The UK Action Plan Against COVID-19

#15,019

While COVID-19 produces an `influenza-like illness', it is not influenza, and so we should expect that pandemic planning based on a novel flu may need some adjustments along the way.  Still, it is the best starting point we have.

Today the UK government released a 28-page self-described `action plan' on how they plan to attack the COVID-19 threat, and what residents can expect over the coming months if, as expected, the virus continues to spread.

First a link to the landing page, then a few excerpts from the document.

Coronavirus action plan

What the health and social care system across the UK has done to tackle the coronavirus (COVID-19) outbreak, and what it plans to do next.

From: Department of Health and Social Care
Updated: 3 March 2020

Details

This document sets out what the UK as a whole has done – and plans to do – to tackle the coronavirus (COVID-19) outbreak, based on our experience dealing with other infectious diseases and our influenza pandemic preparedness work.
The exact response to coronavirus (COVID-19) will be tailored to the nature, scale and location of the threat in the UK, as our understanding of this develops.
The document sets out:

• what we know about the virus and the disease it causes

• how we have planned for an infectious disease outbreak such as the coronavirus (COVID-19) outbreak

• the actions taken so far in response to the coronavirus (COVID-19) outbreak

• what we are planning to do next, depending on the course the coronavirus (COVID-19) outbreak takes

• the role the public can play in supporting this response, now and in the future

The current novel coronavirus (COVID-19) outbreak, which began in December 2019, presents a significant challenge for the entire world. The UK government and devolved administrations, including the health and social care system, have planned extensively over the years for an event like this. The UK is therefore well prepared to respond in a way that offers substantial protection to the public.

Coronavirus action plan: a guide to what you can expect across the UK -
PDF, 263KB, 28 pages

Coronavirus action plan: a guide to what you can expect across the UK -
HTML

Towards the end of the document, the policy papers addresses actions that may be required if containment of the virus fails, and community transmission becomes widespread:

The Mitigate phase – next steps

As and when the disease moves into different phases, for example if transmission of the virus becomes established in the UK population, the nature and scale of the response will change. The chief focus will be to provide essential services, helping those most at risk to access the right treatment. This means that: 

• there will be further publicity of advice to individuals about protecting themselves and others
• treatment and the requirement for medicines and other clinical countermeasures might start to increase, with the need to draw down on existing stockpiles of the most important medicines, medical devices and clinical consumables
• health and social care services will work together to support early discharge from hospital, and to look after people in their own homes
• emergency services, including the police and fire and rescue services, will enact business continuity plans to ensure they are able to maintain a level of service that fulfils their critical functions. For example, with a significant loss of officers and staff, the police would concentrate on responding to serious crimes and maintaining public order
• for businesses facing short-term cash flow issues (for example, as the result of subdued demand), an effective mitigation already exists in HMRC’s Time To Pay system. This is offered on a case-by-case basis if a firm or individual contacts HMRC about falling behind on their tax
• as NHS/HSCNI staff also start to become affected, and more seriously ill patients require admission, clinicians may recommend a significantly different approach to admissions. Some non-urgent care may be delayed to prioritise and triage service delivery. Staff rostering changes may be necessary, including calling leavers and retirees back to duty
• there could well be an increase in deaths arising from the outbreak, particularly among vulnerable and elderly groups. The UK government and devolved administrations will provide advice for local authorities on dealing with this challenge
• there will be less emphasis on large-scale preventative measures such as intensive contact tracing. As the disease becomes established, these measures may lose their effectiveness and resources would be more effectively used elsewhere

Everyone will face increased pressures at work, as well as potentially their own personal illness or caring responsibilities. Supporting staff welfare will be critical to supporting an extended response.

We will implement a distribution strategy for the UK’s stockpiles of key medicines and equipment (for example, protective clothing). This will cover the NHS/HSCNI, and extend to social care and other sectors as appropriate.

We will consider legislative options, if necessary, to help systems and services work more effectively in tackling the outbreak.

The UK’s health and social care systems will start to implement their business continuity plans, which cover:

• continuing to minimise the risk of infection to patients and those receiving care
• further identification of vulnerable persons to be supported
• arrangements for the continuation of essential services, to maintain normal business for as many people as possible for as long as possible
• plans to reduce the impact of absentees during the pandemic
• systems to lessen the impact of disruption to society and the supply chain

The UK remains in a high state of readiness to respond robustly to any disease outbreak, and our track record of success means that we can offer a high degree of assurance that we will be able to maximise the effectiveness of our health and care systems, and in doing so also respond effectively to the outbreak.

As and when we discover more about the disease and what, if any, impact its course has on the UK, we will provide further updates on how our plans are being adapted to respond to specific, changing circumstances.

The UK government is advising businesses to build their own resilience by reviewing their business continuity plans and following the advice for employers.

Businesses should also ensure that they keep up to date with the situation as it changes, at www.gov.uk/coronavirus.

(Continue . . .) 

Although this action plan is long on assurance, it doesn't really do what it says on the tin (`a guide to what you can expect across the UK').  It tells us what the government plans to do, but not what impacts a pandemic is likely to have on the general public.

Personal preparedness isn't mentioned, and disruptions are given surprisingly short shrift (see below).

• Action that would be considered could include population distancing strategies (such as school closures, encouraging greater home working, reducing the number of large-scale gatherings) to slow the spread of the disease throughout the population, while ensuring the country’s ability to continue to run as normally as possible. The UK governments’ education departments’ planning assumptions include the possibility of having to close educational settings in order to reduce the spread of infection.

The word `shortages' doesn't appear anywhere in the document. `Disruptions' appears twice, but not in any meaningful context.  As for the NHS, they state that `Some non-urgent care may be delayed to prioritise and triage service delivery', but nowhere do they openly entertain the notion that their healthcare system might be overwhelmed. 

If COVID-19 ends up little worse than the 2009 pandemic, then this classic example of `British reserve' will probably end up close to the mark. Anything worse, and some people may be in for a rude surprise.