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Why Covid-19 cases are surging in the UK

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After a relatively quiet summer, the United Kingdom is now suffering a new onslaught of Covid-19. Where the seven-day rolling average for much of the summer was regularly below 1,000 cases a day, it began increasing in September, and by October 5, the new average had reached 15,505. The counts are complicated by test shortages and changes in the way cases are counted, but it’s clear the country is going through a serious second wave.

None of this was supposed to happen.

Last year, before Covid-19 hit, the Global Health Security Index judged how prepared countries around the world were to prevent new infectious diseases from coming in, detect them if they did, and treat resulting infections. The UK looked great — it was the second-most prepared country in the world, behind only the US.

Since then, other countries, like Vietnam, Germany, and South Korea, have able to hold their case numbers down. But the UK government made a series of missteps and lost control.

The number of new Covid-19 cases per million people has soared in the UK in recent weeks.
Our World In Data

So how did such a seemingly well-prepared country blow it, not once but twice?

The missteps were primarily the responsibility of Parliament and its leader, Boris Johnson. Unlike in the United States, where public health is primarily the responsibility of state and local governments, in the UK most public health directives for England come directly from the Prime Minister. (Wales, Scotland, and Northern Ireland get some leeway.)

There are currently no checks and balances between the Prime Minister and Parliament; the Prime Minister is head of Parliament, and at the moment the party in power has enough members to ensure that what the PM says, goes.

A person walking on a street in front of Cardiff Castle, Wales.
Many cities across Wales are enforcing local lockdowns due to an uptick in Covid-19 cases.
Matthew Horwood/Getty Images
British Prime Minister Boris Johnson leaves 10 Downing Street on October 7.
David Cliff/NurPhoto via Getty Images

What stands out in the UK response is how uneven it’s been, despite being led by someone who tested positive for the virus and wound up in an intensive care unit in London for several days in April, relatively early on in the pandemic.

Here are some of the missteps Johnson’s government has made leading to the second spike.

Boris Johnson’s plan to help the restaurant industry may have been a public health disaster

If you want to stop the spread of an infectious disease, you do your best to keep uninfected people away from infected people. On March 20, as the epidemic was just beginning, the UK government counted 1,254 positive coronavirus tests, and Johnson ordered all restaurants, cafes, and pubs in England closed. Good so far. (The other nations in the UK made their own rules.)

On July 4, with the daily new case count down to 403, Johnson reopened English pubs and restaurants with no face coverings needed, but with more handwashing and ventilation required, and a limit of two households allowed to dine together. On July 15, to the delight of millions of Brits, Johnson took things a step further with a plan to pay people to eat out.

For the plan, dubbed “Eat Out to Help Out,” the government paid half of everyone’s restaurant bills up to 10 pounds per meal every Monday, Tuesday, and Wednesday in August — for all diners, in groups of any size, as often as people wanted, indoors or out. At the time, face masks were not required in most eating establishments. According to Boris Johnson and finance minister Rishi Sunak, the point of the plan was to help save jobs in the restaurant industry.

The public was more than happy to eat on the government’s dime and did so 100 million times between August 3 and 31, at a cost of £522 million (about $694 million), per Her Majesty’s Revenue and Customs, the IRS of the UK.

A sandwich board outside a restaurant where there are outdoor tables and diners, reads, “10 pounds from Boris.”
A sign advertises the “Eat Out to Help Out” discount in London on August 5.
Leon Neal/Getty Images

The public health community reacted to the plan with horror. “In a word, it’s nuts,” says Lawrence Gostin, director of the WHO Center on National and Global Health Law, professor of global health law at Georgetown University, and a research fellow at Oxford University. “In the midst of a pandemic, it’s actually directly opposite to what the public health evidence suggests.”

The move was made despite evidence available since early in the pandemic that eating indoors, close to others, is a high-risk activity for spreading the virus. For example, there was a well-known incident at a restaurant in Guangzhou, China, back in January, when a diner who’d just returned from Wuhan infected nine others in a restaurant, at his own table and two tables nearby. There’s also been growing concern about the ability of the virus to travel more than 6 feet from an infected individual. A report since published by the Centers for Disease Control and Prevention found that American adults who got Covid-19 were twice as likely to have eaten out as a control group who hadn’t gotten the virus.

No studies have yet been published in the medical literature definitively linking the rise in UK cases beginning in early September to the increased visits to restaurants throughout August. But it’s hard to think otherwise.

Toby Phillips, a public policy research at Oxford University, looked at how many more people ate out, and how many more cases there have been, and concluded in The Conversation that the increased number of cases in early September “is consistent with” the restaurant scheme.

“Looking at the English regions, there is a loose correlation between uptake of the scheme and new cases in the last weeks of August,” he wrote. “Again, this isn’t to say that the scheme caused those cases. But it certainly didn’t discourage those people from going out.”

To Devi Shridhar, a professor of global public health at the University of Edinburgh in Scotland, Johnson was being business-friendly and actively playing to his base. “People loved it. And he was celebrated for it,” she says.

Three weeks after the “Eat Out to Help Out” program ended, as the incidence of Covid-19 took off, Johnson limited restaurant and pub hours. “Now these restaurants and the hospitality industry are being hit by curfews and restrictions,” says Shridhar. “So, it’s like one step forward, five steps backward.”

Even Johnson himself recently acknowledged that his plan might have, in part, fueled the new wave of cases across the country. At the same time, he took responsibility “for everything that has happened since the pandemic began.”

The government has fumbled on PPE, testing, and contact tracing

In October 2016, UK government departments and local authorities gamed out a detailed disaster scenario, called Cygnus, in which a hypothetical new and voracious influenza virus came in from southeast Asia. While the government has yet to release the results of Cygnus, British newspapers reported that the simulation showed there was a shortage of ventilators and critical care beds, a serious lack of personal protective equipment (PPE) for National Health Service employees, and the government scored poorly in its ability to communicate with the public. An unnamed former government official told the Telegraph newspaper that the simulation had results “too terrifying” to reveal.

Indeed, there was a severe shortage of personal protective equipment for NHS staff during the first Covid-19 spike in the spring, with health care workers appealing to the public for donations of masks and other equipment. The British media were quick to publish photos of health workers wearing garbage bags and home-made masks.

The toll of improper preparation hit the UK’s health care providers hard. Amnesty International reported that by September 3, near the start of the second peak, 649 health workers in the UK had died of Covid-19, putting it third in the world for coronavirus-related health care worker deaths, behind only Mexico and the US. That’s left a smaller — and rattled — workforce to deal with the second spike.

The government has promised that it’s now set with PPE, and this time around there seem to be fewer complaints. By contrast, both testing and contact tracing — thought by many epidemiologists to be key, along with face masks and isolation, to controlling the pandemic — remain fraught.

NHS staff across the UK are demanding an early salary increase.
Jeff J. Mitchell/Getty Images
Nurses and other front-line NHS workers stage a protest in Glasgow, United Kingdom, on August 8.
Jeff J Mitchell/Getty Images

The National Health Service has been offering free testing to people with symptoms and for all NHS workers, as well as some others throughout the pandemic. Shortages were the norm early on, which became an issue for health care workers. One of Johnson’s top ministers announced March 31 that there was a shortage of chemical reagents needed for testing; the Chemical Industries Association told ITV News the same day that the problem was not at their end.

The government canceled an early initial contact tracing effort on March 12; some of Johnson’s science advisers thought there were too many cases to trace. Then the number of cases and deaths soared, and the government started a new program in April. It has not gone smoothly.

Work on a contact-tracing phone app, a strategy that has been attributed to helping other countries such as South Korea keep the virus under control, was started in March but stopped in June, before it was ever broadly rolled out, due to issues integrating it effectively with major phone operating systems. When the phone app was revived on September 24, it at first failed to pick up data on who was infected.

Much of the test-and-trace work has been farmed out in no-bid contracts to private companies, which has sparked accusations of profiteering. Sridhar points to the Conservative government for following a long history of privatizing government services. “They’re trying to get contracts for companies rather than improving public health,” she says.

In September, the BMJ reported that the government has a secret £100 billion ($129 billion) plan to do 10 million tests a day (some with tests not yet on the market) by early next year. Critics say the plan disregards the enormous current problems with testing. The government hasn’t confirmed the specifics, but Johnson has announced plans to greatly extend testing.

And yet he has continued to remind people that they were only supposed to ask for tests if they had symptoms (people can also get a free test if a contact tracer instructs them to). Discouraging more people from getting tested, including those who have close contacts who have the virus, is problematic since asymptomatic or presymptomatic people with known exposures may be infected and can spread the virus without knowing it.

Then, in early October, Public Health England (PHE) admitted that because of an IT error, data from nearly 16,000 people who’d tested positive between September 25 and October 2 were left out of the UK’s daily count. This means their contacts were not immediately informed, meaning that people who were exposed to virus-positive contacts did not know to self-isolate, and so potentially infected people continued their normal lives for days. Once again, and in this time in the middle of a spike, the government missed a chance to stem the tide.

Is the UK learning from its mistakes?

Despite all of these failures, the UK government is still not setting itself up for future success. For example, it is axing Public Health England, which in addition to its involvement in testing, also conducts public health research and formulates recommendations on everything from smoking to obesity to poverty — all conditions that may leave people more vulnerable to Covid-19.

On August 18, the government announced PHE would be folded into a new agency called the National Institute for Health Protection (NIHP) by next spring. The NIHP is currently charged with focusing on the Covid-19 pandemic, leaving PHE’s other disease-prevention functions “to be discussed.”

“It is on one level inexplicable, at another level perfectly understandable,” says Martin McKee, professor of European health at the London School of Hygiene and Tropical Medicine. The inexplicable part is gutting a public health agency in the middle of a pandemic — even one that has made mistakes — while the understandable part is that Johnson’s top political adviser, Dominic Cummings, has a history of abrupt changes. “He has this view of creative destruction,” says McKee. “The idea would be that you shake everything up and something good might come out of it.”

A pandemic lockdown warning sign in Manchester, England, on October 7. Manchester now has the highest coronavirus infection rate in the country, with nearly 600 cases per 100,000 people.
Christopher Furlong/Getty Images

In the meantime, the UK is facing new daily case counts 15 times what they were this summer — and a potentially long and difficult winter ahead. Even Prime Minister Johnson is not optimistic. On the BBC’s Andrew Marr show on October 5, Johnson predicted “it will continue to be bumpy through to Christmas and may even be bumpy beyond.”

Many blame the uneven reaction to the new coronavirus — and many of the UK’s more-than 42,500 Covid-19 deaths — on Johnson’s hot-again, cold-again belief in the seriousness of the pandemic, his interest in helping out businesses, and a system that gives him unquestioned power to guide the government response.

“You can have the best health system in the world,” Gostin says. “You can have the most expert scientists in the world as the UK has. But if you don’t have a leader that can effectively implement good policy and effectively communicate the importance of risk avoidance behaviors, you’re finished.”

Joanne Silberner is a freelance journalist who has been reporting on health policy and medicine since the early days of HIV.


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Trump’s misleading tweet about changing your vote, briefly explained

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Searches for changing one’s vote did not trend following the recent presidential debate, and just a few states appear to have processes for changing an early vote. But that didn’t stop President Trump from wrongly saying otherwise on Tuesday.

In early morning posts, the president falsely claimed on Twitter and Facebook that many people had Googled “Can I change my vote?” after the second presidential debate and said those searching wanted to change their vote over to him. Trump also wrongly claimed that most states have a mechanism for changing one’s vote. Actually, just a few states appear to have the ability, and it’s rarely used.

Twitter did not attach a label to Trump’s recent tweet.
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Trump’s claim about what was trending on Google after the debate doesn’t hold up. Searches for changing one’s vote were not among Google’s top trending searches for the day of the debate (October 22) or the day after. Searches for “Can I change my vote?” did increase slightly around the time of the debate, but there is no way to know whether the bump was related to the debate or whether the people searching were doing so in support of Trump.

It was only after Trump’s posts that searches about changing your vote spiked significantly. It’s worth noting that people were also searching for “Can I change my vote?” during a similar period before the 2016 presidential election.

Google declined to comment on the accuracy of Trump’s post.

Trump also claimed that these results indicate that most of the people who were searching for how to change their vote support him. But the Google Trends tool for the searches he mentioned does not provide that specific information.

Perhaps the most egregiously false claim in Trump’s recent posts is about “most states” having processes for changing your early vote. In fact, only a few states have such processes, and they can come with certain conditions. For instance, in Michigan, voters who vote absentee can ask for a new ballot by mail or in person until the day before the election.

The Center for Election Innovation’s David Becker told the Associated Press that changing one’s vote is “extremely rare.” Becker explained, “It’s hard enough to get people to vote once — it’s highly unlikely anybody will go through this process twice.”

Trump’s post on Facebook was accompanied by a link to Facebook’s Voting Information Center.
Facebook

At the time of publication, Trump’s false claims had drawn about 84,000 and 187,000 “Likes” on Twitter and Facebook, respectively. Trump’s posts accelerated searches about changing your vote in places like the swing state of Florida, where changing one’s vote after casting it is not possible. Those numbers are a reminder of the president’s capacity to spread misinformation quickly.

On Facebook, the president’s post came with a label directing people to Facebook’s Voting Information Center, but no fact-checking label. Twitter had no annotation on the president’s post. Neither company responded to a request for comment.

That Trump is willing to spread misinformation to benefit himself and his campaign isn’t a surprise. He does that a lot. Still, just days before a presidential election in which millions have already voted, this latest episode demonstrates that the president has no qualms about using false claims about voting to cause confusion and sow doubt in the electoral process.

Open Sourced is made possible by Omidyar Network. All Open Sourced content is editorially independent and produced by our journalists.


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Nearly 6,000 civilian casualties in Afghanistan so far this year

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From January to September, 5,939 civilians – 2,117 people killed and 3,822 wounded – were casualties of the fighting, the UN says.

Nearly 6,000 Afghan civilians were killed or wounded in the first nine months of the year as heavy fighting between government forces and Taliban fighters rages on despite efforts to find peace, the United Nations has said.

From January to September, there were 5,939 civilian casualties in the fighting – 2,117 people killed and 3,822 wounded, the UN Assistance Mission in Afghanistan (UNAMA) said in a quarterly report on Tuesday.

“High levels of violence continue with a devastating impact on civilians, with Afghanistan remaining among the deadliest places in the world to be a civilian,” the report said.

Civilian casualties were 30 percent lower than in the same period last year but UNAMA said violence has failed to slow since the beginning of talks between government negotiators and the Taliban that began in Qatar’s capital, Doha, last month.

An injured girl receives treatment at a hospital after an attack in Khost province [Anwarullah/Reuters]

The Taliban was responsible for 45 percent of civilian casualties while government troops caused 23 percent, it said. United States-led international forces were responsible for two percent.

Most of the remainder occurred in crossfire, or were caused by ISIL (ISIS) or “undetermined” anti-government or pro-government elements, according to the report.

Ground fighting caused the most casualties followed by suicide and roadside bomb attacks, targeted killings by the Taliban and air raids by Afghan troops, the UN mission said.

Fighting has sharply increased in several parts of the country in recent weeks as government negotiators and the Taliban have failed to make progress in the peace talks.

At least 24 people , mostly teens, were killed in a suicide bomb attack at an education centre in Kabul [Mohammad Ismail/Reuters]

The Taliban has been fighting the Afghan government since it was toppled from power in a US-led invasion in 2001.

Washington blamed the then-Taliban rulers for harbouring al-Qaeda leaders, including Osama bin Laden. Al-Qaeda was accused of plotting the 9/11 attacks.

Calls for urgent reduction of violence

Meanwhile, the US envoy for Afghanistan, Zalmay Khalilzad, said on Tuesday that the level of violence in the country was still too high and the Kabul government and Taliban fighters must work harder towards forging a ceasefire at the Doha talks.

Khalilzad made the comments before heading to the Qatari capital to hold meetings with the two sides.

“I return to the region disappointed that despite commitments to lower violence, it has not happened. The window to achieve a political settlement will not stay open forever,” he said in a tweet.

There needs to be “an agreement on a reduction of violence leading to a permanent and comprehensive ceasefire”, added Khalilzad.

A deal in February between the US and the Taliban paved the way for foreign forces to leave Afghanistan by May 2021 in exchange for counterterrorism guarantees from the Taliban, which agreed to sit with the Afghan government to negotiate a permanent ceasefire and a power-sharing formula.

But progress at the intra-Afghan talks has been slow since their start in mid-September and diplomats and officials have warned that rising violence back home is sapping trust.

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Classic toy tie-up: Etch A Sketch maker to acquire Rubik’s Cube

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Spin Master Corp., the company behind the Etch A Sketch and Paw Patrol brands, has agreed to acquire Rubik’s Brand Ltd. for about $50 million, tying together two of the world’s most iconic toy brands.

The merger comes at a boom time for classic toymakers, as parents turn to familiar products to entertain kids stuck in lockdown. Like sales of Uno, Monopoly and Barbie dolls, Rubik’s Cube purchases have spiked during the pandemic, according to the puzzle maker’s chief executive officer, Christoph Bettin. He expects sales to jump 15% to 20% in 2020, compared with a normal year, when people purchase between 5 million and 10 million cubes.

By acquiring Rubik’s, Toronto-based Spin Master can better compete with its larger rivals, Hasbro Inc. and Mattel Inc. All three companies have pivoted to become less reliant on actual product sales, diversifying into television shows, films and broader entertainment properties based on their toys. Spin Master CEO Anton Rabie said he wouldn’t rule out films or TV shows based on Rubik’s Cubes, but he was focused for now on creating more cube-solving competitions and crossmarketing it with the company’s other products, like the Perplexus.

“Whoever you are, it really has a broad appeal from a consumer standpoint,” Rabie said in an interview. “It’s actually going to become the crown jewel; it will be the most important part of our portfolio worldwide.”

Hungarian inventor Erno Rubik created the Rubik’s Cube in 1974, a solid block featuring squares with colored stickers that users could twist and turn without it falling apart. It gained popularity in the 1980s and has remained one of the best-selling toys of all time, spawning spinoff versions, international competitions of puzzle solvers, books and documentaries.

The toy has been particularly well-suited to pandemic conditions. During lockdowns, parents have sought to give kids puzzles that boost problem-solving skills useful in math and science careers. Normally, toys tied to major film franchises are among the most popular products headed into the holidays, but studios have delayed the release of major new movies because of coronavirus. So classic products are experiencing a mini-renaissance.

“The whole pandemic has really increased games and puzzles,” Rabie said. “But whether the pandemic existed or didn’t exist, we’d still buy Rubik’s. It’s had such steady sales for decades.”

Rubik’s CEO Bettin said it was the right time to sell the company, with the founding families behind it ready to move on. London-based Rubik’s Brand was formed out of a partnership between Erno Rubik and the late entrepreneur Tom Kremer, while private equity firm Bancroft Investment holds a minority stake in the company.

Early on, Bettin felt Spin Master was the right home for the puzzle toy, he said. Spin Master, which was started by a group of three friends in 1994, has expanded through the purchase of well-known brands, including Erector sets and Etch A Sketch. Rabie says he works to honor the “legacy” of those products, which Bettin cited as a key reason to sell the brand to Spin Master over larger companies that were interested.

“It was important for us to not be lost in the crowd, and to be sufficiently important and cared for,” Bettin said. “And there’s a balance between being with someone large enough to invest, and agile enough to ensure you are key part of their plans.”

Spin Master won’t own Rubik’s Cubes in time for the holiday season – the transaction is expected to close on Jan. 4. At that time, the company will move Rubik’s operations from a small office in London’s Notting Hill neighborhood to Spin Master’s new games operations center in Long Island.

Some of Rubik’s Brand’s 10 employees will be part of the transition, but they won’t stay permanently, Bettin said.

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