25 May, the prime minister's adviser Dominic Cummings was criticised over his alleged breaches of the lockdown rules.[160][161] Cummings rejected the allegations, denying that he had acted illegally.[162] On 28 May, Durham police said that no offence had been committed when Cummings had travelled from London to Durham and that a minor breach might have occurred at Barnard Castle, but as there had been no apparent breach of social distancing rules, no further action would be taken.[163]
The evening of 28 May saw the final Clap for Our Carers event.[115] Scotland's First Minister Nicola Sturgeon announced an easing of the lockdown in Scotland from the following day, with people able to meet friends and family outside in groups of no more than eight but keeping two metres apart.[164]
June 2020
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On 1 June, Primary schools in England reopened to some reception (4–5 years), year 1 (5–6 years) and year 6 (10–11 years) pupils with social distancing measures in place.
On 3 June, briefings began[165] (later referred to as 'press conferences') in a series that was set up by Welsh Government as a way of dispersing new information to the people of Wales regarding the COVID-19 pandemic in Wales.
On 6 June, Parliament Square in London, saw thousands of people participating in the Black Lives Matter protest against racism and police violence in the UK, following the death of George Floyd apparently caused by US police in Minneapolis, Minnesota. On 7 June, Health Minister Matt Hancock stated that although he supports the argument of the protests, there is "undoubtedly" a risk of a potential rise in the number of COVID-19 cases and the spread of the virus.[166] Non-essential shops reopened across the UK during this month.[167][168][169][170]
On 8 June, the government introduced new quarantine rules from anyone coming into the UK, requiring individuals to self-isolate for 14 days upon arrival to help slow the spread of COVID-19.
On 15 June, England made face masks compulsory on all public transport. Transport Secretary Grant Shapps still advised people not to use public transport, but acknowledged that for some people this wasn't an option, especially as the use of public transport had been increasing throughout late May and early June, which brought fears of the coronavirus being transmitted on public transport.
July 2020
On 2 July, the government revised the total number of cases down by 30,302 because some people were counted twice in the earlier figures. The actual increase in the number of cases for 2 July was 576 or 0.18%.[3]
Also on 2 July, the UK Government removed 75 countries from the England related quarantine list since they were now dubbed "low risk". Travellers entering the UK would no longer have to self-isolate.
On 17 July, the Health Secretary Matt Hancock called for an urgent review into how COVD-19 deaths were recorded in England. Public Health England had said that the figures for deaths included people that had tested positive for the virus months before their death.[172]
On 24 July, in England, new regulations made it compulsory to wear face coverings in most indoor shops and public spaces. Those breaking the rules could be fined up to £100. Face coverings remained optional in some indoor venues where wearing a mask might be 'impractical', such as restaurants and gyms. Exemptions were made for children under 11, individuals with physical or mental illness or disability, and for anyone to whom it might cause distress.[173]
On 25 July, Health Ministers from all four governments met and agreed to add Spain back onto the quarantine list due to a spike in cases.[174] This drew criticism from the Spanish PM, Pedro Sánchez, as the outbreak was largely only happening in Catalonia.
On 27 July, the first confirmed case of an animal infection with SARS-CoV-2 in the UK was reported, having been detected in a pet cat.[175] UK health officials said that the cat had probably contracted the coronavirus from its owners, but there was no evidence that pets or other domestic animals can transmit the disease to humans.[175]
On 30 July, the UK government announced that people in Greater Manchester, east Lancashire and parts of West Yorkshire faced new restrictions, banning separate households from meeting each other at home after a spike in COVID-19 cases. The new lockdown rules, which came into force at midnight, meant people from different households were not allowed to meet in homes or private gardens.[176]
On 31 July, the UK government announced they were delaying a further ease of lockdown restrictions in England until at least 15 August due to recent increases in cases. This ease of lockdown restrictions would have allowed "higher risk settings", including bowling alleys, skating rinks and casinos, to open on 1 August.[177]
By the end of the month, levels of travel and commerce had started to recover across the UK, but not yet returned to pre-pandemic levels.[178]
August 2020
On 2 August, a major incident was declared in Greater Manchester after rises in coronavirus infection rates.[179][180]
On 12 August, the death count for England was reduced by more than 5,000[181] to 41,329. Previously, people in England who died at any point following a positive test, regardless of cause, were counted in the figures. However, the other UK nations had a cut-off period of 28 days.[182]
On 14 August, thousands of UK holidaymakers in France were rushing to the borders to the UK, following the announcement of anyone returning from France after 4 am on 15 August to self-isolate for fourteen days, causing massive queues and traffic jams at the harbours and Eurotunnel.[183]
On 28 August, shortly before the reopening of schools at full capacity in England, Wales and Northern Ireland, New Scientist examined the three-month history of the test and trace system. The magazine noted that the system had not met its targets and had been affected by an Internet outage in Southampton in the second week of August, affecting contact tracing for several thousand people. It criticised both the lack of a backup for such a vital system and the lack of transparency.[184]
September 2020
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On 6 September, concerns were raised over an increased number of cases in the preceding few days, a trend that continued into the following week.[185]
On 8 September, the government published new social distancing rules to come into effect in England from 14 September, wherein all gatherings of separate households would be restricted to groups of six or few people (the so-called "rule of six"), excluding work or educational settings.[186] Similar rules were also later announced (to begin on the same date) in Scotland and Wales, although – unlike in England – with exemptions for young children.[187]
On 9 September, these rules were further elaborated in a government press conference, alongside details of new legal requirements for data gathering on behalf of venues, social distancing "marshals" to enforce restrictions, and the outline of a "moonshot" plan to further control the virus with greatly expanded mass virus testing.[188] The £100bn "moonshot" plan was derided as lacking expert input by Professor Jon Deeks of the University of Birmingham and Cochrane, speculating on the consequences of false positives that might go along with testing such a large number of people.[189]
From 14 September onwards, the BBC reduced their daily coverage of the Welsh Government's announcements to two to three times a week 'due to cuts'. In Scotland, more than 25,000 signed a petition calling on the BBC to reverse its decision.[190]
On 18 September, the government tightened restrictions further in parts of the north-east of England. Pubs were told to close every day from 10pm to 5am, and households were not allowed to mix. Later, new restrictions were announced for parts of the North West of England, Midlands and West Yorkshire.[192] By now 13.5 million people, around 1 in every 5 UK residents, were living under some degree of extra local restrictions, including much of Northern England and Central Scotland, several council areas in the Midlands and South Wales, along with parts of Belfast and other areas in Northern Ireland.[192]
On 21 September, the UK's coronavirus alert level was upgraded from 3 to 4, indicated the disease's transmission is "high or rising exponentially".[193] This decision followed a warning from the UK government's Chief Scientific Advisor earlier that day, that the UK could be seeing 50,000 cases a day by October unless further action was taken to slow the virus's spread.[194] Fears of a "second lockdown" caused a drop in UK stocks,[195] although the following day the Prime Minister stated that potential additional restrictions would be "by no means a return to the full lockdown of March".[196]
On 22 September, tightening of COVID-19 restrictions were announced by the UK government for England and the devolved administrations in the rest of the UK. Including 10pm closing times for pubs across the UK and a ban on households meeting in other households in Scotland.[197][198][199][200] In a televised address to the nation, Prime Minister Boris Johnson stated that additional rules to combat the case rise could last for a further 6 months.[196]
On 29 September, the UK reported the highest daily rise in new infections with a total of 7,143 new cases.[201]
October 2020: Circuit breakers
On 1 October, restrictions were tightened further in the North-East of England, now banning all indoor gatherings within households. The UK Government also advised people in the regions not to meet outside, although they did not ban people from meeting outside.
On 2 October, Margaret Ferrier, MP for Rutherglen and Hamilton West received calls from other politicians, including the Scottish First Minister, Nicola Sturgeon to resign from her seat. She had been suspended from the SNP for travelling from Scotland to London to attend a coronavirus debate in the House of Commons while awaiting a coronavirus test result, and then travelling back to Scotland after testing positive for COVID-19. Police also began an investigation.[202][203][204][205]
On 3 October, Public Health England announced that a 'technical error' had caused under-reporting of new cases for recent dates, and that the missing positive results would be declared over the forthcoming days. The number of new cases declared on 3 October was approximately double the rate prevailing over the preceding few days.[206]
On 4 October, Public Health England made a further announcement that 15,841 cases had been left out of the daily case figures between 25 September and 2 October and that these would be added to the figures for 3 and 4 October. The error was caused by a limit on the number of columns in an Excel spreadsheet.[207][208][209] Hugh Pym, the BBC's health editor, said that daily figures for the end of the week were "actually nearer 11,000"; around 7,000 had been reported. Referring to the glitch, Labour used the term "shambolic".[210] A smoothed curve of estimates from the COVID Symptom Study suggested that new cases might be estimated to be running just below 8,000 per day.[211] After the corrections, total infections in the UK surpassed 500,000 – the fourth country in Europe to pass that milestone.
On 12 October, a three-tier legal framework was introduced in England to help curb the spread of COVID-19 in local and regional lockdowns, coming into effect on 14 October. Liverpool became the first region under a Tier 3, which ordered the closure of pubs. Households were also banned from mixing with each other in parts of the North-East of England and Manchester.[212][213] The Harrogate, Manchester and Sunderland Nightingale Hospitals were also told to reopen as hospital admissions had risen above the peak in March.[214]
On 13 October, daily deaths increased by more than 100 for the first time since 27 July with 143 deaths recorded in the 24-hour period.
On 14 October, the Northern Irish government announced that from 16 October, Pubs, Restaurants and school closures as well as a ban on mixing in households would come into force, essentially putting Northern Ireland in lockdown. Pubs and Restaurants would be closed for 4 weeks whereas schools would only be shut for 2 weeks.[215]
On 15 October, the government announced that London would move to Tier 2 lockdown following a spike in cases,[216] banning people from mixing indoors privately, while Greater Manchester would move to Tier 3, two months after a Major Incident was declared. The Tier 3 restrictions on Greater Manchester were delayed as Johnson was in a dispute with the mayor, Andy Burnham, who wanted additional financial support for the area.[217][218]
On 19 October, Labour MP Yasmin Qureshi was admitted to the Royal Bolton Hospital and was being treated for pneumonia, after testing positive for COVID-19. She had been feeling unwell for nearly two weeks, and was also self-isolating before being admitted to the hospital.[219][220] On the same day, Welsh first minister Mark Drakeford announced that Wales would go into a two week "time-limited firebreak" lockdown from the 23 October to 9 November. Leisure businesses, community centres, libraries, recycling centres and places of worship (apart from weddings and funerals) would shut whilst gatherings and the sale of non-essential goods would be banned. Schools and colleges would initially shut for the scheduled half term and only reopen in the second week for pupils in year 8 (12–13 years old) and below.[221][222]
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On 30 October, the Office for National Statistics weekly infection survey in England showed that secondary school children ages 11 to 16 had the fastest rate of increase in COVID-19 incidence of any measured age range, giving them the second highest average incidence of 2.0% of any age range, fifty times higher than when children returned to school after the summer holiday, and slightly behind the 16 to 24 years old age range at 2.3% incidence.[223][224][225]
Wales entered a 3-week firebreak period on 21 October, which was described by James Forsyth of the Spectator as "the most dramatic divergence between the UK nations yet".[226]
On 31 October, Prime Minister Boris Johnson announced that England would enter a four-week national lockdown on 5 November, when pubs, restaurants, leisure centres and non-essential shops would close. Unlike in March, schools, colleges and universities would remain open. In addition, the furlough scheme was extended to the end of November.[227] This came as the UK became the ninth country to exceed 1 million cases of COVID-19 nationwide.[228]
November 2020: New lockdowns
On 2 November, a five-level tier system came into force in Scotland to help curb the spread of COVID-19 in regional and local areas. In Scotland, Edinburgh, Glasgow and all towns in the central belt were placed on level 3.
- Level 0 (Lowest) – A maximum of 8 people from three different households would be allowed to meet indoors.
- Level 1 – A maximum of 6 people from two different households would be allowed to meet indoors. Pubs and restaurants would remain open, but still face a curfew at 10:30pm. Funerals and weddings would face a 20 person limit.
- Level 2 – Households would be banned from mixing but a maximum of 6 people from different households can meet outside. Pubs and restaurants still face a curfew. Non-essential shops and hairdressers would remain open under these restrictions.
- Level 3 – Rule of 6 applies to people meeting outside. Non-essential travel out of level three strictions was banned. Non-essential shops, hairdressers, pubs and restaurants would remain open, but alcohol sales would be banned.
- Level 4 (Highest) – Rule of 6 still applies to people meeting outside. Travel limits and a 'Stay at Home' message would be enforced. All non-essential shops, hairdressers, pubs and restaurants would close. Schools would remain open.
No regions of Scotland were immediately placed under level 4 restrictions.
On 9 November, Wales ended its firebreak lockdown and returned to national measures. Two household bubbles could be formed now, 15 people could meet indoors while up to 30 people could now meet outdoors. Schools also reopened as well as non-essential businesses. While travel restirictions within Wales were lifted, people couldn't travel to and from England unless there was an essential reason and the Welsh government still advised working from home.[229]
Total deaths in the UK passed 50,000 on 11 November, the first European nation to do so.[230] It came as the governments of the various countries of the UK announced an evacuation-style plan to get university students home for Christmas and to continue studying from home.[231] By this time, the total number of cases reported was 1,256,725 and the death toll was 50,365.
The following day, 12 November, a new daily high of 33,470 COVID-19 cases which had tested positive were reported for the United Kingdom as a whole, making a new record for the daily figures since mass testing commenced.[232]
On 13 November, Vaughan Gething, Health Minister, announced that initial positive test by Lighthouse Labs (Uk based) have been overturned by Public Health Wales and confirmed that all contact tracing in Wales is organised by the Welsh Government: and that they have contacted 9 out of 10 contacts received from people who have been infected."[233]
Also, the UK Government shortened quarantines for travellers arriving in England to seven days with a 'Test and Release' programme requiring those self-isolating to test negative before leaving quarantine. Heathrow Airport also introduced rapid testing before travellers would board their flights.[234]
On 23 November, trials showed that the COVID-19 vaccine developed by Oxford/AstraZeneca was 70% effective, which could be as high as 90% by tweaking the dose. While hailed as a success, it was 25% less effective than the vaccines developed by Pfizer and Moderna.[235] On the same day, the UK government published some details of a proposed new three-tier legal framework which would apply in England from 2 December.[236]
On 25 November, a total of 696 new deaths due to COVID-19 were announced for the UK, the highest daily figure of coronavirus-related fatalities reported since 5 May 2020.[237]
At the end of November, the UK Government announced it would offer four months of free vitamin D supplements to all those in care homes and shielders – with the prison service also providing supplements to prisoners.[238]
On 29 November, Nadhim Zahawi Parliamentary Under-Secretary of State for Business, Energy and Industry was appointed as COVID vaccine deployment minister.[239]
On 2 December, a replacement three-tier system was implemented in England under The Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020.[240]
Winter 2020–21: Immunisation, new variant and surge
December 2020: First vaccines approved, new variant
On 2 December, the Pfizer‑BioNTech COVID‑19 vaccine (BNT162b2) was approved by the Medicines and Healthcare products Regulatory Agency (MHRA) making the UK the first country in the world to approve a COVID–19 vaccination.[241] The first consignment of the Pfizer–BioNTech COVID-19 vaccine arrived in the UK on 3 December.[242] On the same day, government agreed under regulation secondary to the Vaccine Damage Payment Act 1979 the statutory ₤120,000 blanket payout for any person provably damaged by the vaccine, and by the same token, government-approved COVAX manufacturers were exempted from legal pursuit. Individuals who provide the vaccine (and thus are permitted by government to do so) are also protected.[243] Statutory Instrument 2020 No. 1125 had on 16 October delegated permission to "the classes of persons permitted to administer medicinal products under the protocol" written by the MHRA, as opposed to delegating permission to NHS staff only as had been the practice before the publication of this instrument.[244]
On 8 December, the immunisation campaign commenced, with 90 year-old Margaret Keenan becoming the first individual to receive the Pfizer–BioNTech COVID-19 vaccine, the first administration of a COVID-19 vaccine outside of a clinical trial.[245] This milestone was dubbed "V-day" by some media outlets, an allusion that combined the initial of "vaccine" with a reference to wartime victory celebrations.[246][247] She received her second dose on 29 December,[248] and then had a 5 day wait for optimum protection.
On 19 December, it was announced that a new "tier four" measure would be applied to London, Kent, Essex, Bedfordshire and Hertfordshire, to try to control the spread of a new variant of the virus, Variant of Concern 202012/01. At the time the restrictions were announced, the new variant was becoming more prevalent; it appeared to be more contagious than previous variants, but there was no evidence on its virulence and susceptibility to vaccinations were unclear.[249][250] Under tier four restrictions people are not permitted to interact with others from outside of their own household, even on Christmas Day. This restriction would apply from midnight of 19/20 December. Johnson announced that relaxation of rules outside the new tier 4 over Christmas would now only be for Christmas Day. It was also announced that restrictions would tighten in Wales.[251][252] Nicola Sturgeon announced that the whole of Scotland would enter Scotland's tier four, and travel to and from the rest of the UK would be banned. An exception in Scotland was likewise provided for Christmas Day, and a five-day relaxation of rules was cancelled.[253]
From 20 December 2020 countries around the world were introducing bans on travel from the UK as the first response to the new variant.[27] Operation Stack was implemented to park lorries on the M20 motorway as ferry travel to France for passengers and accompanied freight were stopped entirely.[254] Unaccompanied freight could continue to move, and goods traffic from France into the UK was not directly affected,[254] although drivers may be reluctant to enter the UK and have to quarantine on return. On 22 December, France started allowing accompanied freight again, as long as the driver had proof of a negative COVID-19 test within the past 72 hours.[255]
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On 24 December, the Office for National Statistics weekly infection survey in England showed that COVID-19 incidence in secondary school children ages 11 to 16 had increased to 3.0%, the highest of any measured age range and two and a half times higher than the all ages average of 1.2% incidence.[256][257] Subsequently Education Secretary Gavin Williamson announced on 30 December that schools in some English areas with high COVID-19 levels would remain closed to most children after the Christmas holiday for the first week or two of January, reversing his previous position.[258] The government expected secondary schools to offer weekly lateral flow COVID-19 tests to pupils from January.[259][260] Former Chief Scientific Adviser Sir Mark Walport stated that secondary school children were seven times more likely to introduce COVID-19 into a household than other members of a household.[261]
UK hospitals and emergency services came under severe strain in late December, surpassing their previous record of highest hospital capacity set in April as a result of a record surge in COVID-19 cases. London emergency services had one of the "busiest days ever" on 26 December, and hospitals across the Southeast restricted staff leave and non-COVID related care in response. The NHS warned of further strain on resources, deaths and hospitalizations into January.[262][263][264][265][266] A record 55,892 new cases were reported on 31 December, along with 964 deaths.[267]
On 30 December the (ChAdOx1 nCoV-19 or AZD1222) vaccine developed by Oxford University and AstraZeneca (the British-Swedish pharmaceutical and biopharmaceutical company), became the second Covid-19 vaccine approved for use in the UK, for deployment the following week. This advance was reported to allow for a rapid increase in the speed of the vaccination program, due to more doses being available, and due to the Oxford vaccine's higher storage temperature making distribution easier.[268] On the same day, Covid restrictions increased across England as regions containing 20 million people were escalated to the highest "tier 4" restrictions, across the North of England, the Midlands, and the South West.[269]
January 2021: Vaccination expands and restrictions tightened
On 4 January 82-year-old Brian Pinker became the first person to receive the Oxford–AstraZeneca COVID-19 vaccine as the UK vaccination program expanded to include it.[270] On the same day, the Prime Minister stated that Covid-induced restrictions would likely increase as cases continued to surge across the country, with more than 50,000 daily cases reported for the sixth consecutive day, and the Labour Party calling for immediate escalated action across England.[271]
In addition, the First Minister of Scotland announced new restrictions for Scotland, with stay-at-home orders issued and closure of schools until February.[272] The Prime Minister later confirmed that England would enter a third lockdown from 5 January, with similar restrictions to the first lockdown in March 2020, including school closures unlike the second lockdown in November. Restrictions were initially expected to last until mid-February.[273] In Wales, the government confirmed that schools and colleges will remain closed until 18 January, this was later extended to 22 February.[274][275]
On 8 January 2021, MRNA-1273 (commonly known as the Moderna COVID-19 vaccine) was the third Covid-19 vaccine approved for use in the UK.[276] In total, 17 million doses have been ordered.[277]
After receiving approval from the Medicines and Healthcare products Regulatory Agency (MHRA) on 30 December 2020, the Oxford–AstraZeneca COVID-19 vaccine started being administered in Scotland on 11 January 2021, in GP practices and community centers across the country.[278]
On 26 January, the Prime Minister announced in an address that in the period leading up to 25 January from the start of the pandemic, over 100,000 people in the UK had died within 28 days of a positive Covid-19 test, the UK being the fifth country to reach this number of deaths.[279] The following day, the Prime Minister also announced a plan for "phased easing" of restrictions beginning in early March dependent on the statistics at that time,[280] although also noting that schools in England would remain closed until 8 March "at the earliest".[281] Northern Irish schools were later confirmed to also be closed until this date,[282] although on 29 January it was announced that schools in Wales could still open as soon as 22 February if cases continued to fall in the region.[283]
UK and devolved government responses
Because of devolution, the responses by each of the four nations have differed from one another; the Scottish Government, the Welsh Government, and the Northern Ireland Executive have produced different policies to those produced by Government of the United Kingdom (many of which apply only to England). The National Health Service is the publicly funded healthcare system in the UK; each nation has its own National Health Service and public health bodies, funded by devolved block grants via the Barnett formula and accountable to their devolved governments.
National health services response
Healthcare in the UK is a devolved matter, with England, Northern Ireland, Scotland, and Wales each having their own systems of publicly funded healthcare, funded by and accountable to separate governments and parliaments. As a result of each country having different policies, laws and priorities, a variety of differences now exist between these systems.[10][9]
Personal protective equipment
As early as February 2020 frontline healthcare workers began to raise their concern regarding the UK's preparedness to cope with a large-scale outbreak.[285] On 2 March a poll conducted by the Doctors' Association UK found that just 8 out of 1600 doctors though the NHS was well prepared to deal with Coronavirus.[286]
On 16 March, primary care magazine Pulse reported doctors were receiving out-of-date PPE that had had its 2016 use-by date covered with a sticker saying "2021".[287] In response, the government offered reassurance that this was safe.[288] Earlier in the month, in response to a survey of Pulse's readership, two of five GPs reported they still did not have PPE to protect them from coronavirus.[287] Some of these concerns were raised with Johnson during Prime Minister's Questions, to which the Prime Minister replied the UK had "stockpiles" of PPE.[289] The same day, the Doctors' Association UK (DAUK) reported NHS staff felt they were being put at risk due to lack of PPE.[290]
On 22 March, in a letter with 3,963 signatures co-ordinated by the Doctors' Association UK published in The Times, NHS staff asked Johnson to "protect the lives of the life-savers" and resolve the what they saw as the "unacceptable" shortage of protective equipment.[291][292] On 23 March, in an effort to meet demand and due to concerns about the rising number of medics becoming ill after exposure to the virus, the NHS asked DIY stores to donate PPE for use by NHS staff.[293] Frontline healthcare workers raised concerns that they had been forced to source their own PPE from Screwfix.[294] Hancock said there were "challenges" with supplying PPE to NHS staff and said a million masks had been bought that weekend.[295] The following day, the government said there was enough PPE for everyone in the NHS who needed it; this was contradicted by the Royal College of Nursing,[296] the British Medical Association (BMA), and the Doctors' Association UK which warned that without enough PPE, doctors would die.[297][298]
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On 1 April, the government said 390 million pieces of PPE had been distributed to the health service in the past fortnight. The Royal College of Midwives (RCM),[299] BMA and DAUK said the supplies had yet to reach medical staff.[300][301] The RCM, in a joint statement with unions, including Unite, Unison and the GMB, said the lack of PPE was now 'a crisis within a crisis'.[299]
On 9 April it was reported that protective gowns were set to run out by that weekend in London.[302]
On 10 April the UK Government sent out a document to PPE suppliers informing them that suppliers of certain medical equipment, including protective masks, gloves and aprons, must be registered with the Care Quality Commission, which regulates all health and social care services in England only. There was not a similar agreement in place between suppliers and Care Inspectorate Wales or the Care Inspectorate of Scotland.[303][304] The Welsh Government advised care home providers that they should order through their local council, while Plaid Cymru leader Adam Price lodged a formal complaint with the European Union over the issue.[304] The manager of two care homes in Gwynedd, Wales, was told by two suppliers that they would only sell to care homes in England.[305] The chief executive of the care home umbrella group Scottish Care said that the UK's four largest PPE suppliers had said they were not distributing to Scotland because their priority was going to be "England, the English NHS and then English social care providers".[306] The UK government reported that it had not instructed any company to prioritise PPE for any nation.[306] Healthcare supplier Gompels' website said at the time that "These restrictions are not something we have decided, they are a criteria[sic] given to us by Public Health England".[307]
After collating data from over 1500 frontline NHS doctors on ongoing shortages the Doctors' Association UK demanded a public inquiry into the government's failure to adequately procure and supply PPE and healthcare worker deaths.[308] As of August 2020 over 120,000 people had signed a petition for a public inquiry into healthcare worker deaths and PPE and DAUK launched a legal challenge for a judicial review.[309]
A BBC Panorama episode, Has the government failed the NHS?, broadcast on 27 April, said the government had been counting PPE items in a way that artificially inflated the total. Gloves were counted individually, rather than as pairs, for instance, and non-PPE items, such as paper towels and detergent, were included in the figure.[310] The programme also said the government was changing the guidance on what PPE was appropriate for medical staff to wear when treating COVID-19 patients, not according to best protective procedure, but according to the stock available.[311] The programme also said that, in the years before the pandemic, the government had ignored expert advice and failed to stockpile essential items.[311] Due to lack of stock, in May an NHS trust prioritised anti-bacterial ventilator filters for coronavirus patients over others. .[312]
Ventilators
On 16 March, Boris Johnson held a conference call with business leaders and set them the target of delivering 30,000 ventilators in a fortnight; the government also declined to join an emergency European Union scheme to procure ventilators and other emergency equipment like personal protective equipment (PPE) for hospital staff, saying the UK was no longer part of the EU and that this was area in which it was making its own efforts.[313] Existing ventilator stocks stood at 5,900 at the beginning of the outbreak.[314]
On 29 March, the government issued a specification for the "minimally clinically acceptable" manufacture and use of continuous positive airway pressure (CPAP) machines.[315]
Staffing
On 1 March, Hancock said retired NHS staff might be asked to return to work to help with the crisis.[316] The request was issued on 19 March and included final year medical students.[317] On 29 March, Boris Johnson announced that more than 20,000 former NHS staff were returning to work in response to the pandemic.[318]
Whilst ventilators were procured frontline NHS staff raised concerns about a lack of trained staff to operate them. On 15 March both the BMA and the Doctors' Association UK both raised the alarm that the NHS was short of nearly 43,000 nurses and 10,000 doctors prior to the pandemic.[319] Concerns were also raised that staff were being pressured to return from self-isolation early due to severe short staffing.[320]
On 21 March, the NHS had agreed to use, at cost price, almost the entire private health system, bringing 20,000 medical staff into the national effort.[321]
On 24 March, Matt Hancock launched a scheme to recruit 250,000 volunteers to support the NHS through the pandemic.[322] The volunteers would carry out jobs like collecting and deliver shopping, medication or "other essential supplies" for people in isolation; transporting equipment and medication between NHS services; transporting medically fit patients and providing telephone support to people at risk of loneliness because of self-isolation.[323] The target was surpassed in 24 hours and was raised to 750,000.[324] The scheme was paused on 29 March after the new target was reached.[323]
Military personnel from the newly-formed COVID Support Force helped staff NHS Nightinghale hospitals, mobile test centres and some ambulance services.[325]
Temporary critical care hospitals
In Northern Ireland capacity was upgraded at Belfast City Hospital, while in Scotland, NHS Louisa Jordan was established in Glasgow by NHS Scotland.[326]
NHS England established temporary "Nightingale" hospitals in London, Birmingham, Manchester and Harrogate. The Dragon's Heart Hospital was set up at the Principality Stadium in Cardiff, Wales.[327] Military personnel from the COVID Support Force assisted with the construction and subsequent staffing.[325]
Testing and monitoring
Shortly after confirming that the cause of the cluster of pneumonia in Wuhan was a new coronavirus, Chinese authorities had shared its genetic sequence for international developments of diagnostic kits.[60] By 10 January,[328] the UK had developed a prototype specific laboratory test for the new disease, performed on a sample from the nose, throat, and respiratory tract and tested at PHE's public health laboratory at Colindale in London.[39] Testing of patients began within days,[329] and by 3 February 326 tests had been performed in the UK.[330] Over the following few weeks, PHE made the test available to 12 other laboratories in the UK, making it possible to test 1,000 people a day.[39][331]
By 12/13 March 2020, 29,764 tests had been conducted in the UK, corresponding to 450.8 tests per million people.[332] On 24 March, Matt Hancock said the government had bought 3.5m kits that would test if a person has already had COVID-19; no date was given for their arrival. These tests would allow people to know if they were immune and therefore able to "go back to work".[333] It was later found when the kits, which had cost at least £16 million, were tested, they did not meet the required specifications.[334] Hancock announced on 28 March that 10,000 tests a day were now being processed; the actual figure was 5,000.[335][336] As of 31 March 143,186 people had been tested.[3]
The UK government and Public Health England were criticised for what some saw as a failure to organise mass testing. On 28 March the editor-in-chief of The Lancet published a condemnation of what he saw as government inaction and ignoring of WHO advice.[337] On 31 March, former WHO director Anthony Costello, following WHO advice that countries should "test, test, test", said the key to the UK's transitioning out of lockdown was mass testing, and that the UK had the capacity to reach the level of testing being carried out by Germany (70,000 tests a day, compared to the UK's 5,000) but the government and Public Health England (PHE) had been too slow and controlling to organise.[338] The day after, Conservative MP Jeremy Hunt, chair of the Health and Social Care Select Committee and former Health Secretary, said it was "very worrying" that the government had not introduced mass testing because doing so had been "internationally proven as the most effective way of breaking the chain of transmission".[339] On 2 April, The Telegraph reported that one of the Government's science advisers, Graham Medley, said "mass public testing has never been our strategy for any pandemic". Medley also said the Government "didn't want to invest millions of pounds into something that is about preparedness".[340]
The UK Government launched a booking portal for people to be tested for COVID-19. The governments of Scotland and Northern Ireland governments signed up to use the portal that England were using. The Welsh Government went on to partner with Amazon to create a portal. Later this was scrapped with the Welsh Government citing issues around collecting of data having been resolved with the UK government's portal and now wanted to use it, having only released their version across south east Wales.[341]
In May, the Department of Health and Social Care and Public Health England confirmed that two samples taken from single subjects, such as in the common saliva and nasal swab test, are processed as two separate tests. This, along with other repeated tests such as checking a negative result, led to the daily diagnostic test numbers being over 20% higher than the number of people being tested.[342]
On 18 May, testing was extended to anyone over the age of five after the governments of all four nations agreed to the change.[343]
On 29 September, a letter in Lancet highlighted the increasing likelihood of overestimating of COVID-19 incidence as more asymptomatic people are included in RT-PCR testing with consequent "misdirection of policies regarding lockdowns and school closures," noting that the false-positive rate in the UK is currently unknown, with "preliminary estimates ... somewhere between 0·8% and 4·0%".[344][345] The letter called for "stricter standards ... in laboratory testing, ... and pretest probability assessments ... [including] symptoms, previous medical history of COVID-19 or presence of antibodies, any potential exposure to COVID-19, and likelihood of an alternative diagnosis."[346]
Special arrangements were made with Royal Mail for the delivery of testing kits and their collection from designated "Priority Postboxes", which were identified by the attachment of special stickers.[347]
By the week 12-18 January 2021 testing was running at 3,970,346 tests per week.[348]
England
Following 300 staff being asked to work from home on 26 February in London, while a person was awaiting a test result for the virus, PHE expanded testing around the UK to include people with flu-like symptoms at 100 GP surgeries and eight hospitals: the Royal Brompton and Harefield, Guy's and St Thomas' and Addenbrookes Hospital, as well as hospitals at Brighton and Sussex, Nottingham, South Manchester, Sheffield, Leicester.[349][350]
Drive-through screening centres were set up by Central London Community Healthcare NHS Trust at Parsons Green Health Centre on 24 February 2020,[351] A further drive-through testing station was set up by the Sheffield Teaching Hospitals NHS Foundation Trust at a site just off the A57 Sheffield Parkway dual-carriageway on 10 March; in this case, patients ringing NHS 111 with coronavirus-like symptoms in the Sheffield area will be told to drive, if possible, to the testing centre at an allotted time.[352]
On 11 March, NHS England announced that testing in NHS laboratories would increase from testing 1,500 to 10,000 per day.[353] The test consists of taking a sample from the nose, throat, deeper lung samples, blood or stool, and transporting the packed samples to the listed PHE regional laboratory designated for the referring laboratory region.[354][355] On 14 May PHE approved an antibody test by Swiss company Roche.[356] Abbott Laboratories said that they also had an antibody test approved by the public health boards of England, Scotland and Wales.[357]
The British Medical Association (BMA) asked 8,190 doctors and medical students in England about their concerns about COVID-19; the results were published on 14 September 2020. 86% of respondents expected a second peak, and it was the main concern for 30%. 89% of respondents agreed or strongly agreed that the failure of test and trace risked causing a second wave.[358][359]
Scotland
On 29 February drive-through testing was set-up by NHS Lothian at the Western General Hospital in Edinburgh.[360] On 1 March 2020 it was reported that surveillance was shortly to be extended to some hospitals and GP surgeries in Scotland.[361]
Scotland were developing their own contact tracing system, with contact tracing being done by telephone rather than an app.[362][363]
Wales
On 21 March, Welsh Government Health Minister Vaughan Gething said that the target was 9,000 tests by the end of April. Public Health Wales Chief Executive Tracey Cooper confirmed on 7 May that Wales was to receive an extra 5,000 COVID-19 test kits per day, before the UK Government stepped in and stopped them. The Swiss pharmaceutical company Roche Diagnostics and the Welsh Government had a gentleman's agreement, verbally and through emails. Dr Cooper blamed the UK government "for gazumping Wales's Covid-19 testing deal" with Roche; this left Wales only able to carry out 800 tests a day. Public Health England said that it had not interfered with any contract but said "The UK Government recently asked us to establish a partnership with Roche to support increased diagnostic testing in the UK for Covid-19."[364][365]
On 21 May 2020 the Welsh Government announced that one of the new antibody blood tests for the SARS-CoV-2 virus is being produced by Ortho Clinical Diagnostics (OCD) at Pencoed, Wales, in partnership with Public Health Wales. The test will be rolled out, prioritised and managed and will also be available in care homes. According to Health Minister Vaughan Gething, this test is an important part of the "Test, Trace, Protect" strategy which will help Wales come out of lockdown.[366]
Mobile phone apps
On 4 May, a test version of the NHS's contact tracing app was released.[367][368] The app was trialled on the Isle of Wight.[367][368]
Matthew Gould, CEO of NHSX, the government department responsible for the app, said the data would be accessible to other organisations for legitimate public health reasons, but could not list which.[369] Faculty, a company linked to Cambridge Analytica and Palantir, also linked to Cambridge Analytica,[370] worked on the app.[371] The data collected would be handled according to the data access regulations and would be held in a centralised repository.[372][370][373] Over 150 of the UK's security and privacy experts warned the app's data could be used by 'a bad actor (state, private sector, or hacker)' to spy on citizens.[374][375] Fears were discussed by the House of Commons' Human Rights Select Committee about plans for the app to record user location data.[367] Parliament's Joint Committee on Human Rights said the app should not be released without proper privacy protections.[376]
The Scottish government said they would not recommend the app until they could be confident it would work and would be secure.[377] The functionality of the app was also questioned as the software's use of Bluetooth required the app to be constantly running, meaning users could not use other apps or lock their device if the app was to function efficiently.[368]
Digital inclusion advocates told the Culture, Media and Sport Committee in May that there was a digital divide with the app, with many people missing out due to not having access to the Internet or having poor IT skills. The advocates said that 64% of the population who had not used the Internet were over the age of 65, and that 63% of the population who did not know how to open an app were under the age of 65.[378] It was reported by the Financial Times that a second app was in development using technology from Apple and Google.[379][380] The digital skills advocacy group FutureDotNow is running a campaign to provide connectivity to excluded households.[381]
On 18 June, Health Secretary Matt Hancock announced development would switch to the Apple/Google system after admitting that Apple's restrictions on usage of Bluetooth prevented the app from working effectively.[382]
On 30 July 2020, the Northern Ireland Executive launched the StopCOVID NI app based on the Republic of Ireland app developed by Nearform which uses the Apple/Google Exposure Notification system. The app interoperates with the Republic of Ireland version of the app.[383]
The COVID Symptom Study app is an independent initiative led by Professor Tim Spector of King's College, London and endorsed by the Scottish, Irish and Northern Ireland governments but not the UK government. It was released on the App Store and Google Play on 24 March, and as of 18 September had 4,214,516 contributors who had downloaded the app.[384] It shows the estimated current active infections by local council areas updated daily.[385]
Research and innovation
Biological research
UK Research and Innovation also announced £20 million to develop a COVID-19 vaccine and to test the viability of existing drugs to treat the virus.[386] The COVID-19 Genomics UK Consortium will deliver large-scale, rapid whole genome sequencing of the virus that causes the disease and £260 million to the Coalition for Epidemic Preparedness Innovations to support vaccine development.[387][388] In April, the UK Government launched a task force to help develop and roll out a coronavirus vaccine.[389][390] A University of Edinburgh led study in to whether specific genes cause a predisposition into the effects that COVID-19 had on people began in May.[391][392] The London School of Hygiene & Tropical Medicine, studied whether sniffer dogs could detect coronavirus in humans.[393] Following research by King's College London of symptoms from 1.5 million suspected cases, "loss of taste or smell" was added to the NHS symptoms list.[394]
Design and innovation
In March 2020, the government asked manufacturers in the UK to help in the production of respiratory devices to help fight COVID-19.[395] Innovate UK announced £20 million funding for innovative businesses.[396] The Formula One teams and manufacturers based in the UK linked up to form "Project Pitlane".[397]
A group of engineers from Mercedes and University College London, along with staff from University College Hospital, designed and made a product known as UCL-Ventura breathing aid, which is a continuous positive airway pressure (CPAP) device. The Medicines and Healthcare products Regulatory Agency (MHRA) approved the second model of the device. The UK Government put an order in for 10,000 devices. Mercedes made the drawings for the device available for free to help other countries fight COVID-19.[398][399] On 16 April the MHRA approved the Penlon Prima ESO2, design which was part of the stream known as VentilatorChallengeUK. The UK government ordered 15,000 of these devices.[400][401] A consortium of aerospace companies including Airbus, Meggitt, and GKN worked on scaling up production of an existing design.[402][403] In April this design was approved by the MHRA and an order for 15,000 units was placed.[404] Other designs by JCB, Dyson and BlueSky were not taken forward.[405] Eight other designs had their support ended by the UK government.[405][406][407][399]
A CPAP device, known as a Covid emergency ventilator, designed by Dr Rhys Thomas, a consultant anaesthetist at Glangwili General Hospital in Carmarthen, was given the go-ahead by the Welsh Government.[408] The machine, designed in a few days was used on a patient in mid-March, and subsequently funded by the Welsh Government. In early April, it was approved by the MHRA. Production is by CR Clarke & Co in Betws, Carmarthenshire.[409][410]
Jaguar Land Rover (JLR) produced a reusable visor with the first deliveries just before Easter, and shared the designs to allow wider manufacture.[411][412] The Royal Mint manufactured medical visors for medical staff working during the pandemic.[413][414]
Clinical trials
As of December 2020, clinical trials of five coronavirus vaccine candidates have been conducted in the UK: Oxford-AstraZeneca AZD1222, Imperial College London LNP-nCoVsaRNA, Novavax NVX-CoV2373, Janssen Pharmaceutica Ad26.COV2.S, and Valneva SE VLA2001.[415]
Impacts
Economic
The pandemic was widely disruptive to the economy of the United Kingdom, with most sectors and workforces adversely affected. Some temporary shutdowns became permanent; some people who were furloughed were later made redundant.[416][417] The economic disruption has had a significant impact on people's mental health—with particular damage to the mental health of foreign-born men whose work hours have been reduced/eliminated.[418]
Social
The pandemic has had far-reaching consequences in the country that go beyond the spread of the disease itself and efforts to quarantine it, including political, cultural, and social implications.
Spread to other countries and territories
Sophie Grégoire Trudeau, the wife of Canadian Prime Minister Justin Trudeau, tested positive for COVID-19 upon her return from WE Day events in the UK; on 12 March 2020 the Trudeau family entered two weeks of self-isolation.[419] The first patient in Mauritius was a 59-year-old man who returned from the United Kingdom on 7 March 2020. When he arrived in Mauritius, the Mauritian had no symptoms.[420] Other cases of the novel coronavirus resulting from travel to the UK were subsequently reported in India[421][422] and Nigeria.[423]
On 16 June, it was widely reported in British media that New Zealand's first COVID-19 cases in 24 days were diagnosed in two British women, both of whom had travelled from the UK and were given special permission to visit a dying parent. The women had entered the country on 7 June, after first flying into Doha and Brisbane.[424]
Anti-lockdown protests
On 29 August 2020, thousands of protesters gathered in Trafalgar Square objecting to the continuation and extension of COVID-19 restrictions.[425] The event included speakers such as conspiracy theorist David Icke and Piers Corbyn.[426] Police urged demonstrators to disperse under social distancing laws advising them in a distributed leaflet that they may be committing a criminal offence.[425]
Statistics
Cumulative cases by day of report
Cumulative cases by date of report. Source: figures reported at coronavirus.data.gov.uk.[427] On 2 July, case data from pillars 1 and 2 of the testing programme (swab testing in Public Health England (PHE) labs and NHS hospitals for those with a clinical need, and health and care workers; and swab testing for the wider population, as set out in government guidance) were combined and de-duplicated, resulting in a step decrease in the cumulative number of cases reported.
Cases per day by date of report
Cases per day by date of report, with a seven-day moving average. Source: figures reported at coronavirus.data.gov.uk.[427]
Cumulative deaths within 28 days of positive test by date of report
Cumulative deaths within 28 days of positive test, by date of report, with a seven-day moving average. Source: figures reported at coronavirus.data.gov.uk.[428]
Deaths within 28 days of positive test, per day, by date of report
Deaths within 28 days of positive test, per day, by date of report, with a seven-day moving average. Source: figures reported at coronavirus.data.gov.uk.[428]
New cases by day reported
Source: the figures are as reported daily at coronavirus.data.gov.uk.[429]
' * ' Values for these dates questionable in light of announcement of 3 October: Following under-reporting due to a 'technical issue' between 25 September and 1 October, 15,841 additional cases were reported on 3 and 4 October.
' x ' Values for these dates questionable in light of announcement of 16 December: Public Health Wales announced that there had been a delay in transferring data from the Lighthouse Labs which had resulted in under-reporting over the preceding week of approximately 11,000 positive tests. The 'missing' numbers were reported instead on 16 December.[430]
Warning: the values in the above graph are not directly comparable between different time periods because they were measured under different testing rates. It is therefore vital to consult Test positivity rate and New daily tests, and to understand the strategy for selection of subjects for testing.
Total Vaccinations
As of 4 January 2021, two vaccines are authorised in the UK (the Pfizer‑BioNTech COVID‑19 vaccine and the Oxford/AstraZeneca vaccine). These both require two doses. The upper line shows cumulative first doses and the lower line shows cumulative second doses.[431]
Demographics
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Statistics suggest that certain groups in British society have been particularly affected by the pandemic both medically and by the impact of lockdown.[432]
Coronavirus risk and ethnicity
In April 2020, the British Medical Association called on the government to investigate if and why people from black, Asian and minority ethnic (BAME) groups were more vulnerable to COVID-19, after the first 10 doctors to die were all from the group.[433] The Labour Party called for a public enquiry after the first 10 deaths in the health service were from BAME backgrounds.[434] The Mayor of London Sadiq Khan wrote to the Equality and Human Rights Commission asking them to investigate whether the effects of coronavirus on BAME groups could have been prevented or mitigated.[435] A group of 70 BAME figures sent a letter to Boris Johnson calling for an independent public enquiry into the disproportionate impact of the coronavirus on people from black, Asian and minority ethnic backgrounds.[436]
Research by the Intensive Care National Audit and Research Centre concluded that people from BAME backgrounds made up 34% of critical patients.[437] NHS England and Public Health England were appointed to lead an inquiry into why people from black and minority ethnic backgrounds appear to be disproportionately affected by coronavirus.[438] On 18 April, Public Health England said that they would start recording the ethnicity of victims of coronavirus.[439]
Research carried out by The Guardian newspaper concluded that ethnic minorities in England when compared to white people were dying in disproportionately high numbers. They said that deaths in hospitals up to 19 April 19% were from BAME backgrounds who make up only 15% of the population of England.[440]
The Office for National Statistics (ONS), meanwhile, wrote that in England and Wales black men were four times more likely to die from coronavirus than white men, from figures gathered between 2 March to 10 April.[441][442] They concluded that "the difference between ethnic groups in COVID-19 mortality is partly a result of socio-economic disadvantage and other circumstances, but a remaining part of the difference has not yet been explained". Some commentators including Dr. John Campbell have pointed to Vitamin D deficiency as a possible cause of the discrepancy, but the theory remains unproven.[443]
Another study carried out by University of Oxford and the London School of Hygiene and Tropical Medicine on behalf of NHS England and a separate report by the Institute for Fiscal Studies corroborated the ONS' findings.[444][445][446] An Oxford University led study into the impact of COVID-19 on pregnancy concluded that 55% of pregnant women admitted to hospital with coronavirus from 1 March to 14 April were from a BAME background. The study also concluded that BAME women were four times more likely to be hospitalised than white women.[447][448]
A study by Public Health Scotland found no link between BAME groups and COVID-19.[449] A second Public Health England study found that those with a Bangladeshi heritage were dying at twice the rate of white Britons. Other BAME groups had between 10% and 50% higher risk of death from COVID-19.[450][451][452]
Fines and ethnicity
Figures from the Metropolitan Police showed that BAME people received proportionally more fines than white people for breaching COVID-related restrictions.[453]
Coronavirus risk and employment status
The ONS study, using data collected up to 17 April 2020 across England and Wales, concluded that men in low-skilled jobs were four times more likely to die from the virus than those in professional jobs. Women who worked as carers were twice as likely to die than those who worked in technical or professional jobs. The GMB trade union commented on the findings that ministers must stop any return to work until "proper guidelines, advice and enforcement are in place to keep people safe". An analysis of the figures by The Guardian concluded that deaths were higher in occupations where physical distancing was more difficult to achieve.[454] Analysis by The Independent and the Financial Times concluded that mortality rates from coronavirus were higher in deprived and urban areas than in prosperous and rural locations, across England and Wales.[455][456] Analysis of the ONS data by the Guardian also concluded that by 13 May, only about 12% of people who had died from the virus in England and Wales were under 65 while 59% were over 80.[457] A Public Health England report in June 2020 found that security guards, taxi and bus drivers, construction workers and social care staff were at a higher risk of COVID-19 when compared to other occupations.[452]
Unemployment by age
One of the demographics most severally effected by the increase in unemployment during the pandemic were the youngest members of the working-aged population. Figures from the Office for National Statistics showed that 174,000 fewer 16- to 24-year-olds were employed in July to September 2020 than during the preceding three months. Their statistics also suggested youth unemployment as a percentage had increased more sharply than among the general population reaching 14.6% by November 2020.[458] The pandemic also appeared to have hurried many of the oldest workers exit from employment, data collected by the institute for fiscal studies in June and July 2020 showed that 6% of those aged 66–70 and 11% of those aged 71 and older who were working immediately before the crises were now retired half of whom had not previously planned to do so.[459]
See also
- COVID-19 pandemic in London
- COVID-19 pandemic in the British Overseas Territories
- COVID-19 pandemic in Guernsey
- COVID-19 pandemic in Jersey
- COVID-19 pandemic in the Isle of Man
- COVID-19 pandemic impact on retail (United Kingdom)
- Impact of the COVID-19 pandemic on education in the United Kingdom
- COVID-19 vaccination programme in the United Kingdom
Notes
- Death figures are those who have died after testing positive. It does not include the death of one British citizen on board the Diamond Princess cruise ship (see COVID-19 pandemic on cruise ships), or the 84 recorded deaths in the British Overseas Territories and Crown dependencies.
- Daily updates occur around 2 pm UTC.
- Not including cases identified in British Overseas Territories and Crown Dependencies, all of which test and report cases independently.
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External links
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Wikimedia Commons has media related to COVID-19 pandemic in the United Kingdom. |
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Wikiquote has quotations related to: COVID-19 pandemic in the United Kingdom |
- "Coronavirus (COVID-19)". NHS England.
- "Coronavirus (COVID-19): what you need to do [in England]". Government of the United Kingdom.
- "The Health Protection (Coronavirus) Regulations 2020". Government of the United Kingdom.
- "Advice on COVID-19 (coronavirus)". Health and Social Care (Northern Ireland).
- "Coronavirus | United Kingdom". worldometers.info.
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