Coronavirus: Does the UK have the pandemic under control?

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Society is reopening. The long national hibernation – to quote Prime Minister Boris Johnson – is coming to an end with the biggest lifting of restrictions so far due to take place in England at the start of July.

Lockdowns are also being eased in Scotland, Wales and Northern Ireland, albeit at slightly different paces.

It is a massive moment – and one certainly not without risk. There have been warnings it could lead to a second peak in infections.

So how tight a grip does the UK have on coronavirus?

Infection rates are high

Restrictions have to be lifted at some point. The big question is whether the UK is moving too soon.

The number of infections has fallen dramatically.

There are now just over 1,000 new cases a day on average.

That compares with an estimated 100,000 at the peak at the end of March – we don’t know the exact figure because there was only limited testing in place.

Huge progress has, therefore, been made. But the number of infections is still significantly higher than in other countries.

This certainly leaves the UK at higher risk of a second peak – and it is why there are plenty of experts, including former government chief scientific adviser Sir David King, voicing concern that restrictions are being eased too quickly.

Will we be able to contain the virus?

There are two factors that determine how quickly it will spread – the steps we take to reduce the risk of transmission and the ability of the test and trace system to contain local flare-ups.

While restrictions are easing, there are still many measures being taken to disrupt the spread of the virus.

Most are focused on continued social distancing and creating barriers between people whether that is via wearing face-coverings on public transport, stopping face-to-face seating in workplaces and introducing screens in shops.

An unknown factor in reducing the risk of transmission is how quickly the public will embrace the new freedoms.

Prof Lucy Yardley, an expert in public health psychology at the University of Bristol, believes people will be “naturally cautious”, particularly those at higher risk.

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The tracing system is not yet world-beating

Where local outbreaks happen – and they certainly will – the ability of the test and trace systems to get a handle on the spread of infections will be crucial.

There are separate systems in place in the four UK nations, although the basic principles are the same – a central team of call handlers and contact tracers, supported by local teams who can specialise in handling complex local cases and clusters.

The prime minister promised a “world-beating” system.

But it is clear we are not there yet despite a huge increase in testing and the launch of a contact tracing system in a pretty short period of time.

Even Baroness Harding, the head of the service in England, admits it is not yet “gold standard” – for one thing the contact tracing app that complements the contact tracers is not ready and won’t be for months.

But the key question is whether it is good enough to contain outbreaks from now on.

Contact tracing has already been put to the test

These systems are only a few weeks old, but have already been busy, tracing nearly 90,000 contacts in England alone.

What is interesting is just how much contact tracing work gets devolved to local teams.

The overwhelming majority of the contacts traced in England during the first two weeks were dealt with by councils and local Public Health England teams.

An example of how this has worked can be seen in the West Yorkshire town of Cleckheaton.

The system was alerted to a cluster of cases, which were then linked to a meat-packing factory in the town.

Officials from Public Health England and the local council got involved, the factory was closed down and a mobile testing unit was dispatched to the area.

Hundreds of staff at the factory are being tested – and only those who are negative are being allowed back as it reopens. Close contacts of those who have tested positive have been asked to isolate.

Additional measures, including temperature checking and extra social distancing at work, are being introduced.

The public has a role to play

All the signs are this flare-up was caught early – and there is real hope the measures taken have stopped the spread in its tracks.

But the big risk in the future is what happens if these sort of measures do not work or if they are taken too late.

A return to full lockdowns for local areas has been suggested.

Germany, which has a much stronger track record of containing the virus than the UK, has just announced this for two districts.

The UK would be very lucky if it did not have to take this step somewhere. In fact, there is already talk of a local lockdown in Anglesey after a spike in cases.

The Association of Directors of Public Health, which represents council public health directors who are in charge of contact tracing at a local level, says this should be seen as part of a normal process of controlling the virus.

The important thing is to avoid a big spike where the virus gets out of control.

The ADPH would like to see better sharing of information by the national teams so they can keep an eye on who is testing positive and put more testing in place, particularly around care homes so staff and residents can get weekly testing.

But if the system works as it should and continues to improve, a second runaway peak should be avoided, but only with the help of the public.

Public adherence to the social distancing measures still in place and a willingness to co-operate with the contact tracing system – figures suggest one in four people who test positive do not engage with it – will be essential.

The message is clear – we all have a role to play.

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