Was a Second Wave Inevitable?

It has been just over 6 months since Boris Johnson addressed the nation with the news of a national lockdown. Hand washing, social distancing and staying home wherever possible became the mantra which we were told to live by –  fail to do these things and the virus would not be suppressed.

But we did suppress it.

The ‘new normal’ became a familiar term: we worked from home, we wore masks in shops and we didn’t see our friends or family. As a result we saw cases, hospital admissions, and deaths beginning to decrease. The ‘new normal’ seemed to be working.

Shops, pubs and restaurants started to reopen; we were encouraged to help kickstart the economy; we were told it’s time to return to work.

It was always going to be a fine balancing act between opening up too soon and risking a spike in Covid-19 cases. Unfortunately, we are now seeing an increase in cases across the country as the UK’s R rate sits between 1.1-1.4 – the UK’s coronavirus alert level has now been raised from 3 to 4 meaning that transmission is “high or rising exponentially”.

In an statement to the commons today the Prime Minster said: “We always knew that the prospect of a second wave was real and I’m sorry to say that we have reached that perilous turning point”. The PM’s address to the house comes after the government’s scientific advisers warned that there could be 50,000 new coronavirus cases a day by mid-October if we continue without action.

The stark warning comes after the UK saw 4,368 daily cases reported on Monday, up from 3,899. Although more testing is being done it is the proportion of those tests which are positive that is rising and will be causing some concern for the government.

New measures will mean that hospitality venues will now have to close by 10pm; to work from home wherever possible; masks are to be compulsory for hospitality/retail workers; stricter group sizes for weddings and funerals. Individuals and businesses will now also face increased fines for breaching the rules.

The trajectory of countries like France and Spain has not been as sharp as the worst case scenario put forward. But it is clear that this time the government is wanting to act as early as possible – their initial delay in introducing lockdown in March has been widely criticized, a move which resulted in more deaths.

Johnson has stressed that “we are not returning to the full lockdown of March” but he did warn that these new measure may last for the next 6 months if the R rate remains above 1.

If the government stay on top of this and the public adhere to the new measures, a second full lockdown should be avoidable. The government argues that they are better prepared this time around with new medicines, more ventilators and added hospital capacity thanks to the NHS nightingale hospitals.

The Labour leader, Kier Starmer, has labelled the new measures as “necessary” but said that they were “not inevitable”. He said that both Labour and experts had warned the government that the testing regime would need to be prepared for increased demand.

Cases were expected to increase at this time of the year when respiratory viruses tend to circulate more. Testing will therefore be crucial in order to discern who has the virus or who has a bad flu over the winter period.

Testing has played a central debate in tackling this virus: a strong, robust testing programme with a team of expert contact tracers was deemed essential in suppressing the virus and avoiding a second wave.

Despite being lauded as “world-beating” Britain’s test and trace programme has faced criticism for the way in which much of the work has been outsourced to private companies like Sitel, Serco and Deloitte for eyewatering sums of money – according to the treasury, £10 billion of public money has been allocated to England’s test and trace programme, and only £300 million of that has been offered to local authorities.

Instead of putting local public health experts and NHS services in charge of the test and trace programme, Matt Hancock handed responsibility to private companies and sub-contractors who work in parallel to the NHS as a network of commercial and privatised testing labs, drive through centres and call centres. Working as a separate, rather than integrated, entity to the NHS has resulted in information not making it to local services, delays to accessing result and a failure to trace Covid contacts.

Going forward, the government would do well to ramp down their outsourcing to the private sector in favour of local public health teams who are tracing far more contacts with less resources and a lack of access to real time data. These teams are often comprised of health professionals, rather than call centre workers, who often have a far better understanding of local services.

6 months into their response to the pandemic one would hope that an efficient and cost effective test and trace programme would be in place to target, tackle and control local outbreaks in order to prevent a second wave. However, a poor test and trace programme coupled with the continued re-opening of society has left us open to an impending second wave and even harsher restrictions.

The coming weeks will be a crucial test for the governments test and trace programme, one which will likely define our way of life for the foreseeable future.

My guess is that a properly funded, public health led test and trace programme would likely have avoided this situation entirely

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