One Year on From the Start of a Pandemic

Peter Russell

March 12, 2021

It has been a year since the World Health Organisation (WHO) declared a global pandemic.

In the 12 months since then, the UK, like the rest of the world, has experienced what public health experts had feared for decades: a new and dangerous virus that would emerge to spread rapidly around the globe.

2020 began with the scientific and medical communities knowing almost nothing about the mysterious virus afflicting the Chinese city of Wuhan.

It would end with COVID-19 vaccines rolling off the production line.

The Tragedy That is COVID-19

In-between we witnessed the daily toll of tragic deaths that rose from the first in Berkshire in early March last year to 125,343 today.

That was the equivalent of losing the entire population of a city the size of Cambridge, Exeter, or Gloucester.
 

Credit: NimbleFins

A year ago, Sir Patrick Vallance, the Government's chief scientific adviser, said that 20,000 deaths in the UK from COVID-19 would, while "horrible", be a "good outcome".

In the last 12 months we have seen health services and health staff under unimaginable pressure and stress, learnt what it was like to live in lockdown, washed hands while singing happy birthday, clapped for carers, discovered the meaning of furlough, home schooled our children, bought masks, familiarised ourselves with support bubbles, and learnt more about eye testing in Barnard Castle.

But we have also discovered how international scientific collaboration could create vaccines to protect against this disease in breath-taking short order.

An 'Alarming' Virus

It was on March 11, 2020 that Tedros Adhanom Ghebreyesus, director general of WHO told reporters about the "alarming levels of spread and severity" of the new virus and of the "alarming levels of inaction".

Consequently, "we have therefore made the assessment that COVID-19 can be characterised as a pandemic", he said. "We have rung the alarm bell loud and clear."

During the first 3 weeks of the New Year, what would become known as the SARS-CoV-2 virus and the COVID-19 disease it caused still remained a distant threat to the UK.

Then, on January 22, Public Health England raised the risk level for the novel coronavirus from 'very low' to 'low'.

It was an ominous warning. A week later, the UK's first two patients, both Chinese nationals, tested positive for COVID-19. On February 6, a third person was found to have contracted the virus while at a conference in Singapore.

On 28 February, the first Briton – a passenger on the Diamond Princess cruise ship – was confirmed by the authorities in Japan, to have died.

On March 3, the Government published an action plan for dealing with novel coronavirus that included the scenario of a "severe prolonged pandemic as experienced in 1918".

The next day, exactly a week before WHO declared a global pandemic, the total number of confirmed cases in the UK reached 85.

On March 5, a woman in her 70s with underlying health conditions became the first person in the UK to die after testing positive for COVID-19.

The Prime Minister's official spokesman said it was "highly likely the virus is going to spread in a significant way", and Prof Chris Whitty, the Government's chief medical adviser, told MPs that the UK had moved from 'containment' of the virus to a policy of 'delay'.

However, that week also signposted an important milestone in the fightback against COVID-19, with the Prime Minister Boris Johnson announcing £46 million in funding for research into a vaccine and rapid diagnostic tests.
 

The Road to the First Lockdown

On March 12, the chief medical officers of all four UK nations raised the risk to the UK from moderate to high. It was too late for the thousands of racegoers attending the 4-day Cheltenham Festival in which 68,500 horse-racing enthusiasts were on the track to watch the Gold Cup on March 13.

Two days earlier, 54,000 football fans had squeezed into Anfield to watch Liverpool's Champions League tie against Atlético Madrid. There were 3000 away supporters there that day who had travelled from the Spanish city that had already become a virus hotspot.

By the middle of the month with pandemic deaths reaching 55 and the number of cases passing 1500, the UK slipped towards its first lockdown.

Schools were told to close to most pupils from Friday March 20, and exams were cancelled.

The following week, Boris Johnson addressed the nation on TV. "I must give the British people a very simple instruction - you must stay at home," he said.

All non-essential shops, libraries, places of worship, playgrounds, and outdoor gyms were closed, and the police were given powers to enforce the measures.

England's Health Secretary, Matt Hancock, announced plans to open a temporary hospital, the NHS Nightingale Hospital at the ExCeL in London, to add extra critical care capacity.

The first two working NHS doctors died with COVID-19 on the same day: one a GP and the other a surgeon.

At 8pm, on March 26, millions of people took part in the first 'clap for carers' tribute to NHS and care workers.

In response to growing disquiet among health workers about shortages of personal protective equipment, Home Secretary Priti Patel told a Downing Street briefing on April 11 that she was "sorry if people feel there have been failings".

On the same day, occupancy of critical care beds in England peaked at around 58% of capacity. 

In April, the UK passed 10,000 deaths, and Matt Hancock set a target of 100,000 COVID-19 tests a day.
 

A Summer Pause

By July, the Government was confident enough to loosen lockdown restrictions, with pubs, cinemas, and restaurants allowed to reopen from the 4th. 

By August, we were eating out to help out as the economy struggled back to its feet.

In September, more than a million people downloaded a contract tracing app for England and Wales on its first day of release.

On October 14, England moved to a three-tier system in which areas were categorised according to their infection rates and subject to different restrictions. The Liverpool City region was among those that went into tier 3. Relations between the Government and another tier 3 city, Manchester, were tense.

People in other areas, particularly in the south of the country, were allowed more freedom.
 

The Second Lockdown

As we moved into autumn, Wales opted for a 'firebreak' lockdown.

By the end of October, the Prime Minister abandoned his ambition to prevent a second national lockdown. 

On Halloween, Mr Johnson apologised on TV "for disturbing your Saturday evening" when he announced a 4-week lockdown in the face of a "huge exponential growth in the number of patients", and the risk that "doctors and nurses would be forced to choose which patients to treat".

Pubs, restaurants, and non-essential shops shut again.

The restrictions would end on December 2, Mr Johnson promised.

However, Christmas would be "very different this year", he said.

Plans for a Christmas truce with SARS-CoV-2, in which families would be able to meet for 4 days of festivities, were drastically scaled back to just one day.

Concerns were raised when on December 24 the Office for National Statistics weekly infection survey in England showed that COVID-19 incidence in secondary school children aged 11 to 16 had increased.

UK hospitals and emergency services were coming under increased pressure.
 

A Not So Happy New Year

In the face of a new mutation of SARS-CoV-2, known as the UK or Kent variant, that was found to be more contagious, new national lockdown measures for England were announced from January 4, 2021.

On January 21, the Government announced mandatory hotel quarantine for people travelling to the UK from a list of high-risk countries.
 

The Cavalry Over the Hill

Behind the scenes, an enormous international effort had been underway to develop vaccines that would bring the world back from disease, death, social isolation, and economic hardship.

Sharing of the genetic code of SARS-CoV-2 allowed scientists to get to work on developing vaccines that would target the virus's spike protein to protect people from developing COVID-19, and might also inhibit transmission. 

Some, like the Oxford group, pursued an adenovirus vectored approach; others a newer messenger RNA (mRNA) platform.

On December 8 2020, Margaret Keenan became the first person in the world to be vaccinated in a community setting with the vaccine developed by BioNTech in collaboration with Pfizer.

Ahead of turning 91, she described it as "the best early birthday present I could wish for".

Emergency approval for the Pfizer vaccine by the Medicines and Healthcare products Regulatory Agency was followed by endorsement for vaccines from AstraZeneca/Oxford and Moderna.

To date, vaccine call ups have been sent to people aged 56 and over.

Currently, 23.3 million people in the UK have received a first dose of vaccine, and 1.4 million a second dose.

Schools have reopened for face-to-face teaching, and the Government has set out a 'roadmap' for loosening restrictions throughout the spring and summer.

However, in the last 7 days, 1082 people in the UK have died within 28 days of a positive COVID-19 test.

And scientists have warned that the impact on transmission of allowing more people freedom has yet to be assessed.
 

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