Are UK and NHS prepared for the coronavirus?


The reality of the coronavirus hit home in Britain this week. Although just 19 of more than 7,600 people tested for the virus in the UK have been found to have the disease, its rapid spread in other parts of Europe has dispelled any hope that the country can escape it.

News on Friday of the first British coronavirus death — a man who had been quarantined aboard the Diamond Princess cruise ship in Japan — has further underlined the risks of a disease from which most make a quick and full recovery.

A number of schools have temporarily shut their doors, after pupils were feared to have contracted the virus, while Mark Carney, Bank of England governor, on Friday warned of a likely hit to the economy. Both developments have given a foretaste of how the disease could disrupt daily life.

Meanwhile Boris Johnson, who has been criticised by opposition MPs for his subdued response to the outbreak, will for the first time chair a meeting of the Cobra emergency committee of ministers to discuss the issue on Monday.

How prepared is the UK and its taxpayer-funded National Health Service for a major outbreak?

What measures have been put in place so far?

Matt Hancock, the health secretary, described the UK’s approach in four words: contain, delay, research and mitigate. The government’s hope, spelt out on Thursday by Chris Whitty, the chief medical officer for England, is that the UK can avoid an epidemic until later in the year, when the high demand of the winter season will be over for the NHS, and scientists and public health experts will have a deeper understanding of the disease.

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The government has put in place travel advice, and is ensuring that people returning from the worst-hit areas “self-isolate” or, if they are coming from less affected areas, use the NHS’s helpline if they develop respiratory symptoms. The sick have been treated in specialist infectious disease units and their contacts traced and isolated.

So far these infection-control measures appear to have worked: there has been no evidence of wider transmission in the community, although Prof Whitty made clear in remarks to a conference this week that it is “only a matter of time” before this happens.

Can the health system cope?

There are signs that the government infrastructure is already under strain.

The 111 telephone advice service has been overwhelmed with calls. Louise Davidson, headteacher at Dulwich Prep, a private school in South London that has closed its doors due to fears that pupils may have been infected, made clear she had taken that decision in part because concerned families had been unable to get through for advice.

Simon Stevens, chief executive of the NHS in England, acknowledged on Thursday that more staff were needed for the service and said the numbers were being “ramped up”.

More concerning for many Britons is the prospect of the NHS buckling under the pressure of coronavirus sufferers, limiting access to services for anyone who was not seriously sick. The service is already enduring its worst winter on record, against some yardsticks, with unprecedented numbers languishing for hours on trolleys for lack of a bed.

How bad could it get?

Even though it is now almost two months since the world woke up to the threat of the coronavirus, its likely trajectory remains unclear. Leading epidemiologists on both sides of the Atlantic have estimated that it could eventually affect half, or more, of the population.

Mr Hancock said on Thursday that the government had “set out in 2011 the baseline plan for how to deal with a pandemic flu”. He added: “Coronavirus is different to a flu but that is the baseline from which the government has been planning for some time and the scientific advice is that it is the baseline for a reasonable worst-case scenario.”

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While making no assessment of numbers, Prof Whitty said that if there was a global pandemic it would be impossible for the UK to escape. If that happened, it could mean that the NHS would have to “prioritise access to some services in an ethically appropriate way”, according to the government’s 2011 plan. This could involve postponing non-emergency operations and ultimately, if the outbreak was unremitting, treating only emergency patients.

Another big issue for ministers will be whether to limit large gatherings such as big sporting and music events. On Thursday, Prof Whitty raised the possibility these may have to be restricted and extended school closures imposed. But he added that the nature of the virus meant the measures would have to be maintained for more than two months, and would need public support if they were to be implemented successfully.

Should Britons worry?

Not yet, and perhaps not ever. The command-and-control culture in the NHS is often criticised — but in a crisis it can be an effective weapon.

Single-payer health systems such as the NHS also have inbuilt advantages at a time when public trust is of paramount importance. Robert Yates, director of the global health programme at the Chatham House think-tank, said that such trust was “much less likely in a privately financed health system where market failures lead to exploitation of healthcare consumers, an under-investment in public health services and where poorer members of society feel excluded from the health system”.

On the NHS frontline, leaders remain confident about the service’s ability to cope with coronavirus. One executive said: “The NHS is good at rallying round and doing this stuff when we need to. We absolutely do a have a set of procedures in place.”

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