London Daily

Focus on the big picture.
Friday, Aug 28, 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
Nearly 23,000 UK Households Expected to Move Home on Busiest Day of 2026
UK Benefit Payments to Arrive Early Ahead of August Bank Holiday
Reform UK Pledges to Replace GDPR and Cut Tax Administration Red Tape
Andy Burnham Launches Work Experience Plan for One Million Young People Outside Education or Work
Andy Burnham Faces Labour Backlash After Dropping Support for Political Donations Cap
Andy Burnham Announces UK-Wide Summit With Leaders of Scotland, Wales and Northern Ireland
Met Office Warns of Heavy Rain and Flood Risk Across England and Wales After Summer Heat
Bank of England Warns AI Adoption Could Reduce Demand for Automatable Jobs
UK Confirms National Salmonella Outbreak With More Than 200 Cases
UK Airports Handle Record 81 Million Passengers Despite Middle East Disruption
Ofgem Raises UK Energy Price Cap by Four Percent to £1,723
Cyber Attack Hits Customer Data Systems at Manchester, Stansted and East Midlands Airports
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"
Middlesbrough House Fire Kills Woman and Seven-Year-Old Girl
Prince Harry and Meghan Markle Return to UK Amid Renewed Media Attention
Raheem Sterling Charged With Dangerous Driving After London Collision
Greenpeace Threatens Legal Action Over Crown Estate Offshore Wind Leasing
Nvidia Revenue Surges to Ninety-Six Point Two Billion Dollars on Artificial Intelligence Demand
Meta Agrees to Global Youth Safety Changes Following Multi-State Legal Settlement
UK Government Plans Autumn Summit With Scottish, Welsh and Northern Irish Leaders
CMA Caps Veterinary Prescription Fees at Twenty-One Pounds
Thames Water Pilot Records Forever Chemicals at Thirteen Times the Legal Limit
Kent Meningitis Outbreak Reaches Thirty-Four Confirmed Cases
Forty Children Missing From UK Asylum Accommodation Remain Unaccounted For
UK Court Upholds VAT on Private School Fees
US Designates Palestine Action as Foreign Terrorist Organization
UK Approves Massive New Chinese Embassy Complex in London Amid Security Concerns
Prime Minister Andy Burnham Visits Kyiv and Offers Cruise Missile Designs to Ukraine
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
×