Public health measures are key to curbing Covid in UK, say scientists

Public health measures are key to curbing Covid in UK, say scientists

Stopping the spread of Covid-19 through public health measures remains vital to curbing the pandemic, one of Britain’s most senior scientific figures has warned.

On the eve of the second anniversary of the lockdown that began the UK’s Covid response, Jeremy Farrar, director of the Wellcome Trust, called for investment in next-generation vaccines and better access to vaccinations for poorer countries.

Farrar joined several of the UK’s most eminent scientists in praising the extraordinary response to the pandemic by the clinicians, researchers and business leaders. But with Covid infections and hospital admissions rising across the UK, measures such as masks, social distancing and ventilation are key.

Progress made by researchers over the last two years has been remarkable, from delivering vaccines and treatments in record time, to the hard work of genomic sequencers tracking the spread of the virus and identifying new variants,” said Farrar. “We must ensure more vaccines reach low and middle-income countries while also investing in research into second and third-generation vaccines that give broader protection and block transmission.

“Focus now needs to be on maintaining key public health interventions alongside vaccines, and developing and ensuring equitable access to new treatments and strengthening the supply chains for PPE and oxygen. Stopping the spread will help to break the constant and unsustainable cycle of reacting to new variants.”

A sign for an NHS mobile booster jab unit in High Wycombe, Buckinghamshire, in February. Photograph: Maureen McLean/REX/Shutterstock

Another of the country’s most eminent scientists said Britain’s universities and private laboratories should be handed a permanent role in testing hospital and care home staff in the event of a pandemic, to avoid one of the main mistakes of the early response to Covid.

Paul Nurse, the Nobel prize winner and director of the Francis Crick Institute, said that the failure to harness the equipment and lab expertise of workers willing to offer “public service” meant that testing capacity took far longer than necessary to set up, leaving health and care settings fatally exposed.

“There was no imaginative thinking about how to get testing rapidly in place,” he said. “They simply farmed it all out to commercial operations, working from big Lighthouse labs, which didn’t have a chance of getting working in time to be of any use in the first round of the epidemic.

“We cannot keep big commercial labs running like this for the next 10 years, 15 years, waiting for the next virulent virus outbreak. We do not have a sustainable system in place. Why not actually make use of exactly what we did, which is to identify a range of institutions around the country – universities and publicly funded research places like the Crick – so in an emergency you could activate a network very rapidly, relying on public service and not simply a commercial programme?”

John Edmunds, a member of the Scientific Advisory Group for Emergencies (Sage), also said that work should begin now on vaccines for the most likely candidates to provoke the next pandemic. “I sincerely hope that we will not need to take such extreme measures as lockdown again,” he said.

He added: “One way to help reduce the chances of having to impose very harsh measures on everyone is to improve our surveillance both nationally and internationally. We must also invest in vaccine platforms and develop vaccines against a range of currently rare diseases that have epidemic potential, so that we can adapt them rapidly should we need to.”

London rush hour, during one of the lockdowns
London rush hour, during one of the lockdowns. Photograph: Victoria Jones/PA

Last week the seven-day average for UK hospital admissions related to Covid rose above 1,700, with more than half being admitted directly because of Covid, the NHS Confederation said. Nearly 5% of people in England had Covid in the week ending 12 March, according to the Office for National Statistics’s weekly Covid infection survey. NHS staff absences have begun to rise again too, while emergency departments are also under pressure: in a seven-day period earlier this month nearly a quarter of ambulances in England faced a delay of more than 30 minutes before being able to hand over patients.

“The single biggest lesson from this pandemic is to act early, decisively and globally to prevent problems becoming much bigger,” Farrar said. “At the heart of this is the need for solid, trustworthy, international cooperation, with focus on long-term solutions that will help us to achieve a meaningful and long-lasting recovery.

“This means preparing for all possible scenarios when dealing with an unpredictable virus, not only for the easy outcome where we hope this crisis blows over. The global response can and must be better than what we have experienced.” Nearly two years after the first lockdown began on 23 March 2020, at least 185,000 people have died with Covid on their death certificate. More than 38.5 million people – or almost 58% of the UK population – have received at least three doses of the vaccines that were created, tested and delivered by scientists and pharmaceutical companies around the world.

About 487m virus tests have been conducted in the UK, most of them at the network of Lighthouse labs that was built after successive governments had allowed the public health laboratory system to run down. Now many of the Lighthouse labs are also being shut down, as part of the government’s “living with Covid” plan.

Some of the institutions that played a crucial role in advising the government how to cope with the virus are also gone.

Sage, which was made up of some of the most eminent academics in the UK, has been mothballed, while funding has ended for many of the research projects that it relied on such as Imperial College London’s React-1 survey of infection prevalence, the CoMix social contacts survey and the Isaric-4C (Coronavirus Clinical Characterisation Consortium) information network that used healthcare records to discover Covid’s clinical features.

Three months after it was established on 23 March 2020, the Recovery trial, based at Oxford University, had discovered that dexamethasone reduced the chances of death for the sickest patients, and has since established the effectiveness of three other treatments.

Sir Martin Landray, Recovery’s joint chief investigator and professor of medicine and epidemiology at Oxford Population Health, said he “would not have thought it possible to go from a blank piece of paper to enrolling the first patient in nine days, to finding the first life-saving treatment within 10 weeks and for it to be made standard NHS policy within three hours”.

Landray said he hoped the progress in how research is conducted would continue. “We cannot afford to go backwards. Recovery was integrated into the routine care being delivered in our hospitals, and there was a commitment to act quickly and minimise bureaucracy.”

With NHS staff keen to continue, he added, it “could herald a new age for research, not just for this pandemic and the next but for other common infections such as influenza and chronic diseases” – if policy-makers invest and maintain existing staff and structures.

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