COVID-19 pandemic in the United Kingdom

ongoing coronavirus pandemic in the United Kingdom

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COVID-19 pandemic in the United Kingdom
UK covid-19 cases by local authority.jpg
UK coronavirus cases per local authority as of 4 October 2020
Thank you NHS sign in Leeds
NHS Nightingale Hospital in London
Movement restrictions Sign at a Welsh county border
Deserted A1 road near Newry
Nicolson Street in Edinburgh
(clockwise from top)
DiseaseCOVID-19
Virus strainSARS-CoV-2
LocationUnited Kingdom
First outbreakWuhan, China
Index caseYork, North Yorkshire
Arrival date31 January 2020
(8 months, 2 weeks and 1 day ago)[1]
Confirmed cases673,622[2]
Deaths
43,293[nb 1][2][3]
Fatality rate6.43%
Government website
UK Government[nb 2]
Scottish Government
Welsh Government
Northern Ireland Department of Health

The COVID-19 pandemic in the United Kingdom is part of the worldwide pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus reached the country in late January 2020. As of 6 October 2020 there have been 515,571 confirmed cases[nb 3] and 42,369 deaths of confirmed cases,[nb 1] the world's tenth-highest death rate per hundred thousand population.[4][5] There were 58,342 deaths where the death certificate mentioned COVID-19 by 2 October (see Statistics).[6][7] More than 90% of those dying had underlying illnesses or were over 60 years old. The infection rate is higher in care homes than in the community. There has been large regional variation in the outbreak's severity. Health care in the United Kingdom is a devolved matter, with England, Northern Ireland, Scotland and Wales each having their own systems of publicly funded healthcare, funded by and accountable to separate governments and parliaments, together with smaller private sector and voluntary provision.[8][9][10]

The Department of Health and Social Care (DHSC) for England launched a public health information campaign to help slow the virus's spread, and began posting daily updates in early February. In February, the Health Secretary, Matt Hancock, introduced the Health Protection (Coronavirus) Regulations 2020 for England, and hospitals set up drive-through screening. The Chief Medical Officer for England, Chris Whitty, outlined a four-pronged strategy, relevant to England, to tackle the outbreak: contain, delay, research and mitigate.

In March, the UK government imposed a stay-at-home order, dubbed "Stay Home, Protect the NHS, Save Lives", banning all non-essential travel and contact with people outside one's home (including family and partners), and shutting almost all schools, business, venues, facilities, amenities and places of worship. Those with symptoms, and their households, were told to self-isolate, while those with certain illnesses were told to shield themselves.[11] People were told to keep apart in public. Police were empowered to enforce the measures, and the Coronavirus Act 2020 gave the government emergency powers[12] not used since the Second World War.[13][14] It was forecast that lengthy restrictions would severely damage the UK economy,[15] worsen mental health and suicide rates,[16] and cause additional deaths due to isolation, delays and falling living standards.

All four national health services worked to raise hospital capacity and set up temporary critical care hospitals. By mid-April it was reported that social distancing had "flattened the curve" of the epidemic.[17] In late April, Prime Minister Boris Johnson said that the UK had passed the peak of its outbreak.[18] Daily cases and deaths slowly declined in May and June. The total number of excess deaths in the UK from the start of the outbreak to mid-June was just over 65,000.[19]

Background

On 12 January 2020, the World Health Organization (WHO) confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster of people in Wuhan City, Hubei, China, which was reported to the WHO on 31 December 2019.[20][21] The case fatality ratio for COVID-19 has been much lower than SARS of 2003,[22][23] but the transmission has been significantly greater, with a significant total death toll.[24][22]

Mathematical modelling

Social distancing at a London pharmacy, 23 March 2020

Reports from the Medical Research Council's Centre for Global Infectious Disease Analysis at Imperial College, London have been providing mathematically calculated estimates of cases and case fatality rates.[25][26] In February, the team at Imperial, led by epidemiologist Neil Ferguson, estimated about two-thirds of cases in travellers from China were not detected and that some of these may have begun "chains of transmission within the countries they entered".[27][28][29] They forecast that the new coronavirus could infect up to 60% of the UK's population, in the worst-case scenario.[30]

In a paper on 16 March, the Imperial team provided detailed forecasts of the potential impacts of the epidemic in the UK and US.[31][32] It detailed the potential outcomes of an array of 'non-pharmaceutical interventions'. Two potential overall strategies outlined were: mitigation, in which the aim is to reduce the health impact of the epidemic but not to stop transmission completely; and suppression, where the aim is to reduce transmission rates to a point where case numbers fall. Until this point, government actions had been based on a strategy of mitigation, but the modelling predicted that while this would reduce deaths by approximately 2/3, it would still lead to approximately 250,000 deaths from the disease and the health systems becoming overwhelmed.[31] On 16 March, the Prime Minister announced changes to government advice, extending self-isolation to whole households, advising social distancing particularly for vulnerable groups, and indicating that further measures were likely to be required in the future.[33][32] A paper on 30 March by Imperial estimated that the lockdown would reduce the number of dead from 510,000 to less than 20,000.[34]

In April, biostatistician Professor Sheila Bird said delay in the reporting of deaths from the virus meant there was a risk of underestimating the steepness of the rising epidemic trend.[35]

Timeline

COVID-19 cases in the United Kingdom  ( )
     Deaths        Confirmed cases

Jan JanFeb FebMar MarApr AprMay MayJun JunJul JulAug AugSep SepOct OctLast 15 days Last 15 days

Date
Cases (% rise)
Deaths (% rise)
2020-01-31 2(n.a.)
2(=)
2020-02-06 3(50%)
3(=)
2020-02-09 4(33%)
2020-02-10 8(100%)
8(=)
2020-02-13 9(13%)
9(=)
2020-02-24
13(44%)
13(=)
2020-02-28
19(46%)
2020-02-29
23(21%)
2020-03-01
35(52%)
2020-03-02
40(14%)
2020-03-03
51(28%)
2020-03-04
85(67%)
2020-03-05
114(34%) 1(n.a.)
2020-03-06
160(40%) 2(100%)
2020-03-07
206(29%) 2
2020-03-08
271(32%) 3(50%)
2020-03-09
321(18%) 7(133%)
2020-03-10
373(16%) 7
2020-03-11
456(22%) 9(29%)
2020-03-12
590(29%) 10(11%)
2020-03-13
797(35%) 28(180%)
2020-03-14
1,061(33%) 43(54%)
2020-03-15
1,391(31%) 65(51%)
2020-03-16
1,543(11%) 81(25%)
2020-03-17
1,950(26%) 115(42%)
2020-03-18
2,626(35%) 158(37%)
2020-03-19
3,269(24%) 194(23%)
2020-03-20
3,983(22%) 250(29%)
2020-03-21
5,018(26%) 285(14%)
2020-03-22
5,683(13%) 359(26%)
2020-03-23
6,650(17%) 508(42%)
2020-03-24
8,077(21%) 694(37%[i])
2020-03-25
9,529(18%) 877(26%)
2020-03-26
11,658(22%) 1,161(32%)
2020-03-27
14,548(25%[ii]) 1,455(25%)
2020-03-28
17,104(18%) 1,669(15%)
2020-03-29
19,606(15%) 2,043(22%)
2020-03-30
22,271(14%) 2,425(19%)
2020-03-31
25,521(15%) 3,095(28%)
2020-04-01
30,088(18%) 3,747(21%)
2020-04-02
34,610(15%) 4,461(19%)
2020-04-03
39,282(13%) 5,221(17%)
2020-04-04
43,282(10%) 5,865(12%)
2020-04-05
49,481(14%) 6,433(9.7%)
2020-04-06
53,624(8.4%) 7,471(16%)
2020-04-07
57,512(7.3%) 8,505(14%)
2020-04-08
63,377(10%) 9,608(13%)
2020-04-09
68,052(7.4%) 10,760(12%)
2020-04-10
73,758(8.4%) 11,599(7.8%)
2020-04-11
78,991(7.1%) 12,285(5.9%)
2020-04-12
84,279(6.7%) 13,029(6.1%)
2020-04-13
88,621(5.2%) 14,073(8.0%)
2020-04-14
93,873(5.9%) 14,915(6.0%)
2020-04-15
98,476(4.9%) 15,944(6.9%)
2020-04-16
103,093(4.7%) 16,879(5.9%)
2020-04-17
108,692(5.4%) 17,994(6.6%)
2020-04-18
114,217(5.1%) 18,492(2.8%)
2020-04-19
120,067(5.1%) 19,051(3.0%)
2020-04-20
124,743(3.9%) 20,223(6.2%)
2020-04-21
129,044(3.4%) 21,060(4.1%)
2020-04-22
133,495(3.4%) 21,787(3.5%)
2020-04-23
138,078(3.4%) 22,792(4.6%)
2020-04-24
143,464(3.9%) 23,635(3.7%)
2020-04-25
148,377(3.4%) 24,055(1.8%)
2020-04-26
152,840(3.0%) 24,393(1.4%)
2020-04-27
157,149(2.8%) 25,302(3.7%)
2020-04-28
161,145(2.5%) 26,097(3.1%[iii])
2020-04-29
165,221(2.5%) 26,771(2.6%)
2020-04-30
171,253(3.7%) 27,510(2.8%)
2020-05-01
177,454(3.6%) 28,131(2.3%)
2020-05-02
182,260(2.7%) 28,446(1.1%)
2020-05-03
186,599(2.4%) 28,734(1.0%)
2020-05-04
190,584(2.1%) 29,427(2.4%)
2020-05-05
194,990(2.3%) 30,076(2.2%)
2020-05-06
201,101(3.1%) 30,615(1.8%)
2020-05-07
206,715(2.8%) 31,241(2.0%)
2020-05-08
211,364(2.2%) 31,587(1.1%)
2020-05-09
215,260(1.8%) 31,855(0.85%)
2020-05-10
219,183(1.8%) 32,065(0.66%)
2020-05-11
223,060(1.8%) 32,692(2.0%)
2020-05-12
226,463(1.5%) 33,186(1.5%)
2020-05-13
229,705(1.4%) 33,614(1.3%)
2020-05-14
233,151(1.5%) 33,998(1.1%)
2020-05-15
236,711(1.5%) 34,466(1.4%)
2020-05-16
240,161(1.5%) 34,636(0.49%)
2020-05-17
243,695(1.5%) 34,796(0.46%)
2020-05-18
246,406(1.1%[iv]) 35,341(1.6%)
2020-05-19
248,818(0.98%) 35,704(1.0%)
2020-05-20
248,293(-0.21%[v]) 36,042(0.95%)
2020-05-21
250,908(1.1%) 36,393(0.97%)
2020-05-22
254,195(1.3%) 36,675(0.77%)
2020-05-23
257,154(1.2%) 37,116(1.2%)
2020-05-24
259,559(0.94%) 37,237(0.33%)
2020-05-25
261,184(0.63%) 37,373(0.37%)
2020-05-26
263,188(0.77%) 37,807(1.2%)
2020-05-27
267,240(1.5%) 38,220(1.1%)
2020-05-28
269,127(0.71%) 38,593(0.98%)
2020-05-29
271,222(0.78%) 38,819(0.59%)
2020-05-30
272,826(0.59%) 38,934(0.30%)
2020-05-31
274,762(0.71%) 39,045(0.29%[vi])
2020-06-01
276,332(0.57%) 39,369(0.83%)
2020-06-02
277,985(0.60%) 39,728(0.91%)
2020-06-03
279,856(0.67%) 39,904(0.44%)
2020-06-04
281,661(0.64%) 40,261(0.89%)
2020-06-05
283,311(0.59%) 40,465(0.51%)
2020-06-06
284,868(0.55%) 40,542(0.19%)
2020-06-07
286,194(0.47%) 40,597(0.14%)
2020-06-08
287,399(0.42%) 40,883(0.70%)
2020-06-09
289,140(0.61%) 41,128(0.60%)
2020-06-10
290,143(0.35%) 41,279(0.37%)
2020-06-11
291,409(0.44%) 41,481(0.49%)
2020-06-12
292,950(0.53%) 41,662(0.44%)
2020-06-13
294,375(0.49%) 41,698(0.09%)
2020-06-14
295,889(0.51%) 41,736(0.09%)
2020-06-15
296,857(0.33%) 41,969(0.56%)
2020-06-16
298,136(0.43%) 42,153(0.44%)
2020-06-17
299,251(0.37%) 42,288(0.32%)
2020-06-18
300,469(0.41%) 42,461(0.41%)
2020-06-19
301,815(0.45%) 42,589(0.30%)
2020-06-20
303,110(0.43%) 42,632(0.10%)
2020-06-21
304,331(0.40%) 42,647(0.04%)
2020-06-22
305,289(0.31%) 42,927(0.66%)
2020-06-23
306,210(0.30%) 43,081(0.36%)
2020-06-24
306,862(0.21%) 43,230(0.35%)
2020-06-25
307,980(0.36%) 43,414(0.43%)
2020-06-26
309,360(0.45%) 43,514(0.23%)
2020-06-27
310,250(0.29%) 43,550(0.08%)
2020-06-28
311,151(0.29%) 43,575(0.06%)
2020-06-29
311,965(0.26%) 43,730(0.36%)
2020-06-30
312,654(0.22%) 43,906(0.40%)
2020-07-01
313,483(0.27%) 43,995(0.20%)
2020-07-02
283,757(-9.48%[vii]) 44,131(0.31%)
2020-07-03
284,276(0.18%) 44,198(0.15%)
2020-07-04
284,900(0.22%) 44,220(0.05%)
2020-07-05
285,416(0.18%) 44,236(0.04%)
2020-07-06
285,768(0.12%) 44,391(0.35%)
2020-07-07
286,349(0.20%) 44,517(0.28%)
2020-07-08
286,979(0.22%) 44,602(0.19%)
2020-07-09
287,621(0.22%) 44,650(0.11%)
2020-07-10
288,133(0.18%) 44,798(0.33%)
2020-07-11
288,953(0.28%) 44,819(0.05%)
2020-07-12
289,603(0.22%) 44,830(0.02%)
2020-07-13
290,133(0.18%) 44,968(0.31%)
2020-07-14
291,373(0.43%[viii]) 45,053(0.19%)
2020-07-15
291,911(0.18%) 45,119(0.15%)
2020-07-16
292,552(0.22%) 45,233(0.25%[ix])
2020-07-17
293,239(0.23%) 45,273(0.08%)
2020-07-18
294,066(0.28%) 45,301(0.06%)
2020-07-19
294,792(0.25%) 45,312(0.02%)
2020-07-20
295,372(0.20%) 45,422(0.25%)
2020-07-21
295,817(0.15%) 45,501(0.17%)
2020-07-22
296,377(0.19%) 45,554(0.11%)
2020-07-23
297,146(0.26%) 45,677(0.26%)
2020-07-24
297,914(0.26%) 45,738(0.13%)
2020-07-25
298,681(0.26%) 45,752(0.03%)
2020-07-26
299,426(0.25%) 45,759(0.02%)
2020-07-27
300,111(0.23%) 45,878(0.25%)
2020-07-28
300,692(0.19%) 45,961(0.17%)
2020-07-29
301,455(0.25%) 45,999(0.08%)
2020-07-30
302,301(0.28%) 46,054(0.26%)
2020-07-31
303,181(0.29%) 46,119(0.16%)
2020-08-01
303,952(0.25%) 46,193(0.02%)
2020-08-02
304,695(0.24%) 46,201(0.02%)
2020-08-03
305,623(0.30%) 46,210(0.02%)
2020-08-04
306,293(0.22%) 46,299(0.19%)
2020-08-05
307,184(0.29%) 46,364(0.19%)
2020-08-06
308,134(0.31%) 46,413(0.11%)
2020-08-07
309,005(0.28%) 46,511(0.21%)
2020-08-08
309,763(0.24%) 46,566(0.12%)
2020-08-09
310,825(0.34%) 46,574(0.02%)
2020-08-10
311,641(0.26%) 46,526(-0.10%)
2020-08-11
312,789(0.37%) 46,526(0.0%)
2020-08-12
313,798(0.32%) 41,329(-11.12%[x])
2020-08-13
314,927(0.36%) 41,329(0.0%)
2020-08-14
316,367(0.46%) 41,357(0.08%)
2020-08-15
317,444(0.34%) 41,361(0.01%)
2020-08-16
318,484(0.33%) 41,366(0.01%)
2020-08-17
319,197(0.22%) 41,369(0.01%)
2020-08-18
320,286(0.34%) 41,381(0.03%)
2020-08-19
321,098(0.25%) 41,397(0.04%)
2020-08-20
322,280(0.37%) 41,403(0.01%)
2020-08-21
323,313(0.32%) 41,405(<0.01%)
2020-08-22
324,601(0.40%) 41,423(0.04%)
2020-08-23
325,642(0.32%) 41,429(0.01%)
2020-08-24
326,614(0.30%) 41,433(0.01%)
2020-08-25
327,798(0.36%) 41,449(0.04%)
2020-08-26
328,846(0.32%) 41,465(0.04%)
2020-08-27
330,368(0.46%) 41,477(0.03%)
2020-08-28
331,644(0.39%) 41,486(0.02%)
2020-08-29
332,752(0.33%) 41,498(0.03%)
2020-08-30
334,467(0.52%) 41,499(<0.01%)
2020-08-31
335,873(0.42%) 41,501(<0.01%)
2020-09-01
337,168(0.38%) 41,504(<0.01%)
2020-09-02
338,676(0.44%) 41,514(0.02%)
2020-09-03
340,411(0.51%) 41,527(0.03%)
2020-09-04
342,351(0.57%) 41,537(0.02%)
2020-09-05
344,164(0.53%) 41,549(0.03%)
2020-09-06
347,152(0.87%) 41,551(<0.01%)
2020-09-07
350,100(0.85%) 41,554(0.01%)
2020-09-08
352,520(0.69%) 41,584(0.07%)
2020-09-09
355,219(0.77%) 41,594(0.02%)
2020-09-10
358,138(0.82%) 41,608(0.03%)
2020-09-11
361,677(0.99%) 41,614(0.01%)
2020-09-12
365,174(0.97%) 41,623(0.02%)
2020-09-13
368,504(0.91%) 41,628(0.01%)
2020-09-14
371,125(0.71%) 41,637(0.02%)
2020-09-15
374,228(0.82%) 41,664(0.06%)
2020-09-16
378,219(1.05%) 41,684(0.05%)
2020-09-17
381,614(0.89%) 41,705(0.05%)
2020-09-18
385,936(1.13%) 41,732(0.06%)
2020-09-19
390,358(1.15%) 41,759(0.06%)
2020-09-20
394,257(1.00%) 41,777(0.04%)
2020-09-21
398,625(1.11%) 41,788(0.03%)
2020-09-22
403,551(1.24%) 41,825(0.09%)
2020-09-23
409,759(1.54%) 41,862(0.09%)
2020-09-24
416,363(1.61%) 41,902(0.10%)
2020-09-25
423,236(1.65%) 41,936(0.08%)
2020-09-26
429,277(1.43%) 41,971(0.08%)
2020-09-27
434,969(1.33%) 41,988(0.04%)
2020-09-28
439,013(0.93%) 42,001(0.03%)
2020-09-29
446,156(1.63%) 42,072(0.17%)
2020-09-30
453,264(1.59%) 42,143(0.17%)
2020-10-01
460,178(1.53%) 42,202(0.14%)
2020-10-02
467,146(1.51%) 42,268(0.16%)
2020-10-03
480,017(2.76%[xi]) 42,317(0.12%)
2020-10-04
502,978(4.78%[xi]) 42,350(0.08%)
2020-10-05
515,571(2.50%) 42,369(0.04%)
2020-10-06
530,113(2.82%) 42,445(0.18%)
2020-10-07
544,275(2.67%) 42,515(0.16%)
2020-10-08
561,815(3.22%) 42,592(0.18%)
2020-10-09
575,679(2.47%) 42,679(0.20%)
2020-10-10
590,844(2.63%) 42,760(0.19%)
2020-10-11
603,716(2.18%) 42,825(0.15%)
2020-10-12
617,688(2.31%) 42,875(0.12%)
2020-10-13
634,920(2.79%) 43,018(0.33%)
2020-10-14
654,644(3.11%) 43,155(0.32%)
2020-10-15
673,622(2.90%) 43,293(0.32%)
Sources:


Notes:

  1. ^ On 25 March PHE changed reporting of deaths to be correct up to 17:00 the previous day, while cases are reported up to 09:00 the same day. Deaths reported for Tuesday 24 March only covered from 09:00 to 17:00 on that day; subsequent reporting is for 24-hour periods from 17:00 to 17:00.[38]
  2. ^ Figures for 27 March and after include additional cases from tests carried out on key workers.
  3. ^ Starting with the figures published on 29 April, deaths in all settings are now included. Previously, only deaths in hospitals were included in the official figures. The numbers in this table have been updated with backdated figures for previous dates.
  4. ^ Positive cases are 27 lower than the difference between today’s and yesterday’s cumulative. This is due to Northern Ireland not processing testing data for 17 May, and the removal of a quality control sample from Wales data.
  5. ^ Reduction in the cumulative total is due to unpublished corrections, and the reallocation of some positive test results to previous days.
  6. ^ 111 deaths were reported for 31 May. However, the cumulative total was revised to include an additional 445 deaths from the period from 26 April to 31 May identified by PHE as COVID-19 deaths having received a positive test. The numbers in this table have been updated with backdated figures from 23 May onwards.
  7. ^ The methodology of reporting positive cases has been updated to remove duplicates within and across pillars 1 and 2, to ensure that a person who tests positive is only counted once. This has resulted in a reduction in the number of cumulative tests. Pillar 1: swab testing in Public Health England (PHE) labs and NHS hospitals for those with a clinical need, and health and care workers. Pillar 2: swab testing for the wider population, as set out in government guidance.
  8. ^ Total positive cases reported for 14 July include an additional 842 cases from a testing laboratory in Wales. These positive cases should have been reflected in the data for 13 July. Had they been included in the 13 July data, there would have been 398 positive cases reported on 14 July, and the increases for 13 July and 14 July would have been 0.47% and 0.14% respectively.
  9. ^ The way daily death figures are calculated is currently under review. Statement from HM Government: "The Secretary of State has today, 17 July, asked PHE to urgently review their estimation of daily death statistics. Currently the daily deaths measure counts all people who have tested positive for coronavirus and since died, with no cut-off between time of testing and date of death. There have been claims that the lack of cut-off may distort the current daily deaths number. We are therefore pausing the publication of the daily figure while this is resolved."
  10. ^ After a review, the way daily death figures are calculated was changed. The daily death figures now only includes cases where a death occurred within 28 days of a positive test.
  11. ^ a b A backlog of positive test results from the previous week are included in this figure. Statement from Public Health England: "Due to a technical issue, which has now been resolved, there has been a delay in publishing a number of COVID-19 cases to the dashboard in England. This means the total reported over the coming days will include some additional cases from the period between 24 September and 1 October, increasing the number of cases reported."


Winter 2019–20: Arrival and embedment

Late 2019 and January 2020: Suspected cases

In May 2020, the BBC reported that several members of a choir in Yorkshire had suffered COVID-19-like symptoms shortly after the partner of one of the choir members returned from a business trip to Wuhan, China, on 17 or 18 December.[39]

Earlier, in March 2020, it was reported that a 50-year-old man from East Sussex fell ill, also with COVID-19 symptoms, on 20 January after he returned from Ischgl in Austria, which is under investigation because it failed to report early cases on February. Also, the three other members of his family have experienced same symptoms.[40][41]

In June 2020 BBC reported it was found coronavirus in UK had at least 1356 origins, mostly from Italy (late February), Spain (early-to-mid-March), and France (mid-to-late-March).[42]

In August 2020 the Kent coroner reportedly certified that the death of Peter Attwood (aged 84) on 30 January had been related to COVID-19 ('COVID-19 infection and bronchopneumonia', according to an email on 3 September, after COVID-19 was detected in his lung tissue), making him the first confirmed UK victim of the disease. He first showed symptoms on 15 December 2019.[43] Attwood had not travelled overseas.[44]

January 2020: First confirmed cases

22 January: Following a confirmed case of COVID-19 in the United States the previous day, in a man returning to Washington from Wuhan, China, where there were 440 confirmed cases at the time, the DHSC and Public Health England (PHE) raised the risk level from "very low" to "low". As a result, Heathrow Airport received additional clinical support and tightened surveillance of the three direct flights from Wuhan every week; each was to be met by a Port Health team with Mandarin and Cantonese language support. In addition, all airports in the UK were to make written guidance available for unwell travellers.[45][46] Simultaneously, efforts to trace 2,000 people who had flown into the UK from Wuhan over the previous 14 days were made.[47][48]

31 January: The first UK cases were confirmed in York.[49][50] On the same day, British nationals were evacuated from Wuhan to quarantine at Arrowe Park Hospital.[51] However, due to confusion over eligibility, some people missed the flight.[51]

February 2020: Early spread

6 February: A third confirmed case was reported in Brighton – a man who returned from Singapore and France to the UK on 28 January.[52][53][54] Following confirmation of his result, the UK's CMOs expanded the number of countries where a history of previous travel associated with flu-like symptoms—such as fever, cough, and difficulty breathing—in the previous 14 days would require self-isolation and calling NHS 111. These countries included China, Hong Kong, Japan, Macau, Malaysia, Republic of Korea, Singapore, Taiwan, and Thailand.[55]

23 February: The DHSC confirmed four new cases from the Diamond Princess cruise ship.[56]

26/27 February: A Nike conference in Edinburgh led to at least 25 cases including 8 residents of Scotland. Health Protection Scotland established an incident management team at the time and traced contacts from delegates.[57]

27 February: The first cases were confirmed in Northern Ireland.[58][59]

28 February: The first case was confirmed in Wales, and a passenger on the Diamond Princess became the first Briton to die from the virus.[60]

Spring 2020: First wave

March 2020: Closures and restrictions
Early to mid-March: closures and cancellations
Soap almost sold out, London, 12 March

1 March: A further 13 cases were reported including new cases in Greater Manchester and Scotland; bringing the total to 36, three of which were believed to be contacts of the case in Surrey who had no history of travel abroad.[61][62]

3 March: The UK Government unveiled their Coronavirus Action Plan, which outlined what the UK had done and what it planned to do next.[3] Paul Cosford, a medical director at Public Health England, said widespread transmission of COVID-19 in the United Kingdom was "highly likely".[63]

5 March: The first death from COVID-19 (within the UK), a woman in her 70s, was reported in Reading,[64] and the second, a man in his 80s in Milton Keynes, was reported to have died later that day.[65][66]

Some supermarkets began to limit purchases of items in high demand. 12 March.

12 March: The total of cases in the UK was reported to be 590.[3] On the same day, the UK CMOs raised the risk to the UK from moderate to high.[67] The government advised that anyone with a new continuous cough or a fever should self-isolate for seven days. Schools were asked to cancel trips abroad, and people over 70 and those with pre-existing medical conditions were advised to avoid cruises.[68][69]

Shopping in gloves and a face mask, London, 15 March

13 March: The 2020 United Kingdom local elections were postponed for a year.[70]

16 March: Prime Minister Boris Johnson advised everyone in the UK against "non-essential" travel and contact with others, as well as suggesting people should avoid pubs, clubs and theatres, and work from home if possible. Pregnant women, people over 70 and those with certain health conditions were urged to consider the advice "particularly important", and would be asked to self-isolate within days.[33] On the same day, a second MP, Kate Osborne, tested positive after a period of self-isolation.[71][72][73][74]

Supermarkets introduced early shopping hours for the elderly and vulnerable.

17 March: NHS England announced that all non-urgent operations in England would be postponed from 15 April to free up 30,000 beds.[75] General practice moved rapidly to remote working. In March 2020 the proportion of telephone appointments increased by over 600%.[76] Also, the government provided a £3.2million emergency support package to help rough sleepers into accommodation.[77][78] With complex physical and mental health needs, in general, homeless people are at a significant risk of catching the virus.[77]

18 March: Johnson announced the closure of schools to all pupils except children of key workers and those considered vulnerable, from 20 March until further notice. He also announced that public examinations would not take place as a result.[79]

20 March: The government announced the closure of public venues, such as pubs, restaurants, gyms, leisure centres, nightclubs, theatres and cinemas. The chancellor, Rishi Sunak also announced that the government would cover 80% of the salaries of retained workers until restrictions were over.

Late March: Restrictions begin
Next closed its 700 stores on 23 March, having previously traded with warning notices about the virus.

23 March: Having previously advised the public to avoid pubs and restaurants, Boris Johnson announced in a television broadcast that measures to mitigate the virus were to be tightened to protect the NHS, with wide-ranging restrictions on freedom of movement, enforceable in law,[12] under a stay-at-home order which would last for at least three weeks.[80] The slogan "Stay home, Protect the NHS, Save Lives" was introduced, often seen in capital letters, on a yellow background, with a red border.

The government directed people to stay home throughout this period except for essential purchases, essential work travel (if remote work was not possible), medical needs, one exercise per day (alone or with household members), and providing care for others.[81] Many other non-essential activities, including all public gatherings and social events except funerals, were prohibited, with many categories of retail businesses ordered to be closed.[12][82]

Despite the announcement, the Health Protection (Coronavirus, Restrictions) (England) Regulations 2020, which made the sweeping restrictions legally enforceable, did not take effect until three days later on 26 March.[83]

Operation Rescript and Operation Broadshare saw the deployment of the COVID Support Force, a military task force to support public services and civilian authorities in tackling the outbreak within the United Kingdom and overseas.[84]

26 March: The number of UK coronavirus deaths increased by more than 100 in a day for the first time, rising to 578, while a total of 11,568 had tested positive for the virus.[85] At 8:00 pm that day, people from across the UK took part in applause in appreciation of health workers, later branded as Clap for Our Carers.[86][87] This gesture was repeated on the next nine Thursdays, up to 28 May.[88]

Electronic display sign normally used for traffic management displays COVID-19-related advices on an almost deserted Chichester Street in Belfast City Centre, 24 March.

27 March: Boris Johnson and Matt Hancock announced that they had tested positive for the virus.[89][90] On the same day, Labour Party MP Angela Rayner, the Shadow Secretary of State for Education, confirmed she had been suffering symptoms and was self-isolating.[91]

Chief Medical Adviser Chris Whitty also reported suffering from symptoms and would be self-isolating, while continuing to advise the UK government.[92] That day also saw the largest increase in the number of deaths, with the figure rising by 181 from the previous day, bringing the total to 759, while 14,579 cases had been confirmed.[93]

Social distancing while queueing to enter a Sainsburys supermarket, 30 March 2020

29 March: It was reported that the government would send a letter to 30 million households warning things would "get worse before they get better" and that tighter restrictions could be implemented if necessary. The letter would also be accompanied by a leaflet setting out the government's lockdown rules along with health information.[94] Dr Jenny Harries, England's deputy chief medical officer, suggested it could be six months before life could return to "normal", because social distancing measures would have to be reduced "gradually".[95] The first NHS nurse died of COVID-19.[96]

30 March: The Prime Minister's senior adviser Dominic Cummings was reported to be self-isolating after experiencing coronavirus symptoms. He had been at Downing Street on 27 March and was stated to have developed symptoms over 28 and 29 March.[97]

Also, transmission within the community was thought to be decreasing, and hospital admission data suggested cases were increasing at a slower rate.[98] The Foreign and Commonwealth Office repatriated tens of thousands of British nationals who had been stranded abroad by the coronavirus outbreak.[99]

April 2020: Lockdown continues
A letter from the Prime Minister to UK households accompanying government guidance on coronavirus, 3 April

On 1 April, the government confirmed that a total of 2,000 NHS staff had been tested for coronavirus since the outbreak began, but Cabinet Office Minister Michael Gove said a shortage of chemical reagents needed for COVID-19 testing meant it was not possible to screen the NHS's 1.2 million workforces.[100] Gove's statement was contradicted by the Chemical Industries Association, which said there was not a shortage of the relevant chemicals and that at a meeting with a business minister the week before the government had not tried to find out about potential supply problems.[101]

On 2 April, Health Secretary Matt Hancock, after his seven-day period of isolation, announced a "five pillar" plan for testing people for the virus, with the aim of conducting 100,000 tests a day by the end of April.[102] The plan referred to ambitions to:

  • scale up swab testing in PHE labs and NHS hospitals for those with a medical need and the most critical workers to 25,000 a day in England by mid to late April, with the aligned testing strategies of the NHS in the Devolved Administrations benefiting from PHE's partnership with Roche through a central UK allocation mechanism;
  • deliver increased commercial swab testing for critical key workers in the NHS across the UK, before then expanding to key workers in other sectors;
  • develop blood testing to help know if people across the UK have the right antibodies and so have high levels of immunity to coronavirus;
  • conduct UK-wide surveillance testing to learn more about the spread of the disease and help develop new tests and treatments; and
  • build a mass-testing capacity for the UK at a completely new scale.[103]

On 4 April, Boris Johnson was admitted to hospital as a "precautionary measure" after suffering from symptoms for more than a week with no improvement.[104] Catherine Calderwood, the Chief Medical Officer for Scotland, resigned from her post after it emerged she had been spoken to by police for visiting her second home during lockdown.[105] On 6 April, Johnson was moved to the intensive care unit at St Thomas' Hospital in London as his symptoms worsened. First Secretary of State Dominic Raab assumed Johnson's duties.[106]

On 7 April the UK Government Chief Scientific Adviser, Sir Patrick Vallance, said that death figures were not accelerating as had been predicted but it was too early to tell whether the outbreak was peaking.[107][108] On 9 April, the number of daily recorded deaths was 881, taking the total to 7,978. Dominic Raab said the UK was "starting to see the impact" of the restrictions but it was "too early" to lift them, and urged people to stay indoors over the Easter weekend.[109]

On 10 April, the UK recorded another 980 deaths, taking the total to 8,958. Jonathan Van-Tam, England's deputy chief medical officer, told the UK Government's daily briefing the lockdown was "beginning to pay off" but the UK was still in a "dangerous situation", and although cases in London had started to drop they were still rising in Yorkshire and the North East.[110] Johnson left hospital on 12 April.[111]

On 14 April, figures released by the Office of National Statistics indicated that coronavirus had been linked to one in five deaths during the week ending 3 April. More than 16,000 deaths in the UK were recorded for that week, 6,000 higher than would be the average for that time of year.[112] Several UK charities, including Age UK and the Alzheimer's Society, expressed their concern that older people were being "airbrushed" out of official figures because they focused on hospital deaths while not including those in care homes or a person's own home.[113]

Matt Hancock announced new guidelines that would allow close family members to see dying relatives to say goodbye to them. Hancock also launched a new network to provide personal protective equipment to care home staff.[114] On that day, NHS England and the Care Quality Commission began rolling out tests for care home staff and residents as it was reported the number of care home deaths was rising but that official figures, which relied on death certificates, were not reflecting the full extent of the problem.[115] Also on 15 April, Arlene Foster, the First Minister of Northern Ireland, extended the period of lockdown in Northern Ireland to 9 May.[116]

On 16 April, Dominic Raab revealed that lockdown restrictions would continue for "at least" another three weeks, and to relax them too early would "risk wasting all the sacrifices and all the progress that has been made". He set out five conditions for any easing of the lockdown .[117] On that day the number of recorded deaths increased by 861 to 13,729, while the number of cases of the virus passed 100,000, reaching 103,093.[118]

On 18 April, unions representing doctors and nurses expressed concern at a change in government guidelines advising medics to reuse gowns or wear other kits if stocks run low.[119] Robert Jenrick, the Secretary of State for Local Government, announced a further £1.6bn of support for local authorities, on top of £1.6bn that was given to them at the beginning of the outbreak.[120]

On 29 April, the number of people who had died with coronavirus in the UK passed 26,000, as official figures include deaths in the community, such as in care homes, for the first time.[121] On 30 April, Boris Johnson said the country was "past the peak of this disease".[18]

May 2020: Lockdown easing begins
VE Day celebrations took place under lockdown; here a socially distanced street party is taking place on Hallfield Estate, Wetherby, West Yorkshire.

On 5 May, the UK death toll became the highest in Europe and second highest in the world.[122]

On 7 May, the lockdown in Wales was extended by the Welsh Government, with some slight relaxations.[123][124]

On 10 May, Prime Minister Johnson asked those who could not work from home to go to work, avoiding public transport if possible; and encouraged the taking of "unlimited amounts" of outdoor exercise, and allowing driving to outdoor destinations within England. In his statement he changed the "Stay at Home" slogan to "Stay Alert".[125] The devolved administrations in Scotland, Northern Ireland, and Wales did not adopt the new slogan as there had been no agreement with the UK government to change it, and because the announcement sent a mixed message to the public.[126][127]

UK's COVID-19 Alert Levels (introduced in May 2020)

On 11 May, Johnson published a 60-page document called "Our Plan to rebuild: the UK Government's COVID-19 recovery strategy", with details of the COVID-19 recovery strategy for the UK. In the report a new COVID-19 alert level system was announced.[128] At the same time the Cabinet Office published guidance on "staying safe outside your home", comprising eleven principles which "all of us" should adopt "wherever possible".[129]

In May a COVID-19 alert system was announced, to be run by a new joint biosecurity centre. When first announced, Johnson stated that the UK was on level 4, moving towards level 3.[130][128][131]

The Health and Safety Executive stated that from 9 March to 7 May they were contacted 4,813 times. Around 8% of the complaints related to Scotland. The executive managed to resolve 60% of them while another 40% needed further investigation, with some workplaces suspended whilst safety measures were put in place. As of 17 May the executive had not issued any enforcement notices in relation to COVID-19.[132]

On 25 May, the prime minister's adviser Dominic Cummings was criticised over his alleged breaches of the lockdown rules.[133][134] Cummings rejected the allegations, denying that he had acted illegally.[135] On 28 May, Durham police said that no offence had been committed when Cummings had travelled from London to Durham and that a minor breach might have occurred at Barnard Castle, but as there had been no apparent breach of social distancing rules, no further action would be taken.[136]

The evening of 28 May saw the final Clap for Our Carers event.[88] Scotland's First Minister Nicola Sturgeon announced an easing of the lockdown in Scotland from the following day, with people able to meet friends and family outside in groups of no more than eight but keeping two metres apart.[137]

Summer 2020: Continued restrictions and local lockdowns

June 2020

On 1 June, Primary schools reopened to some reception, year 1 and year 6 pupils with social distancing measures in place.

On 6 June, Parliament Square in London, saw thousands of people participating in the Black Lives Matter protest against racism and police violence in the UK, following the death of George Floyd apparently caused by US police in Mineapolis, Minnesota. On 7 June, Health Minister Matt Hancock stated that although he supports the argument of the protests, there is "undoubtedly" a risk of a potential rise in the number of COVID-19 cases and the spread of the virus.[138] Non-essential shops reopened across the UK during this month.[139][140][141][142]

On 8 June, the government introduced new quarantine rules from anyone coming into the UK, requiring individuals to self-isolate for 14 days upon arrival to help slow the spread of the coronavirus.

On 15 June, England made face masks compulsory on all public transport. Transport Secretary Grant Shapps still advised people not to use public transport, but acknowledged that for some people this wasn't an option, especially as the use of public transport had been increasing throughout late May and early June, which brought fears of the coronavirus being transmitted on public transport.

July 2020
World maps of countries and territories from which travellers arriving in England from 10 July 2020 need not self-isolate[143]

On 2 July, the government revised the total number of cases down by 30,302 because some people were counted twice in the earlier figures. The actual increase in the number of cases for 2 July was 576 or 0.18%.[3]

Also on 2 July, the government removed 75 countries from the quarantine list since they were now dubbed "low risk". Travellers entering the UK would no longer have to self-isolate.

On 17 July, the Health Secretary Matt Hancock called for an urgent review into how coronavirus deaths were recorded in England. Public Health England had said that the figures for deaths included people that had tested positive for the virus months before their death.[144]

On 24 July, in England, new regulations made it compulsory to wear face coverings in most indoor shops and public spaces. Those breaking the rules could be fined up to £100. Face coverings remained optional in some indoor venues where wearing a mask might be 'impractical', such as restaurants and gyms. Exemptions were made for children under 11, individuals with physical or mental illness or disability, and for anyone to whom it might cause distress.[145]

On 25 July, the government added Spain back onto the quarantine list due to a spike in cases. This drew criticism from the Spanish PM, Pedro Sanchez, as the outbreak was largely only happening in Catalonia.

On 27 July, the first confirmed case of an animal infection with SARS-CoV-2 in the UK was reported, having been detected in a pet cat.[146] UK health officials said that the cat had probably contracted the coronavirus from its owners, but there was no evidence that pets or other domestic animals can transmit the disease to humans.[146]

On 30 July, the UK government announced that people in Greater Manchester, east Lancashire and parts of West Yorkshire faced new restrictions, banning separate households from meeting each other at home after a spike in COVID-19 cases. The new lockdown rules, which came into force at midnight, meant people from different households were not allowed to meet in homes or private gardens.[147]

On 31 July, the UK government announced they were delaying a further ease of lockdown restrictions in England until at least 15 August due to recent increases in cases. This ease of lockdown restrictions would have allowed "higher risk settings", including bowling alleys, skating rinks and casinos, to open on 1 August.[148]

By the end of the month, levels of travel and commerce had started to recover across the UK, but not yet returned to pre-pandemic levels.[149]

August 2020

On 2 August, a major incident was declared in Greater Manchester after rises in coronavirus infection rates.[150][151]

On 12 August, the death count for England was reduced by more than 5,000[152] to 41,329. Previously, people in England who died at any point following a positive test, regardless of cause, were counted in the figures. However, the other UK nations had a cut-off period of 28 days.

On 14 August, thousands of UK holidaymakers in France were rushing to the borders to the UK, following the announcement of anyone returning from France after 4 am on 15 August to self-isolate for fourteen days, causing massive ques and traffic jams at the harbours and eurotunnel.

On 28 August, shortly before the reopening of schools at full capacity in England, Wales and Northern Ireland, New Scientist examined the three-month history of the test and trace system. The magazine noted that the system had not met its targets and had been affected by an internet outage in Southampton in the second week of August, affecting contact tracing for several thousand people. It criticised both the lack of a backup for such a vital system and the lack of transparency.[153]

September 2020–present: Resurgence

September 2020

On 6 September, concerns were raised over an increased number of cases in the preceding few days, a trend that continued into the following week.[154]

On 8 September, the government published new social distancing rules to come into effect in England from 14 September, wherein all gatherings of separate households would be restricted to groups of six or few people (the so-called "rule of six"), excluding work or educational settings.[155] Similar rules were also later announced (to begin on the same date) in Scotland and Wales, although – unlike in England – with exemptions for young children.[156]

On 9 September, these rules were further elaborated in a government press conference, alongside details of new legal requirements for data gathering on behalf of venues, social distancing "marshals" to enforce restrictions, and the outline of a "moonshot" plan to further control the virus with greatly expanded mass virus testing.[157] The £100bn "moonshot" plan was derided as lacking expert input by Professor Jon Deeks of the University of Birmingham and Cochrane, speculating on the consequences of false positives that might go along with testing such a large number of people.[158]

On 18 September, the government tightened restrictions further in parts of the north-east of England. Pubs were told to close every day from 10pm to 5am, and households were not allowed to mix. Later, new restrictions were announced for parts of the North West of England, Midlands and West Yorkshire.[159] By now 13.5 million people, around 1 in every 5 UK residents, were living under some degree of extra local restrictions, including much of Northern England and Central Scotland, several council areas in the Midlands and South Wales, along with parts of Belfast and other areas in Northern Ireland.[159]

On 21 September, the UK's coronavirus alert level was upgraded from 3 to 4, indicated the disease's transmission is "high or rising exponentially".[160] This decision followed a warning from the UK government's Chief Scientific Advisor earlier that day, that the UK could be seeing 50,000 cases a day by October unless further action was taken to slow the virus's spread.[161] Fears of a "second lockdown" caused a drop in UK stocks,[162] although the following day the Prime Minister stated that potential additional restrictions would be "by no means a return to the full lockdown of March".[163]

On 22 September, tightening of coronavirus restrictions were announced by the UK government for England and the devolved administrations in the rest of the UK. Including 10pm closing times for pubs across the UK and a ban on households meeting in other households in Scotland.[164][165][166][167] In a televised adress to the nation, Prime Minister Boris Johnson stated that additional rules to combat the case rise could last for a further 6 months.[163]

On 29 September, the UK reported the highest daily rise in new infections with a total of 7,143 new cases.[168]

October 2020

On 1 October, restrictions were tightened further in the North-East, now banning all indoor gatherings within households. The government also advised people in the regions not to meet outside, although they did not ban people from meeting outside.

On 2 October, Margaret Ferrier, MP for Rutherglen and Hamilton West received calls from other politicians, including the Scottish First Minister, Nicola Sturgeon to resign from her seat. She had been suspended from the SNP for travelling from Scotland to London to attend a coronavirus debate in the House of Commons while awaiting a coronavirus test result, and then travelling back to Scotland after testing positive for COVID-19. Police also began an investigation.[169][170][171][172]

On 3 October, Public Health England announced that a 'technical error' had caused under-reporting of new cases for recent dates, and that the missing positive results would be declared over the forthcoming days. The number of new cases declared on 3 October was approximately double the rate prevailing over the preceding few days.[173]

On 4 October, Public Health England made a further announcement that 15,841 cases had been left out of the daily case figures between 25 September and 2 October and that these would be added to the figures for 3 and 4 October. The error was caused by a limit on the number of columns in an Excel spreadsheet.[174][175][176] Hugh Pym, the BBC's health editor, said that daily figures for the end of the week were "actually nearer 11,000"; around 7,000 had been reported. Referring to the glitch, Labour used the term "shambolic".[177] A smoothed curve of estimates from the COVID Symptom Study suggested that new cases might be estimated to be running just below 8,000 per day.[178] After the corrections, total infections in the UK surpassed 500,000 – the fourth country in Europe to pass that milestone.

On 12 October, a Three-Tier lockdown system was introduced to help curb the spread of coronavirus in local and regional lockdowns, coming into effect on 14 October. Liverpool became the first region under a Tier 3, which ordered the closure of pubs. Households were also banned from mixing with each other in parts of the North-East of England and Manchester. The Harrogate, Manchester and Sunderland Nightingale Hospitals were also told to reopen as hospital admissions had risen above the peak in March.[179]

On 13 October, daily deaths increased by more than 100 for the first time since 27 July with 143 deaths recorded in the 24-hour period.

On 14 October, the Northern Irish government announced that from 16 October, Pubs, Restaurants and school closures as well as a ban on mixing in households would come into force, essentially putting Northern Ireland in lockdown. Pubs and Restaurants would be closed for 4 weeks whereas schools would only be shut for 2 weeks.

On 15 October, the government announced that London would move to Tier 2 lockdown following a spike in cases, banning people from mixing indoors privately, while Greater Manchester would move to Tier 3, two months after a Major Incident was declared. However, the Tier 3 restrictions on Greater Manchester were delayed hours later as Johnson was in a dispute with the mayor of Manchester, Andy Burnham who didn't want the lockdown to happen.

Government response

Bilingual information from Welsh Government and NHS Wales with lockdown instructions at Aberystwyth railway station, 4 April 2020
NHS England coronavirus poster, February 2020[180]

The first published government statement on the coronavirus situation in Wuhan was released on 22 January by the Department of Health and Social Care and Public Health England.[181] Guidance has progressed in line with the number of cases detected and changes in where affected people have contracted the virus, as well as with what has been happening in other countries.[53] In February, Chief Medical Officer (CMO) to the UK Government, Chris Whitty said "we basically have a strategy which depends upon four tactical aims: the first one is to contain; the second of these is to delay; the third of these is to do the science and the research; and the fourth is to mitigate so we can brace the NHS".[182] These aims equate to four phases; specific actions involved in each of these phases are:

  • Contain: detect early cases, follow up close contacts, and prevent the disease from taking hold in this country for as long as is reasonably possible
  • Delay: slow the spread within the UK, and (if it does take hold) lower the peak impact and push it away from the winter season
  • Research: better understand the virus and the actions that will lessen its effect on the UK population; innovate responses including diagnostics, drugs, and vaccines; use the evidence to inform the development of the most effective models of care
  • Mitigate: provide the best care possible for people who become ill, support hospitals to maintain essential services and ensure ongoing support for people ill in the community, to minimise the overall impact of the disease on society, public services and on the economy.[183]

The four UK CMOs raised the UK's risk level from low to moderate on 30 January 2020, upon the WHO's announcement of the disease as a Public Health Emergency of International Concern.[3][184] As soon as cases appeared in the UK on 31 January 2020, a public health information campaign, similar to the previous "Catch it, Bin it, Kill it" campaign, was launched in the UK, to advise people how to lessen the risk of spreading the virus.[184] Travellers from Hubei province in China, including the capital Wuhan, were advised to self-isolate, "stay at home, not go to work, school or public places, not use public transport or taxis; ask friends, family members or delivery services to do errands",[185] and call NHS 111 if they had arrived in the UK in the previous 14 days, regardless of whether they were unwell or not.[184] Further cases in early February prompted the Secretary of State for Health and Social Care, Matt Hancock, to announce the Health Protection (Coronavirus) Regulations 2020.[3] Daily updates have been published by the DHSC.[3] NHS Digital in the meanwhile, have been collecting data.[186]

NHS England poster for the "Catch it, Bin it, Kill it" slogan which has been revived in the fight against coronavirus

Initially, Prime Minister Boris Johnson largely kept Britain open, resisting the kind of lockdowns seen elsewhere in Europe. In a speech on 3 February, Johnson's main concern was that the "coronavirus will trigger a panic and a desire for market segregation that go beyond what is medically rational to the point of doing real and unnecessary economic damage".[187] On 11 February, a "senior member of the government" told the ITV journalist Robert Peston that "If there is a pandemic, the peak will be March, April, May" and, further, that "the risk is 60% of the population getting it. With a mortality rate of perhaps just over 1%, we are looking at not far off 500,000 deaths".[188]

On 13 March, UK Government Chief Scientific Adviser Sir Patrick Vallance told BBC Radio 4 one of "the key things we need to do" is to "build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission".[189] This involves enough people getting infected, upon which they develop immunity to the disease.[190][191] Vallance said 60% of the UK's population will need to become infected for herd immunity to be achieved.[192][191] This stance was criticised by experts who said it would lead to hundreds of thousands of deaths and overwhelm the NHS. More than 200 scientists urged the government to rethink the approach in an open letter.[193] Subsequently, Health Secretary Matt Hancock said that herd immunity was not a plan for the UK, and the Department of Health and Social Care said that "herd immunity is a natural byproduct of an epidemic".[194]

Public Health England has also been involved with efforts to support the British Overseas Territories against the outbreak.[195][196]

On 23 March, a 20,000-strong military task force, named the COVID Support Force, was launched to provide support to public services and civilian authorities. Two military operations — Operation Rescript and Operation Broadshare — commenced to address the outbreak within the United Kingdom and its overseas territories.[84]

On 27 March, Johnson said he had contracted coronavirus and was self-isolating, and that he would continue to lead the Government's response to coronavirus through video conference.[89] On the evening of 5 April the Prime Minister was admitted to hospital for tests.[197] The next day he was moved to the intensive care unit at St Thomas' Hospital, and First Secretary of State Dominic Raab deputised for him.[198] On 11 July 2020, the MPs urged the Prime Minister to clarify on wearing masks, after he hinted a day earlier that it could become compulsory to wear them in shops.[199]

On 9 September 2020, the UK government announced the banning of social gatherings of more than six people, which was to be implemented from 14 September, amidst rising cases of coronavirus. A £100 fine was initiated to be imposed on the people who fail to comply, doubling on each offense up to a maximum of £3,200.[200]

On 12 March, the government announced it was moving out of the contain phase and into the delay phase of the response to the coronavirus outbreak. The announcement said that in the following weeks, the government would introduce further social distancing measures for older and vulnerable people, and asking them to self-isolate regardless of symptoms. It announcement sidd that if the next stage were introduced too early, the measures would not protect at the time of greatest risk but they could have a huge social impact. The government said that its decisions were based on careful modelling and that government measures would only be introduced that were supported by clinical and scientific evidence.[67]

On 16 March, the UK government started holding daily press briefings. The briefings were to be held by the Prime Minister or government ministers and advisers. Daily briefings were also held by the devolved administrations of Northern Ireland, Scotland and Wales.[201]

Prior pandemic planning

The UK Influenza Pandemic Preparedness Strategy was published in 2011 and updated in 2014,[202] alongside a review of the available medical and social countermeasures .[203] Pandemic flu guidance was published in 2013 and updated in 2017 covering guidance for local planners, business sectors, and an ethical framework for the government response. The guidance stated:[204]

There are important differences between 'ordinary' seasonal flu and pandemic flu. These differences explain why we regard pandemic flu as such a serious threat. Pandemic influenza is one of the most severe natural challenges likely to affect the UK.

Restaurant in London offering home deliveries after dining-in was banned. March 2020.

The government published the Health Protection (Coronavirus) Regulations 2020 on 10 February 2020, a statutory instrument covering the legal framework behind the government's initial containment and isolation strategies and its organisation of the national reaction to the virus for England.[205] Other published regulations include changes to Statutory sick pay (into force on 13 March),[206] and changes to Employment and Support Allowance and Universal Credit (also 13 March).[207]

On 19 March, the government introduced the Coronavirus Act 2020, which grants the government discretionary emergency powers in the areas of the NHS, social care, schools, police, the Border Force, local councils, funerals and courts.[208] The act received royal assent on 25 March 2020.[209]

Closures to pubs, restaurants and indoor sports and leisure facilities were imposed in England via the Health Protection (Coronavirus, Business Closure) (England) Regulations 2020.[210]

Criticism of the government response

Criticism of the government's response has included accusations of a lack of transparency over their plans to tackle the virus[211] and arguments that the government did not do enough or did not act quickly enough. Others have criticised the government's actions as being too harsh and draconian. They have argued that the lockdown and social distancing policies have been disproportionate to the threat presented by the virus and the consequences of policies too severe in comparison.[212]

Scottish Government

On 28 April the First Minister of Scotland, Nicola Sturgeon, advised the voluntary use of non-medical grade cloth face masks in Scotland to be used in enclosed spaces such as shops and public transport, but not generally in public (excluding those who are under two years old or who have respiratory illnesses such as asthma). Sturgeon noted their limitation and said co-operation with the face mask guidance was voluntary.[213] This is in contrast to advice given by Boris Johnson and the UK government.[214]

Lifting lockdown

In mid-April, a member of the Cabinet told The Telegraph that there was no exit plan yet.[215] Several members of the UK government stated that it was not possible to draw up a definitive plan on how to exit lockdown as it is based on scientific advice.[216]

New COVID-19 cases and deaths in the UK, with the dates of lockdown and its partial lifting. This shows both the Covid death figures confirmed by tests and the figures registered by 3 authorities

In early May, research was published which concluded that if the most vulnerable (the elderly and those with certain underlying illnesses) were completely shielded, the lockdown could mostly be lifted, avoiding "a huge economic, social and health cost", without significantly increasing severe infections and deaths.[217] It also recommended regular testing and contact tracing.[218][219]

Johnson made a second televised address on 10 May, changing the slogan from 'Stay at Home' to 'Stay Alert'. He also outlined how restrictions might end and introduced a COVID-19 warning system.[125] Additionally measures were announced stating that the public could exercise more than once a day in outdoor spaces such as parks, could interact with others whilst maintaining social distance and drive to other destinations from 13 May in England.[220] This was leaked to the press[221][222] and criticised by leaders and ministers of the four nations, who said it would cause confusion.[223] The leaders of Scotland, Northern Ireland, and Wales said they would not adopt the new slogan.[224][225] Labour leader Sir Keir Starmer said that the new message "lacked clarity".[226]

The next day the government published a 60-page roadmap of what exiting lockdown could look like.[128] On 17 May, Labour leader Keir Starmer called for a 'four-nation' unified approach.[227] Greater Manchester Mayor Andy Burnham said that there was a risk of national unity in ignoring the different demands of regions in England.[228][229] Boris Johnson acknowledged the frustrations in some of the rules and said that "complicated messages were needed during the next phase of the response and as restrictions changed".[230]

The Northern Ireland Executive published a five-stage plan for exiting lockdown on 12 May, but unlike the plans announced in England the plans did not include any dates of when steps may be taken.[231][232][224] An announcement was made on 14 May that garden centres and recycling centres would reopen on Monday in the first steps taken to end the lockdown in Northern Ireland.[233][231]

On 15 May, Mark Drakeford announced a traffic light plan to remove the lockdown restrictions in Wales, which would start no earlier than 29 May.[234][235] On 20 June 2020, a group of cross-party MPs wrote a letter to the government, urging them to consider a four-day working week for the UK post COVID-19.[236]

While nationwide lockdown measures were gradually relaxed throughout the summer, including a shift towards regional measures such as those instituted in Northern England in July,[147] lockdown easing plans were delayed at the end of July due to rises in case numbers,[148] and measures were increased once more following the resurgence of the virus nationwide starting in early September.[155][157]

By 1 October 2020, around a quarter of the population of the United Kingdom, about 16.8 million people, were subject to local lockdown measures with some 23% of people in England, 76% of people in Wales and 32% of people in Scotland being in local lockdown.[237]

National health services response

Healthcare in the UK is a devolved matter, with England, Northern Ireland, Scotland and Wales each having their own systems of publicly funded healthcare, funded by and accountable to separate governments and parliaments. As a result of each country having different policies, laws and priorities, a variety of differences now exist between these systems.[238][239]

Equipment

Personal protective equipment
Primary care nurse wearing Personal Protective Equipment (PPE)
Face masks given to NHS staff, March 2020

As early as February 2020 frontline healthcare workers began to raise their concern regarding the UK's preparedness to cope with a large-scale outbreak.[240] On 2 March a poll conducted by the Doctors' Association UK found that just 8 out of 1600 doctors though the NHS was well prepared to deal with Coronavirus.[241]

On 16 March, primary care magazine Pulse reported doctors were receiving out-of-date PPE that had had its 2016 use-by date covered with a sticker saying "2021".[242] In response, the government offered reassurance that this was safe.[243] Earlier in the month, in response to a survey of Pulse's readership, two of five GPs reported they still did not have PPE to protect them from coronavirus.[242] Some of these concerns were raised with Johnson during Prime Minister's Questions, to which the Prime Minister replied the UK had "stockpiles" of PPE.[244] The same day, the Doctors' Association UK (DAUK) reported NHS staff felt they were being put at risk due to lack of PPE.[245]

On 22 March, in a letter with 3,963 signatures co-ordinated by the Doctors' Association UK published in The Times, NHS staff asked Johnson to "protect the lives of the life-savers" and resolve the what they saw as the "unacceptable" shortage of protective equipment.[246][247] On 23 March, in an effort to meet demand and due to concerns about the rising number of medics becoming ill after exposure to the virus, the NHS asked DIY stores to donate PPE for use by NHS staff.[248] Frontline healthcare workers raised concerns that they had been forced to source their own PPE from Screwfix.[249] Hancock said there were "challenges" with supplying PPE to NHS staff and said a million masks had been bought that weekend.[250] The following day, the government said there was enough PPE for everyone in the NHS who needed it; this was contradicted by the Royal College of Nursing,[251] the British Medical Association (BMA), and the Doctors' Association UK which warned that without enough PPE, doctors would die.[252][253]

Three people in London wearing masks, 19 March 2020. The wearing of masks was not made compulsory in the UK.

On 1 April, the government said 390 million pieces of PPE had been distributed to the health service in the past fortnight. The Royal College of Midwives (RCM),[254] BMA and DAUK said the supplies had yet to reach medical staff.[255][256] The RCM, in a joint statement with unions, including Unite, Unison and the GMB, said the lack of PPE was now 'a crisis within a crisis'.[254]

On 9 April it was reported that protective gowns were set to run out by that weekend in London.[257]

On 10 April the UK Government sent out a document to PPE suppliers informing them that suppliers of certain medical equipment, including protective masks, gloves and aprons, must be registered with the Care Quality Commission, which regulates all health and social care services in England only. There was not a similar agreement in place between suppliers and Care Inspectorate Wales or the Care Inspectorate of Scotland.[258][259] The Welsh Government advised care home providers that they should order through their local council, while Plaid Cymru leader Adam Price lodged a formal complaint with the European Union over the issue.[259] The manager of two care homes in Gwynedd, Wales was told by two suppliers that they would only sell to care homes in England.[260] The chief executive of the care home umbrella group Scottish Care said that the UK's four largest PPE suppliers had said they were not distributing to Scotland because their priority was going to be "England, the English NHS and then English social care providers".[261] The UK government reported that it had not instructed any company to prioritise PPE for any nation.[261] Healthcare supplier Gompels' website said at the time that "These restrictions are not something we have decided, they are a criteria[sic] given to us by Public Health England".[262]

After collating data from over 1500 frontline NHS doctors on ongoing shortages the Doctors' Association UK demanded a public inquiry into the government's failure to adequately procure and supply PPE and healthcare worker deaths.[263] As of August 2020 over 120,000 people had signed a petition for a public inquiry into healthcare worker deaths and PPE and DAUK launched a legal challenge for a judicial review.[264]

A BBC Panorama episode, Has the government failed the NHS?, broadcast on 27 April, said the government had been counting PPE items in a way that artificially inflated the total. Gloves were counted individually, rather than as pairs, for instance, and non-PPE items, such as paper towels and detergent, were included in the figure.[265] The programme also said the government was changing the guidance on what PPE was appropriate for medical staff to wear when treating COVID-19 patients, not according to best protective procedure, but according to the stock available.[266] The programme also said that, in the years before the pandemic, the government had ignored expert advice and failed to stockpile essential items.[266] Due to lack of stock, in May an NHS trust prioritised anti-bacterial ventilator filters for coronavirus patients over others. .[267]

Ventilators

On 16 March, Boris Johnson held a conference call with business leaders and set them the target of delivering 30,000 ventilators in a fortnight; the government also declined to join an emergency European Union scheme to procure ventilators and other emergency equipment like personal protective equipment (PPE) for hospital staff, saying the UK was no longer part of the EU and that this was area in which it was making its own efforts.[268] Existing ventilator stocks stood at 5,900 at the beginning of the outbreak.[269]

On 29 March, the government issued a specification for the "minimally clinically acceptable" manufacture and use of continuous positive airway pressure (CPAP) machines.[270]

Staffing

On 1 March, Hancock said retired NHS staff might be asked to return to work to help with the crisis.[271] The request was issued on 19 March and included final year medical students.[272] On 29 March, Boris Johnson announced that more than 20,000 former NHS staff were returning to work in response to the pandemic.[273]

Whilst ventilators were procured frontline NHS staff raised concerns about a lack of trained staff to operate them. On 15 March both the BMA and the Doctors' Association UK both raised the alarm that the NHS was short of nearly 43,000 nurses and 10,000 doctors prior to the pandemic.[274] Concerns were also raised that staff were being pressured to return from self-isolation early due to severe short staffing.[275]

On 21 March, the NHS had agreed to use, at cost price, almost the entire private health system, bringing 20,000 medical staff into the national effort.[276]

On 24 March, Matt Hancock launched a scheme to recruit 250,000 volunteers to support the NHS through the pandemic.[277] The volunteers would carry out jobs like collecting and deliver shopping, medication or "other essential supplies" for people in isolation; transporting equipment and medication between NHS services; transporting medically fit patients and providing telephone support to people at risk of loneliness because of self-isolation.[278] The target was surpassed in 24 hours and was raised to 750,000.[279] The scheme was paused on 29 March after the new target was reached.[278]

Military personnel from the newly-formed COVID Support Force helped staff NHS Nightinghale hospitals, mobile test centres and some ambulance services.[280]

Temporary critical care hospitals

In Northern Ireland capacity was upgraded at Belfast City Hospital, while in Scotland, NHS Louisa Jordan was established in Glasgow by NHS Scotland.[281]

NHS England established temporary "Nightingale" hospitals in London, Birmingham, Manchester and Harrogate. The Dragon's Heart Hospital was set up at the Principality Stadium in Cardiff, Wales.[282] Military personnel from the COVID Support Force assisted with the construction and subsequent staffing.[280]

Testing and monitoring

A temporary test site staffed by the army in Ealing

Shortly after confirming that the cause of the cluster of pneumonia in Wuhan was a new coronavirus, Chinese authorities had shared its genetic sequence for international developments of diagnostic kits.[45] By 10 January,[283] the UK had developed a prototype specific laboratory test for the new disease, performed on a sample from the nose, throat, and respiratory tract and tested at PHE's public health laboratory at Colindale in London.[25] Testing of patients began within days,[284] and by 3 February 326 tests had been performed in the UK.[184] Over the following few weeks, PHE made the test available to 12 other laboratories in the UK, making it possible to test 1,000 people a day.[25][285]

As of 12/13 March 2020, 29,764 tests had been conducted in the UK, corresponding to 450.8 tests per million people.[286] On 24 March, Matt Hancock said the government had bought 3.5m kits that would test if a person has already had COVID-19; no date was given for their arrival. These tests would allow people to know if they were immune and therefore able to "go back to work".[287] It was later found when the kits, which had cost at least £16 million, were tested, they did not meet the required specifications.[288] Hancock announced on 28 March that 10,000 tests a day were now being processed; the actual figure was 5,000.[289][290] As of 31 March 143,186 people had been tested.[3]

The UK government and Public Health England were criticised for what some saw as a failure to organise mass testing. On 28 March the editor-in-chief of The Lancet published a condemnation of what he saw as government inaction and ignoring of WHO advice.[291] On 31 March, former WHO director Anthony Costello, following WHO advice that countries should "test, test, test", said the key to the UK's transitioning out of lockdown was mass testing, and that the UK had the capacity to reach the level of testing being carried out by Germany (70,000 tests a day, compared to the UK's 5,000) but the government and Public Health England (PHE) had been too slow and controlling to organise.[292] The day after, Conservative MP Jeremy Hunt, chair of the Health and Social Care Select Committee and former Health Secretary, said it was "very worrying" that the government had not introduced mass testing because doing so had been "internationally proven as the most effective way of breaking the chain of transmission".[293] On 2 April, The Telegraph reported that one of the Government's science advisers, Graham Medley, said "mass public testing has never been our strategy for any pandemic". Medley also said the Government "didn't want to invest millions of pounds into something that is about preparedness".[294]

The government launched a booking portal for people to be tested for COVID-19. The governments of Scotland and Northern Ireland governments signed up to use the portal that England were using. The Welsh Government went on to partner with Amazon to create a portal. Later this was scrapped with the Welsh Government citing issues around collecting of data having been resolved with the UK government's portal and now wanted to use it, having only released their version across south east Wales.[295]

In May, the Department of Health and Social Care and Public Health England confirmed that two samples taken from single subjects, such as in the common saliva and nasal swab test, are processed as two separate tests. This, along with other repeated tests such as checking a negative result, led to the daily diagnostic test numbers being over 20% higher than the number of people being tested.[296]

On 18 May, testing was extended to anyone over the age of five after the governments of all four nations agreed to the change.[297]

On 29 September, a letter in Lancet highlighted the increasing likelihood of overestimating of COVID-19 incidence as more asymptomatic people are included in RT-PCR testing with consequent "misdirection of policies regarding lockdowns and school closures," noting that the false-positive rate in the UK is currently unknown, with "preliminary estimates ... somewhere between 0·8% and 4·0%".[298][299] The letter called for "stricter standards ... in laboratory testing, ... and pretest probability assessments ... [including] symptoms, previous medical history of COVID-19 or presence of antibodies, any potential exposure to COVID-19, and likelihood of an alternative diagnosis."[300]

England

Following 300 staff being asked to work from home on 26 February in London, while a person was awaiting a test result for the virus, PHE expanded testing around the UK to include people with flu-like symptoms at 100 GP surgeries and eight hospitals: the Royal Brompton and Harefield, Guy's and St Thomas' and Addenbrookes Hospital, as well as hospitals at Brighton and Sussex, Nottingham, South Manchester, Sheffield, Leicester.[301][302]

Drive-through screening centres were set up by Central London Community Healthcare NHS Trust at Parsons Green Health Centre on 24 February 2020,[303] A further drive-through testing station was set up by the Sheffield Teaching Hospitals NHS Foundation Trust at a site just off the A57 Sheffield Parkway dual-carriageway on 10 March; in this case, patients ringing NHS 111 with coronavirus-like symptoms in the Sheffield area will be told to drive, if possible, to the testing centre at an allotted time.[304]

On 11 March, NHS England announced that testing in NHS laboratories would increase from testing 1,500 to 10,000 per day.[305] The test consists of taking a sample from the nose, throat, deeper lung samples, blood or stool, and transporting the packed samples to the listed PHE regional laboratory designated for the referring laboratory region.[306][307] On 14 May PHE approved an antibody test by Swiss company Roche.[308] Abbott Laboratories said that they also had an antibody test approved by the public health boards of England, Scotland and Wales.[309]

The British Medical Association (BMA) asked 8,190 doctors and medical students in England about their concerns about COVID-19; the results were published on 14 September 2020. 86% of respondents expected a second peak, and it was the main concern for 30%. 89% of respondents agreed or strongly agreed that the failure of test and trace risked causing a second wave.[310][311]

Scotland

On 29 February drive-through testing was set-up by NHS Lothian at the Western General Hospital in Edinburgh.[312] On 1 March 2020 it was reported that surveillance was shortly to be extended to some hospitals and GP surgeries in Scotland.[313]

Scotland were developing their own contact tracing system, with contact tracing being done by telephone rather than an app.[314][315]

Wales

On 21 March, Welsh Government Health Minister Vaughan Gething said that the target was 9,000 tests by the end of April. Public Health Wales Chief Executive Tracey Cooper confirmed on 7 May that Wales was to receive an extra 5,000 COVID-19 test kits per day, before the UK Government stepped in and stopped them. The Swiss pharmaceutical company Roche Diagnostics and the Welsh Government had a gentleman's agreement, verbally and through emails. Dr Cooper blamed the UK government "for gazumping Wales's Covid-19 testing deal" with Roche; this left Wales only able to carry out 800 tests a day. Public Health England said that it had not interfered with any contract but said "The UK Government recently asked us to establish a partnership with Roche to support increased diagnostic testing in the UK for Covid-19."[316][317]

On 21 May 2020 the Welsh Government announced that one of the new antibody blood tests for the SARS-CoV-2 virus is being produced by Ortho Clinical Diagnostics (OCD) at Pencoed, Wales, in partnership with Public Health Wales. The test will be rolled out, prioritised and managed and will also be available in care homes. According to Health Minister Vaughan Gething, this test is an important part of the "Test, Trace, Protect" strategy which will help Wales come out of lockdown.[318]

Mobile phone apps

On 4 May, a test version of the NHS's contact tracing app was released.[319][320] The app is being trialled on the Isle of Wight.[319][320]

Matthew Gould, CEO of NHSX, the government department responsible for the app, said the data would be accessible to other organisations for legitimate public health reasons, but could not list which.[321] Faculty, a company linked to Cambridge Analytica and Palantir, also linked to Cambridge Analytica,[322] worked on the app.[323] The data collected would be handled according to the data access regulations and would be held in a centralised repository.[324][322][325] Over 150 of the UK's security and privacy experts warned the app's data could be used by 'a bad actor (state, private sector, or hacker)' to spy on citizens.[326][327] Fears were discussed by the House of Commons' Human Rights Select Committee about plans for the app to record user location data.[319] Parliament's Joint Committee on Human Rights said the app should not be released without proper privacy protections.[328]

The Scottish government said they would not recommend the app until they could be confident it would work and would be secure.[329] The functionality of the app was also questioned as the software's use of Bluetooth required the app to be constantly running, meaning users could not use other apps or lock their device if the app was to function efficiently.[320]

Digital inclusion advocates told the Culture, Media and Sport Committee in May that there was a digital divide with the app, with many people missing out due to not having access to the Internet or having poor IT skills. The advocates said that 64% of the population who had not used the Internet were over the age of 65, and that 63% of the population who did not know how to open an app were under the age of 65.[330] It was reported by the Financial Times that a second app was in development using technology from Apple and Google.[331][332] The digital skills advocacy group FutureDotNow is running a campaign to provide connectivity to excluded households.[333]

On 18 June, Health Secretary Matt Hancock announced development would switch to the Apple/Google system after admitting that Apple's restrictions on usage of Bluetooth prevented the app from working effectively.[334]

On 30 July 2020, the Northern Ireland Executive launched the StopCOVID NI app based on the Republic of Ireland app developed by Nearform which uses the Apple/Google Exposure Notification system. The app interoperates with the southern Ireland version of the app.[335]

The COVID Symptom Study app is an independent initiative led by Professor Tim Spector of King's College, London and endorsed by the Scottish, Irish and Northern Ireland governments but not the English government. It was released on the App Store and Google Play on 24 March, and as of 18 September had 4,214,516 contributors who had downloaded the app.[336] It shows the estimated current active infections by local council areas updated daily.[337]

Research and innovation

Biological research

UK Research and Innovation also announced £20 million to develop a COVID-19 vaccine and to test the viability of existing drugs to treat the virus.[338] The COVID-19 Genomics UK Consortium will deliver large-scale, rapid whole genome sequencing of the virus that causes the disease and £260 million to the Coalition for Epidemic Preparedness Innovations to support vaccine development.[339][340] In April, the UK Government launched a task force to help develop and roll out a coronavirus vaccine.[341][342] A University of Edinburgh led study in to whether specific genes cause a predisposition into the effects that COVID-19 had on people began in May.[343][344] The London School of Hygiene & Tropical Medicine, studied whether sniffer dogs could detect coronavirus in humans.[345] Following research by King's College London of symptoms from 1.5 million suspected cases, "loss of taste or smell" was added to the NHS symptoms list.[346]

Design and innovation

In March 2020, the government asked manufacturers in the UK to help in the production of respiratory devices to help fight COVID-19.[347] Innovate UK announced £20 million funding for innovative businesses.[348] The Formula One teams and manufacturers based in the UK linked up to form "Project Pitlane".[349]

A group of engineers from Mercedes and University College London, along with staff from University College Hospital, designed and made a product known as UCL-Ventura breathing aid, which is a continuous positive airway pressure (CPAP) device. The Medicines and Healthcare products Regulatory Agency (MHRA) approved the second model of the device. The UK Government put an order in for 10,000 devices. Mercedes made the drawings for the device available for free to help other countries fight COVID-19.[350][351] On 16 April the MHRA approved the Penlon Prima ESO2, design which was part of the stream known as VentilatorChallengeUK. The UK government ordered 15,000 of these devices.[352][353] A consortium of aerospace companies including Airbus, Meggitt, and GKN worked on scaling up production of an existing design.[354][355] In April this design was approved by the MHRA and an order for 15,000 units was placed.[356] Other designs by JCB, Dyson and BlueSky were not taken forward.[357] Eight other designs had their support ended by the UK government.[357][358][359][351]

A CPAP device, known as a Covid emergency ventilator, designed by Dr Rhys Thomas, a consultant anaesthetist at Glangwili General Hospital in Carmarthen, was given the go-ahead by the Welsh Government.[360] The machine, designed in a few days was used on a patient in mid-March, and subsequently funded by the Welsh Government. In early April, it was approved by the MHRA. Production is by CR Clarke & Co in Betws, Carmarthenshire.[361][362]

Jaguar Land Rover (JLR) produced a reusable visor with the first deliveries just before Easter, and shared the designs to allow wider manufacture.[363][364] The Royal Mint manufactured medical visors for medical staff working during the pandemic.[365][366]

Impacts

Economic

The pandemic was widely disruptive to the economy of the United Kingdom, with most sectors and workforces adversely affected. Some temporary shutdowns became permanent; some people who were furloughed were later made redundant.[367][368] The economic disruption has had a significant impact on people's mental health—with particular damage to the mental health of foreign-born men whose work hours have been reduced/eliminated.[369]

Social

The pandemic has had far-reaching consequences in the country that go beyond the spread of the disease itself and efforts to quarantine it, including political, cultural, and social implications.

Spread to other countries and territories

Sophie Grégoire Trudeau, the wife of Canadian Prime Minister Justin Trudeau, tested positive for COVID-19 upon her return from WE Day events in the UK; on 12 March 2020 the Trudeau family entered two weeks of self-isolation.[370] The first patient in Mauritius was a 59-year-old man who returned from the United Kingdom on 7 March 2020. When he arrived in Mauritius, the Mauritian had no symptoms.[371] Other cases of the novel coronavirus resulting from travel to the UK were subsequently reported in India[372][373] and Nigeria.[374]

On 16 June, it was widely reported in British media that New Zealand's first COVID-19 cases in 24 days were diagnosed in two British women, both of whom had travelled from the UK and were given special permission to visit a dying parent. The women had entered the country on 7 June, after first flying into Doha and Brisbane.[375]

Anti-lockdown protests

On 29 August 2020, thousands of protesters gathered in Trafalgar Square objecting to the continuation and extension of COVID-19 restrictions.[376] The event included speakers such as conspiracy theorist David Icke and Piers Corbyn.[377] Police urged demonstrators to disperse under social distancing laws advising them in a distributed leaflet that they may be committing a criminal offence.[376]

Statistics

The official daily report from the Department of Health and Social Care (DHSC) counts those who died after testing positive for coronavirus. It "could be the major cause, a contributory factor or simply present when they are dying of something else".[378] From 29 April, the official figures include all coronavirus-positive deaths in the UK, wherever they happened.[379] Before then, the official daily toll included only hospital deaths in England, but included all coronavirus-positive deaths in the rest of the UK wherever they happened, if known to public health agencies.[380][381] There may be a delay between a death and it entering official statistics so families can be informed; this delay is usually a few days, but can be longer.[382][35]

The Office for National Statistics (ONS) has analysed death certificates and reported 48,168 deaths due to Covid-19 in England and Wales by the end of August. This compares with 394 deaths due to influenza and 13,619 due to pneumonia in the same period.[383] At this date the government reported 38,447 deaths and the total number of registrations which mention Covid-19 was 52,401. The ONS issues a weekly report covering England and Wales, which counts all deaths where coronavirus was mentioned on the death certificate; not necessarily as the main cause of death. This figure is higher because it also counts deaths where no test was done.[380][381][384] The National Records of Scotland and Northern Ireland Statistics and Research Agency issue similar reports for those two countries. As of 6 October 2020 , the reported figures for 2 October were 50,544 deaths for England, 2,620 for Wales, 4,277 for Scotland and 901 for Northern Ireland, totalling 58,342.[6]

As of 5 June 2020 the death rate across the UK from COVID-19 is 592 per million population.[385] The death rate varies greatly by age and healthiness. More than 90% of deaths are among the most vulnerable: those with underlying illnesses and the over-60s.[386][387][154] COVID-19 deaths are "remarkably uncommon" among the least vulnerable: those under 65 and with no underlying illnesses.[219]

There is also large regional variation in the pandemic's severity. The outbreak in London has the highest number and highest rate of infections.[388] England is the UK country with the highest recorded death rate per capita, followed by Wales and then Scotland, while Northern Ireland has the lowest per capita.[389]

On 22 April, The Financial Times estimated that 41,000 may have died by that date, by extrapolating the ONS data and counting all deaths above the average for the time of year.[390] The World Health Organisation cautioned on 23 April that up to half of coronavirus deaths in Europe were among care home residents. The Chief Medical Officer for England warned that even the ONS figures on coronavirus deaths in care homes are likely to be "an underestimate" and said he is "sure we will see a high mortality rate sadly in care homes, because this is a very, very vulnerable group".[119][391][390] On 28 April, Health Secretary Matt Hancock said the number of coronavirus-linked deaths in care homes would be announced as part of the daily report, instead of weekly.[392] By 7 May 2020, the epidemic was concentrated in hospitals and care homes, with the infection rate being higher in care homes than in the community.[393][394] By 28 May, The Financial Times estimate of 'excess deaths', the increase over the figure expected for the time of year, had increased to 59,537 since 20 March.[395]

The Guardian wrote in May 2020 that across the UK around 8,000 more people had died in their homes since the start of the pandemic, when compared to normal times. Of that total around 80% of the people according to their death certificates, died from non COVID-19 illnesses. The statistics additionally showed a drop in non COVID-19 deaths in hospitals, leading many to think that people who normally would have been admitted were avoiding hospitals.[396] NHS England said that between 10 and 20% of people who were admitted to hospital for other reasons contracted coronavirus during their stay.[397]

The number of cases in the table represent laboratory confirmed cases only. The UK Government's Chief Scientific Adviser Patrick Vallance, says it is likely that other cases are not included in these figures.[68]

In the week ending 19 June, registered deaths fell below the average for the previous five years for the first time since mid-March.[19] The total number of excess deaths in the UK since the start of the outbreak is just over 65,000.[19]

On 12 August, the UK death toll was reduced by more than 5,000, after a review of how deaths are counted in England.[152]

In the latter half of August, testing increased from 2.3 to 2.6 tests per thousand population per day.[398]

2,460 new cases in the UK were reported on Tuesday 8 September.[399] This number was approximately double what it had been a fortnight previously[400] and the daily case number further doubled to 4,926 a fortnight later, on 22 September.[400] On 18 September, the COVID Symptom Study estimated the value to be above 1 in each of England, Scotland and Wales, with a value of 1.4 for England meaning that cases were doubling every seven days.[401]


Total cases and deaths

New cases

New cases by day reported

Source: the figures are as reported daily at coronavirus.data.gov.uk.[400]

' * ' Values for these dates questionable in light of announcement of 3 October.

Warning: the values in the above graph are not directly comparable between different time periods because they were measured under different testing rates. It is therefore vital to consult Test positivity rate and New daily tests, and to understand the strategy for selection of subjects for testing.

On 3 October, the UK Government Dashboard "GOV.UKCoronavirus (COVID-19) in the UK" issued the following note:

Due to a technical issue, which has now been resolved, there has been a delay in publishing a number of COVID-19 cases to the dashboard in England. This means the total reported over the coming days will include some additional cases from the period between 24 September and 1 October, increasing the number of cases reported.

On 4 October, the UK Government Dashboard "GOV.UKCoronavirus (COVID-19) in the UK" issued the following note:

An issue was identified overnight on Friday 2 October in the automated process that transfers positive cases data to PHE. It has now been resolved. The cases by publish date for 3 and 4 October include 15,841 additional cases with specimen dates between 25 September and 2 October — they are therefore artificially high for England and the UK.

After correction as calculated by the BBC,[177] the case numbers should read from 25 September as below, showing a trend (apart from the 28 September and 4 October figures) which is subsequently maintained:

Date 25-Sep 26-Sep 27-Sep 28-Sep 29-Sep 30-Sep 1-Oct 2-Oct 3-Oct 4-Oct 5-Oct 6-Oct
Original 6874 6042 5693 4044 7143 7108 6914 6968 12872 22961 12594 14542
Adjustment 957 744 757 0 1415 3049 4133 4786 0 -15841 0 0
Adjusted Total 7831 6786 6450 4044 8558 10157 11047 11754 12872 7120 12594 14542
New cases by week reported

Number of people who have had a lab-confirmed positive test result[2]

' * ' Values for these dates are questionable in light of the announcements of 3 & 4 October, see New cases by day reported

The values in the above graph are not directly comparable between different time periods because they were measured under different testing rates. It is therefore vital to consult Test positivity rate and New daily tests.

Numbers of deaths

New deaths by week reported

Deaths of people within 28 days of a positive test result[nb 4][2]

Daily deaths within 28 days of positive test, listed by date reported

Test positivity rate

Test positivity rate for the UK[398] (chart), smoothed via seven-day moving average:

Test positivity rate is the ratio of positive tests to all tests made on the day.

New daily tests

New daily tests per 1000 pop, smoothed, UK[398] (chart):

All-cause deaths

Comparison of 2020 (England and Wales) with average death rates and the 2014–15 flu season
  Average deaths per week 2010–2019 excluding 'flu year q4,2014-q3,2015
  deaths per week, 2014 quarter 4
  deaths per week, 2015 quarters 1–3
  deaths per week, 2020

Note: Average deaths per week are presented using the years 2010–2019 but excluding the recent year with particularly high incidence of 'flu, q4,2014-q3,2015;[378] deaths per week 2020 covers weeks 1–33 inclusive. Data downloaded from mortality.org.[402] The pronounced zigzags typically correspond to holiday periods when there may be a lag in the reporting of some deaths.

Comparison of numbers of deaths for all ages, second quarter

Excess deaths in the UK in 2020 to date have occurred mainly in the second quarter of the year. For this period, in England and Wales there were 49% more deaths than for the average of the preceding 10 years. The bar chart below shows all-cause deaths in England and Wales in quarter 2 (weeks 14–26, inclusive), year by year, based on mortality.org data, stmf.csv:[402]

Mortality.org indicates the data for 2020 to be preliminary. The above is not adjusted by population size.

All-cause deaths for all ages

All-cause deaths in England and Wales in weeks 1–33, year by year, based on mortality.org data, stmf.csv:[402]

mortality.org indicates the data for 2020 to be preliminary; above, the last two weeks available from mortality.org were excluded to prevent the worst effect of registration delay. The above is not adjusted by population size.

All-cause deaths in Scotland in weeks 1–30, year by year, based on mortality.org data, stmf.csv:[403]

Note that a similar effect is seen to that in England and Wales, namely most excess deaths occurred in the second quarter of the year. Note also that mortality.org indicates the data for 2020 to be preliminary; above, the last two weeks available from mortality.org were excluded to prevent the worst effect of registration delay. The above is not adjusted by population size.

All-cause deaths for ages 0–14

All-cause deaths in England and Wales in weeks 1–33, ages 0–14, year by year, based on mortality.org data, stmf.csv:[402]

Note that Covid-19 has generally been found to have very low mortality rates for the very young. The source, mortality.org, indicates the data for 2020 to be preliminary; above, the last two weeks available from mortality.org were excluded to prevent the worst effect of registration delay. The above is not adjusted by population size.

All-cause deaths in Scotland in weeks 1–30, ages 0–14, year by year, based on mortality.org data, stmf.csv:[403]

Note that the smaller population of Scotland compared with England and Wales results in a 'noisier' data set due to the relatively random nature of the events recorded here. The source, mortality.org indicates the data for 2020 to be preliminary; above, the last two weeks available from mortality.org were excluded to prevent the worst effect of registration delay. The above is not adjusted by population size.

All-cause deaths for ages 65–74

All-cause deaths in England and Wales in weeks 1–33, ages 65–74, year by year, based on mortality.org data, stmf.csv:[402]

Note that the period for 2020 is unique in that it includes deaths from Covid-19, but with very few of these prior to week 14. The source, mortality.org, indicates the data for 2020 to be preliminary; above, the last two weeks available from mortality.org were excluded to prevent the worst effect of registration delay. The above is not adjusted by population size.

Hospitalisations

Daily hospital admissions of covid-positive patients for England Statistics » COVID-19 Hospital Activity, with 7-day moving averages, based on two spreadsheets in the same source, one historic, one more current- note however that the data seems to be inconsistent between these two, 'admissions' vs. 'admissions... and diagnoses in hospital'.

Source for figures from March: COVID-19 daily situation report- Summary information from the daily situation report returns regarding COVID-19 Capacity, discharges and deaths: Provider Level Data – Admissions – Number of patients admitted with COVID-19 (Last 24hrs)[404]

August and September figures from a separate file at the same webpage: COVID-19 daily situation report COVID-19 admissions estimates in England- Number of estimated daily admissions and diagnoses for COVID-19: Section 1. Total reported admissions to hospital and diagnoses in hospital.[405]

Demographics

A 'visiting window' at a nursing home in Wetherby, West Yorkshire designed to reduce transmission to vulnerable residents.

Different demographics in the UK have been affected to different degrees by the coronavirus pandemic, leading to calls to investigate what the medical, social and cultural reasons for the discrepancy might be.

Coronavirus risk and ethnicity

In April 2020, the British Medical Association called on the government to investigate if and why people from black, Asian and minority ethnic (BAME) groups were more vulnerable to COVID-19, after the first 10 doctors to die were all from the group.[406] The Labour Party called for a public enquiry after the first 10 deaths in the health service were from BAME backgrounds.[407] The Mayor of London Sadiq Khan wrote to the Equality and Human Rights Commission asking them to investigate whether the effects of coronavirus on BAME groups could have been prevented or mitigated.[408] A group of 70 BAME figures sent a letter to Boris Johnson calling for an independent public enquiry into the disproportionate impact of the coronavirus on people from black, Asian and minority ethnic backgrounds.[409]

Research by the Intensive Care National Audit and Research Centre concluded that people from BAME backgrounds made up 34% of critical patients.[410] NHS England and Public Health England were appointed to lead an inquiry into why people from black and minority ethnic backgrounds appear to be disproportionately affected by coronavirus.[411] On 18 April, Public Health England said that they would start recording the ethnicity of victims of coronavirus.[412]

Research carried out by The Guardian newspaper concluded that ethnic minorities in England when compared to white people were dying in disproportionately high numbers. They said that deaths in hospitals up to 19 April 19% were from BAME backgrounds who make up only 15% of the population of England.[413]

The Office for National Statistics (ONS), meanwhile, wrote that in England and Wales black men were four times more likely to die from coronavirus than white men, from figures gathered between 2 March to 10 April.[414][415] They concluded that "the difference between ethnic groups in COVID-19 mortality is partly a result of socio-economic disadvantage and other circumstances, but a remaining part of the difference has not yet been explained". Some commentators including Dr. John Campbell have pointed to Vitamin D deficiency as a possible cause of the discrepancy, but the theory remains unproven.[416]

Another study carried out by University of Oxford and the London School of Hygiene and Tropical Medicine on behalf of NHS England and a separate report by the Institute for Fiscal Studies corroborated the ONS' findings.[417][418][419] An Oxford University led study into the impact of COVID-19 on pregnancy concluded that 55% of pregnant women admitted to hospital with coronavirus from 1 March to 14 April were from a BAME background. The study also concluded that BAME women were four times more likely to be hospitalised than white women.[420][421]

A study by Public Health Scotland found no link between BAME groups and COVID-19.[422] A second Public Health England study found that those with a Bangladeshi heritage were dying at twice the rate of white Britons. Other BAME groups had between 10% and 50% higher risk of death from COVID-19.[423][424][425]

Fines and ethnicity

Figures from the Metropolitan Police showed that BAME people received proportionally more fines than white people for breaching COVID-related restrictions.[426]

Coronavirus risk and employment status

The ONS study, using data collected up to 17 April 2020 across England and Wales, concluded that men in low-skilled jobs were four times more likely to die from the virus than those in professional jobs. Women who worked as carers were twice as likely to die than those who worked in technical or professional jobs. The GMB trade union commented on the findings that ministers must stop any return to work until "proper guidelines, advice and enforcement are in place to keep people safe". An analysis of the figures by The Guardian concluded that deaths were higher in occupations where physical distancing was more difficult to achieve.[427] Analysis by The Independent and the Financial Times concluded that mortality rates from coronavirus were higher in deprived and urban areas than in prosperous and rural locations, across England and Wales.[428][429] Analysis of the ONS data by the Guardian also concluded that by 13 May, only about 12% of people who had died from the virus in England and Wales were under 65 while 59% were over 80.[430] A Public Health England report in June 2020 found that security guards, taxi and bus drivers, construction workers and social care staff were at a higher risk of COVID-19 when compared to other occupations.[425]

See also

Notes

  1. ^ a b Death figures are those who have died after testing positive. It does not include the death of one British citizen on board the Diamond Princess cruise ship (see COVID-19 pandemic on cruise ships), or the 84 recorded deaths in the British Overseas Territories and Crown dependencies.
  2. ^ Daily updates occur around 2 pm UTC.
  3. ^ Not including cases identified in British Overseas Territories and Crown Dependencies, all of which test and report cases independently.
  4. ^ Number of deaths of people who had had a positive test result for COVID-19 and died within 28 days of the first positive test. The actual cause of death may not be COVID-19 in all cases. People who died from COVID-19 but had not tested positive are not included and people who died from COVID-19 more than 28 days after their first positive test are not included. Data from the four nations are not directly comparable as methodologies and inclusion criteria vary.
  5. ^ Data on COVID-19 associated deaths in England are produced by Public Health England (PHE) from multiple sources linked to confirmed case data. Deaths newly reported each day cover the 24 hours up to 5pm on the previous day. Deaths are only included if the deceased had had a positive test for COVID-19 and died within 28 days of the first positive test.
  6. ^ Data for Northern Ireland include all cases reported to the Public Health Agency (PHA) where the deceased had a positive test for COVID-19 and died within 28 days. PHA sources include reports by healthcare workers (eg Health and Social Care Trusts, GPs) and information from local laboratory reports. Deaths reported against each date cover the 24 hours up to 9:30am on the same day.
  7. ^ Data for Scotland include deaths in all settings which have been registered with National Records of Scotland (NRS) where a laboratory confirmed report of COVID-19 in the 28 days prior to death exists. Deaths reported against each date cover the 24 hours up to 9:30am on the same day.
  8. ^ Data for Wales include reports to Public Health Wales of deaths of hospitalised patients in Welsh Hospitals or care home residents where COVID-19 has been confirmed with a positive laboratory test and the clinician suspects this was a causative factor in the death. The figures do not include individuals who may have died from COVID-19 but who were not confirmed by laboratory testing, those who died in other settings, or Welsh residents who died outside of Wales. Deaths reported each day cover the 24 hours up to 5pm on the previous day. The majority of deaths included occur within 28 days of a positive test result.

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