Strict social distancing measures may need to remain in place until the autumn to have the required impact on controlling the Covid-19 epidemic in the UK, according to government documents that reveal the thinking behind the UK approach to the crisis.
The documents, published online on Friday, give an extraordinary insight into the projected toll of the pandemic, the tactics that government advisers believe will be most effective in containing the spread of the virus and how messaging has been carefully framed to so the public accepts the need for unprecedented changes to daily life.
In a consensus statement on the overall strategy being deployed, the government’s scientific advisory group for emergencies (SAGE) suggests the UK would need to alternate between “periods of more and less strict social distancing measures” to have a plausible chance of keeping the number of critical care cases within capacity. “These [social distancing measures] would need to be in place for at least most of a year,” it concludes.
What is Covid-19?
It is caused by a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals.
What are the symptoms this coronavirus causes?
The virus can cause pneumonia-like symptoms. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties.
In the UK, the National Heath Service has defined the symptoms as:
- a high temperature – you feel hot to touch on your chest or back
- a new continuous cough – this means you’ve started coughing repeatedly
Should I go to the doctor if I have a cough?
Medical advice varies around the world – with many countries imposing travel bans and lockdowns to try and prevent the spread of the virus. In many place people are being told to stay at home rather than visit a doctor of hospital in person. Check with your local authorities.
In the UK, NHS advice is that anyone with symptoms should stay at home for at least 7 days. If you live with other people, they should stay at home for at least 14 days, to avoid spreading the infection outside the home.
Is the virus being transmitted from one person to another?
Yes. China’s national health commission confirmed human-to-human transmission in January.
How many people have been affected?
China’s national health commission confirmed human-to-human transmission in January. As of 19 March, more than 219,000 people have been infected in more than 150 countries, according to the Johns Hopkins University Center for Systems Science and Engineering.
There have been over 8,900 deaths globally. Just over 3,200 of those deaths have occurred in mainland China. Many of those who have died had underlying health conditions, which the coronavirus complicated.
More than 84,000 people are recorded as having recovered from the coronavirus.
The advisory group also stresses the need to promote a sense of collectivism in a modern-day spin on “Keep Calm and Carry On”. “All messaging should reinforce a sense of community, that ‘we are all in this together’. This will avoid increasing tensions between different groups,” the documents say.
In papers, dating from mid-February to the present, the group also considers issues ranging from public disorder to the psychology of self-isolation and potential social impacts of school closures. One paper outlines the potential for unintended consequences and the need to be clear about the purpose of school closures to prevent children from continuing to mix or grandparents taking on childcare responsibilities. Some social and workplace norms will need to be rapidly overturned. For instance, for many healthcare workers it is the norm that people continue to work when unwell. “It will be important to make it socially unacceptable to attend work or school if unwell,” the documents say. “To avoid the risk of stigma, ‘voluntary quarantine’ should be portrayed as an act of altruistic civic duty.”
An assessment of the chances of public disorder, drawn up in February, concluded that while “large-scale rioting” seemed unlikely, if there was any disorder it was likely to be generated by anger at the government’s response, rather than the direct effects of the pandemic.
One 12 March paper on public expectations about measures to stop public gatherings noted there was general support for this, especially as people could see this happening abroad – and that if policy on this was not properly explained, people might not trust the government, potentially increasing the risk of disorder.
“Acting in a way that does not meet expectations poses a risk that a section of the public will view government actions as incompetent or not in the public’s best interests,” it says. “It may also be taken as signifying that the situation is not expected to be severe for the UK. This could have knock-on implications for public attitudes to other recommendations made by government.”
It adds that “the risk of public disorder would be higher if there was a perception that the government’s response was not competent”.
Other issues that could cause tensions, it says, include a possible lack of certain goods such as hand sanitisers, not enough police officers due to sickness, and police efforts seen as unfair, for example limiting access to food or healthcare.
Particularly, a lack of police numbers “could lead to a rise in opportunistic crime by those who are already antagonistic towards the police”, the paper says.
There is also more detail on what the government’s advisers expect to see as case numbers rise and how effective they expect various measures to be in reducing and delaying the epidemic’s peak. The experts estimate about 8% of those infected will be hospitalised, including 44% of those aged over 80. Of those taken to hospital, 12% are likely to die.
Social distancing, if enacted early and if people are compliant, could reduce the peak by 50-60% and, combined with other measures, lead to a 30-45% reduction in deaths. Quarantining people with symptoms could make a 20% difference to the peak and closing schools could reduce the peak by 10-30%. There is expected to be a two- to three-week delay between measures being put into place and their impact being felt in intensive care units.
