To Prevent Second Spike, UK Must Learn from Other Countries’ Infection Rates

As COVID-19 cases fall in the UK and restrictions ease, learning from the global experience and not falling victim to false confidence is essential to avoid walking into a second spike of infections.

Expert comment Updated 15 September 2020 Published 24 June 2020 2 minute READ

Benjamin Wakefield

Former Research Fellow, Global Health Programme

Cleaning glasses in preparation for pubs to reopen following an easing of coronavirus restrictions in England. Photo by TOLGA AKMEN/AFP via Getty Images.

Cleaning glasses in preparation for pubs to reopen following an easing of coronavirus restrictions in England. Photo by TOLGA AKMEN/AFP via Getty Images.

With growing pressure to get the economy going, the falling case numbers in the UK and downgrading of the alert level are positive indicators that efforts to tackle the pandemic are working and that work can begin to reverse some of the economic and societal damage.

But without the appropriate public health systems in place — such as the crucial capacity to effectively find, test and isolate cases and trace, quarantine and monitor contacts — a quick easing of lockdown measures and relaxation in public behaviour could walk the country into a second spike of infections, illness and perhaps deaths.

There is a danger that positive steps may encourage a shift in public attitudes toward the pandemic, such as the threat being taken less seriously or thinking the pandemic is over. This attitude is evident already from those flouting social distancing measures at beaches, parks, and even illegal raves.

While it is important not to catastrophize, it is important to stay grounded and remember this is a crucial moment to control coronavirus. Although many continue to abide by public health guidance, resolve is weakening in certain areas and public fatigue of restrictions is being exacerbated by confusing information and misinformation.

This is not limited to social media. A group of scientists signed an open letter to the journal PNAS urging retraction of a scientific paper for fear it could encourage people to put themselves at risk and congregate in groups, because it incorrectly stated masks are enough to protect from infection.

Across the UK, crowded beaches and packed crowds at recent protests, along with mixed messages from the controversies around breaches – or not – of lockdown rules could understandably encourage a softening of attitudes as, to many, it may seem continued restrictions are an overreaction causing unnecessary economic hardship.

But the reality is that cases could easily spike if the basic proven personal public health measures that reduce the risk of transmission are not adhered to - hand washing, social distancing and - where appropriate - wearing a mask or face covering.

Although public health interventions must be balanced with short-term and long-term economic and health impacts, a recent study shows no country in the world has yet lowered infection rates sufficiently to prevent a second wave of transmission if restrictions and behavioural precautions were relaxed without other compensatory measures in place - such as an efficient system to find, test, isolate and treat cases, and trace, quarantine and monitor contacts.

The UK government has a responsibility to take the right course of action but caving in to pressure to prematurely ease restrictions to gain a ‘quick win’ before the appropriate systems are in place may result in re-implementing restrictions. Just as everyone has an individual responsibility not to prematurely revert to ‘normal behaviour’.

A resurgence of infection has begun in other countries and it is crucial to learn from this. South Korea initially saw second spikes in Seoul linked to the opening of clubs and bars and recently re-closed parks, museums and art galleries due to additional cases. Iran had a sharp rise in infections having eased restrictions in April, with the spike linked to public fatigue of health regulations and a false sense of confidence.

Beijing too has experienced an outbreak linked to local food markets which resulted in the lockdown of 27 neighbourhoods. And New Zealand mobilised its defence force to oversee mandatory quarantine after an outbreak occurred shortly after the country declared it had eliminated the virus.

The drop in reported cases in the UK gives an opportunity to control the virus, but livelihoods, the economy and people’s mental health can ill-afford another lockdown and - without appropriate and effective public health systems in place - a significant second spike of infections would see harsher restrictions back in place.

While it remains the responsibility of the UK government to ease restrictions through a measured and evidence-based process and to put in place an effective system to control this pandemic, everyone has an individual responsibility to remain cautious and grounded in the reality that the pandemic is a long-term issue, and not fall victim to false confidence. The risks should not be overstated, but equally must not be understated. The pandemic is not yet over.