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Covid-19 one year on

9th Apr 2021
Covid-19 one year on

(Photo credit: Postermywall/CC)

On March 23, 2020, Boris Johnson announced the UK was to go into lockdown to prevent the spread of Covid-19.The last pandemic on this scale was the Spanish Flu in 1918, making it a ‘once in a 100 years’ event. We all stayed in our homes and began our isolation not knowing how long it would last or how bad it would get. Given our modern technology and medicine, many thought the lockdown would last a few weeks, and we would soon find ways to treat Covid-19 – how wrong they were. Restrictions have been in place for a whole year, and as we slowly and cautiously start to emerge from another lockdown, we are all waiting to determine if the vaccines can be the difference this time, or if numbers will start rising again, and we get a third wave – as many European countries are experiencing.

Coronavirus proved to be highly transmissible, and the number of cases and deaths makes grim reading; to date, we have had over 125,000 deaths linked to Covid-19. Looking back, by March 23 many other nations had gone into a lockdown, and it seemed inevitable the UK would have to follow, but there were growing concerns that the UK Government was taking too long to make the decision. There were rumours the Government was discussing the option of so-called ‘herd immunity’, allowing the virus to spread in a controlled way throughout the community until enough people develop immunity and infection levels level off.

There were also concerns about what effect a lockdown would have on the economy. There were virtually no border controls, Heathrow Airport, one of the busiest in the world, still had passengers flying in and out all over the globe. The pressure was growing on the government to start lockdown, but instead, the advice to keep washing our hands, self-isolate, if you felt ill or lived with someone with symptoms, was re-iterated. Public Health England was trying to follow up on cases and limit outbreaks, but it soon became obvious that the virus was spreading rapidly in the community. Cases were growing across Europe and as dire warnings came from Italy that their health system was close to breaking point the government finally announced lockdown.

Many ask what would have happened had the decision been made earlier? Could it have reduced the number of cases and deaths? The UK has one of the highest Covid-19 death tolls in the world.

As Covid-19 is a new virus people did not have any immunity against it and so everyone was potentially at risk. Quickly, scientists were able to identify the virus, code its DNA and start work on how it was spread, what it did to the body and how to treat it.

However, the doctors were learning on the job and soon realised Covid-19 was more than just a respiratory virus. In some patients, it resulted in severe disease requiring ventilation, as their lungs were so badly affected they could not breathe. Other patients seemed to ‘overreact’ to the virus leading to an inflammatory response that affected other organs, such as the heart and kidneys, and many patients experienced blood-clotting issues. In contrast, some only developed mild disease or remained symptom-free – meaning it was not always easy to know who was infected, for these reasons, it was suggested that people wear masks when in public to reduce spread.

Many countries were already advocating the use of masks, for example, China, Taiwan, Korea and Singapore, their citizens perhaps more accustomed to such measures having experienced SARs and MERs outbreaks in previous years.

But across Europe and America, there seemed a reluctance to endorse the use of face masks. Perhaps this reflected the growing scrabble to get PPE for healthcare workers, and they did not want the public to compete for medical masks. There was a global lack of PPE, leaving medical and healthcare staff inadequately protected as the hospital wards started to fill up with Covid-19 patients. Many healthcare workers have lost their lives as they were on the front line treating Covid-19 patients for weeks on end.

Mask wearing in public became a growing issue. Some said there was no evidence it would make much difference, or that it might give a false sense of security and people would not social distance if wearing a mask. There was no encouragement to wear masks from world leaders, Trump famously seemed reluctant to wear one, and in the UK, Government ministers were not seen wearing them. However, once again, as evidence was mounting that masks could reduce the spread so too was the pressure on the Government to make mask-wearing compulsory in public.

The Mayor of London, Sadiq Khan, was vocal in his demands for the Government to make masks compulsory on London transport. Eventually, last summer the mandate to wear a mask was announced with fines for those that did not comply. However, if mask-wearing had been encouraged earlier, if not enforced, could it have reduced the spread and number of Covid cases? There is evidence now that masks not only reduce the spread of the virus but can reduce the severity of the disease if it is transmitted, possibly by reducing the amount of virus you are exposed to.

Cases over the summer remained low. The Government’s long-awaited Covid-19 app was eventually launched in September after several setbacks delayed its development. However, despite the hopes that this technology could help identify and contain outbreaks, it was not met with much confidence. There were still concerns about how accurate it was and people feared being told to self-isolate unnecessarily. Self-isolating for 14 days was also an issue, there were reports that track and trace were not always successful in tracking down contacts of Covid-19 cases, and that people often did not comply with the 14-day isolation period.

September saw students return to schools and universities and as feared, once again, cases of Covid-19 started to rise. There were calls for a short 2week lockdown over the half-term in October to lower cases, instead, the Government continued with its Tier system with tougher restrictions in place in the worst affected areas (Northwest and Northeast of England were worst affected). The hope was we could get the virus under control enough to enjoy some freedom to see family and friends over Christmas. However, by mid-December it was clear this was not going to be possible, the emergence of a new more transmissible strain of the virus was circulating and cases were rising again.

The government had to accept that Christmas was cancelled for most of the country and with an ever-increasing sense of inevitability, another national lockdown was announced in January. Again, many questioned if this was too late and if any hopes of a Merry Christmas shouldn’t have been abandoned earlier. But one piece of good news was on the horizon – vaccines had been developed and approved and were starting to be given to the vulnerable groups.

Was this the last lockdown? As of March 29 people can mix outdoors again – with the now familiar ‘rule of 6’ and outdoor sports activities can then restart. From April 12 non-essential retail, hairdressers, gyms and leisure centres will be allowed to open and slowly the country will start to come out of lockdown. Restrictions and social distancing must still be adhered to and masks will still need to be worn. This will be a key moment in the Government’s roadmap out of lockdown. If cases remain low, the UK could be on target for further easing of restrictions in May and June 21is cited as a possible date for all restrictions to be lifted.

The Government has stressed that these dates are all dependent on the number of Covid-19 infections and hospitalisations, the key difference this time is the vaccine rollout; the UK has seen a successful rollout of the vaccines with over half of all adults now vaccinated with the first dose. Without a vaccine, cases would inevitably rise if restrictions were lifted, so it is hoped vaccination will prevent the need for another lockdown.

Although, it is likely that some restrictions may continue for a while, such as mask-wearing in public places. The UK vaccine roll-out has been at an impressive pace and has been one of the successes during this whole pandemic. In contrast, Europe has experienced delays with its vaccine roll out and many countries are now experiencing the third wave of infections.

After what has been a mixed response from the UK Government throughout this pandemic, it could be that the success of the vaccine rollout is what finally allows us to get back to some normality. However, there are still many people who have not yet received a vaccine, new variants could emerge, which require new vaccinations and if people do not follow the guidelines and mix too freely over the coming weeks another wave of infections could still appear as many people remain unvaccinated. The next few months will tell us how effective the vaccines are.

Rachel Kayani

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