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UK opts for less drastic coronavirus containment strategy. But is it a good idea?

The British government is facing criticism for having decided to allow spread of Covid-19 to infect low-risk people, supposedly to reduce stress on health services and build up immunity. Critics say the strategy risks lives. (Leer en español)
17 Mar 2020 – 10:51 AM EDT
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In the absence of treatments or a vaccine for the Covid-19 virus, the UK government has resisted drastic ‘social distancing’ and other containment measures being used in other countries and has considered allowing the illness to spread, supposedly to avoid a collapse of its much vaunted national health service.

The government has considering a concept of so-called ‘herd immunity’ as an option in its effort to deal with the coronavirus, allowing it to spread to younger people who are least at risk of dying, according to Patrick Vallance, the U.K.’s chief scientific adviser, said. For example, all schools in the UK, public and private, remain open and have no plans to close.

‘If you suppress something very, very hard, when you release those measures it bounces back and it bounces back at the wrong time,” Vallance told the BBC.

“What we don’t want is everybody to end up getting it in a short period of time so we swamp and overwhelm [National Health Service] services,” he added.

The U.K. has had 1,553 confirmed cases as of Tuesday morning and 55 deaths, according to data the latest tally compiled by Johns Hopkins University. That is a considerably lower rate of infection than other countries in Europe, such as Spain and Italy which have many more cases despite having lower populations.

The UK's approach to coping with the coronavirus pandemic has been in stark contrast to other countries, including the United States. The whole of Italy and Spain are on national lockdown, while the French government ordered the closure of all non-essential public locations.

US more aggressive

Despite many mixed messages from the White House, the British approach also represents the complete opposite to the declaration of national emergency by President Donald Trump at the weekend, as well as the advice of experts at the Centers for Disease Control (CDC). The U.S. has had at least 4,661 confirmed coronavirus cases and 85 deaths. Coronavirus has infected 185,000 people globally and at least 7,000 deaths, John Hopkins said.

The idea proposed in the U.K. is to separate those at a lower risk of dying from the higher-risk group, namely people who are over 70 and have pre-existing conditions. According to the herd-immunity theory, if some 60% of the lower-risk group contracts the virus and builds up a resistance to infection, that could lower the risk of giving it to the higher-risk group.

Those aged nine months and younger are believed to have the strongest natural defenses against the virus.

As most people will eventually get the virus anyway, this strategy could potentially avoid the kind of major economic disruptions the world is currently witnessing, advocates say. If it works, it could help spread of the virus without overwhelming hospitals with sick people, while also allowing daily life to go on, without completely shutting down public areas, canceling major events and introducing travel bans.

"Worst public health crisis in a generation”

“Many more families are going to lose loved ones before their time,” Britain’s prime minister, Boris Johnson, has warned, adding that the coronavirus pandemic was the ”worst public health crisis in a generation”.

On Monday, Johnson changed his tone somewhat, though still appearing to opt for a calibrated response. “ We need to go further, because …. it looks as though we’re now approaching the fast growth part of the upward curve,” he said.

Avoid pubs

He did not go as far as the United States, where Trump on Monday recommended avoiding all public gatherings of more than ten people. Instead, Johnson advised the British public, especially those over 70 years old, “to stop non-essential contact with others,” by avoiding pubs, clubs, theaters and other social venues.

By the weekend, he said it would be necessary to go further and quarantine anyone showing the most serious health conditions are largely shielded from social contact for around 12 weeks.”

“I don't quite understand, and I think a lot of people don't, how letting us all go about our business is not going to make a lot of people sick in a short space of time,” one UK public employee told Univision, asking not to be named. “But with underground (metro) and bus use down around 20% or more, and people avoiding the rush hour, a degree of very mild social distancing is already creeping into daily life, which should slow things down a bit,” he added.

Risky

Critics say allowing a virus to slowly infect lower-risk people to create immunity is very risky, despite the large – and entirely free - public health system in the UK. The success of such a strategy would depend on the ability to keep those two groups separated, they point out.

"Some of us would say that it is irrational," said José Szapocznik, professor of public health science at the University of Miami, referring to the British government's strategy.

Herd immunity only works when a third or half of the population has already been exposed to the virus, which breaks the chain of transmission, Szapocznik explained to Univision News. "If half the population has antibodies, that limits the spread because infected cases are more likely to meet people who already have antibodies," he said.

"The fallacy is that it means that between half and two thirds of people have to contract the disease," he added. In the case of the United Kingdom, that means between 33 and 44 million people, with the possibility of up to 800,000 deaths.

Although the United States is already taking more aggressive steps to combat the virus, "if we had started testing six weeks ago, when the first cases began in Washignton state, we could have confined this by tracing contacts and quarantining the people who were exposed," he said.

"Instead we will have to close the entire country to deal with this," he added.

Scientists letter

More than 200 scientists have written to the government urging them to introduce tougher measures to tackle the spread of Covid-19. In an open letter, the 229 specialists in subjects ranging from mathematics to genetics say the UK's current approach will put the National Health Service under additional stress and "risk many more lives than necessary".

They argued that "going for 'herd immunity' at this point does not seem a viable option,” instead urging stronger social distancing measures would dramatically slow the rate of growth of the disease in the UK.

A Department of Health spokesperson told the BBC that Vallance’s comments had been misinterpreted.

"Herd immunity is not part of our action plan, but is a natural by-product of an epidemic. Our aims are to save lives, protect the most vulnerable, and relieve pressure [on the health service]," he said.

Rory Stewart, the former international development secretary who is running for mayor of London told reporters the government should have acted to close down schools and events weeks ago.

Tea with friends

Former U.K. Health Secretary Jeremy Hunt said Britain should take a more aggressive approach along the lines currently being adopted by the U.S..

“Whether we then go on to have tea with our friend who’s recovering from cancer, our grandfather, grandmother — that’s the issue,” he said. “It is surprising and concerning that we’re not doing any of it at all when we have just four weeks before we get to the stage that Italy is at,” he added.

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