Like many other countries, we are having a severe COVID-19 problem here in the UK today. In this post I share my opinion on the causes and what I think we should do.

Indeed, the situation is dire:

Image courtesy of *ourworldindata.org*.

To begin, I'll try to summarise what is probably going wrong here.

August: the bend upwards

After hitting a low on the 29th of July, August clearly marks the starting point of the second wave of COVID-19 in the UK. There are four things of note here:

First, one measure that was imposed in that month was the Eat Out to Help Out scheme, where everyone got a 50% discount when eating out on Mondays, Tuesdays or Wednesdays throughout the UK. Economically the scheme was a success, but inevitably more people shared indoor spaces, which inevitably led to an increase in cases again.

Second, August marked a period in general where the lockdown restriction were relatively light. But even the measures that were there were not followed very rigorously, as only 18% of the people fully self-isolated when having symptoms. The Independent has a clear piece on it as well, featuring this chart for clarity:

One could argue that people may have gotten tired of the lockdown measures, but if you check the paper you find the reasons are more complicated, involving for example:

• That only ~60% of the people can correctly identify the main symptoms of COVID-19 (cough, high temperature, loss of smell and taste) throughout this period.
• That the compliance rate itself actually only dropped a little bit between early April (starting phase of the lockdown) and August. In fact, the change is not even statistically significant.

Third, a lot of people went on holiday abroad, especially to countries like France and Spain, which saw a surge of cases already in August. In all fairness, this has likely led to a sizable number of new infections in the UK, and with a proper test and trace system, once could actually find this out entirely. This is because the SARS-CoV2 virus does tend to mutate, allowing you to track clearly the origin of most infections.

Reason 4: Track and Trace

The fourth and foremost reason is the failing track and trace system. Track and trace failed in February, because the authorities were caught prepared for the wrong pandemic, and many cases had already spread under the radar before everyone realised the extent of infections in the UK. We then entered a heavy lockdown in March, and track and trace was instated to make sure such a failure would not occur again.

Given that 40,000 funerals had taken place in the first few months, one would expect the government to realise the importance of this. And they did to some extent by investing £11 billion into a track and trace system. Some of this money went to a company named Serco, but the NHS itself and Public Health England also play a major role in the test and trace system.

However, the track and trace system failed again. Rapid testing is essential to limit the spread, but in August tests were often delayed or not done at all. This gave rise to an increase in COVID-19 cases leading into September.

September: the blooper

Already it was clear that the test and trace system was not effective in stopping the spread, as the cases per day steadily started to increase.

But the big, sudden peak towards the end of the month is caused by a humiliating blooper involving Microsoft Excel caused Public Health England to miss out on a whopping 15,841 COVID-19 cases. The exact blooper? They used a spreadsheet with too many columns. This blooper caused a huge gap in the track and trace system, and the number of cases to balloon even further.

Indeed, aside from lockdown measures and everything else, this error has caused a large amount of damage. Together with the overloaded test and trace system, we suddenly find ourselves in the situation we are in now, here in October.

October: what do we do now?

Courtesy of Flickr (shefftim).

Boris Johnson enacted a three Tier system of restrictions, with London currently in Tier-2. It's a step in the right directions, but with the number of cases still growing and people exhausted with the lockdown, they may comply with the measures (even) less now. So I doubt this will work well.

One of the biggest problems here is that we are still driving blind. Test and trace cannot cover most of the contacts, many cases in general are simply missed, and few people are measuring who is complying with the lockdown measures and who isn't. Letting the pandemic rage on is not an option. Hospitals will be overwhelmed, and the mortality count will quickly grow to exceed 100,000, perhaps even 200,000.

So the only thing people can reasonably aim for to reduce the number of cases quickly, fix and improve the test and trace system (might I suggest a port away from Excel?), and get the pandemic to a level where the test and trace can be done without major shortcomings.

The three Tier system can help to achieve that, but only if it is strongly and strictly enforced (which it is not, due to incessant budget cuts on law enforcement in the past decade).

The alternative offered by Labour is to enact a stricter “circuit-breaker” lockdown for a limited period of 2-4 weeks. But here too, the efficacy of that measure depends strongly on how well it is enforced.

Being rigorous: enforce and compensate

In general, the problem with this pandemic is that you can't afford to roll out half-baked, half-assed, half-enforced solutions to fight it.

A properly enforced lockdown will work (see New Zealand), massive adoption of masks will work (see Japan) and comprehensive testing and tracing can work as well (see Korea). But whatever it is the UK chooses to adopt, it needs to be done rigorously, not in the half-baked Pipo the Clown fashion that has been done now. And it also needs to compensate those who are most heavily hurt by the measures that need to enacted.

So pick an approach, throw the kitchen sink at it and make sure it's fully enforced and compensated for.

As for my personal preference: I think the best option is a very strongly enforced 3 week lock-down followed by (a) universal mask-wearing outside of the household (yes, that means keeping pubs and restaurants closed and properly compensating the owners) and (b) vastly improved track and tracing work. That way, the UK may be out of the woods relatively quickly, with somewhat limited further damage to people's health, well-being and financial stability.

Credits

Header image courtesy of CovidLive.