British government response to the COVID-19 pandemic - Biblioteka.sk

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British government response to the COVID-19 pandemic
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Prime Minister Boris Johnson delivers a press conference on 22 October 2020 with Chancellor of the Exchequer Rishi Sunak. The "Hands, Face, Space" slogan is displayed on their podiums

In response to the COVID-19 pandemic in the United Kingdom, the UK Government introduced various public health and economic measures to mitigate its impact. Devolution meant that the four nations' administrative responses to the pandemic differed; the Scottish Government, the Welsh Government, and the Northern Ireland Executive produced different policies to those that apply in England. Numerous laws were enacted or introduced throughout the crisis.

The UK government had developed a pandemic response plan in previous years. In response to the first confirmed COVID-19 cases in January 2020, the UK introduced advice for travellers coming from affected countries in late January and February 2020, and began contact tracing, although this was later abandoned.[1] The government incrementally introduced further societal restrictions on the public as the virus spread across the country in the following weeks, initially resisting more stringent measures introduced elsewhere in Europe and Asia.[2] Prime Minister Boris Johnson announced the first national lockdown on 23 March 2020 and Parliament introduced the Coronavirus Act 2020, which granted the devolved governments emergency powers and empowered the police to enforce public health measures.[3]

As the governments began lifting the nationwide stay-at-home order, policies and approaches diverged between the four nations. The Scottish government uniquely pursued an elimination strategy. Across the country, localised lockdowns, social distancing measures, self-isolation laws for those exposed to the virus and rules on face masks were introduced, as well as efforts to expand COVID-19 testing and tracing. In autumn and winter 2020, further nationwide lockdowns were introduced in response to a surge in COVID-19 cases and the Alpha variant. A COVID-19 vaccination programme began in December 2020. In mid-2021, the government lifted most restrictions during the third wave driven by the Delta variant, until the "winter plan" reintroduced some rules in response to the Omicron variant in December that year. Remaining restrictions were lifted in England from 24 February 2022 under a "living with COVID" plan announced by the government on that date. Economic support was provided to struggling businesses and to furlough employees to mitigate the severe economic impact. It also forwent the procurement process in contracts in response to shortages of PPE and medical equipment, major issues in the early months of the outbreak, and for developing a contact tracing app.

The UK government's response to the pandemic, in particular the timeliness of public health measures being introduced and lifted, has faced criticism from academic medical sources, media outlets, relatives of COVID-19 patients and various political figures. This criticism continued amid the Partygate scandal, as multiple government officials were revealed to have breached COVID-19 social distancing restrictions during lockdowns. A public inquiry into the response was established in June 2022.

Prior pandemic response plans

The UK Influenza Pandemic Preparedness Strategy was published in 2011 and updated in 2014,[4] alongside a review of the available medical and social countermeasures.[5] Pandemic flu guidance was published in 2013 and updated in 2017, covering guidance for local planners, business sectors, and an ethical framework for the government response. The guidance stated:[6]

There are important differences between 'ordinary' seasonal flu and pandemic flu. These differences explain why we regard pandemic flu as such a serious threat. Pandemic influenza is one of the most severe natural challenges likely to affect the UK.

In 2016, the government carried out Exercise Cygnus, a three-day simulation of a widespread flu outbreak. A report compiled the following year by Public Health England (but not made public) found deficiencies in emergency plans, lack of central oversight and difficulty managing capacity in care homes.[7] In June 2020, the Permanent Secretary at the Treasury Tom Scholar and the Cabinet Office Permanent Secretary Alex Chisholm told the Public Accounts Committee that the civil service did not subsequently create a plan for dealing with the pandemic's effects on the economy.[8]

Regulations and legislation

A restaurant in London in March 2020 offering home deliveries after dining-in was banned

The government published the Health Protection (Coronavirus) Regulations 2020 on 10 February 2020, a statutory instrument covering the legal framework behind the government's initial containment and isolation strategies and its organisation of the national reaction to the virus for England.[9] Other published regulations include changes to Statutory sick pay (into force on 13 March),[10] and changes to Employment and Support Allowance and Universal Credit (also 13 March).[11]

On 19 March, the government introduced the Coronavirus Act 2020, which grants the government discretionary emergency powers in the areas of the NHS, social care, schools, police, the Border Force, local councils, funerals and courts.[12] The act received royal assent on 25 March 2020.[13]

Closures to pubs, restaurants and indoor sports and leisure facilities were imposed in England via the Health Protection (Coronavirus, Business Closure) (England) Regulations 2020.[14]

The restrictions on movements, except for allowed purposes, were:

In England from 15 June 2020, the Health Protection (Coronavirus, Wearing of Face Coverings on Public Transport) (England) Regulations 2020 required travellers on public transport to wear a face covering.[19]

On 25 June 2020, the Corporate Insolvency and Governance Act 2020 was enacted to provide additional protections to companies in financial difficulty as a result of the impacts of the pandemic.[20]

Initial response (January–March 2020)

NHS England coronavirus poster, February 2020[21]
NHS England poster for the "Catch it, Bin it, Kill it" slogan which has been revived in the fight against COVID-19

The first published government statement on the COVID-19 situation in Wuhan was released on 22 January 2020 by the Department of Health and Social Care and Public Health England.[22] Guidance has progressed in line with the number of cases detected and changes in where affected people have contracted the virus, as well as with what has been happening in other countries.[23] In February, Chief Medical Officer (CMO) to the British government, Chris Whitty said "we basically have a strategy which depends upon four tactical aims: the first one is to contain; the second of these is to delay; the third of these is to do the science and the research; and the fourth is to mitigate so we can brace the NHS".[1] These aims equate to four phases; specific actions involved in each of these phases are:[citation needed]

  • Contain: detect early cases, follow up close contacts, and prevent the disease from taking hold in this country for as long as is reasonably possible
  • Delay: slow the spread within the UK, and (if it does take hold) lower the peak impact and push it away from the winter season
  • Research: better understand the virus and the actions that will lessen its effect on the British population; innovate responses including diagnostics, drugs, and vaccines; use the evidence to inform the development of the most effective models of care
  • Mitigate: provide the best care possible for people who become ill, support hospitals to maintain essential services and ensure ongoing support for people ill in the community, to minimise the overall impact of the disease on society, public services and on the economy.[24]

The four CMOs of the home nations raised the UK's risk level from low to moderate on 30 January 2020, upon the WHO's announcement of the disease as a Public Health Emergency of International Concern.[25][26] As soon as cases appeared in the UK on 31 January 2020, a public health information campaign, similar to the previous "Catch it, Bin it, Kill it" campaign, was launched in the UK, to advise people how to lessen the risk of spreading the virus.[26] Travellers from Hubei province in China, including the capital Wuhan, were advised to self-isolate, "stay at home, not go to work, school or public places, not use public transport or taxis; ask friends, family members or delivery services to do errands",[27] and call NHS 111 if they had arrived in the UK in the previous 14 days, regardless of whether they were unwell or not.[26] Further cases in early February prompted the Secretary of State for Health and Social Care, Matt Hancock, to announce the Health Protection (Coronavirus) Regulations 2020.[25] Daily updates have been published by the Department of Health and Social Care.[25] NHS Digital in the meanwhile, have been collecting data.[28]

On 25 February 2020, the British CMOs advised all travellers (unwell or not) who had returned to the UK from Hubei province in the previous 14 days, Iran, specific areas designated by the Italian government as quarantine areas in northern Italy, and special care zones in South Korea since 19 February, to self-isolate and call NHS 111.[29] This advice was also advocated for any person with flu-like symptoms and a history of travelling from Vietnam, Cambodia, Laos, Myanmar and areas in Italy north of Pisa, Florence and Rimini, returning to the UK since 19 February. Later, self-isolation was recommended for anyone returning from any part of Italy from 9 March.[25][29]

Initially, Prime Minister Boris Johnson largely kept Britain open, resisting the kind of lockdowns seen elsewhere in Europe. In a speech on 3 February, Johnson's main concern was that the "coronavirus will trigger a panic and a desire for market segregation that go beyond what is medically rational to the point of doing real and unnecessary economic damage".[30] On 11 February, a "senior member of the government" told the ITV journalist Robert Peston that "If there is a pandemic, the peak will be March, April, May" and, further, that "the risk is 60% of the population getting it. With a mortality rate of perhaps just over 1%, we are looking at not far off 500,000 deaths".[31] On 8 March, Peston reported that the government believed the Italian government's approach to lockdown to be based on "several of the populist – non-science based – measures that aren't any use. They're who not to follow".[32] Later the Times revealed that, in early March, the government did not even ask its scientists to model whether a lockdown might be a solution.[3]

On 2 March, Johnson said in an interview with BBC News: "The most important thing now is that we prepare against a possible very significant expansion of coronavirus in the UK population". This came after the 39th case in the UK was confirmed and over a month after the first confirmed case in the UK.[33] The same day, a BBC One programme Coronavirus: Everything You Need to Know addressed questions from the public on the outbreak.[34] The following day, the Coronavirus Action Plan was unveiled.[25] The next day, as the total number of cases in the UK stood at 51, the government declared the COVID-19 pandemic as a "level 4 incident",[35] permitting NHS England to take command of all NHS resources.[35][36] Planning has been made for behaviour changing publicity including good hygiene and respiratory hygiene ("catch it, bin it, kill it"),[37] a measure designed to delay the peak of the infection and allow time for the testing of drugs and initial development of vaccines.[24] Primary care has been issued guidance.[38]

On 11 March, the Deputy Chief Medical Officer for England Jenny Harries said that the government was "following the science" by not banning mass gatherings. She also said, on face masks, "If a healthcare professional hasn't advised you to wear a face mask... it's really not a good idea and doesn't help".[39] She added that masks could "actually trap the virus in the mask and start breathing it in".[40] On 13 March, British government Chief Scientific Adviser Patrick Vallance told BBC Radio 4 one of "the key things we need to do" is to "build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission".[41] This involves enough people getting infected, upon which they develop immunity to the disease.[42][43] Vallance said 60% of the UK's population will need to become infected for herd immunity to be achieved.[44][43] Another member of the UK government's Scientific Advisory Group for Emergencies (SAGE), Graham Medley, told BBC's Newsnight that: "We're going to have to generate what we call herd immunity ... and the only way of developing that, in the absence of a vaccine, is for the majority of the population to become infected."[45] A Downing Street source later revealed that the "mantra" in government at this time was that "we've all got to get it."[3]

This stance was criticised by experts[who?] who said it would lead to hundreds of thousands of deaths and overwhelm the NHS. More than 200 scientists urged the government to rethink the approach in an open letter.[46][47][medical citation needed] Subsequently, Health Secretary Matt Hancock said that herd immunity was not a plan for the UK, and the Department of Health and Social Care said that "herd immunity is a natural by-product of an epidemic".[48] On 26 March, Deputy Chief Medical Officer Jenny Harries said that testing and contact tracing was no longer "an appropriate mechanism as we go forward".[49] On 4 April, The Times reported that Graham Medley, a member of the UK government's Scientific Advisory Group for Emergencies (SAGE), was still advocating a "herd immunity" strategy.[50] There was a letter published in The Lancet on 17 March calling on the government to openly share its data and models as a matter of urgency.[2]

COVID-19 alert levels introduced by the government

Public Health England has also been involved with efforts to support the British Overseas Territories against the outbreak.[51][52]

Large sporting and cultural events took place into mid-March, with Culture Secretary Oliver Dowden and Jonathan Van-Tam dismissing calls to ban them in early that month. Cheltenham Festival and a Liverpool match of the UEFA Champions League knockout phase are particularly thought to have increased the virus' spread.[53][54] As many event organisers themselves began cancelling events, reports emerged on 13 March that the government would introduce a ban on large gatherings the following week.[55][56]

On 16 March, the British government started holding daily press briefings. The briefings were to be held by the Prime Minister or government ministers and advisers. The government had been accused of a lack of transparency over their plans to tackle the virus.[57] Daily briefings were also held by the devolved administrations of Northern Ireland, Scotland and Wales.[58] The speakers at the daily press briefings were accompanied by sign language interpreters. British sign language is a recognised language in Scotland and Wales, with interpreters standing 2 metres behind Ministers. Northern Ireland's briefings had both British and Irish Sign Language interpreters who were shown on a small screen in the press conference room. The British government briefing did not have an interpreter in the room or on a screen leading to a Twitter campaign about the issue. The government reached an agreement to have the press conferences signed on the BBC News Channel and on iPlayer in response to the campaign.[59] In response to this a petition was created by Sylvia Simmonds that required the government to use sign language interpreters for emergency announcements.[60] Legal firm Fry Law looked to commence court proceedings as they said the government had broken the Equality Act 2010, but also said that the government was doing the bare minimum and were crowdfunding to cover the government's legal costs if they lost.[59]

On 17 March 2020, Johnson announced in a daily news conference that the government "must act like any wartime government and do whatever it takes to support our economy".[61]

Progression between phases

On 12 March, the government announced it was moving out of the contain phase and into the delay phase of the response to the COVID-19 pandemic. The announcement said that in the following weeks, the government would introduce further social distancing measures for older and vulnerable people, and asking them to self-isolate regardless of symptoms. Its announcement said that if the next stage were introduced too early, the measures would not protect at the time of greatest risk but they could have a huge social impact. The government said that its decisions were based on careful modelling and that government measures would only be introduced that were supported by clinical and scientific evidence.[62] The UK abandoned contact tracing on 12 March.[63][64]

Classification of the disease

From 19 March, Public Health England, consistent with the opinion of the Advisory Committee on Dangerous Pathogens, no longer classified COVID-19 as a "High consequence infectious disease" (HCID). This reversed an interim recommendation made in January 2020, due to more information about the disease confirming low overall mortality rates, greater clinical awareness, and a specific and sensitive laboratory test, the availability of which continues to increase. The statement said "the need to have a national, coordinated response remains" and added, "this is being met by the government's COVID-19 response". This meant cases of COVID-19 are no longer managed by HCID treatment centres only.[65] An editorial in The BMJ questioned this decision, suggesting this was to permit healthcare staff to use "a lower level" of personal protective equipment for treating patients.[63]

First national lockdown (March–April 2020)

Empty street outside of a London Underground station.
Bond Street tube station in London during the first nationwide lockdown in May 2020.

The slogan "Stay Home, Protect the NHS, Save Lives" was first suggested internally in a government conference call on 19 March, days before they imposed a full national lockdown.[citation needed] The slogan was introduced concurrently with the national lockdown imposed on 23 March, ordering the public against undergoing non-essential travel and ordering many public amenities to close.[citation needed]

Essential travel included food shopping, exercise, medical attention, and travelling for necessary work, which included those working in the healthcare, journalism, policing, and food distribution industries.[66] To ensure that the lockdown was obeyed, all shops selling "non-essential goods", as well as playgrounds, libraries, and places of worship, were to be closed.[67] Gatherings of more than two people in public were also banned, including social events, such as weddings, baptisms and other ceremonies, but excluding funerals.[68]

The stay-at-home order was announced by the Prime Minister, Boris Johnson, in a television broadcast. It was initially expected to last at least three weeks, superseding the government's guidance for the public to go about their normal lives while remembering to wash their hands thoroughly.[69] The "Stay Home" slogan appeared on the lecterns that speakers stood behind at the press conferences. It was often seen in capital letters, on a yellow background, with a red and yellow tape border. The government commissioned and broadcast millions of radio, television,[69] newspaper and social media adverts. These were often accompanied by photographs of healthcare workers wearing personal protective equipment, including face masks.[70]

On 23 March, a 20,000-strong military task force, named the COVID Support Force, was launched to provide support to public services and civilian authorities. Two military operations — Operation Rescript and Operation Broadshare — commenced to address the outbreak within the United Kingdom and its overseas territories.[71]

GOV.UK CORONAVIRUS ALERT. New rules in force now: you must stay at home. More info and exemptions at gov.uk/coronavirus Stay at home. Protect the NHS. Save lives.
UK Government advisory SMS message, 24 March 2020

On 24 March, all major mobile telephony providers, acting upon a government request, sent out an SMS message to each of their customers, with advice on staying isolated.[72] This was the first ever use of the facility.[72] Although the government in 2013 endorsed the use of Cell Broadcast to send official emergency messages to all mobile phones, and has tested such a system, it has never actually been implemented. Backer Toby Harris said the government had not yet agreed upon who would fund and govern such a system.[73][74]

The Daily Telegraph reported that ministers had discussed but been divided on banning international arrivals from countries most affected by COVID-19 (particularly Iran, the United States) altogether in March 2020.[75] In early 2021, Home Secretary Priti Patel said that she had advocated for UK borders to be closed at the time.[76]

On 27 March, Johnson said he had contracted coronavirus and was self-isolating, and that he would continue to lead the government's response to coronavirus through video conference.[77] On the evening of 5 April the Prime Minister was admitted to hospital for tests.[78] The next day he was moved to the intensive care unit at St Thomas' Hospital, and First Secretary of State Dominic Raab deputised for him.[79]

On 5 April 2020, Hancock warned that all outdoor exercise in England could be banned in response to COVID-19 if people did not follow social distancing rules, saying: "So my message is really clear. If you don't want us to have to take the step to ban exercise of all forms outside of your own home then you've got to follow the rules and the vast majority of people are following the rules."[80]

Lifting the first lockdown and regional restrictions (April–September 2020)

In mid-April, a member of the Cabinet told The Telegraph that there was no exit plan yet.[81] Several members of the British government stated that it was not possible to draw up a definitive plan on how to exit lockdown as it is based on scientific advice.[82]

In April, the Scottish government published plans to pursue a zero-COVID "elimination" strategy, in contrast with the rest of the UK, and expanded a "test, trace, isolate support" system.[83]

New COVID-19 cases and deaths in the UK, with the dates of lockdown and its partial lifting. This shows both the COVID-19 death figures confirmed by tests and the figures registered by three authorities

In early May, research was published which concluded that if the most vulnerable (the elderly and those with certain underlying illnesses) were completely shielded, the lockdown could mostly be lifted, avoiding "a huge economic, social and health cost", without significantly increasing severe infections and deaths.[84] It also recommended regular testing and contact tracing.[85][86]

On 8 May the Welsh government relaxed restrictions on exercise and allowed some garden centres and recycling facilities would reopen.[87] Nicola Sturgeon stated that she wanted all nations to make changes together as it would give the public a clear and consistent message.[88] Boris Johnson acknowledged different areas move at slightly different speeds with actions based on the science for each area.[89] Scotland announced a similar measure in terms on exercise as Wales, to go live on the same day.[90] The Scottish government generally pursued a slower lifting of lockdown measures than the rest of the UK over the following months.[83]

Boris Johnson with the "Hands, Face, Space" slogan introduced in September

Johnson made a second televised address on 10 May, changing the slogan from "Stay at Home" to "Stay Alert". "Stay Home" was reported as being at the core of the government's communications until being phased out around this time.[91] The full "Stay Alert, Control the Virus, Save Lives" would later be followed by "Hands, Face, Space".[92][93] Johnson also outlined on 10 May address how restrictions might end and introduced a COVID-19 warning system.[94] Additionally measures were announced stating that the public could exercise more than once a day in outdoor spaces such as parks, could interact with others whilst maintaining social distance and drive to other destinations from 13 May in England.[95] This was leaked to the press[96][97] and criticised by leaders and ministers of the four nations, who said it would cause confusion.[98] The leaders of Scotland, Northern Ireland, and Wales said they would not adopt the new slogan.[99][100] Welsh Health Minister Vaughan Gething said that the four nations had not agreed to it, and the Scottish Health Secretary Jeane Freeman said that they were not consulted on the change.[101][102] Labour leader Sir Keir Starmer said that the new message "lacked clarity".[103] The Guardian were told that neither Chris Whitty, the chief medical officer for England, nor Sir Patrick Vallance, government's chief scientific adviser, had given the go-ahead for the new slogan. Witty later said at a Downing Street press conference that "Neither Sir Patrick nor I consider ourselves to be comms experts, so we're not going to get involved in actual details of comms strategies, but we are involved in the overall strategic things and we have been at every stage." The slogan was criticised by members[who?] of SAGE.[104] Scottish First Minister Nicola Sturgeon said: "We mustn't squander progress by easing up too soon or sending mixed messages. People will die unnecessarily."[105]

The next day the government published a 60-page roadmap of what exiting lockdown could look like.[106] A document was additionally published outlining nine points which applied to England, with an update of measures from 13 May.[107] As the rules between England and Wales were different in terms of exercise, many officials warned against the public driving to destinations in Wales for exercise.[108] The Counsel General for Wales, Jeremy Miles, said visitors could be fined if they drove into Wales for leisure.[101] Sturgeon gave a similar warning about driving into Scotland.[109] She additionally said that politicians and the media must be clear about what they are saying for different parts of the UK after Johnson's address did not state which measures only applied to England.[95][110][111] On 17 May, Labour leader Keir Starmer called for a 'four-nation' unified approach.[112] Greater Manchester Mayor Andy Burnham said that there was a risk of national unity in ignoring the different demands of regions in England.[113][114] Boris Johnson acknowledged the frustrations in some of the rules and said that "complicated messages were needed during the next phase of the response and as restrictions changed".[115]

Contact tracing was resumed at different points in each of the four nations. Pilot tracing began on 27 April in Northern Ireland, 28 May in Scotland and England, and 1 June in Wales. By 18 June 92% of all positive cases and their contacts were being traced within 24 hours in Northern Ireland.[116]

The Northern Ireland Executive published a five-stage plan for exiting lockdown on 12 May, but unlike the plans announced in England the plans did not include any dates of when steps may be taken.[117][118][99] An announcement was made on 14 May that garden centres and recycling centres would reopen on Monday in the first steps taken to end the lockdown in Northern Ireland.[119][117]

On 15 May, Mark Drakeford announced a traffic light plan to remove the lockdown restrictions in Wales, which would start no earlier than 29 May.[120][121] On 20 June 2020, a group of cross-party MPs wrote a letter to the government, urging them to consider a four-day working week for the UK after the pandemic.[122]

While nationwide lockdown measures were gradually relaxed throughout the summer, including a shift towards regional measures such as those instituted in Northern England in July,[123] lockdown easing plans were delayed at the end of July due to rises in case numbers,[124] and measures were increased once more following the resurgence of the virus nationwide starting in early September.[125][126] On 14 August the Chancellor of the Exchequer Rishi Sunak urged people to return to offices, cafés and restaurants.[127] On 27 August Boris Johnson launched a campaign emphasising the benefits to the public of returning to the office instead of working from home.[128]

On 11 July 2020, the MPs urged the Prime Minister to clarify on wearing masks, after he hinted a day earlier that it could become compulsory to wear them in shops.[129][needs update]

In August, Scottish First Minister Nicola Sturgeon advocated for the rest of the UK to adopt the zero-COVID approach that Scotland and Northern Ireland were both pursuing.[130]

On 9 September 2020, the British government announced the banning of social gatherings of more than six people, which was to be implemented from 14 September, amidst rising cases of coronavirus. A £100 fine was initiated to be imposed on the people who fail to comply, doubling on each offence up to a maximum of £3,200.[131]

Lockdowns 2 and 3 (October 2020 – July 2021)

Boris Johnson chose not to follow his scientific advisers' advice on 21 September when he did not introduce a short "circuit-breaker" lockdown as advised by SAGE.[132] By 1 October 2020, around a quarter of the population of the United Kingdom, about 16.8 million people, were subject to local lockdown measures with some 23% of people in England, 76% of people in Wales and 32% of people in Scotland being in local lockdown.[133] On 12 October, Johnson unveiled a three-tier approach for England, in which local authorities were divided into different levels of restrictions.[134] An article in The Lancet suggested the localised restrictions were ineffective at reducing the spread of the disease.[135] Zdroj:https://en.wikipedia.org?pojem=British_government_response_to_the_COVID-19_pandemic
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