COVID-19 pandemic in the United Kingdom

The ongoing COVID-19 pandemic spread to the United Kingdom in late January 2020. As of 27 May 2020 there have been 267,240 confirmed cases[nb 4] and 37,460 confirmed deaths overall,[nb 2] the third-highest rate of deaths in the world per 100,000 population.[3] There were 46,370 certified deaths by the three statutory authorities as at 15 May.[4] More than 90% of those dying had underlying illnesses or were over 60 years old. The infection rate is higher in care homes than in the community, which is inflating the overall infection rate. There is large regional variation in the outbreak's severity. In March, London had the highest number of infections[5] while North East England has the highest infection rate.[6] England is the country of the UK with the highest recorded death rate per capita, while Northern Ireland has the lowest per capita. Healthcare in the UK is devolved to each country.

COVID-19 pandemic in the United Kingdom
COVID-19 outbreak UK per capita cases map.svg
Confirmed cases per ten thousand residents[nb 1]
Thank you NHS sign in Leeds
NHS Nightingale Hospital in London
Belfast City Hospital in Belfast
Deserted A1 near Newry
Nicolson Street in Edinburgh
(clockwise from top)
DiseaseCOVID-19
Virus strainSARS-CoV-2
LocationUnited Kingdom
First outbreakWuhan, China
Index caseYork
Arrival date31 January 2020
(3 months and 4 weeks ago)[1]
Confirmed cases267,240 [2]
Deaths
37,460[nb 2][2]
Government website
'Coronavirus (COVID-19): latest information and advice' at www.gov.uk[nb 3]

The Department of Health and Social Care launched a public health information campaign to help slow the virus's spread, and began posting daily updates in early February. In February, the Heath Secretary, Matt Hancock, introduced the Health Protection (Coronavirus) Regulations 2020 for England, and hospitals set up drive-through screening. The Chief Medical Officer for England, Chris Whitty, outlined a four-pronged strategy to tackle the outbreak: contain, delay, research and mitigate. In March, the UK government imposed a lockdown, banning all "non-essential" travel and contact with people outside one's home and closing most business and gathering places. Police were empowered to enforce the lockdown, and the Coronavirus Act 2020 gave the government emergency powers[7] not used since the Second World War.[8][9]

It is forecast that a lengthy lockdown will severely damage the UK economy,[10] lead to millions of job losses,[11] worsen mental health and suicide rates,[12] and cause "collateral" deaths due to isolation, delays and falling living standards.

All four national health services (NHS Wales, Northern Ireland, England and Scotland) worked to raise hospital capacity and set up temporary critical care hospitals. By mid-April NHS Providers, the membership organisation for NHS trusts in England, predicted it could now cope with a peak in cases,[13] and it was reported that social distancing had "flattened the curve" of the epidemic.[14] In late April, Prime Minister Boris Johnson said that the UK had passed the peak of its outbreak.[15]

Background

On 12 January 2020, the World Health Organization (WHO) confirmed that a novel coronavirus was the cause of a respiratory illness in a cluster of people in Wuhan City, Hubei Province, China, which was reported to the WHO on 31 December 2019.[16][17] The case fatality ratio for COVID-19 has been much lower than SARS of 2003,[18][19] but the transmission has been significantly greater, with a significant total death toll.[20][18] In the context of a pandemic, or other public threat, the government has a duty to take proportionate and reasonable measures to protect the public.[21][22][23]

Mathematical modelling

 
Social distancing at a London pharmacy, 23 March 2020

Reports from the Medical Research Council's Centre for Global Infectious Disease Analysis at Imperial College, London have been providing mathematically calculated estimates of cases and case fatality rates.[24][25] In February, the team at Imperial, led by epidemiologist Neil Ferguson, estimated about two-thirds of cases in travellers from China were not detected and that some of these may have begun "chains of transmission within the countries they entered".[26][27][28] They forecast that the new coronavirus could infect up to 60% of the UK's population, in the worst-case scenario.[29]

In a paper on 16 March, the Imperial team provided detailed forecasts of the potential impacts of the epidemic in the UK and US.[30][31] It detailed the potential outcomes of an array of 'non-pharmaceutical interventions'. Two potential overall strategies outlined were: mitigation, in which the aim is to reduce the health impact of the epidemic but not to stop transmission completely; and suppression, where the aim is to reduce transmission rates to a point where case numbers fall. Until this point, government actions had been based on a strategy of mitigation, but the modelling predicted that while this would reduce deaths by approximately 2/3, it would still lead to approximately 250,000 deaths from the disease and the health systems becoming overwhelmed.[30] On 16 March, the Prime Minister announced changes to government advice, extending self-isolation to whole households, advising social distancing particularly for vulnerable groups, and indicating that further measures were likely to be required in the future.[32][31] A paper on 30 March by Imperial estimated that the lockdown would reduce the number of dead from 510,000 to less than 20,000.[33]

In April, biostatistician Professor Sheila Bird said delay in the reporting of deaths from the virus meant there was a risk of underestimating the steepness of the rising epidemic trend.[34]

Timeline

COVID-19 cases in the United Kingdom  ()
     Deaths        Confirmed cases
Date
Cases (% rise)
Deaths (% rise)
2020-01-31 2(n.a.)
2020-02-01 2
2020-02-02 2
2020-02-03 2
2020-02-04 2
2020-02-05 2
2020-02-06 3(50%)
2020-02-07 3
2020-02-08 3
2020-02-09 4(33%)
2020-02-10
8(100%)
2020-02-11
8
2020-02-12
8
2020-02-13
9(13%)
2020-02-14
9
2020-02-15
9
2020-02-16
9
2020-02-17
9
2020-02-18
9
2020-02-19
9
2020-02-20
9
2020-02-21
9
2020-02-22
9
2020-02-23
9
2020-02-24
13(44%)
2020-02-25
13
2020-02-26
13
2020-02-27
13
2020-02-28
19(46%)
2020-02-29
23(21%)
2020-03-01
35(52%)
2020-03-02
40(14%)
2020-03-03
51(28%)
2020-03-04
85(67%)
2020-03-05
114(34%) 1(n.a.)
2020-03-06
160(40%) 2(100%)
2020-03-07
206(29%) 2
2020-03-08
271(32%) 3(50%)
2020-03-09
321(18%) 7(133%)
2020-03-10
373(16%) 7
2020-03-11
456(22%) 9(29%)
2020-03-12
590(29%) 10(11%)
2020-03-13
797(35%) 28(180%)
2020-03-14
1,061(33%) 43(54%)
2020-03-15
1,391(31%) 65(51%)
2020-03-16
1,543(11%) 81(25%)
2020-03-17
1,950(26%) 115(42%)
2020-03-18
2,626(35%) 158(37%)
2020-03-19
3,269(24%) 194(23%)
2020-03-20
3,983(22%) 250(29%)
2020-03-21
5,018(27%) 285(14%)
2020-03-22
5,683(13%) 359(26%)
2020-03-23
6,650(17%) 508(42%)
2020-03-24
8,077(21%) 694(37%[i])
2020-03-25
9,529(18%) 877(26%)
2020-03-26
11,658(22%) 1,161(32%)
2020-03-27
14,548(25%[ii]) 1,455(25%)
2020-03-28
17,104(18%) 1,669(15%)
2020-03-29
19,606(15%) 2,043(22%)
2020-03-30
22,271(14%) 2,425(19%)
2020-03-31
25,521(15%) 3,095(28%)
2020-04-01
30,088(18%) 3,747(21%)
2020-04-02
34,610(15%) 4,461(19%)
2020-04-03
39,282(13%) 5,221(17%)
2020-04-04
43,282(10%) 5,865(12%)
2020-04-05
49,481(14%) 6,433(10%)
2020-04-06
53,624(8.4%) 7,471(16%)
2020-04-07
57,512(7.3%) 8,505(14%)
2020-04-08
63,377(10%) 9,608(13%)
2020-04-09
68,052(7.4%) 10,760(12%)
2020-04-10
73,758(8.4%) 11,599(7.8%)
2020-04-11
78,991(7.1%) 12,285(5.9%)
2020-04-12
84,279(6.7%) 13,029(6.1%)
2020-04-13
88,621(5.2%) 14,073(8.0%)
2020-04-14
93,873(5.9%) 14,915(6.0%)
2020-04-15
98,476(4.9%) 15,944(6.9%)
2020-04-16
103,093(4.7%) 16,879(5.9%)
2020-04-17
108,692(5.4%) 17,994(6.6%)
2020-04-18
114,217(5.1%) 18,492(2.8%)
2020-04-19
120,067(5.1%) 19,051(3.0%)
2020-04-20
124,743(3.9%) 20,223(6.2%)
2020-04-21
129,044(3.4%) 21,060(4.1%)
2020-04-22
133,495(3.4%) 21,787(3.5%)
2020-04-23
138,078(3.4%) 22,792(4.6%)
2020-04-24
143,464(3.9%) 23,635(3.7%)
2020-04-25
148,377(3.4%) 24,055(1.8%)
2020-04-26
152,840(3.0%) 24,393(1.4%)
2020-04-27
157,149(2.8%) 25,302(3.7%)
2020-04-28
161,145(2.5%) 26,097(3.1%[iii])
2020-04-29
165,221(2.5%) 26,771(2.6%)
2020-04-30
171,253(3.7%) 27,510(2.8%)
2020-05-01
177,454(3.6%) 28,131(2.3%)
2020-05-02
182,260(2.7%) 28,446(1.1%)
2020-05-03
186,599(2.4%) 28,734(1.0%)
2020-05-04
190,584(2.1%) 29,427(2.4%)
2020-05-05
194,990(2.3%) 30,076(2.2%)
2020-05-06
201,101(3.1%) 30,615(1.8%)
2020-05-07
206,715(2.8%) 31,241(2.0%)
2020-05-08
211,364(2.2%) 31,587(1.1%)
2020-05-09
215,260(1.8%) 31,855(0.8%)
2020-05-10
219,183(1.8%) 32,065(0.7%)
2020-05-11
223,060(1.8%) 32,692(2.0%)
2020-05-12
226,463(1.5%) 33,186(1.5%)
2020-05-13
229,705(1.4%) 33,614(1.3%)
2020-05-14
233,151(1.5%) 33,998(1.1%)
2020-05-15
236,711(1.5%) 34,466(1.4%)
2020-05-16
240,161(1.5%) 34,636(0.5%)
2020-05-17
243,695(1.5%) 34,796(0.5%)
2020-05-18
246,406(1.1%[iv]) 35,341(1.6%)
2020-05-19
248,818(1.0%) 35,704(1.0%)
2020-05-20
248,293(-0.2%[v]) 36,042(0.9%)
2020-05-21
250,908(1.1%) 36,393(1.0%)
2020-05-22
254,195(1.3%) 36,675(0.8%)
2020-05-23
257,154(1.2%) 36,793(0.3%)
2020-05-24
259,559(0.9%) 36,914(0.3%)
2020-05-25
261,184(0.6%) 37,048(0.4%)
2020-05-26
263,188(0.8%)
Sources:


Notes:

  1. ^ On 25 March PHE changed reporting of deaths to be correct up to 17:00 the previous day, while cases are reported up to 09:00 the same day. Deaths reported for Tuesday 24 March only covered from 09:00 to 17:00 on that day; subsequent reporting is for 24-hour periods from 17:00 to 17:00.[37]
  2. ^ Figures for 27 March and after include additional cases from tests carried out on key workers.
  3. ^ Starting with the figures published on 29 April, deaths in all settings are now included. Previously, only deaths in hospitals were included in the official figures. The numbers in this table have been updated with backdated figures for previous dates.
  4. ^ Positive cases are 27 lower than the difference between today’s and yesterday’s cumulative. This is due to Northern Ireland not processing testing data for 17 May, and the removal of a quality control sample from Wales data.
  5. ^ Reduction in the cumulative total is due to unpublished corrections, and the reallocation of some positive test results to previous days.[citation needed]


Late 2019: suspected cases

On 25 November, Connor Reed, a 25 year old Welshman from Llanrwst teaching at a college in Wuhan, first showed signs of having caught the SARS-CoV-2 virus.[38] He is thought to be the first British person to be infected by the disease.[39]

In May 2020, the BBC reported that several members of a choir in Yorkshire had suffered COVID-19-like symptoms shortly after the partner of one of the choir members returned from a business trip to Wuhan, China, on 17 or 18 December.[40]

January 2020: first confirmed cases

On 22 January, following a confirmed case of COVID-19 in the United States the previous day, in a man returning to Washington from Wuhan, China, where there were 440 confirmed cases at the time, the DHSC and PHE raised the risk level from "very low" to "low". As a result, Heathrow Airport received additional clinical support and tightened surveillance of the three direct flights from Wuhan every week; each was to be met by a Port Health team with Mandarin and Cantonese language support. In addition, all airports in the UK were to make written guidance available for unwell travellers.[41][42] Simultaneously, efforts to trace 2,000 people who had flown into the UK from Wuhan over the previous 14 days were made.[43][44]

On 31 January, the first UK cases were confirmed in York.[45][46] On the same day, British nationals were evacuated from Wuhan to quarantine at Arrowe Park Hospital.[47] However, due to confusion over eligibility, some people missed the flight.[47]

February 2020: early spread

On 6 February, a third confirmed case was reported in Brighton - a man who returned from Singapore and France to the UK on 28 January.[48][49][50] Following confirmation of his result, the UK's CMOs expanded the number of countries where a history of previous travel associated with flu-like symptoms—such as fever, cough, and difficulty breathing—in the previous 14 days would require self-isolation and calling NHS 111. These countries included China, Hong Kong, Japan, Macau, Malaysia, Republic of Korea, Singapore, Taiwan, and Thailand.[51]

On 23 February, the DHSC confirmed four new cases from the Diamond Princess cruise ship.[52]

On 26/27 February, a Nike conference in Edinburgh led to at least 25 cases including 8 residents of Scotland. Health Protection Scotland established an incident management team at the time and traced contacts from delegates.[53] On 27 and 28 February, first cases were confirmed in Wales and Northern Ireland. [54][55]

March 2020: closures and restrictions

Early to mid-March: closures and cancellations

 
Soap almost sold out, London, 12 March

On 1 March, a further 13 cases were reported including new cases in Greater Manchester and Scotland; bringing the total to 36, three of which were believed to be contacts of the case in Surrey who had no history of travel abroad.[56][57]

On 3 March the UK Government unveiled their Coronavirus Action Plan, which outlined what the UK had done and what it planned to do next.[58] Paul Cosford, a medical director at Public Health England, said widespread transmission of COVID-19 in the United Kingdom was "highly likely".[59]

 
Some supermarkets began to limit purchases of items in high demand. 12 March.

On 12 March, the total of cases in the UK was reported to be 590.[58] On the same day, the UK CMOs raised the risk to the UK from moderate to high.[60] The government advised that anyone with a new continuous cough or a fever should self-isolate for seven days. Schools were asked to cancel trips abroad, and people over 70 and those with pre-existing medical conditions were advised to avoid cruises.[61][62]

 
Shopping in rubber gloves and a face mask, London, 15 March

The 2020 United Kingdom local elections were postponed for a year.[63]

On 16 March, Prime Minister Boris Johnson advised everyone in the UK against "non-essential" travel and contact with others, as well as suggesting people should avoid pubs, clubs and theatres, and work from home if possible. Pregnant women, people over 70 and those with certain health conditions were urged to consider the advice "particularly important", and would be asked to self-isolate within days.[32] On the same day, a second MP, Kate Osborne, tested positive after a period of self-isolation.[64][65][66][67]

 
Supermarkets introduced early shopping hours for the elderly and vulnerable.

On 17 March, NHS England announced that all non-urgent operations in England would be postponed from 15 April to free up 30,000 beds.[68]

On 17 March, the government provided a £3.2million emergency support package to help rough sleepers into accommodation.[69][70] With complex physical and mental health needs, in general, homeless people are at a significant risk of catching the virus.[69]

Late March: restrictions begin

 
Next closed its 700 stores on 23 March, having previously traded with warning notices about the virus.

Having previously "advised" the public to avoid pubs and restaurants, on 23 March, Boris Johnson announced in a television broadcast that measures to mitigate the virus were to be tightened further in order to protect the NHS, with wide-ranging restrictions made on freedom of movement, enforceable in law,[7] for a "stay at home" period which would last for at least three weeks.[71] The government directed people to stay at home throughout this period except for essential purchases, essential work travel (if remote work was not possible), medical needs, one exercise per day (alone or with household members), and providing care for others.[72] Many other non-essential activities, including all public gatherings and social events except funerals, were prohibited, with many categories of retail businesses ordered to be closed.[7][73]

The UK, Scottish and Welsh Parliaments scaled back their activities.[74]

On 26 March, the number of UK coronavirus deaths increased by more than 100 in a day for the first time, rising to 578, while a total of 11,568 had tested positive for the virus.[75] At 8:00 pm that day, people from across the UK took part in national applause in appreciation of health workers.[76] This applause was repeated the following week.[77]

 
Electronic display sign normally used for traffic management displays COVID-19-related advices on an almost deserted Chichester Street in Belfast City Centre, 24 March.

On 27 March, Boris Johnson and Matt Hancock announced that they had tested positive for the virus.[78][79] On the same day, Labour Party MP Angela Rayner, the Shadow Secretary of State for Education, confirmed she had been suffering symptoms and was self-isolating.[80] Chief Medical Adviser Chris Whitty also reported suffering from symptoms and would be self-isolating, while continuing to advise the UK government.[81] That day also saw the largest increase in the number of deaths, with the figure rising by 181 from the previous day, bringing the total to 759, while 14,579 cases had been confirmed.[82]

 
Social distancing while queueing to enter a Sainsburys supermarket, 30 March 2020

On 29 March, it was reported that the government would send a letter to 30 million households warning things would "get worse before they get better" and that tighter restrictions could be implemented if necessary. The letter would also be accompanied by a leaflet setting out the government's lockdown rules along with health information.[83] Dr Jenny Harries, England's deputy chief medical officer, suggested it could be six months before life could return to "normal", because social distancing measures would have to be reduced "gradually".[84] The first NHS nurse died of COVID-19.[85]

On 30 March the Prime Minister's senior adviser Dominic Cummings was reported to be self-isolating after experiencing coronavirus symptoms. He had been at Downing Street on 27 March and was stated to have developed symptoms over 28 and 29 March[86]

At the end of March, transmission within the community was thought to be decreasing, and hospital admission data suggested cases were increasing at a slower rate.[87] The Foreign and Commonwealth Office repatriated tens of thousands of British nationals who had been stranded abroad by the coronavirus outbreak.[88]

April 2020

 
A letter sent by the Prime Minister to every household in the UK along with government guidance on coronavirus, 3 April

On 1 April, the government confirmed that a total of 2,000 NHS staff had been tested for coronavirus since the outbreak began, but Cabinet Office Minister Michael Gove said a shortage of chemical reagents needed for COVID-19 testing meant it was not possible to screen the NHS's 1.2 million workforces.[89] Gove's statement was contradicted by the Chemical Industries Association, which said there was not a shortage of the relevant chemicals and that at a meeting with a business minister the week before the government had not tried to find out about potential supply problems.[90] On 1 April the number of deaths was confirmed to have increased by 563 to 2,362, while a total of 29,474 cases had been diagnosed, 4,324 over the previous 24 hours.[89]

On 2 April, Health Secretary Matt Hancock, after his seven-day period of isolation, announced a "five pillar" plan for testing people for the virus, with the aim of conducting 100,000 tests a day by the end of April.[91] At 8:00 pm on 2 April the UK gave another national round of applause for NHS staff and other key workers.[92]

With the warm weather forecast for some areas during the upcoming weekend, on 3 April Hancock warned people to stay at home, telling them this was an instruction "not a request".[93] On 4 April it was announced that a five-year-old had died from the virus, believed to be the youngest victim to date.[94] The death total was reported as 4,313, having risen by 708 from the previous day's figure.

That day, Boris Johnson was admitted to hospital as a "precautionary measure" after suffering from symptoms for more than a week with no improvement.[95] Catherine Calderwood, Scotland's chief medical officer, resigned from her post after it emerged she had been spoken to by police for visiting her second home during lockdown.[96] On 6 April, Johnson was moved to the intensive care unit at St Thomas' Hospital in London as his symptoms worsened. Dominic Raab assumed Johnson's duties.[97]

On 7 April the number of reported deaths increased by 786, taking the total to 6,159. The figure compared with 439 deaths for the previous day. Patrick Vallance, the government's chief scientific adviser, said the figures were not accelerating as had been predicted but it was too early to tell whether the outbreak was peaking.[98][99]

On 8 April, Mark Drakeford, the First Minister of Wales, confirmed the Welsh Government would extend the lockdown beyond the initial three-week period for Wales.[100] On that day a further 938 deaths were reported in the UK, taking the total to 7,097.[101]

On 9 April the number of daily recorded deaths increased by 881, taking the total to 7,978. Dominic Raab said the UK was "starting to see the impact" of the restrictions but it was "too early" to lift them, and urged people to stay indoors over the Easter weekend.[102] With warm weather forecast again for Easter, this message was echoed by police and tourist destinations.[103] Johnson was moved out of intensive care, but remained in hospital.[104] At 8:00 pm on 9 April the nation staged a third round of applause for NHS staff and other key workers.[105]

On 10 April the UK recorded another 980 deaths taking the total to 8,958. Jonathan Van-Tam, England's deputy chief medical officer, told the UK Government's daily briefing the lockdown was "beginning to pay off" but the UK was still in a "dangerous situation", and although cases in London had started to drop they were still rising in Yorkshire and the North East.[106] Matt Hancock told the briefing a "Herculean effort" was being made to ensure daily deliveries of personal protective equipment (PPE) to frontline workers, including the establishment of domestic manufacturing industry to produce the equipment. Fifteen drive-through testing centres had also been opened around the UK to test frontline workers.[107]

On 11 April the number of reported deaths increased by 917, taking the total to 9,875. After some NHS workers said they still did not have the correct personal protective equipment to treat patients, Home Secretary Priti Patel told that day's Downing Street briefing she was "sorry if people feel there have been failings" in providing kit.[108]

Boris Johnson left hospital on Sunday 12 April.[109] On that day a further 737 coronavirus-related deaths were reported, taking the total past 10,000 to 10,612. Matt Hancock described it as a "sombre day".[110] On 13 April the number of reported deaths increased by 717 to 11,329. Dominic Raab told the Downing Street briefing the government did not expect to make any immediate changes to the lockdown restrictions and that the UK's plan "is working [but] we are still not past the peak of this virus".[111]

On 14 April the number of reported deaths increased by 778 to 12,107.[112] On that day figures released by the Office of National Statistics indicated that coronavirus had been linked to one in five deaths during the week ending 3 April. More than 16,000 deaths in the UK were recorded for that week, 6,000 higher than would be the average for that time of year.[113] Several UK charities, including Age UK and the Alzheimer's Society, expressed their concern that older people were being "airbrushed" out of official figures because they focus on hospital deaths while not including those in care homes or a person's own home. Responding to these concerns, Therese Coffey, the Secretary of State for Work and Pensions, said hospital figures were being used because "it's accurate and quick".[114]

Matt Hancock announced new guidelines that would allow close family members to see dying relatives in order to say goodbye to them. Hancock also launched a new network to provide personal protective equipment to care home staff.[115] On that day, NHS England and the Care Quality Commission began rolling out tests for care home staff and residents as it was reported the number of care home deaths was rising but that official figures, which rely on death certificates, were not reflecting the full extent of the problem. Helen Whately, the Minister for Social Care, said the government were aware the figures were being understated.[116] Also on 15 April, Arlene Foster, the First Minister of Northern Ireland, extended the period of lockdown in Northern Ireland to 9 May.[117]

On 16 April Dominic Raab briefed that lockdown restrictions would continue for "at least" another three weeks, and to relax them too early would "risk wasting all the sacrifices and all the progress that has been made". He set out five conditions for any easing of the lockdown .[118] On that day the number of recorded deaths increased by 861 to 13,729, while the number of cases of the virus passed 100,000, reaching 103,093.[119] Also on 16 April, the NHS Nightingale Hospital Birmingham was officially opened by Prince William,[120] and the nation staged a fourth round of applause for NHS staff and key workers at 8pm.[121]

On 17 April the number of recorded deaths rose by 847 taking the total to 14,576. Matt Hancock confirmed coronavirus tests would be rolled out to cover more public service staff such as police officers, firefighters and prison staff.[122]

On 18 April, Imran Ahmad-Khan, the MP for Wakefield, secured a shipment of 110,000 reusable face masks through his connections with charity Solidarités international and the Vietnamese Government for Mid Yorkshire Hospitals NHS Trust to help tackle the shortage of PPE.[123] Unions representing doctors and nurses expressed concern at a change in government guidelines advising medics to reuse gowns or wear other kits if stocks run low.[124] Speaking at the Downing Street daily briefing later that day, Robert Jenrick, the Secretary of State for Local Government said a further 400,000 gowns would be arriving from Turkey the following day.[125] The number of recorded deaths rose by 888 to 15,464.[126] Care England, the UK's largest care homes representative body, estimated that as many as 7,500 care home residents may have died because of coronavirus, compared to the official figure of 1,400 released a few days earlier.[124] Jenrick announced a further £1.6bn of support for local authorities, on top of £1.6bn that was given to them at the beginning of the outbreak.[127] Jenrick also said parks and cemeteries must remain open.[127]

On 19 April the number of recorded deaths increased by 596 to 16,060. Dr. Jenny Harries said the lower number of deaths was "very good news" but cautioned against drawing conclusions from the figures. The Department for Education announced a focus on home learning for children.[128] Also on 19 April, the flight from Turkey carrying a shipment of 84 tonnes of PPE scheduled to land in the UK that day was delayed.[129]

On 28 April Kawasaki Syndrome was reported in children.[130][131]

On 29 April, the number of people who have died with coronavirus in the UK passed 26,000, as official figures include deaths in the community, such as in care homes, for the first time.[132] On 30 April, Boris Johnson said the country was "past the peak of this disease".[133]

May 2020

 
VE Day celebrations took place under lockdown; here a socially distanced street party is taking place on Hallfield Estate, Wetherby, West Yorkshire.

On 5 May, the UK death toll became the highest in Europe and second highest in the world.[134]

On 7 May, the lockdown in Wales was extended with some slight relaxations.[135][136]

On 10 May, Prime Minister Johnson asked those who could not work from home to go to work, although avoiding public transport if possible; and encouraged the taking of outdoor exercise, mentioning "unlimited amounts" and the possibility of driving to outdoor destinations in England. In his address he changed the 'Stay at Home' slogan to 'Stay Alert'.[137] The devolved administrations in Scotland, Northern Ireland, and Wales did not adopt the new slogan.[138]

 
UK's COVID-19 Alert Levels (introduced in May 2019)

On 11 May, Johnson published a 60-page document called "Our Plan to rebuild: the UK Government's COVID-19 recovery strategy", with details about the COVID-19 recovery strategy for the UK. Within the report a new COVID-19 alert level system was announced.[139] At the same time the Cabinet Office published guidance on "staying safe outside your home", comprising eleven principles which "all of us" should adopt "wherever possible".[140]

In May a COVID-19 Alert System was announced, to be run by a new Joint Biosecurity Centre. When first announced, Johnson stated that the UK was on level 4, moving towards level 3.[141][139][142]

The Health and Safety Executive stated that from 9 March to 7 May they were contacted 4,813 times. Around 8% of the complaints related to Scotland. The executive managed to resolve 60% of them while another 40% needed further investigation, with some workplaces suspended whilst safety measures were put in place. As of 17 May the executive had not issued any enforcement notices in relation to COVID-19.[143]

On 25 May 2020, the prime minister's adviser Dominic Cummings was criticised over his alleged breaches of the lockdown.[144][145] On 28 May 2020, Durham police said that no offence had been committed when Cummings travelled from London to Durham and that a minor breach might have occurred at Barnard Castle, but as there was no apparent breach of social distancing rules, no further action would be taken.[146]

Government response

Overview

 
Bilingual information from Welsh Government and NHS Wales with lockdown instructions; Aberystwyth railway station; 4 April 2020
 
NHS England coronavirus poster, February 2020[147]

The first published government statement on the coronavirus situation in Wuhan was released on 22 January by the Department of Health and Social Care and Public Health England.[148] Guidance has progressed in line with the number of cases detected and changes in where affected people have contracted the virus, as well as with what has been happening in other countries.[49] In February, Chief Medical Officer (CMO) to the UK Government, Chris Whitty said "we basically have a strategy which depends upon four tactical aims: the first one is to contain; the second of these is to delay; the third of these is to do the science and the research; and the fourth is to mitigate so we can brace the NHS."[149] These aims equate to four phases; specific actions involved in each of these phases are:[citation needed]

  • Contain: detect early cases, follow up close contacts, and prevent the disease from taking hold in this country for as long as is reasonably possible
  • Delay: slow the spread within the UK, and (if it does take hold) lower the peak impact and push it away from the winter season
  • Research: better understand the virus and the actions that will lessen its effect on the UK population; innovate responses including diagnostics, drugs, and vaccines; use the evidence to inform the development of the most effective models of care
  • Mitigate: provide the best care possible for people who become ill, support hospitals to maintain essential services and ensure ongoing support for people ill in the community, to minimise the overall impact of the disease on society, public services and on the economy.[150]

The four UK CMOs raised the UK risk level from low to moderate on 30 January 2020, upon the WHO's announcement of the disease as a Public Health Emergency of International Concern.[58][151] As soon as cases appeared in the UK on 31 January 2020, a public health information campaign, similar to the previous "Catch it, Bin it, Kill it" campaign, was launched in the UK, to advise people how to lessen the risk of spreading the virus.[151] Travellers from Hubei province in China, including the capital Wuhan were advised to self-isolate, "stay at home, not go to work, school or public places, not use public transport or taxis, ask friends, family members or delivery services to do errands",[152] and call NHS 111 if they had arrived in the UK in previous 14 days, regardless of whether they were unwell or not.[151] Further cases in early February prompted the Secretary of State for Health and Social Care, Matt Hancock, to announce the Health Protection (Coronavirus) Regulations 2020.[58] Daily updates have been published by the DHSC.[58] NHS Digital in the meanwhile, have been collecting data.[153]

 
NHS England poster for the "Catch it, Bin it, Kill it" slogan which has been revived in the fight against coronavirus

On 25 February 2020, the UK's CMOs advice for all travellers (unwell or not) who had returned to the UK from Hubei province in the previous 14 days, Iran, specific areas designated by the Italian government as quarantine areas in northern Italy and special care zones in South Korea since 19 February, to self-isolate and call NHS 111.[51] This advice was also advocated for any person who has flu-like symptoms with a history of travelling from Vietnam, Cambodia, Laos, Myanmar and areas in Italy north of Pisa, Florence and Rimini, returning to the UK since 19 February. Later, self-isolation was recommended for anyone returning from any part of Italy from 9 March.[58][51]

Initially, Prime Minister Boris Johnson largely kept Britain open, resisting the kind of lockdowns seen elsewhere in Europe. In a speech on 3 February, Johnson's main concern was that the "coronavirus will trigger a panic and a desire for market segregation that go beyond what is medically rational to the point of doing real and unnecessary economic damage."[154] On 11 February, a "senior member of the government" told the ITV journalist Robert Peston that "If there is a pandemic, the peak will be March, April, May" and, further, that "the risk is 60% of the population getting it. With a mortality rate of perhaps just over 1%, we are looking at not far off 500,000 deaths."[155]

On 13 March, UK Government Chief Scientific Adviser Patrick Vallance told BBC Radio 4 one of "the key things we need to do" is to "build up some kind of herd immunity so more people are immune to this disease and we reduce the transmission".[156] This involves enough people getting infected, upon which they develop immunity to the disease.[157][158] Vallance said 60% of the UK's population will need to become infected for herd immunity to be achieved.[159][158] This stance was criticised by experts[who?] who said it would lead to hundreds of thousands deaths and overwhelm the NHS. More than 200 scientists urged the government to rethink the approach in an open letter.[160] Subsequently, Health Secretary Matt Hancock said that herd immunity was not a plan for the UK, and the Department of Health and Social Care said that "herd immunity is a natural byproduct of an epidemic".[161] On 4 April, The Times reported that the government's science adviser Graham Medley was still advocating a "herd immunity" strategy.[162] There was a letter published in The Lancet on 17 March calling on the government to openly share its data and models as a matter of urgency.[163]

On 2 March, Johnson said in an interview with BBC News: "The most important thing now is that we prepare against a possible very significant expansion of coronavirus in the UK population". This came after the 39th case in the UK was confirmed and over a month after the first confirmed case in the UK.[164] The same day, a BBC One programme Coronavirus: Everything You Need to Know addressed questions from the public on the outbreak.[165] The following day, the Coronavirus Action Plan was unveiled.[58] The next day, as the total number of cases in the UK stood at 51, the government declared the coronavirus pandemic as a "level 4 incident",[166] permitting NHS England to take command of all NHS resources.[166][167] Planning has been made for behaviour changing publicity including good hygiene and respiratory hygiene ("catch it, bin it, kill it"),[168] a measure designed to delay the peak of the infection and allow time for the testing of drugs and initial development of vaccines.[150] Primary care has been issued guidance.[169]

Public Health England has also been involved with efforts to support the British Overseas Territories against the outbreak.[170][171]

On 27 March, Johnson said he had contracted coronavirus and was self-isolating, and that he would continue to lead the Government's response to coronavirus through video conference.[78] On the evening of 5 April the Prime Minister was admitted to hospital for tests.[172] The next day he was moved to the intensive care unit at St Thomas' Hospital, and First Secretary of State Dominic Raab deputised for him.[173]

Progression between phases

On 12 March, the government announced it was moving out of the contain phase and into the delay phase of the response to the coronavirus outbreak. The announcement said that in the following weeks, the government would introduce further social distancing measures for older and vulnerable people, and asking them to self-isolate regardless of symptoms. It announcement sidd that if the next stage were introduced too early, the measures would not protect at the time of greatest risk but they could have a huge social impact. The government said that its decisions were based on careful modelling and that government measures would only be introduced that were supported by clinical and scientific evidence,[174]

Classification of the disease

From 19 March, Public Health England, consistent with the opinion of the Advisory Committee on Dangerous Pathogens, no longer classified COVID-19 as a "High consequence infectious disease" (HCID). This reversed an interim recommendation made in January 2020, due to more information about the disease confirming low overall mortality rates, greater clinical awareness, and a specific and sensitive laboratory test, the availability of which continues to increase. The statement said "the need to have a national, coordinated response remains" and added, "this is being met by the government's COVID-19 response". This meant cases of COVID-19 are no longer managed by HCID treatment centres only.[19]

Communications

 
UK Government advisory SMS message, 24 March 2020

On 16 March, the UK government started holding daily press briefings. The briefings were to be held by the Prime Minister or government ministers and advisers. The government had been accused of a lack of transparency over their plans to tackle the virus.[175] Daily briefings were also held by the administrations of Northern Ireland, Scotland and Wales.[176] The speakers at the daily press briefings were accompanied by sign language interpreters. British sign language is a recognised language in Scotland and Wales, with interpreters standing 2 metres behind Ministers. Northern Ireland's briefings had both British and Irish sign language interpreters who were shown on a small screen in the press conference room. The UK briefing did not have an interpreter in the room or on a screen leading to a twitter campaign about the issue. The UK government reached an agreement to have the press conferences signed on the BBC News Channel and on iPlayer in response to the campaign.[177] In response to this a petition was created by Sylvia Simmonds that required the UK government to use sign language interpreters for emergency announcements.[178] Legal firm, Fry Law looked to commence court proceedings as they said the government had broken the Equality Act 2010, but also said that the government was doing the bare minimum and were crowdfunding to cover the government's legal costs if they lost.[177]

On 24 March, all major mobile telephony providers, acting upon a government request, sent out an SMS message to each of their customers, with advice on staying isolated.[179] This was the first ever use of the facility.[179] Although the government in 2013 endorsed the use of Cell Broadcast to send official emergency messages to all mobile phones, and has tested such a system, it has never actually been implemented. Backer Toby Harris said the government had not yet agreed upon who would fund and govern such a system.[180][181]

Prior pandemic planning

The UK Influenza Pandemic Preparedness Strategy was published in 2011 and updated in 2014,[182] alongside a review of the available medical and social countermeasures .[183] Pandemic flu guidance was published in 2013 and updated in 2017 covering guidance for local planners, business sectors, and an ethical framework for the government response. The guidance stated:[184]

There are important differences between 'ordinary' seasonal flu and pandemic flu. These differences explain why we regard pandemic flu as such a serious threat. Pandemic influenza is one of the most severe natural challenges likely to affect the UK.

Regulations and legislation

 
Restaurant in London offering home deliveries after dining-in was banned. March 2020.

The government published the Health Protection (Coronavirus) Regulations 2020 on 10 February 2020, a statutory instrument covering the legal framework behind the government's initial containment and isolation strategies and its organisation of the national reaction to the virus for England.[185] Other published regulations include changes to Statutory Sick Pay (into force on 13 March),[186] and changes to Employment and Support Allowance and Universal Credit (also 13 March).[187]

On 19 March, the government introduced the Coronavirus Act 2020, which grants the government discretionary emergency powers in the areas of the NHS, social care, schools, police, the Border Force, local councils, funerals and courts.[188] The act received royal assent on 25 March 2020.[189]

Closures to pubs, restaurants and indoor sports and leisure facilities were imposed via the Health Protection (Coronavirus, Business Closure) (England) Regulations 2020.[190]

The restrictions on movements, except for allowed purposes, are:

  • Health Protection (Coronavirus, Restrictions) (England) Regulations 2020[191]
    • amended on 22 April by The Health Protection (Coronavirus, Restrictions) (England) (Amendment) Regulations 2020
      • and further amended on 13 May by the Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 2) Regulations 2020[192]
  • Health Protection (Coronavirus) (Restrictions) (Scotland) Regulations 2020[193]
  • Health Protection (Coronavirus Restrictions) (Wales) Regulations 2020[194]
  • The Health Protection (Coronavirus, Restrictions) (Northern Ireland) Regulations 2020[195]

Criticism of the UK Government's response

There has been criticism of the UK Government's response. In late March Dr. Richard Horton, editor of The Lancet told BBC's Question Time that "we knew in the last week of January that this was coming. The message from China was absolutely clear that a new virus with pandemic potential was hitting cities. ... We knew that 11 weeks ago and then we wasted February when we could have acted."[196] Dr. Anthony Costello, a former WHO director, made a similar point in April, saying: "We should have introduced the lockdown two or three weeks earlier. ... It is a total mess and we have been wrong every stage of the way." He also said that "they keep talking about flattening the curve which implies they are seeking herd immunity."[197] And David King, the former Chief Scientific Advisor, said: "We didn't manage this until too late and every day's delay has resulted in further deaths."[198]

In May, Sir Lawrence Freedman, writing for the International Institute for Strategic Studies, accused the government of following public opinion instead of leading it when taking the lockdown decision; and of missing the threat to care homes.[199] At Prime Minister's Questions on 13 May, Labour Party leader Keir Starmer accused Boris Johnson of misleading the Commons in relation to care homes.[200][201]

Criticisms from within the Government have been largely anonymous. On 20 April, a No. 10 adviser was quoted by The Times saying: "Almost every plan we had was not activated in February. ... It was a massive spider's web of failing." The same article said Boris Johnson did not attend any of the five coronavirus COBR meetings held in January and February.[202] On The Andrew Marr Show, Minister for the Cabinet Office Michael Gove said it was normal for prime ministers to be absent as they are normally chaired by the relevant department head, who then reports to the PM. The Guardian said the meetings are normally chaired by the PM during a time of crisis and later reported that Johnson did attend one meeting "very briefly".[203]

Millions are going hungry[clarification needed] because of the coronavirus pandemic, according to an April survey carried out by YouGov.[204][205] Tim Lang, professor of food policy at City University, London, said that "borders are closing, lorries are being slowed down and checked. We only produce 53% of our own food in the UK. It's a failure of the government to plan."[206]

When Johnson announced plans on 10 May to end the lockdown, some experts were even more critical. Anthony Costello warned that Johnson's "plans will lead to the epidemic returning early [and] further preventable deaths,"[207] while Devi Sridhar, chair of global public health at the University of Edinburgh, said that lifting the lockdown "will allow Covid-19 to spread through the population unchecked. The result could be a Darwinian culling of the elderly and vulnerable."[208]

Scottish Government

On 28 April the First Minister of Scotland, Nicola Sturgeon, advised the voluntary use of non-medical grade cloth face masks in Scotland to be used in enclosed spaces such as shops and public transport, but not generally in public (excluding those who are under two years old or who have respiratory illnesses such as asthma). Sturgeon noted their limitation and said co-operation with the face mask guidance was voluntary.[209] This is in contrast to advice given by Boris Johnson and the UK government in Westminster.[210]

Lifting lockdown

 
Document published by the UK Government explaining the "roadmap" for lifting the lockdown in the country.[139]

In mid-April The Telegraph quoted a member of the Cabinet saying: "There's no exit plan at the moment ... We didn't want to go down this route in the first place—public and media pressure pushed the lockdown ..."[211] Several members of the government have stated that it is not possible to draw up a definitive plan on how to exit lockdown as it is based on scientific advice.[212]

In early May, research was published[213] showing that if the most vulnerable (the elderly and those with certain underlying illnesses) were completely shielded, the lockdown could mostly be lifted, avoiding "a huge economic, social and health cost", without significantly increasing severe infections and deaths. It also recommended regular testing and contact tracing.[214][215]

On 8 May the Welsh Government relaxed restrictions on exercise and allowed some garden centres and recycling facilities would reopen.[216] Nicola Sturgeon stated that she wanted all nations to make changes together as it would give the public a clear and consistent message.[217] Boris Johnson acknowledged different areas move at slightly different speeds with actions based on the science for each area.[218] Scotland announced a similar measure in terms on exercise as Wales, to go live on the same day.[219]

Johnson made a second televised address on 10 May, changing the slogan from 'Stay at Home' to 'Stay Alert'. He also outlined how restrictions might end and introduced a COVID-19 warning system.[137] Additionally measures were announced stating that the public could exercise more than once a day in outdoor spaces such as parks, could interact with others whilst maintaining social distance and drive to other destinations from 13 May in England.[220] This was leaked to the press [221][222] and criticised by leaders and ministers of the four nations, who said it would cause confusion.[223] The leaders of Scotland, Northern Ireland, and Wales said they would not adopt the new slogan.[224][225] The Welsh Health Minister Vaughan Gething said that the four nations had not agreed to it and the Scottish Health Secretary Jeane Freeman said that they were not consulted on the change.[138][226] Labour leader Sir Keir Starmer said that the new message "lacked clarity".[227] The Guardian were told that neither Chris Whitty, the chief medical officer for England, or Sir Patrick Vallance, government's chief scientific adviser, had given the go ahead for the new slogan. Witty later said at a Downing Street press conference that "Neither Sir Patrick nor I consider ourselves to be comms experts, so we’re not going to get involved in actual details of comms strategies, but we are involved in the overall strategic things and we have been at every stage." The slogan was criticised by members[who?] of the scientific advisory group on emergencies.[228] Scottish First Minister Nicola Sturgeon said: "We mustn't squander progress by easing up too soon or sending mixed messages. People will die unnecessarily."[229]

The next day the government published a 60-page roadmap of what exiting lockdown could look like.[139] A document was additionally published outlining nine points which applied to England, with an update of measures from 13 May.[230] As the rules between England and Wales were different in terms of exercise, many officials warned against the public driving to destinations in Wales for exercise.[231] The Counsel General for Wales, Jeremy Miles, said visitors could be fined if they drove into Wales for leisure.[138] Sturgeon gave a similar warning about driving into Scotland.[232] She additionally said that politicians and the media must be clear about what they are saying for different parts of the UK after Johnson's address did not state which measures only applied to England.[220][233][234] On 17 May, Labour leader Keir Starmer called for a 'four-nation' unified approach.[235] Manchester Mayor Andy Burnham said that there was a risk of national unity in ignoring the different demands of regions in England.[236][237] Boris Johnson acknowledged the frustrations in some of the rules and said that "complicated messages were needed during the next phase of the response and as restrictions changed."[238]

The Northern Ireland Executive published a five-stage plan for exiting lockdown on 12 May, but without any specific dates.[239][240][224] An announcement was made on 14 May that garden centres and recycling centres would reopen on Monday in the first steps taken to end the lockdown in Northern Ireland.[241]

On 15 May, Mark Drakeford announced a traffic light plan to remove the lockdown restrictions in Wales, which would start no earlier than 29 May.[242][243]

National health services response

Healthcare in the UK is a devolved matter, with England, Northern Ireland, Scotland and Wales each having their own systems of publicly funded healthcare, funded by and accountable to separate governments and parliaments. As a result of each country having different policies, laws and priorities, a variety of differences now exist between these systems.[244][245]

Equipment

 
Primary care nurse wearing Personal Protective Equipment (PPE)
 
Face masks given to NHS staff, March 2020

On 16 March, Boris Johnson held a conference call with business leaders and set them the target of delivering 30,000 ventilators in a fortnight; the government also declined to join an emergency European Union scheme to procure ventilators and other emergency equipment like personal protective equipment (PPE) for hospital staff, saying the UK was no longer part of the EU and that this was area in which it was making its own efforts.[246] Existing ventilator stocks stood at 5,900 at the beginning of the outbreak.[247]

On 16 March, primary care magazine Pulse reported doctors were receiving out-of-date PPE that had had its 2016 use-by date covered with a sticker saying "2021".[248] In response, the government offered reassurance that this was safe.[249] Earlier in the month, in response to a survey of Pulse's readership, two of five GPs reported they still did not have PPE to protect them from coronavirus.[248] Some of these concerns were raised with Johnson during Prime Minister's Questions, to which the Prime Minister replied the UK had "stockpiles" of PPE.[250] The same day, the Doctors' Association reported NHS staff felt they were being put at risk due to lack of PPE.[251]

On 22 March, in a letter with 3,963 signatures published in The Times, NHS staff asked Johnson to "protect the lives of the life-savers" and resolve the what they saw as the "unacceptable" shortage of protective equipment.[252][253] On 23 March, in an effort to meet demand and due to concerns about the rising number of medics becoming ill after exposure to the virus, the NHS asked DIY stores to donate PPE for use by NHS staff.[254] Hancock said there were "challenges" with supplying PPE to NHS staff and said a million masks had been bought that weekend.[255] The following day, the government said there was enough PPE for everyone in the NHS who needed it; this was contradicted by the Royal College of Nursing,[256] and the British Medical Association (BMA), which warned that without enough PPE, doctors would die.[257]

 
Three people in London wearing masks, 19 March 2020. The wearing of masks was not made compulsory in the UK.

On 31 March, 10,000 health workers wrote to the prime minister demanding better safeguards, including the right PPE.[258] On 1 April, the government said 390 million pieces of PPE had been distributed to the health service in the past fortnight. The Royal College of Midwives (RCM)[259] and the BMA said the supplies had yet to reach medical staff.[260] The RCM, in a joint statement with unions, including Unite, Unison and the GMB, said the lack of PPE was now 'a crisis within a crisis'.[259]

On 29 March, the government issued a specification for the "minimally clinically acceptable" manufacture and use of Continuous Positive Airway Pressure (CPAP) machines.[261]

On 10 April the UK Government sent out a document to PPE suppliers informing them that suppliers of certain medical equipment, including protective masks, gloves and aprons, must be registered with the Care Quality Commission, which regulates all health and social care services in England only. There was not a similar agreement in place between suppliers and Care Inspectorate Wales or the Care Inspectorate of Scotland.[262][263] The Welsh Government advised care home providers that they should order through their local council, while Plaid Cymru leader Adam Price lodged a formal complaint with the European Union over the issue.[263] The manager of two care homes in Gwynedd, Wales was told by two suppliers that they would only sell to care homes in England.[264] The chief executive of the care home umbrella group Scottish Care said that the UK's four largest PPE suppliers had said they were not distributing to Scotland because their priority was going to be "England, the English NHS and then English social care providers".[265] The UK government reported that it had not instructed any company to prioritise PPE for any nation.[265] Healthcare supplier Gompels' website said at the time that "These restrictions are not something we have decided, they are a criteria given to us by Public Health England".[266]

A BBC Panorama episode, Has the government failed the NHS?, broadcast on 27 April, said the government had been counting PPE items in a way that artificially inflated the total. Gloves were counted individually, rather than as pairs, for instance, and non-PPE items, such as paper towels and detergent, were included in the figure.[267] The programme also said the government was changing the guidance on what PPE was appropriate for medical staff to wear when treating COVID-19 patients, not according to best protective procedure, but according to the stock available.[268] The programme also said that, in the years before the pandemic, the government had ignored expert advice and failed to stockpile essential items.[268] Due to lack of stock, in May an NHS trust prioritised anti-bacterial ventilator filters for coronavirus patients over others. .[269]

Staffing

On 1 March, Hancock said retired NHS staff might be asked to return to work to help with the crisis.[270] The request was issued on 19 March and included final year medical students.[271] On 29 March, Boris Johnson announced that more than 20,000 former NHS staff were returning to work in response to the pandemic.[272]

On 21 March, the NHS had agreed to use, at cost price, almost the entire private health system, bringing 20,000 medical staff into the national effort.[273]

On 24 March, Matt Hancock launched a scheme to recruit 250,000 volunteers to support the NHS through the pandemic.[274] The volunteers would carry out jobs like collecting and deliver shopping, medication or "other essential supplies" for people in isolation; transporting equipment and medication between NHS services; transporting medically fit patients and providing telephone support to people at risk of loneliness because of self-isolation.[275] The target was surpassed in 24 hours and was raised to 750,000.[276] The scheme was paused on 29 March after the new target was reached.[275]

England

Appointments and self-isolation

 
A Coronavirus 'pod' at Hull Royal Infirmary

In March, hospitals in England began to cancel all elective procedures.[277] On 22 March, the government announced that it would be asking about 1.5 million people (everyone in England with certain health conditions that carry serious risk if infected) to "shield" for 12 weeks. They were to be notified by mail or text messaged by their NHS general practitioners, and provided deliveries of medication, food, and household essentials, delivered by pharmacists and local governments, and at least initially paid for by the UK government.[278] Members of the public were told to stay at home, should they suspect they have symptoms of COVID-19, and not visit a GP, pharmacy, or hospital.[279] For advice, the public were told to use a dedicated online self-assessment form before calling NHS 111, the non-emergency medical helpline.[280]

To allow vulnerable patients with underlying conditions to still be able to attend for routine blood tests without having to come to a hospital, from 8 April, the Sheffield Teaching Hospitals NHS Foundation Trust opened a drive-through phlebotomy service operating out of a tent in the car park of Sheffield Arena.[281] This allows patients to have their blood tests taken from within their car, in a similar manner to how COVID-19 swabbing drive-through stations work. Following the success of the service, it was expanded to cover all patients registered with any GP in the Sheffield area from 27 April.[282]

Beds

The NHS England freed up 30,000 beds by discharging patients who were well enough and delaying non-emergency treatment,[283] and acquired use of 8,000 beds in private sector facilities.[283] Emergency building work was undertaken to add capacity to existing hospitals, 52 beds in Wigan, for example.[284] An additional capacity of almost 20,000 beds was created with NHS Nightingale Hospitals in major conurbations across the United Kingdom.[citation needed]

Temporary critical care hospitals

Testing and monitoring

 
A temporary test site staffed by the army in Ealing

Shortly after confirming that the cause of the cluster of pneumonia in Wuhan was a new coronavirus, Chinese authorities had shared its genetic sequence for international developments of diagnostic kits.[41] By 10 January,[285] the UK had developed a prototype specific laboratory test for the new disease, performed on a sample from the nose, throat, and respiratory tract and tested at PHE's public health laboratory at Colindale in London.[24] Testing of patients began within days,[286] and by 3 February 326 tests had been performed in the UK.[151] Over the following few weeks, PHE made the test available to 12 other laboratories in the UK, making it possible to test 1,000 people a day.[24][287]

As of 12/13 March 2020, 29,764 tests had been conducted in the UK, corresponding to 450.8 tests per million people.[288] On 24 March, Matt Hancock said the government had bought 3.5m kits that would test if a person has already had COVID-19; no date was given for their arrival. These tests would allow people to know if they were immune and therefore able to "go back to work".[289] It was later found when the kits, which had cost at least £16 million, were tested, they did not meet the required specifications.[290] Hancock announced on 28 March that 10,000 tests a day were now being processed; the actual figure was 5,000.[291][292] As of 31 March 143,186 people had been tested.[58]

The UK government and Public Health England were criticised for what some[who?] saw as a failure to organise mass testing. On 28 March the editor-in-chief of The Lancet published a condemnation of what he saw as government inaction and ignoring of WHO advice.[293] On 31 March former WHO director Anthony Costello, following WHO advice that countries should "test, test, test", said the key to the UK's transitioning out of lockdown was mass testing, and that the UK had the capacity to reach the level of testing being carried out by Germany (70,000 tests a day, compared to the UK's 5,000) but the government and Public Health England (PHE) had been too slow and controlling to organise.[294] The day after, Conservative MP Jeremy Hunt, chair of the Health and Social Care Select Committee and former Health Secretary, said it was "very worrying" that the government had not introduced mass testing because doing so had been "internationally proven as the most effective way of breaking the chain of transmission".[295] On 2 April, The Telegraph reported that one of the Government's science advisers, Graham Medley, said "mass public testing has never been our strategy for any pandemic." Medley also said the Government "didn't want to invest millions of pounds into something that is about preparedness".[296]

The Government[which?] launched a booking portal for people to be tested for COVID-19. The governments of Scotland and Northern Ireland governments signed up to use the portal that England were using. The Welsh Government went on to partner with Amazon to create a portal. Later this was scrapped with the Welsh Government citing issues around collecting of data having been resolved with the UK government's portal and now wanted to use it, having only released their version across south east Wales.[297]

In May, the Department of Health and Social Care and Public Health England confirmed that two samples taken from single subjects, such as in the common saliva and nasal swab test, are processed as two separate tests. This, along with other repeated tests such as checking a negative result, led to the daily diagnostic test numbers being over 20% higher than the number of people being tested.[298]

On 18 May testing was extended to anyone over the age of five after the governments of all four nations agreed to the change.[299]

England

Following 300 staff being asked to work from home on 26 February in London, while a person was awaiting a test result for the virus, PHE expanded testing around the UK to include people with flu-like symptoms at 100 GP surgeries and eight hospitals: the Royal Brompton and Harefield, Guy's and St Thomas' and Addenbrookes Hospital, as well as hospitals at Brighton and Sussex, Nottingham, South Manchester, Sheffield, Leicester.[300][301]

Drive-through screening centres were set up by Central London Community Healthcare NHS Trust at Parsons Green Health Centre on 24 February 2020,[302] A further drive-through testing station was set up by the Sheffield Teaching Hospitals NHS Foundation Trust at a site just off the A57 Sheffield Parkway dual-carriageway on 10 March; in this case, patients ringing NHS 111 with coronavirus-like symptoms in the Sheffield area will be told to drive, if possible, to the testing centre at an allotted time.[303]

On 11 March, NHS England announced that testing in NHS laboratories would increase from testing 1,500 to 10,000 per day.[304] The test consists of taking a sample from the nose, throat, deeper lung samples, blood or stool, and transporting the packed samples to the listed PHE regional laboratory designated for the referring laboratory region.[305][306] On 14 May PHE approved an antibody test by Swiss company Roche.[307] Abbott Laboratories said that they also had an antibody test approved by the public health boards of England, Scotland and Wales.[308]

Scotland

On 29 February drive-through testing was set-up by NHS Lothian at the Western General Hospital in Edinburgh.[309] On 1 March 2020 it was reported that surveillance was shortly to be extended to some hospitals and GP surgeries in Scotland.[310]

Scotland were developing their own contact tracing system, with contact tracing being done by telephone rather than an app.[311][312]

Wales

On 21 March, Welsh Government Health Minister Vaughan Gething said that the target was 9,000 tests by the end of April. Public Health Wales Chief Executive Tracey Cooper confirmed on 7 May that Wales was to receive an extra 5,000 COVID-19 test kits per day, before the UK Government stepped in and stopped them. The Swiss pharmaceutical company Roche Diagnostics and the Welsh Government had a gentleman's agreement, verbally and through emails. Dr Cooper blamed Westminster "for gazumping Wales's Covid-19 testing deal" with Roche; this left Wales only able to carry out 800 tests a day. Public Health England said that it had not interfered with any contract but said "The UK Government recently asked us to establish a partnership with Roche to support increased diagnostic testing in the UK for Covid-19."[313][314]

On 21 May 2020 the Welsh Government announced that one of the new antibody blood tests for the SARS-CoV-2 virus is being produced by Ortho Clinical Diagnostics (OCD) at Pencoed, Wales, in partnership with Public Health Wales. The test will be rolled out, prioritised and managed and will also be available in care homes. According to Health Minister Vaughan Gething, this test is an important part of the "Test, Trace, Protect" strategy which will help Wales come out of lockdown.[315]

Mobile phone app

On 4 May, a test version of the NHS's contact tracing app was released.[316][317] The app is being trialled on the Isle of Wight.[316][317]

Matthew Gould, CEO of NHSX, the government department responsible for the app, said the data would be accessible to other organisations for legitimate public health reasons, but could not list which.[318] Faculty, a company linked to Cambridge Analytica and Palantir, also linked to Cambridge Analytica,[319] worked on the app.[320] The data collected would be handled according to the data access regulations and would be held in a centralised repository.[321][319][322] Over 150 of the UK's security and privacy experts warned the app's data could be used by 'a bad actor (state, private sector, or hacker)' to spy on citizens.[323][324] Fears were discussed by the House of Commons' Human Rights Select Committee about plans for the app to record user location data.[316] Parliament's Joint Committee on Human Rights said the app should not be released without proper privacy protections.[325]

The Scottish government said they would not recommend the app until they could be confident it would work and would be secure.[326] The functionality of the app was also questioned as the software's use of Bluetooth required the app to be constantly running, meaning users could not use other apps or lock their device if the app was to function efficiently.[317]

Digital inclusion advocates told the Culture, Media and Sport Committee in May that there was a digital divide with the app, with many people missing out due to not having access to the Internet or having poor IT skills. The advocates said that 64% of the population who had not used the Internet were over the age of 65, and that 63% of the population who did not know how to open an app were under the age of 65.[327] It was reported by the Financial Times that a second app was in development using technology from Apple and Google.[328][329] The digital skills advocacy group FutureDotNow is running a campaign to provide connectivity to excluded households.[330]

Research and innovation

Existing research[331] by the Medical Research Council Centre for Global Infectious Disease Analysis informs understanding of the COVID-19 outbreak and Diamond Light Source allows scientists to design and develop compounds that may lead to clinical drugs to tackle it.[332]

Sociological research

In March 2020, UK Research and Innovation announced[333] the launch of a website to explain the scientific evidence and the facts about the virus, the disease, the epidemic, and its control, in a bid to dispel misinformation. The editorial team come from University of Oxford, European Bioinformatics Institute, London School of Hygiene & Tropical Medicine, Imperial College London, University of Glasgow and King's College London.[citation needed]

Research carried out by the Reuters Institute for the Study of Journalism at the University of Oxford concluded that of 225 examples false or misleading claims about coronavirus 88% of the claims had appeared on social media platforms, with just 9% of the claims on television and 8% in news outlets.[334][335] One such claim regarding 5G mobile phone masts which began on social media, ended up with arson attacks on masts.[336] A YouGov survey for the Institute concluded that 54% of the people polled thought that the government[which?] was doing a good job of responding to the pandemic. A quarter of those surveyed felt that the pandemic had been exaggerated by the media indicating that criticism could be eroding trust.[337][338][339] An earlier Sky News survey also concluded that people surveyed thought that the media were being overly critical of the government.[339][340] The Sky News survey simply asked the public about trust in journalists. Polls by YouGov, the Reuters Institute, Survation, Ipsos MORI and research by Ofcom, concluded that broadcasters and newspapers are widely considered to be the most trusted sources of information on pandemic.[339] According to research from Ofcom, the BBC was the most trusted broadcaster on the pandemic, followed by ITV, Sky, Channel 4 and Channel 5.[341][339] While newspapers The Guardian, Financial Times, The Daily Telegraph and The Times were ranked with trust levels similar to that of the television broadcasters during the pandemic.[339][342] A survey by YouGov for the Reuters Institute concluded that the BBC's output dominated online news coverage in the UK with 36% of the population saying that they had been on the corporation's website to consume news. Around 16% polled acknowledged that they had visited the Guardian's website, with Sky News and MailOnline in joint third place with 9% of those polled saying that they had visited their sites.[342] A few weeks after the start of the pandemic Reuters Insitiute and Ofcom both said that people were actively trying to avoid the news coverage regarding it.[342][339]

A study by a team of researchers from the University of Sheffield and Ulster University concluded that young men were more likely to break lockdown rules than women. The study concluded that those suffering from depression were more likely to break the rules. Around half of the participants said that they felt anxious during the restrictions. The team called on the government[which?] to issue better target messages for young people.[343] According to data from the National Police Chiefs' Council, two thirds of the people who were issued fines for breaking lockdown rules in England and Wales, between 27 March and 27 April, were between the ages of 18 and 34. Approximately eight out of 10 of those who were issued fines were men.[344]

The British Medical Association called on the government[which?] to investigate if and why people from black, Asian and minority ethnic (BAME) groups were more vulnerable to COVID-19, after the first 10 doctors to die were all from the group.[345] Labour Party called for a public enquiry after the first 10 deaths in the health service were from BAME backgrounds.[346] Research by the Intensive Care National Audit and Research Centre concluded that people from BAME backgrounds made up 34% of critical patients.[347] NHS England and Public Health England were appointed to lead an inquiry into why people from black and minority ethnic backgrounds appear to be disproportionately affected by coronavirus.[348] On 18 April Public Health England said that they would start recording the ethnicity of victims of cornavirus.[349] Research carried out by The Guardian newspaper concluded that ethnic minorities in England when compared to white people were dying in disproportionately high numbers. They said that deaths in hospitals up to 19 April 19% were from BAME backgrounds who make up only 15% of the population of England.[350] The Office for National Statistics (ONS) wrote that in England and Wales black men were four times more likely to die from cornavirus than white men, from figures gathered between 2 March to 10 April.[351][352] A Study carried out by University of Oxford and the London School of Hygiene & Tropical Medicine on behalf of NHS England and a separate report by the Institute for Fiscal Studies corroborated the ONS' findings.[353][354][355] An Oxford University led study into the impact of COVID-19 on pregnancy concluded that 55% of pregnant women admitted to hospital with coronavirus from 1 March to 14 April were from a BAME background. The study also concluded that BAME women were four times more likely to be hospitalised than white women.[356][357] The opposition London Mayor Sadiq Khan wrote to the Equality and Human Rights Commission asking them to investigate whether the effects of cornavirus on BAME groups could have been prevented or mitigated.[358] A group of 70 BAME figures sent a letter to Boris Johnson calling for an independent public enquiry into the disproportionate impact of the coronavirus on people from black, Asian and minority ethnic backgrounds.[359]

The ONS study, using data collected to the 17 April 2020 across England and Wales, concluded that men in low skilled jobs were four times more likely to die from the virus than those in professional jobs. Women who worked as carers were twice as likely to die than those who worked in technical or professional jobs. The GMB trade union stated as a result of the findings that ministers must stop any return to work until "proper guidelines, advice and enforcement are in place to keep people safe." It was noted that the figures indicated that deaths were higher in occupations where where physical distancing was more difficult to achieve.[360] The ONS data also showed that there was a difference in morality rate from cornavirus in deprived and urban areas when compared to prosperous and rural locations, across England and Wales.[361][362] Data from the ONS showed that by 13 May, only about 12% of people who had died from the virus in England and Wales were under 65.[363]

The Guardian wrote that across the UK around 8,000 more people had died in their homes since the start of the pandemic, when compared to normal times. Of that total around 80% of the people according to their death certificates, died from non COVID-19 illnesses. The statistics additionally showed a drop in non COVID-19 deaths in hospitals, leading many to think that people who normally would have been admitted were avoiding hospitals.[364] NHS England said that between 10 and 20% of people who were admitted to hospital for other reasons contracted cornavirus during their stay.[365]

Research by the Institute for Fiscal Studies concluded that children from wealthy homes were spending more time studying at home when compared to those from the poorest households.[366]

Biological research

UK Research and Innovation also announced £20 million to develop a COVID-19 vaccine and to test the viability of existing drugs to treat the virus.[367] The COVID-19 Genomics UK Consortium will deliver large-scale, rapid whole genome sequencing of the virus that causes the disease and £260 million to the Coalition for Epidemic Preparedness Innovations to support vaccine development.[368][369] In April, the UK Government launched a task force to help develop and roll out a coronavirus vaccine.[370][371] A University of Edinburgh led study in to whether specific genes cause a predisposition into the effects that COVID-19 had on people began in May. [372][373] The London School of Hygiene & Tropical Medicine, studied whether sniffer dogs could detect coronavirus in humans.[374] Following research by King's College London of symptoms from 1.5 million suspected cases, "loss of taste or smell" was added to the NHS symptoms list.[375]

Design and innovation

In March 2020 the government[which?] asked manufacturers in the UK to help in the production of respiratory devices to help fight COVID-19.[376] Innovate UK announced £20 million funding for innovative businesses.[377] The Formula One teams and manufacturers based in the UK linked up to form "Project Pitlane."[378]

A group of engineers from Mercedes and University College London, along with staff from University College Hospital, designed and made a product known as UCL-Ventura breathing aid, which is a continuous positive airway pressure (CPAP) device. The Medicines and Healthcare products Regulatory Agency (MHRA) approved the second model of the device. The UK Government put an order in for 10,000 devices. Mercedes made the drawings for the device available for free to help other countries fight COVID-19.[379][380] On 16 April the MHRA approved the Penlon Prima ESO2, design which was part of the stream known as VentilatorChallengeUK. The UK government ordered 15,000 of these devices.[381][382] A consortium of aerospace companies including Airbus, Meggitt, and GKN worked on scaling up production of an existing design.[383][384] In April this design was approved by the MHRA and an order for 15,000 units was placed.[385] Other designs by JCB, Dyson and BlueSky were not taken forward.[386] Eight other designs had their support ended by the UK government.[386][387][388][380]

A CPAP device, known as a Covid emergency ventilator, designed by Dr Rhys Thomas, a consultant anaesthetist at Glangwili General Hospital in Carmarthen, was given the go-ahead by the Welsh Government.[389] The machine, designed in a few days was used on a patient in mid-March, and subsequently funded by the Welsh Government. In early April, it was approved by the MHRA. Production is by CR Clarke & Co in Betws, Carmarthenshire.[390][391]

Jaguar Land Rover (JLR) produced a reusable visor with the first deliveries just before Easter, and shared the designs to allow wider manufacture. [392][393] The Royal Mint manufactured medical visors for medical staff working during the pandemic.[394][395]

Response in other sectors

Arts and entertainment

Music

 
The "Wee Annie" statue in Gourock with a face mask, on 22 March

On 13 March, BBC Radio 1 cancelled its Big Weekend music festival, scheduled to take place at the end of May.[396] Other music events to be cancelled included the C2C: Country to Country festival,[397][398] the Glastonbury Festival,[399] the Isle of Wight and Download music festivals,[400] the Cambridge Folk Festival,[401] and the Love Supreme Jazz Festival.[402] The organisers of the Download festival subsequently announced plans to hold a virtual festival to be held on the dates it would have happened, and featuring streamed performances and interviews.[403] Big Weekend organisers decided to run an alternative event called Big Weekend UK 2020. Stars appeared on one of 5 virtual stages and performed from their homes, with the event also featuring past performances from previous Big Weekend events.[404]

Among the artists and bands to postpone or cancel UK gigs or tours were Avril Lavigne and The Who.[398][405] Other, including Chris Martin of Coldplay, and Yungblud responded to the situation by live-streaming gigs through social media.[406] Various musicians announced free gigs for NHS staff.[407] [408]

Visual arts

A number of artists began painting portraits of NHS workers, as a way of organising their work and thanking the for it.[409] An exhibition is planned, once the pandemic subsides.[409]

Theatre and cinema

On 15 March, London's Old Vic became the first West End theatre to cancel a performance when it ended its run of Samuel Beckett's Endgame two weeks early.[410] On 16 March, other theatres in London, as well as elsewhere around the UK, closed following Boris Johnson's advice that people should avoid such venues.[411] On 17 March, cinema chains Odeon, Cineworld, Vue and Picturehouse announced they would be closing all their UK outlets.[412] On 1 April, the 2020 Edinburgh festivals, planned for August, were cancelled.[413]

On 26 March the National Theatre launched National Theatre at Home, a two-month programme whereby a different production from its archives would be streamed for free each week. The project began with Richard Bean's comedy One Man, Two Guvnors, featuring James Corden.[414]

Television and radio

Television programmes to be affected included forthcoming series of Peaky Blinders and Line of Duty, which had their filming schedules delayed.[415] On 13 March, ITV announced that the 2020 series finale of Ant & Dec's Saturday Night Takeaway, scheduled to be broadcast from Walt Disney World in Florida would no longer go ahead after the resort announced its intention to close as a precautionary measure.[416] On 16 March, ITV announced that the filming schedule for its two soaps, Coronation Street and Emmerdale had not been affected by the pandemic,[415] but filming ceased on 23 March.[417] On 18 March ITV announced the semi-final of the ninth series of The Voice UK, scheduled for 28 March, would be postponed until later in the year.[418]

On 16 March, the BBC delayed implementation of its planned changes to TV licences for those aged over 75 from June to August.[419] On 25 March the BBC also announced that it would delay its plans to cut 450 news jobs due to the pressure of covering the pandemic.[420]

On 17 March, the BBC announced major changes to the schedule across the network. While some programmes were suspended, others such as Newsnight and The Andrew Marr Show continued with a smaller number of production staff. Some podcasts were also suspended.[421] On 18 March it was announced that filming of soap operas and regular dramas would be suspended.[422] The BBC also said it would show more educational programmes to cater for children not attending school,[423] and more programmes focused on health, fitness, education, religion and food recipes.[418] On 23 March, ITV ceased the live broadcasting of two programmes.[417]

On radio, some BBC World Service programmes were suspended. Summaries on Radio 2, Radio 3, Radio 4 and 5 Live were merged into a single output, with BBC 6 using the same script. The BBC Asian Network and Newsbeat worked together to maintain production of stories.[421] On 18 March, the BBC announced that its local radio stations in England would broadcast a virtual church service, led initially by the Archbishop of Canterbury, but with plans to expand religious services to cover other faiths.[418] On the same day Radio News Hub, a radio news bulletin provider based in Leeds, announced that it would produce a daily ten-minute programme giving a round-up of information about the pandemic, and that would be made available free of charge to radio stations.[424] On 28 March, BBC Local Radio announced that it had teamed up with manufacturers, retailers and the social isolation charity WaveLength to give away free DAB radios to people over 70.[425]

Charity fundraising

A number of charities reported significant drops in income as a funding hole of £4 billion was identified, as fund-raising events were cancelled.[426][427]

Several individuals and groups began to raise funds for charitable organisations working to support those affected by the pandemic. 99-year-old Tom Mooreraised over £28.2 million,[428] the largest-ever amount raised by a JustGiving campaign.[429][430]

The London Marathon, the world's biggest annual one-day fundraising event, was postponed from its April slot until October 2020.[426] In 2019 £66.4m was raised for charities on the day of the Marathon.[426] To compensate for the loss of income the Mass Participation Sports Organisers group organised The 2.6 Challenge.[426][431]

On 18 April, several UK artists participated in Together at Home, a live music event in which artists performed in their own homes, in aid of the World Health Organization's COVID-19 Solidarity Response Fund.[432] A version was broadcast on BBC One on 19 April.[433]

Children in Need and Comic Relief announced their first joint initiative, The Big Night In, a telethon broadcast on 23 April.[434] The event raised £27.4 million in just three hours. The UK Government promised to match the total.[435]

Northern Ireland's Chief Charity Commissioner said that the public had been "very altruistic" in its support for Covid-response causes, such as the Big Night In, The 2.6 Challenge and Captain Tom Moore, and encouraged the public to consider all of the charities in existence.[436]

The UK government announced a £750 million package of support for charities across the UK. £370 million of the money was set aside to support small, local charities working with vulnerable people. £60 million of £370 was allocated to Scotland, Wales and Northern Ireland in the following breakdown

  • £30 million for Scotland
  • £20 million for Wales
  • £10 million for Northern Ireland.[437][438]

On 27 April Christian Aid advised that its annual fundraising week would go ahead through 10–16 May but without door-to-door envelope delivery and collection and the holding of associated face-to-face fundraising events in favour of encouraging online donations.[439]

Construction and property

Many construction sites initially remained operational following the introduction of social distancing rules. Following government advice, housebuilders including Barratt and Taylor Wimpey, and contractors including Mace paused work on 24 March.[440] Confusion about what constituted essential work, along with contractors' enforcement of subcontractors' contractual obligations, meant some projects remained operational, and many site workers experienced highly variable application of social distancing precautions[441] (some projects were temporarily halted after workers breached social distancing rules).[442] In Scotland, work was ordered to be suspended on all non-essential construction projects from 6 April.[443] Major contractors including Mace, McAlpine, Laing O'Rourke, Wates and Morgan Sindall each put 100s of workers on furlough.[444] By 8 April, work at 80% of UK housebuilding sites had stopped;[445] Barratt put 5,000 of its 6,000 workers on furlough.[446]

By 17 April, work had halted on 2,434 UK sites (according to a Glenigan survey of projects with a construction value of more than £250,000); approximately £58bn or 35% of total UK construction value had been paused. Around 44% of private housing and 32% of social housing schemes were suspended. In Scotland and Northern Ireland, where stricter lockdowns were enforced, 79% and 78% of schemes were suspended respectively.[447] Glenigan later updated its estimate to say 43% of sites stopped work during the first six weeks of the COVID-19 crisis, with 3,636 sites closed, including 466 in Scotland; Barbour ABI said 4,500 projects, with a total value of £70.7bn, had been delayed.[448] In May, the Construction Products Association (CPA) estimated housebuilding activity had slumped 85% during the lockdown.[449]

Reduced construction activity affected materials suppliers: Kingspan reported its UK business had been halved, with global revenues down a third;[450] Marshalls plc reported a 27% drop in sales and contemplated 400 staff redundancies;[451] and on 21 May builders' merchants reported Q1 sales down by 6.7%[452] amid continued shortages of building materials.[453]

In early May: data firm Builders' Conference said construction tender opportunities fell from a monthly average of 664 projects in the 12 months to March 2020 to 220 in April 2020, with 217 available until July;[454] the IHS Markit/CIPS UK Construction Total Activity Index reported the steepest decline in UK construction output since the survey began in 1997;[455] 115 contracts were awarded in April 2020 compared to 180 in April 2019, while the total value plunged from £2.82bn to £1.25bn, with clients wary of signing off large contracts;[456] and an Irwin Mitchell/Centre for Economics & Business Research report said construction, losing around £300m a day, was one of the three most badly affected economic sectors.[457] The most optimistic of three scenarios in a late May CPA forecast predicted UK construction output would fall 25% in 2020 before rebounding in 2021 (but still finish 6% lower than 2019) due to the COVID-19 pandemic.[458]

An analysis by estate agent Knight Frank forecast a 38% drop in house sales, equivalent to over half a million transactions, due to the effects of the coronavirus lockdown, reducing government revenues through a £4.4bn fall in stamp duty and a £1.6bn cut in VAT revenue.[459]

Some contractors, including Mace[460] and McAlpine, later reopened some sites in April,[461] and housebuilders including Barratt,[462] Taylor Wimpey,[463] Vistry,[464] Persimmon,[465] Redrow[466] and Bellway[467] planned to deploy safe working procedures and reopen sites in late April and early May. While some larger sites—for example, the £9bn Battersea Power Station redevelopment which had 4,000 workers prior to the lock-down—remained closed,[468] almost 70% of sites in England and Wales operated by 36 Build UK major contractor members were working in late April,[469] rising to 86% on 20 May.[470] Trade union Unite called for the Health and Safety Executive to increase visits to police social distancing on sites.[471] Construction workers became eligible for targeted COVID-19 testing on 28 April.[472] On 10 May, Boris Johnson said construction workers should be "actively encouraged" to return to sites in England and Wales, but the Scottish Government said non-essential construction sites should remain closed.[473] The following day, ONS data showed male construction workers were among those in low-skilled jobs most likely to die after contracting COVID-19.[474] On 20 May 19% of projects in Scotland were running;[470] on 21 May, Scotland first minister Nicola Sturgeon announced a gradual lifting of the lockdown in Scotland, with contractors cleared to start site preparations for a phased return to work from 28 May.[475]

Defence

The coronavirus pandemic affected British military deployments at home and abroad. Training exercises, including those in Canada and Kenya, had to be cancelled to free up personnel for the COVID Support Force.[476] The British training mission in Iraq, part of Operation Shader, had to be down-scaled.[477] An air base supporting this military operation also confirmed nine cases of coronavirus.[478] The British Army paused face-to-face recruitment and basic training operations, instead conducting them virtually.[479] Training locations, such as Royal Military Academy Sandhurst and HMS Raleigh, had to adapt their passing out parades. Cadets involved were made to stand 2 metres (6 ft 7 in) apart in combat dress and there were no spectators in the grandstands.[480][481] Ceremonial duties [482][483] and displays were stopped.[484][485] The British Army deployed two experts to NATO to help counter disinformation around the pandemic.[486] The Government's defence and security review, named the Integrated Review, was delayed.[487]

In March 2020, following requests for military aid to the civil authorities, the Ministry of Defence announced the formation of the COVID Support Force under the Standing Joint Commander (UK), Lieutenant General Tyrone Urch at Aldershot to support public services and civil authorities in tackling the pandemic. Unlike the police and some other civil agencies, members of the armed forces (during peacetime) have no powers over and above those of ordinary citizens.[488][489] The support force initially consisted of 20,000 personnel but later grew to amount to 23,000.[490] Two military operations; Operation Rescript, based in the UK, and Operation Broadshare, focused on overseas defence activities, were launched.[491] Chief of the Defence Staff Nick Carter ordered the military to prepare for a "six month" operation and to be on an "operational footing" by mid-April.[492] The COVID Support Force was initially tasked with driving oxygen tankers for the NHS, as well as delivering medical supplies, including PPE, to hospitals.[488][493] Prior to the announcement of the COVID Support Force, the armed forces had assisted the British government in repatriating British citizens from affected areas, including China and Japan.[494] The Royal Air Force also repatriated British and EU citizens from Cuba.[495] The armed forces additionally assisted in the transportation of coronavirus patients around the UK, including Shetland and the Isles of Scilly.[496][497] On 23 March 2020, Joint Helicopter Command began assisting the coronavirus relief effort by transporting people and supplies. Helicopters were based at RAF Leeming to cover Northern England and Scotland, whilst helicopters based at RAF Benson, RAF Odiham and RNAS Yeovilton supported the Midlands and Southern England.[498]

The armed forces helped to build temporary hospitals, testing centres and mortuaries, and supported ambulance services across the country.[499][500][501] The COVID Support Force had responded to 76 requests for assistance from government ministries with 2,680 personnel deployed from a total of 23,000 on standby. 2,300 vehicles were also in use as temporary ambulances and to transport personnel and supplies in 34 locations across the country.[502] On 16 April 2020, it was reported that 9.1% of the defence workforce, representing 13,000 personnel, were off work due to coronavirus, whilst under 100 personnel had tested positive.[503] Carter described the military's assistance to the NHS as the "single greatest logistic challenge" he had come across.[504]

On 26 April 2020, forces were reported as testing critical workers and people at risk, in areas with "significant" demand.[505] Following the Government's announcement of a target of 100,000 coronavirus tests to be carried out per day, the armed forces helped deploy and operate mobile testing units.[506]

Education

Kirsty Williams, Minister for Education in Welsh Government confirming her decision not to re-open schools in Wales in June 2020

Following cases in Italy, the Cransley School in Northwich, Cheshire, and Trinity Catholic College in Middlesbrough closed, as some of their pupils had returned with symptoms from Italy. Fourteen schools in England had closed by 28 February.[507] Loughborough University reported a student confirmed to have the virus after recent travel to Italy, and indicated that several staff members and students began self-isolation.[508]

Cambridge University closed all buildings from 20 March,[509] which was criticised by the local UCU as students from countries with weaker healthcare provisions would be forced to return home.[509] More than a thousand Cambridge students signed an open letter requesting alternatives to cancelled examinations in Cambridge, including the option to retake the year in 2020–21.[510]

Coventry University first suspended all graduation ceremonies due to be held in March and April,[511] and from 20 March, suspended all face-to-face teaching, in favour of on-line delivery.[512] Many other higher education institutions took similar steps at around the same time.[513]

All UK schools closed by 20 March 2020 for an indefinite period of time,[514][515][516][517] except for children of key workers and vulnerable children.[518] GCSE and A Level exams were cancelled, an unprecedented action in UK educational history, with results awarded using predicted grades and teacher assessment.[518][519][520] On 16 April the Department for Education said these grades would be published on their original intended dates, 13 August for A Levels and 20 August for GCSEs.[521] In Scotland it was announced that exams would not take place and coursework would not be marked for National 5, Higher and Advanced Higher courses with teachers estimating grades.[522][523]

On 7 May Welsh Government Minister Kirsty Williams MS, announced that schools in Wales would not reopen on 1 June.[524]

Events

On 23 March, Pride in London, the UK's largest LGBT Pride festival, scheduled for 27 June, was postponed. It was one of more than a hundred pride events to be postponed or cancelled in the UK.[525] On 3 April, Brighton Pride, scheduled for Saturday 1 August, was cancelled.[526]

On 6 April the Orange Lodge of Ireland announced that the traditional Twelfth of July parades in Northern Ireland had been cancelled.[527]

The national VE Day 75th anniversary events planned for 8 to 10 May were cancelled.[528]

Food retail

 
The almost empty pasta section in a London supermarket, 7 March 2020

In early March, The Guardian reported that British supermarkets and their suppliers had developed plans to ensure adequate food supplies in light of panic buying.[529] There were reports of hand sanitiser and anti-bacterial products selling out at some supermarkets.[530] Online retailers reported consumers placing unusually large orders while the managing director of the frozen food chain Iceland reported increased sales of "multibuy deals and larger packs".[529]

 
People in London buying more canned foods and toilet paper, 18 March 2020
 
Contents of a food box supplied by supermarket Morrisons in response to the pandemic and described as sufficient to feed two adults for one week.[531]

Some supermarkets and other shops responded by limiting the quantity of popular items that each customer could buy, while others had a limit across their entire range.[532][533] Sainsbury's introduce a dedicated shopping hour for elderly and disabled customers, as well as giving them priority for online deliveries.[534] Other supermarkets such as Iceland and Morrisons also introduced measures,[535] with Morrisons introducing a range of basic food boxes, to feed two adults for one week.[536][531] Sainsbury's further announced on 21 March that they would give healthcare workers allocated shopping hours on three mornings a week.[537]

Amazon stopped sellers from sending non-essential products to their warehouses.[538] Selfridges closed all its stores and sold only online.[538]

In response to panic buying, Professor Stephen Powis, medical director at NHS England, said on 21 March that NHS staff were being deprived of food supplies because of the activities of some consumers, and urged people to shop responsibly. Helen Dickinson, head of the British Retail Consortium said that sufficient food was available. She added that an extra £1bn had been spent on food in the preceding three weeks.[539] Environment Secretary George Eustice also urged shoppers to stop panic buying.[540] On the same day several supermarkets began to recruit additional staff.[541]

On 21 March, the government announced that the 5p charge for carrier bags would be waived for online deliveries.[542]

Sainsbury's removed purchasing limits on most items from 5 April.[543] On 8 April Tesco said it could not meet the increased demand for online shopping despite expanding its home delivery service, and 85-90% of food would need to be bought in store.[544]

Finance and the economy

The governor of the Bank of England called on the British government to provide support to businesses affected by the virus[545] and was reported to be working with the Treasury to provide an economic stimulus package to prevent the British economy falling into recession.[546] Companies listed on the London stock markets have fallen in value, with commentators citing worries about the virus.[547] To stimulate the economy, the Bank of England cut its bank rate of interest from 0.75% to 0.25%.[548] On 19 March, the interest rate was again cut, this time to 0.10%—the lowest rate in the bank's 325-year existence.[549] On 28 March, Fitch Ratings downgraded the UK's government debt rating from AA to AA-, because of coronavirus borrowing, economic decline, and lingering uncertainty over Brexit. The ratings agency believed the UK's government deficit for 2020 might equal 9% of gross domestic product (GDP), compared to 2% the previous year.[550] The government extended its overdraft with the Bank of England.[551] The Bank of England forecasted, on 7 May, that this would turn into the UK's worst recession since the "Great Frost" over 300 years ago.[552] The Bank also predicted that the economy would recover in 2021.[553]

During the second half of March, 1 million British workers applied for the Universal Credit benefit scheme.[554][555] The unemployment could rise to 3.4 million and the GDP could fall by 35%, according to the Office for Budget Responsibility.[556] In April people claiming unemployment benefit rose to 2.1 million, a jump of 856,500 claims according to the Office for National Statistics (ONS). In addition the employment rate fell to 3.9% for the first quarter of the year; this period included the first week of lockdown according to ONS figure.[557]

On 20 March the government announced the Coronavirus Job Retention Scheme to enable companies to furlough workers and avoid mass unemplyment.[558]

In March the Self Employed Income Support Scheme (SEISS) was announced.[559] The scheme paid a grant worth 80% of self employed profits profits up to £2,500 each month, on companies who's trading profit was less than £50,000 in the 2018-19 financial year or an average less than £50,000 over the last three financial tax years for those who suffered a loss of income. Her Majesty's Revenue & Customs (HMRC) were tasked with contacting those who were eligible and the grant was taxable. The government also had announced a six month delay on tax payments. Self employed workers who pay themselves a salary and dividends are not covered by the scheme and instead had to apply for the job retention scheme.[560] The scheme went live on 13 May.[561] The scheme went live ahead of schedule and people were invited to claim on a specific date between 13 and 18 May based on their Unique Tax Reference number. Claimants would receive their money by 25 May or within six days of a completed claim.[562] By 15 May, more than 1 million self employed people had applied to the scheme.[563]

The government announced Retail, Hospitality and Leisure Grant Fund (RHLGF) and changes to the Small Business Grant Fund (SBGF) on 17 March. The SBGF was changed from £3,000 to £10,000, while the RHLGF offered grants of up to £25,000.[564][565][566] £12.33 billion in funding was committed to the SBGF and the RHLGF schemes with another £617 million added at the start of May.[567] RHLGF and SBGF only applied to business in England.[568] By 25 April only around 50% of eligible business had received funding.[569] The government pledge £3.5 billion in funding for Northern Ireland, Scotland and Wales to support to businesses.[564] At the start of May the NI Executive announced a £40m scheme for small businesses had not been eligible for other schemes of support.[570]

On 23 March the Government announced the Coronavirus Business Interruption Loan Scheme (CBILS) for small and medium-sized businesses and Covid Corporate Financing Facility for large companies.[571] The government banned banks from seeking personal guarantees on Coronavirus Business Interruption loans under £250,000 following complaints.[572][573] Coronavirus Large Business Interruption Loan Scheme (CLBILS) was announced on 3 April and later tweaked to include more companies.[573][574] In May the amount a company could borrow on the scheme was raised from £50 million to £200 million. Restrictions were put in place on companies on the scheme including dividends payout and bonuses to members of the board.[575] On 20 April the Government announced a scheme worth £1.25 billion to support innovative new companies that could not claim for coronavirus rescue schemes.[576] The government additionally announced the Bounce Back Loan Scheme (BBLS) for small and medium size businesses. The scheme offered loans of up to £50,000 and was interest free for the first year before an interest rate of 2.5% a year was applied, with the loan being paid back within six years. Businesses who had an existing CBILS loan of up to £50,000 could transfer on to this scheme, but had to do so by 4 November 2020. The scheme launched on 4 May.[577][578] The loan was 100% guaranteed by the government and was designed to be simpler than the CBILS scheme.[579] More than 130,000 BBLS applications were received by banks on the first day of operation with more than 69,500 being approved.[580][579] On 13 May the Government announced that it was under writing Trade credit insurance, to prevent businesses struggling in the pandemic from having no insurance cover.[581][582] On 12 May almost £15 billion of state aid had been given to businesses.[583] The Treasury and the Bank of England on 17 March announced the Covid Corporate Financing Facility (CCFF).[584][585]

The Resolution Foundation surveyed 6,000 workers, and concluded that 30% of those in the lowest income bracket had been affected by the pandemic compared with 10% of those in the top fifth of earners.[586] The foundation said that about a quarter of 18 to 24-year-olds included in the research had been furloughed whilst another 9% had lost their job altogether. They also said that 35 to 44 year olds were least likely to be furloughed or lose their jobs with only around 15% of the surveyed population having experienced these outcomes.[587] Earlier research by the Institute for Fiscal Studies concluded that young people (those under 25) and women were more likely to be working in a shutdown business sector.[588]

The Guardian reported that after the government had suspended the standard tender process so contracts could to be issued "with extreme urgency", over a billion pounds of state contracts had been awarded under the new fast-track rules. These included a contract to Edenred to replace free school meals[589] and Randox Laboratories for testing kits.[590]

Hospitality

 
People queuing to buy takeaway beer in London on 1 May 2020.

On 16 March, Boris Johnson appealed for people to avoid social places including pubs, clubs and restaurants,[64] then, on 20 March, requested their closure from that evening.[591] Initially, the pub chain J D Wetherspoon remained open, seeking to promote social distancing, including spacing out tables more and encouraging use of its mobile app to order food and drink.[592] From 20 March, all Wetherspoon pubs did close in line with government instructions.[593] On 25 March, off-licences were added to the list of essential businesses allowed to stay open, also enabling pubs and brewery taprooms with licences to sell beer for home consumption to offer takeaway sales and home deliveries.[594]

Fast food and drink outlets Pret a Manger and McDonald's[595] (among others) at first announced that they would not permit customers to sit and eat on the premises, but customers could still order products to take away and consume off the premises. On 22 March McDonald's announced it would close all outlets in the UK and Ireland by 7pm on 23 March.[596] Nando's announced later the same day they would also close their outlets.[596] Some chains' reopened selected takeaway and drive-through outlets as lockdown measures eased in late May.[597]

Hotels were badly affected, with Keith Barr, chief executive of InterContinental Hotels Group (IHG) warning the industry faced its “most significant challenge” ever. IHG cccupancy levels fell to historic lows in the first quarter with revenue per available room down 55% in March 2020 compared with 2019, and expected to drop to 80% in April.[598] Some hotels were used to provide NHS patient accommodation and free up space for COVID-19 cases,[599] to provide accommodation for NHS and other key workers,[600] and to house homeless people.[601]

On 18 May, Casual Dining Group, owner of about 250 Bella Italia, Café Rouge and Las Iguanas restaurants, said it was preparing to call in administrators, potentially putting 6,000 jobs at risk.[602] On 22 May, it was estimated over 30,000 UK pubs and restaurants might remain permanently closed after the lockdown.[603]

Law and order

A poll published on 20 March concluded that 23% of British adults were strictly following the government's[which?] coronavirus advice.[604] In March police forces in each nation of the UK were given powers to arrest and fine citizens who broke lockdown rules.[605][606][607][608][609] The National Police Chiefs' Council said police had issued their first fines for people breaking lockdown rules on 27 March. The fixed penalty notices were £60 but would be reduced to £30 if paid within 14 days.[610] By 31 March, some police forces and individual officers, were being criticised by a variety of people including,[611] former Supreme Court judge Lord Sumption,[612][613] former Justice secretary David Gauke,[611] former Chancellor George Osborne and privacy and civil liberties group Big Brother Watch for over-zealous and incorrect application of the new powers.[611][614] Police had put black dye into Harpur Hill Quarry and using a drone, filmed people before posting the images on social media.[614] New guidance to "Engage, Explain, Encourage and Enforce"[615] was released by the National Police Chiefs Council.[612][616]

 
A group of people in London, 8 April 2020

According to data from the National Police Chiefs' Council, around 9,000 people were issued fines for breaking lockdown rules in England and Wales, between 27 March and 27 April.[344] National Police Chiefs’ Council figures from 27 March to 11 May (the date when fines in England increased[230]) showed that more than 14,000 fines were issued for breaking lockdown rules in England and Wales. There were 862 repeat offenders in the figures with one person fined 9 times. The Easter weekend (11 and 12 April) had the highest amount of fines issued within the period. The Crown Prosecution Service stated 56 people were wrongly charged, mainly due to Welsh regulations being applied in England and vice versa.[617][618][619] In the first two weeks of the coranavirus police powers being introduced more than 500 fixed penalty notices were issued in Scotland.[620] Police Scotland figures from 6 April to 6 May showed that there had been 21,487 breaches of lockdown rules. The figures highlighted that people were attracted to rural beauty spots with two areas Loch Lomond and Stirling in the top 5 areas of Scotland for breaches.[621]

There have been reports of hate incidents against Italian and Chinese persons and a Singaporean student was assaulted in London in an attack that police linked to coronavirus fears.[622][623] In addition there have been reports of young people deliberately coughing and spitting in the faces of people, including an incident involving health workers.[624][625][626][627][628]

On 9 May, Police broke up an anti-lockdown protest took place in London consisting of around 40 people. It was thought to be the first such protest in the UK following protests in other nations.[629] It was reported that around 60 protests had been planed on the weekend of the 16 May, with police saying that they were preparing to break them up.[630] Protests took place in Belfast, Glasgow, London and Southampton, with several protesters arrested and fined at the London demonstration.[631]

Following a conspiracy theory regarding 5G mobile phone masts, 77 mobile phone masts were attacked across the country,[632] including the one serving NHS Nightingale hospital in Birmingham. Philip Jansen, the chief executive of BT, said that 39 engineers had been physically or verbally assaulted by members of the public, with some also receiving death threats.[633] Trade union, Communication Workers Union stated that they had received 120 reports of workers being abused.[634]

Fraud

Following the commencement of the job retention scheme, there had been over 800 reports of fraudulent claims by mid-May. Employers were accused of claiming whilst still having employees attend work.[635] During the contact tracing app trial on the Isle of Wight the Chartered Trading Standards Institute found evidence of a phishing scam. In the scam recipients would receive a text stating that they had been in contact with someone with COVID-19 and were directed to a website to input their personal details.[636] The National Cyber Security Centre had taken down over 2,000 examples of fraud during March and April.[637] Local councils found fake goods being sold including testing kits, face masks and hand sanitiser. There had also been reports of scams involving the replacement school meals scheme and incidents of people posing as government officials and council workers depending on their target along with fake IT workers.[638] Benefit officials said that up to £1.5 billion could have been lost due to fraudulent benefit claims.[639]

Courts and prisons

On 17 March, trials lasting longer than three days were postponed until May in England and Wales, while Scottish courts were not starting any new trial indefinitely. In England and Wales those cases already running would continue in the hope of reaching a conclusion.[640][641]

The government[which?] released specific guidance to prisons in the event of coronavirus symptoms or cases, specifically the rule that "any prisoner or detainee with a new, continuous cough or a high temperature should be placed in protective isolation for 7 days".[642] There are around 83,000 prisoners in England and Wales.[643] On 24 March, the Ministry of Justice announced that prison visits would be suspended and that inmates would be confined to their cells.[644] In order to maintain communication between prisoners and their families, the government[which?] promised 900 secure phones to 55 prisons, with calls being monitored and time-limited.[645] In a committee meeting on the same day, Justice Secretary Robert Buckland suggested that 50 pregnant inmates might be given early release, and another 9,000 inmates awaiting trial could be transferred to bail hostels.[646] On 14 April, the Ministry of Justice ordered 500 modular buildings, reportedly adapted from shipping containers, to provide additional single prison cell accommodation at seven jails: HMPs North Sea Camp, Littlehey, Hollesley Bay, Highpoint[disambiguation needed], Moorland, Lindholme and Humber.[647] Following a COVID-19 case in HMP Manchester, public services think tank Reform called for the release of 2,305 "low-risk" offenders on short sentences to reduce the risk of coronavirus on the prison population.[648][649] Similar actions have been taken in Iran and the United States.[650] Former justice secretary David Gauke echoed similar sentiments, citing the "churn" of prisoners going in and out of prison as a risk.[651] Up to 4,000 prisoners in England and Wales are to be released.[652] Amnesty International's Europe Deputy Director of Research said that authorities in UK should consider releasing those who are more vulnerable to COVID-19.[653]

On 18 March, the first coronavirus case was reported within the UK prison population. The prisoner, who had been serving time in HMP Manchester (commonly referred to as Strangeways), was moved to a hospital. While no other prisoners or staff tested positive for the virus, thirteen prisoners and four members of staff were put into isolation as a precaution.[654] On 26 March, it was reported that an 84-year-old sex offender had died from COVID-19 on 22 March at HMP Littlehey in Cambridgeshire, becoming the first inmate in the UK to die from the virus.[643] On 28 April, Public Health England had identified around 2,000 "possible/probable" and confirmed COVID-19 cases; outbreaks had occurred in 75 different institutions, with 35 inmates treated in hospital and 15 deaths.[655] In mid-May the Scottish Prison Service said that six inmates who had died were suspected to have had COVID-19.[656]

Immigration centres

During mid-March, 300 people were released from immigration detention centres because of the pandemic following a campaign by charities concerned with an outbreak of COVID-19 in the centres.[657] On 25 March, it was reported that three immigration detention centres had reported cases of people with coronavirus.[658] On 2 April, a letter leaked from G4S, a company running immigration detention centres for the Home Office, said detainees who were at high risk from COVID-19 were being put in solitary confinement.[659]

Religion

 
Statement at Scottish Episcopal Church in Gourock: no public services until further notice.

The Church of England and other Anglican churches in the British Isles suspended in-person worship during the COVID-19 pandemic.[660][661][662] The Archbishop of Canterbury led a virtual service that was broadcast on 39 local BBC stations.[663] The Catholic Church, Methodist Church in Great Britain and the Society of Friends also put a temporary moratorium on public worship.[664][665]

The chief rabbi in the United Kingdom advised the suspension of Jewish worship in synagogues and the Muslim Council of Britain has ordered the closure of mosques in the country.[664]

Royal family

On 4 March, the 93-year-old Queen Elizabeth II wore long gloves while awarding honours at a public investiture ceremony, seen as a precaution against COVID-19.[666][667] On 19 March the Queen left London for Windsor Castle.[668] On the same day she issued a message to the nation noting that the country and the world were entering a period of great concern and uncertainty.[669] On 5 April 2020 the Queen gave a televised address watched by 23.97 million people.[670][671][672] The Queen additionally recorded an audio message for Easter Saturday, in which she spoke of hope and said "coronavirus will not overcome us".[673][674][675] The annual gun salute and Trooping the Colour to mark the Queen's birthday were cancelled for the first time.[676][677]

In March, Prince Charles greeted people with a namaste gesture instead of a handshake at the Commonwealth Service at Westminster Abbey and the Prince's Trust Awards.[678] On 10 March, Charles met Albert II, Prince of Monaco, who later was diagnosed with the infection.[679] On 25 March, Charles tested positive and self-isolated at Birkhall on the Balmoral Castle estate.[680][681] Concerns were raised for the health of the entire royal family, as well as concerns that he may have unwittingly become a super-spreader of the disease due to the vast number of people he regularly meets. Charles last saw the Queen on 12 March, one day before the earliest date medical experts believed he would have been contagious.[679] The Duchess of Cornwall tested negative, but self-isolated.[680][681] On 30 March Clarence House, the Prince's official residence, confirmed that he had come out of self-isolation after seven days having recovered from the illness.[682][683] The Prince released a video message on 1 April in support of Age UK.[684] Charles remotely opened the Nightingale hospital at the ExCeL on 3 April, which was the first time any member of the royal family had opened something remotely.[685] On 6 April, the Duchess came out of self-isolation after showing no symptoms for 14 days.[686]

Princes William and Harry both sent messages out via social media in response to the pandemic on 19 March.[687] The Duke and Duchess of Cambridge supported a PHE campaign to protect people's mental health.[688] William remotely opened the Nightingale Hospital at the National Exhibition Centre on 16 April.[689] Prince William allowed land at Kensington Palace to be used for refuelling air ambulances.[690] The Duchess of Cambridge launched a new initiative with the National Portrait Gallery called "Hold Still", to highlight heroes and helpers and acts of kindness.[691][692] The Royal Foundation launched a mental health initiative called "Our Frontline".[693] Prince Philip issued a rare statement on 20 April, in which he thanked key workers.[694][695][696]

Further royal events in May and June were postponed or cancelled including Princess Beatrice's wedding.[697] .[698][699] [700]

Sport

The men's and women's Six Nations Championship tournaments were suspended.[701]

The Premier League suspended pre-match handshakes on 6 March.[702] On 10 March, the Premier League match between Manchester City and Arsenal was postponed in light of confirmation that Nottingham Forest and Olympiacos owner Evangelos Marinakis had contracted the virus. Marinakis had met with several Arsenal players when the London side hosted Olympiacos in a Europa League round of 32 match.[703] On 10 March the four-day National Hunt horse racing Cheltenham Festival took place with more than 250,000 people attending the four-day festival albeit with enhanced hygiene measures in place,[704][705] as did the All England Open Badminton Championships in Birmingham the next day.[706]

In mid-March, Arsenal manager Mikel Arteta[707] and Chelsea's Callum Hudson-Odoi tested positive for coronavirus.[708] Professional football was later suspended across the United Kingdom on 13 March, with the Premier League, English Football League, Women's Super League, and Welsh and Northern Irish football leagues delaying matches until the beginning of April[709] and the Scottish Professional Football League suspending matches indefinitely.[710] Professional football in England was later postponed until the end of April.[711] The day also saw the cancellation of the Wales–Scotland Six Nations match scheduled for 14 March[712] and the postponement of the London, Manchester and Brighton Marathons.[713]

The next week saw a flurry of further sporting cancellations in football[714], rugby[715], and netball.[716] Monday additionally saw the cancellation of the Grand National,[717] the postponement of the Edinburgh Marathon from May to September,[718] and the first peacetime cancellation of the Boat Race.[719] On Tuesday 17 March all motor racing events sanctioned by the national governing body Motorsport UK were suspended until May.[720] All horse racing [717] and boxing events were postponed.[721]

Transport

 
An empty M4 motorway in Cardiff on the afternoon of Saturday, 28 March 2020

Following the late March introduction of lockdown restrictions, UK road traffic volumes dropped to levels last experienced in the 1950s, with corresponding falls in air and noise pollution.[722][723] In May, as lockdown road traffic levels slowly grew, but remained around 35% to 45% of usual levels, the AA said volumes were similar to those of the early 1970s.[724]

In April 2020 petrol prices fell below £1/litre at some outlets. When Morrison's supermarket chain became the first national retailer of petrol in the UK to sell petrol at under £1 a litre, it was the first time since February 2016.[725]

Aviation

From the latter half of January, Heathrow Airport received additional clinical support and tightened surveillance of the three direct flights it receives from Wuhan every week; each were to be met by a Port Health team.[41] Later, airlines including British Airways and Ryanair announced a number of flight cancellations for March.[726]

Regional airline Flybe, already struggling financially, entered administration and ceased operations the following day.[727] Having already put some 23,000 workers on furlough, on 28 April British Airways' parent IAG announced a restructuring and redundancy programme that could result in 12,000 BA job redundancies.[728] EasyJet laid off 4,000 UK-based cabin crew for two months.[728] On 5 May, Virgin Atlantic announced it was cutting 3,000 jobs and quitting Gatwick Airport.[729]

On 25 March, London City Airport temporarily closed.[730] Heathrow Airport closed one runway from 6 April, while Gatwick Airport closed one terminal and reduced runway hours.[731] Most other UK airports also significantly scaled back operations[732] and put airport expansion plans on hold.[733]

In May, a 14-day mandatory quarantine period for anyone arriving from outside the UK or Ireland was announced, [734] which was criticised by Airlines UK.[735] This excluded those travelling from the Channel Islands, Isle of Man, Ireland and selected occupations. If a person arrived and did not have a place to isolate then they would be asked to go into Government accommodation, which they would have to pay for. Each nation could decide how they would enforce the new rules.[736]

Public transport

 
"Stay at home" and "Please keep your distance" notices on the London Underground, 27 March 2020

On 20 March the government[which?] announced emergency measures to safeguard the nation's rail network, with season ticket holders given refunds if working from home, and rail franchise agreements nationalised for at least six months to prevent train operating companies from collapsing.[737][738] From 30 March, open-access operator Hull Trains suspended all services,[739] with Gatwick Express and Grand Central following shortly afterwards.[740][741] Other operators reduced their timetables.

On 19 March, the Stagecoach Supertram light rail network in Sheffield announced that they would be switching to a modified Sunday service from 23 March until further notice.[742] Local bus operators First South Yorkshire and Stagecoach Yorkshire, which operate across the same area, announced that they would also be switching to a reduced timetable from 23 March.[743] National Express suspended all its long-distance coach services from 6 April.[744]

 
London bus with COVID-19 central door entry

Transport for London (TfL) services were reduced in stages. All Night Overground and Night Tube services, as well as all services on the Waterloo & City line, were suspended from 20 March, and 40 tube stations were closed on the same day.[745] The Mayor of London and TfL urged people to use public transport only if absolutely essential, so it could be used by critical workers.[746]

In April, TfL directed passengers to board buses by the middle or rear doors and not "touch in" to reduce the risks to their drivers, after the deaths of 14 TfL workers including nine drivers.[747][748]

Due to a huge decline in fares income, on 7 May TfL requested £2 billion in state aid to keep services running until September 2020.[749] on 12 May, TfL documents warned it expected to lose £4bn due to the pandemic and said it needed £3.2bn to balance a proposed emergency budget for 2021, having lost 90% of its overall income. Without an agreement with the government[which?], TfL risked insolvency.[750][751] On 14 May, the UK Government agreed £1.6bn in emergency funding for TfL.[752]

In April, Govia Thameslink Railway re-branded three trains with special liveries to show its support for the NHS and the 200,000 essential workers commuting on GTR's network every week.[753]

On 8 May, Transport Secretary Grant Shapps said that even with all public transport services running as normal across the country, when the two metre social distancing rules were applied, the network would be a running at 10% of normal capacity.[754][755] Shapps also said that there had been an increase in walking and cycling, with people on bikes up by 70% in some areas. The Department for Transport announced plans for improving cycle networks, and said that when lockdown ends, more people would need to walk or cycle to work to ease congestion across transport networks.[756][757][758]

Spread to other countries and territories

Sophie Grégoire Trudeau, the wife of Canadian Prime Minister Justin Trudeau, tested positive for COVID-19 upon her return from WE Day events in the UK; on 12 March 2020 the Trudeau family entered two weeks of self-isolation.[759] The first patient in Mauritius was a 59-year-old man who returned from the United Kingdom on 7 March 2020. When he arrived in Mauritius, the Mauritian had no symptoms.[760] Other cases of the novel coronavirus resulting from travel to the UK were subsequently reported in India,[761][762] and Nigeria.[763]

Statistics

The official daily report from the Department of Health and Social Care (DHSC) counts those who died after testing positive for coronavirus. It "could be the major cause, a contributory factor or simply present when they are dying of something else".[764] From 29 April, the official figures include all coronavirus-positive deaths in the UK, wherever they happened.[765] Before then, the official daily toll included only hospital deaths in England, but included all coronavirus-positive deaths in the rest of the UK wherever they happened, if known to public health agencies.[766][767] There may be a delay between a death and it entering official statistics so families can be informed; this delay is usually a few days, but can be longer.[768][34]

The Office for National Statistics (ONS) issues a weekly report covering England and Wales, which counts all deaths where coronavirus was mentioned on the death certificate; not necessarily as the main cause of death. This figure is higher because it also counts deaths where no test was done.[766][767][769] The National Records of Scotland and Northern Ireland Statistics and Research Agency issue similar reports for those two countries. As at 23 May, the reported figures for 15 May were 42,173 deaths for England and Wales, 3,533 for Scotland and 664 for Ireland, totalling 46,370.[4]

As of 23 May 2020 the death rate across the UK from COVID-19 is 540 per million population.[770] The death rate varies greatly by age and healthiness. More than 90% of deaths are among the most vulnerable: those with underlying illnesses and the over-60s.[771][772][773] COVID-19 deaths are "remarkably uncommon" among the least vulnerable: those under 65 and with no underlying illnesses.[215]

There is also large regional variation in the pandemic's severity. The outbreak in London has the highest number and highest rate of infections.[774] England is the UK country with the highest recorded death rate per capita, followed by Wales and then Scotland, while Northern Ireland has the lowest per capita.[775]

On 22 April, The Financial Times estimated that 41,000 may have died by that date, by extrapolating the ONS data and counting all deaths above the average for the time of year.[776] The World Health Organisation cautioned on 23 April that up to half of coronavirus deaths in Europe were among care home residents. The government's[which?] Chief Medical Officer warned that even the ONS figures on coronavirus deaths in care homes are likely to be "an underestimate" and said he is "sure we will see a high mortality rate sadly in care homes, because this is a very, very vulnerable group".[124][777][776] On 28 April, Health Secretary Matt Hancock said the number of coronavirus-linked deaths in care homes would be announced as part of the daily report, instead of weekly.[778] By 7 May 2020, the epidemic was concentrated in hospitals and care homes, with the infection rate being higher in care homes than in the community, thus inflating the overall infection rate.[779][780]

The number of cases in the table represent laboratory confirmed cases only. The UK Government's Chief Scientific Adviser Patrick Vallance, says it is likely that other cases are not included in these figures.[61]

[nb 5]

See also

Notes

  1. ^ By county (England), London borough, unitary authority (England and Wales), council area (Scotland), and local government district (Northern Ireland)
  2. ^ a b Death figures are those who have died after testing positive. It does not include the death of one British citizen on board the Diamond Princess cruise ship (see COVID-19 pandemic on cruise ships), or the deaths of 72 British nationals in the British Overseas Territories and Crown dependencies.
  3. ^ Daily updates occur around 2 pm UTC.
  4. ^ Not including cases identified in British Overseas Territories and Crown Dependencies, all of which test and report cases independently.
  5. ^ This graph shows the number of deaths in all settings reported on each day, but the death may have occurred prior to the reporting date.

References

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