London Daily

Focus on the big picture.
Thursday, Aug 27, 2026

The UK’s Covid-19 strategy dangerously leaves too many questions unanswered

The coronavirus outbreak can be suppressed as China and others have done, but we need to act now, says academic Anthony Costello

The public health response to a serious epidemic is laid out simply and clearly by the World Health Organization (WHO). Test intensively, trace contacts, quarantine and maintain social distancing. When Covid-19 got out of control in Wuhan, after three weeks of public health inaction, the Chinese authorities mounted a proper campaign to control the virus. They listened to the WHO. They tested extensively, setting up mobile testing centres, and getting the test result time down from four days to four hours. They cut the time from onset of symptoms to lab result from 12 to three days. They identified family clusters (the virus spreads mainly through extended close contact so family members are most at risk) and arranged isolation centres for contacts.

Above all, they mobilised communities. They didn’t leave it all to messages and nudge behavioural methods. Yes, Wuhan was in lockdown, but across the country local authorities had high autonomy to help people abide by these best public health principles. This was not a terrorised population but one passionate about tackling an existential threat. They also used apps and smartphones to get messages across, to share information about local clusters and for data collection. Everyone in Wuhan, a city of 11 million, ordered their food online, and had it delivered. And the strategy worked. In seven weeks China stopped the epidemic in its tracks. It now reports only 10 to 20 new cases per day in a population of nearly 1.4 billion. Deaths have plummeted. Several other countries, including South Korea, Japan, Singapore and Taiwan, have copied this strategy, with local modifications, with similar results.

Now they realise they must face the challenge of how to loosen up, and whether allowing the economy to recover will lead to more outbreaks, but they have a nationwide system to jump on new clusters and outbreaks to keep this under control. The aim is to wait and hope for drugs and vaccines to emerge in the next 12 months to enable them to treat cases and to build proper herd immunity from a vaccine.

I had assumed that the UK would do the same, that the authorities would be building their resources and plans around nationwide testing, contact tracing, quarantine and a progressive policy of social distancing. I assumed they would inform the public they had a two- to three-month “contain and delay” strategy to get the epidemic under control, and mobilise communities everywhere to provide local support. But from the press conferences last week, the government is not following the WHO strategy. They appear to have concluded that it is inevitable most people would get the disease, so we should let the epidemic proceed to allow 60% of the population to become infected and build herd immunity through the wild virus. What is the scientific justification for this departure from WHO policy? I have questions:

Why have they abandoned population testing and contact tracing to identify and seclude clusters of infections? They recommend only testing cases in hospital. Won’t this strategy ensure that the spread of the virus is intense and will cause more infections and more deaths in the near term?

Why do they recommend self-isolation only for people with symptoms when Maria Van Kerkhove of the WHO reports that “it seems that people shed more virus in the early phases rather than the late phases of disease”? Asymptomatic contacts may be highly infectious, so they should be tested, isolated and followed up in the community. Will they set up quarantine centres to help those who have no family support or are homeless, or need social care?

What are their plans for national, district, municipal, village and community mobilisation? “Nudge” is not enough. We need to devolve power and autonomy to allow locally intelligent decisions around a coherent national strategy. What is their detailed strategy for screening of infected people in the home, and provision of CT scans for those with early signs of pneumonia and to identify those at high risk? Without an all-out national mobilisation for social distancing, are the behavioural and nudge strategies really evidence-based to flatten the peak? Or simply based on models?

Why are we emphasising herd immunity now? Does coronavirus induce strong herd immunity or is it like flu, where immunity remains weak and new strains emerge each year? We have much to learn about Covid-19 immune responses. Doesn’t this contradict WHO policy? Tedros Adhanom Ghebreyesus, WHO director-general, said after declaring a pandemic: “The idea that countries should shift from containment to mitigation is wrong and dangerous.”

Shouldn’t we wait to see the China situation? They have contained the epidemic after seven weeks of intensive national effort. Will epidemics break out again in new states? Maybe. Will their strengthened systems not contain them quickly and effectively? What is their herd immunity to date? We don’t have the data available but new tests are coming online. It might be substantial, without a massive epidemic.

The WHO policy – practised by China, South Korea, Singapore, Taiwan and Hong Kong – is to keep things damped down until drugs and a vaccine are available. Vaccines are a safer way to develop herd immunity, without the risks associated with the disease itself. Is it wise or ethical to adopt a policy that threatens immediate casualties on the basis of uncertain future benefit?

What is the policy to promote social distancing? How can we promote advice for families, mass gatherings, schools, workplaces, restaurants, theatres? And can we make it locally relevant? School closures might be phased depending on the intensity of transmission based on local data about clusters, as they did in Singapore. But we need testing and sharing of information online for local decisions.

Finally, on the precautionary principle, shouldn’t we go all out to damp this epidemic down, with all possible measures, whether evidence is strong, uncertain or weak, and worry about herd immunity when we have more evidence? The stated government policy is to allow 40 million people to become infected. This could mean 6 million hospital admissions, 2 million requiring special or intensive care, and 402,000 deaths if the chief medical officer Prof Chris Whitty’s 1% estimate of mortality is correct.

We can suppress this epidemic in the way that China and other countries have done. Then we can worry about how to loosen up, and hope that a vaccine comes onboard. But we need to act now. Every day of delay will mean more people become infected or die.

• Anthony Costello is professor of global health and sustainable development at University College London and a former director of maternal and child health at the WHO

Newsletter

Related Articles

0:00
0:00
Close
TSA Unveils Major Airport-Security Overhaul as It Drops Gold+ Privatization Plan
CIA Chief Warned Russia Against Attacking NATO in Secret Moscow Mission
Raheem Sterling Charged With Dangerous Driving After Lamborghini Crash
The Secret Dolly Parton Kept Until Her Death: "She Was Much Sicker Than She Let On"
Glacier Collapse, Not Earthquake, Triggered Deadly Nepal-Tibet Flood
Andy Burnham Drops Plan to Cap Political Donations
Conservative Leadership Contest Intensifies as Robert Jenrick Attacks Kemi Badenoch
French-Born Defence Secretary Wes Streeting Condemns Homophobic Abuse Since Taking Office
UK Government Delays Commercial Robotaxi Rollout in London Over Regulatory Gaps
NHS Complaints About Autism and ADHD Care Waiting Times Triple Over Five Years
UK Government Launches 10,000 Work Placements for Young People With Sainsbury's
NHS England to Offer Free At-Home Cervical Cancer Screening Kits
EU Biometric Border Checks Cause Delays of Up to Five Hours for British Travellers
US Imposes Economic Sanctions on UK-Based Protest Group Palestine Action
Two Planned UK Datacentres Could Produce More Annual Carbon Emissions Than ExxonMobil's Entire UK Operation
London Surgeons Complete First Artificial Intelligence-Assisted Brain Tumour Removal
UK Services Growth Rebounds as Consumer Confidence Reaches Two-Year High
Ofgem Confirms Four Percent October Energy Price Cap Increase for UK Households
Government Considers Insolvency Law Changes to Bring Thames Water Into Public Ownership
Andy Burnham Signs Artificial Intelligence Defence Pact During Visit to Kyiv
Church of England Faces Renewed Scrutiny Over Historical Safeguarding Failures
Reform UK Proposes £30 Tax Credit for Long HMRC Telephone Queues
Greater Manchester Secures More Than £100 Million to Upgrade Victorian Railway Stations
East Midlands Railway Urges Essential Travel Ahead of Bank Holiday Strikes
UK Economy Grows 0.4 Percent in Second Quarter as Global and Energy Pressures Weigh
UK Government and Sainsbury’s Launch Plan for 10,000 Youth Work Experience Placements
Scottish Government Plans Tighter Remote-Working Rules and Possible Voluntary Redundancies
Scottish Budget Faces More Than £700 Million Reduction After Tax Revenue Adjustment
Nearly 100 Labour MPs Press Andy Burnham to Back Electoral Reform Commission
UK Energy Price Cap Rises Four Percent to £1,723 as Middle East Conflict Drives Wholesale Gas Costs
Turnbull Warns AUKUS Could Leave Australia Without Promised Nuclear Submarines
California Billionaires Pour More Than $150 Million Into Fight Over Proposed Wealth Tax
German Broadcaster Goes Dark to Warn AfD Could End Its Saxony-Anhalt Service
Badenoch Plans Major Shadow Cabinet Reshuffle as Tories Struggle in Third Place
UK Government Demands Action Against Social Media Content Promoting Dangerous Driving
Labour Backbenchers Prepare Push for Electoral Reform Under Andy Burnham
Fire at Gatwick Airport Car Park Destroys 140 Vehicles and Cuts Local Power
UK Plans Voluntary Libido-Suppressing Medication Programme Across 20 Prisons
NHS England Launches Free Home Cervical Cancer Testing Kits Nationwide
Imperial College Study Warns North Sea Oil Projects Could Cause Hundreds of Billions of Pounds in Climate Damage
UK Inflation Rises to 2.9% as Middle East Conflict Pushes Up Energy Costs
Prime Minister Andy Burnham Visits Kyiv to Strengthen UK Support for Ukraine
Premier League Season Opens With Managerial Debuts and Dramatic Early Fixtures
England Cricket Drops Brydon Carse From Selection Pending Club Investigation
Graeme Dott Convicted of Child Sexual Abuse Offences in Scotland
Protesters Occupy British Aircraft Parts Factory Over Alleged Military Links to Israel
More Than 100 Former British and French Diplomats Call for Sanctions on Israel
Ipsos Poll Shows British Public Split Between Immigration Controls and Economic Growth
British Cybersecurity Agencies Raise Alert Over Growing Threats to Critical Infrastructure
Two-Thirds of England Now Under Official Drought Conditions After Prolonged Summer Heat
×