PM: COVID-19 'Worst Public Health Crisis in a Generation'

Peter Russell & Tim Locke

March 12, 2020

Editor's note: This article may not reflect the latest COVID-19 information. Find the latest news, expert opinion, and guidance in Medscape UK's COVID-19 Resource Centre

"This is the worst public health crisis for a generation." That was Prime Minister Boris Johnson's assessment of the coronavirus pandemic. He made the remarks as he confirmed the UK had moved from the 'contain' phase of the operation dealing with the disease to 'delay'.

"We've done what can be done to contain this disease, and this has bought us valuable time," he told a Downing Street news conference. "But it's now a global pandemic."
Today also saw the official UK public risk level raised from moderate to high.

The news conference followed an announcement that two more people had died in the UK as a result of the coronavirus. It took the total number of people who had died to 10.

The deaths were at Barking, Havering, and Redbridge University Trust, and Imperial College Healthcare NHS Trust. The Government's chief medical adviser Prof Chris Whitty, said  those who died had underlying health conditions.

New Measures

In an anticipated move, people with persistent coughs or high temperatures will now be advised to self-isolate for 7 days.

Prof Whitty explained: "The virus seems to have its maximum transmission around the time of the first symptoms and for 2 or 3 days afterwards, and then rapidly declines, so that by 7 days, the great majority of people are not infectious, and it is fine for them to go back into society. 

"And you may ask why are we asking people with minor symptoms to do this. And the answer is the evidence would appear to be that some people with really quite mild symptoms can spread this virus to a lot of people."

Mr Johnson warned: "Some people compare it to seasonal flu, alas that is not right. Owing to the lack of immunity, this disease is more dangerous.

"It is going to spread further and I must level with you, I must level with the British public, many more families are going to lose loved ones before their time."

Boris Johnson rejected calls to take more stringent action, just as the Republic of Ireland announced it was shutting schools to contain the virus there. "The scientific advice is that this could do more harm than good at this time, but of course we're keeping this under review. And this, again, may change as the disease spreads," he said.

He didn't signal UK-wide bans on large events, such as sports fixtures yet.

However, Scotland is banning all large gatherings of more than 500 people from Monday. As well as the possibility of the virus spreading First Minister Nicola Sturgeon said pressure had to be eased on health workers and other public services: "Removing unnecessary burdens on our frontline workers is the right thing to do so they can prioritise their response to where it is needed most."

10,000 People Probably Infected

The Government's  Scientific Adviser, Sir Patrick Vallance, said that although confirmed cases were in the hundreds, the actual number was probably many times higher: "There are currently 590 cases that have been identified in the UK. And there are more than 20 patients on intensive care units. If you calculate what that really means in terms of the total number, it's much more likely that we've got somewhere between 5000 and 10,000 people infected at the moment."

This week Italy entered total lockdown to try to halt the spread of the virus, "And currently, we're on a trajectory that looks as though it's about 4 weeks or so behind Italy's and some other countries in Europe," Sir Patrick said.

He confirmed the measures were being taken to flatten the curve of the increase in cases and delay the peak until the summer when the NHS may be better able to cope.

Social distancing would be key to slowing the spread, but Prof Whitty warned against deploying measures too early: "If people go too early, they become very fatigued. This is going to be a long haul. It is very important we do not start things in advance of need."

Reacting to the change in tactics through the Science Media Centre, Dr Michael Head, senior research fellow in global health, University of Southampton, said: "Our existing knowledge suggests that social distancing is effective in delaying and reducing the peak of the outbreak. However, these interventions require significant compliance from the general population over an extended period of time, otherwise fatigue can set in among the general public.  

"The peak of the outbreak is estimated to be 10-12 weeks away. The impact of closing sporting events or stopping flights is of limited impact in reducing and delaying transmission. Therefore, the Chief Medical Officer has highlighted the importance of the timing when implementing any large-scale shutdown and encouraged the support of the general population, particularly around protecting the most vulnerable members of society."

Also responding to the plans Jimmy Whitworth, professor of international public health, London School of Hygiene & Tropical Medicine, said: "This is a balanced and measured response. They have clearly come to a different strategy to some other European countries about what to do."

He continued: "Based on evidence from other countries the most realistic approach to this is to initiate the strongest public health measures that will be supported by the general British public.

"I am surprised that stronger measures haven’t been introduced at this stage but I anticipate that they will come in the next week or 2.

"The longer we delay in introducing social distancing measures, the harder it is for these to be effective at delaying the outbreak. But at the same time, measures that are introduced will need to be in place for a substantial time in order to be effective.  So it is important that the public accept the measures and don’t tire of their engagement too early."

What if You're Wrong?

German Chancellor Angela Merkel had predicted 70% of her country's population would become infected with COVID-19. Prof Whitty was asked if he agreed with the estimate for the UK. "Actually, our top number for our reasonable worst-case scenario is higher than the Chancellor's. In fact, our top planning assumption would be up to 80% of the population being infected. But that is an entirely speculative number."

He went on to assess the likely overall mortality rate as 1% or lower, but higher in vulnerable groups.

Reporters asked Mr Johnson how sure he was that the UK was taking the right approach when other countries are taking a harder line. "We're guided by the science," he said.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: