The threat of pandemic flu has been a concern for successive governments. In 2008, it formed part of the National Risk Register and since then has been considered a tier-one risk – one of the most serious civil emergency risks facing the UK. The coalition government published its UK Influenza Pandemic Preparedness Strategy in 2011. Pandemic influenza also featured as part of the 2016 National Biosecurity Strategy.
The 2011 strategy incorporated lessons from the H1N1 (swine flu) outbreak in 2009. This included the need for better early assessment of the nature of the outbreak, better understanding of the way in which the pandemic could spread across different age groups and regions, and more use of behavioural science to understand how people might respond during such a crisis.
The Department of Health and Social Care (DHSC) is the lead department on planning for pandemic flu. Other departments have plans and guidance in place for the wider impact of a pandemic. The Cabinet Office’s Civil Contingency Secretariat manages civil emergency plans and COBR.
Alongside the central government strategy, devolved and local government, agencies and public services have their own plans in place. These are all guided by central government. The government has also published guidance for specific sectors, local planners, businesses and faith groups.
The government’s strategy and guidance has been updated following the Covid-19 outbreak. On 3 March 2020 it published its coronavirus action plan.
The government’s plan is divided into four stages: contain, delay, research and mitigate:
- Contain – reducing the spread of the virus. This focuses on detecting new cases and isolating individuals or tracking who they have come into contact with. This requires public health agencies working with the NHS, border agencies, the Foreign Office and the devolved governments to pass on information and take action.
- Delay – delaying the spread of the disease. This is designed to reduce the burden on the NHS at a time when it is also dealing with seasonal flu. This has involved a major government public information campaign focused on the need for washing hands, not touching the face, catching coughs and sneezes in tissues and reducing personal contact. The government is also considering what other actions could be taken to delay the spread, such as encouraging people to work from home or reducing travel, but these have societal and economic costs and may have only a limited effect.
- Research – developing a vaccine. The UK government, like many around the world, is working on the development of a vaccine, but this is unlikely to be ready to help with this outbreak. It is also working on improvements to disease modelling and other tools to help understand how the virus, and future viruses, are transmitted.
- Mitigate – prioritising resources. If the disease becomes widespread in the UK there will be a much greater focus on how to prioritise resources, particularly for those most at risk. The government is already issuing reassurances: those with the disease will be prioritised, drugs have been stockpiled and food supplies will not be affected. All public agencies have continuity plans in place for maintaining critical services with reduced staff numbers. The government is also considering the impact of large numbers of people taking sick leave and the effect this could have on businesses.
The 2011 UK Influenza Pandemic Preparedness Strategy sets out different ‘proportionate’ steps that could be taken depending on the severity of the outbreak and how quickly it was spreading.
Different measures will be dependent on which phase the government decides the UK is in. During the 'contain' phase the focus was on isolating those whose travel or symptoms show a risk of having the virus, testing and attempting to isolate anyone who has come into contracted the virus. There was also a strong public information push on hygiene (also part of 'delay' planning).
The government has moved into the 'delay' phase.
At a press conference on 16 March, the prime minister, government chief scientific adviser and chief medical officer announced further social distancing measures to reduce the peak of the outbreak and delay it over a longer time frame. These included a requirement for all members of a household to self-isolate for 14 days if any member of the household showed symptoms, even mild, of a respiratory-tract infection (a cough or temperature).
Everyone, even if well, is being asked to avoid close contact with others, to work from home where possible and to stay away from pubs, cafés, restaurants and other crowded venues for the foreseeable future. These social distancing measures should be adhered to by the elderly and those with underlying medical conditions, who are more susceptible to becoming seriously ill from the disease. As a precaution, pregnant women have also been strongly advised to adhere to social distancing measures. Additional advice will be provided to those with serious medical conditions later this week. In order to reduce pressure on the emergency services, the government has also said it will no longer support mass gatherings. It is not yet known how long these measures will last, but they may be required for several months.
The government has not yet recommended that schools close, but this may be required at some point. Scientific modelling, undertaken by Imperial College London and which has informed the government’s response, has also been published.
At present, the government has opted to make these measures advisory, rather than enforce them using legislation.
At a press conference on 17 March, Chancellor Rishi Sunak described the coronavirus crisis as "a public health emergency but also an economic emergency" and announced a package of measures designed to support the economy. He said the package amounted to £20bn of extra government spending and a further £330bn of government loan guarantees – equal to 15% of national income. The package includes:
- Making £330 billion of government loan guarantees available to businesses from early next week through a new Bank of England lending facility and increasing the maximum size of loan from the Business Interruption Loan Scheme (announced in the budget) from £1.2m to £5m, with no interest due for the first six months. Sunak added that he would “go further” if needed, to “provide as much capacity as required”.
- Stating that for businesses in the retail, hospitality and leisure sectors with insurance policies that cover pandemics, that the government advice on social distancing is sufficient to allow them to make claims.
- Extending the business rates holiday that was announced in the budget for small businesses in the retail, hospitality and leisure sectors to all businesses in those sectors.
- For smaller businesses in those sectors, providing cash grants of up to £25,000.
- Increasing the size of cash grants available to the smallest businesses (those that pay no business rates) from £3,000 (announced in the budget) to £10,000.
- Mortgage lenders providing three-month mortgage holidays for those that need them as a result of coronavirus.
- A potential support package specifically targeted at airlines and airports, with similar targeted support being considered for other sectors that are “most affected”.
Other measures announced in the Budget last week, including the government reimbursing businesses with fewer than 250 staff for the cost of statutory sick pay, remain in place.
The government will make funds available to local authorities and the devolved authorities to ensure they are able to provide support to businesses, including providing compensation for the loss of business rates revenues.
The chancellor said that further measures will be announced in the coming days following talks with trade unions and business groups and that all measures will remain under review. The government will include a power in the forthcoming coronavirus bill to allow it to take further action to support the economy.
The latest information from the government says that it does not currently have plans to close parliament. However, parliamentary authorities have also made the decision to restrict access to non-essential visitors from 17 March 2020 – meaning that only those with parliamentary passes, or who are on official business, will be allowed in.
If parliament had to close it could go into recess. It is due to go into recess over the Easter break from 31 March 2020 to 21 April 2020.
The government has powers under the Public Health (Control of Disease) Act 1984 (as amended by the Health Protection Act 2008) that include quarantine, detention and compulsory medical examination, and other powers, for local authorities. These lapse after 28 days if they have not been laid before parliament.
The government has recently laid new regulations before parliament to allow health officials to impose restrictions on any individual or group who might spread the virus, to enable increased screening and to ensure all public health officials notify of any Covid-19 cases.
The government is expected to introduce a coronavirus bill to deal with the wider effects of the virus, including use of video hearings in courts, employment safeguards for health and care volunteers, the emergency registration of retired health professionals, additional powers to reduce unnecessary social contacts, measures to enable the death management system to deal with increased demand and changes to the statutory sick pay system to allow people to claim from day one. The government is also planning on loosening restrictions on shop deliveries to allow them to be made at night.
If greater powers are needed, the Civil Contingencies Act 2004 gives powers to the government to make regulations by Order in Council (legislation made by the Privy Council under the Royal Prerogative) if an ‘emergency’ has occurred or is about to occur. A minister can also make regulations if it is not possible to arrange for an Order in Council. The Act requires parliament to be summoned if it is not already sitting.
- Department for Health and Social Care and Public Health England, Coronavirus (COVID-19): UK government response, GOV.UK, www.gov.uk/government/topical-events/coronavirus-covid-19-uk-government-response
- NHS, Coronavirus (COVID-19), www.nhs.uk/conditions/coronavirus-covid-19/
- Imperial College COVID-19 Response Team, Impact of non-pharmaceutical interventions (NPIs) to reduce COVID19 mortality and healthcare demand, Imperial College London, 16 March 2020, retrieved on 17 March 2020, www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf