Health leaders urge review of UK’s readiness for Covid-19 second wave | Society


The UK’s top health leaders have written to all political parties asking them to work together to ensure the country is ready to contain a second phase of coronavirus as Brexit approaches.

The experts – who include presidents of the Royal College of Physicians, Surgeons, GPs and Nursing, and the chair of the British Medical Association – ask for a review of the first stage of the pandemic to learn lessons including why black, Asian, and minority ethnic communities have borne a “disproportionate burden”.

They also ask for better parliamentary scrutiny and involvement of regional and local leaders and more international collaboration, “especially to mitigate any new difficulties in pandemic management due to Brexit”.

In an open letter published on the British Medical Journal website, the leaders warn that “local flareups are increasingly likely and a second wave a real risk”. They say “substantial challenges remain” despite many elements of the infrastructure needed to contain the virus “beginning” to be put in place.

The job now is not only to deal urgently with the wide ranging impacts of the first phase of the pandemic, but to ensure the country is adequately prepared to contain a second phase, they suggest.

A review into the UK’s handling of Covid-19 so far is “crucial, they write, and needs to happen soon if the public is to have confidence that the virus can be contained”.

The review should “not be about looking back or attributing blame. Rather it should be a rapid and forward-looking assessment of national preparedness, based on an examination of the complex and interrelated policy areas.”

They suggest it should not be handled by select committees in parliament but by a cross-party commission, establishing “a constructive, non-partisan, four nations approach that could rapidly produce practical recommendations for action, based on what we have all learnt, and without itself becoming a distraction for those at the front line or in government”.

Epidemics of infectious diseases behave in different ways but the 1918 influenza pandemic that killed more than 50 million people is regarded as a key example of a pandemic that occurred in multiple waves, with the latter more severe than the first. It has been replicated – albeit more mildly – in subsequent flu pandemics.

How and why multiple-wave outbreaks occur, and how subsequent waves of infection can be prevented, has become a staple of epidemiological modelling studies and pandemic preparation, which have looked at everything from social behaviour and health policy to vaccination and the buildup of community immunity, also known as herd immunity.

Is there evidence of coronavirus coming back in a second wave?

This is being watched very carefully. Without a vaccine, and with no widespread immunity to the new disease, one alarm is being sounded by the experience of Singapore, which has seen a sudden resurgence in infections despite being lauded for its early handling of the outbreak.

Although Singapore instituted a strong contact tracing system for its general population, the disease re-emerged in cramped dormitory accommodation used by thousands of foreign workers with inadequate hygiene facilities and shared canteens.

Singapore’s experience, although very specific, has demonstrated the ability of the disease to come back strongly in places where people are in close proximity and its ability to exploit any weakness in public health regimes set up to counter it.

In June 2020, Beijing suffered from a new cluster of coronavirus cases which caused authorities to re-implement restrictions that CHina had previously been able to lift.

What are experts worried about?

Conventional wisdom among scientists suggests second waves of resistant infections occur after the capacity for treatment and isolation becomes exhausted. In this case the concern is that the social and political consensus supporting lockdowns is being overtaken by public frustration and the urgent need to reopen economies.

The threat declines when susceptibility of the population to the disease falls below a certain threshold or when widespread vaccination becomes available.

In general terms the ratio of susceptible and immune individuals in a population at the end of one wave determines the potential magnitude of a subsequent wave. The worry right now is that with a vaccine still many months away, and the real rate of infection only being guessed at, populations worldwide remain highly vulnerable to both resurgence and subsequent waves.

Peter Beaumont

Polls show that a majority of the public now support an inquiry, with the Covid-19 Bereaved Families for Justice group, requesting a full public inquiry. “There’s a strong case for an immediate assessment of national preparedness, with the first results available no later than August, and that all its work should be completed by the end of October,” the health leaders argue.

Ministers have already said the temporary Nightingale hospitals set up in case the NHS was overwhelmed by Covid-19 cases will remain on standby over the coming months.

Boris Johnson announced on Tuesday the biggest easing to date of the coronavirus lockdown in England. The prime minister said the 2-metre distancing rule would be replaced with a “1-metre-plus” rule, paving the way for pubs, restaurants, hotels and cinemas to begin reopening from 4 July.


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