Six months on, has anything been learned?

As we enter a second wave of COVID-19, six months on, the public seems more divided than ever. Months of restrictions have frayed patience and it appears that sections of the public have lost confidence in the country’s leadership. A recent Demos think tank survey indicated that measures such as mask wearing and lockdown have become more divisive than Brexit. And a King’s College study reported that just 18% of people with symptoms are self-isolating. Set against this backdrop, this is what you told us about lessons learned.

Anonymous
We were all told to stay at home, work from home and carry out risk assessments and only go out in emergency situations, but I think it might have helped if enforcers were more visible – as long as you had the correct PPE and carried out the risk assessments. The police were out. Some authorities were more active, but I think we should have taken a tougher line in the beginning.

Tony Lewis
EHP and associate professor at the Royal Agricultural University
We’ve learned that, as a nation and as a government, we don’t learn. We’re starting to repeat the same mistakes we made in March, such as our inability to test and to have a proper testing system. The tracking system is, how can I put it? Haphazard? Bits of it seem to work, the bits that are largely under the control of local authorities. So in parts of the country where local EHOs have got control of the tracing part of it, that seems to work – so Isle of Man and places like that, it works. We’re sleepwalking into the same issues and my concern is we’ll pay the price as a society. We’re trying to put the economy before the health of the public,
as we did in March.

John Machin
EHP consultant
The rest of the UK outside London could have been told to use the existing procedures to deal with infectious disease. With the small number of cases in the rest of the UK they could have kept a lid on it. Instead, they were trying to get all of these different systems out – everything was delayed and it became unmanageable in the rest of the UK.
EH works with PHE, and people go to their GP when they are sick – those mechanisms have always worked and
if we needed extra hands it could have been supplemented.

Maggi Morris
Former director of public health, Central Lancashire
Politics has been running this game, not the science. When it didn’t suit the political narrative, the science was ignored and the politics ruled – and that’s why we’re in such a terrible state. Even then at times, the science was a bit poor: you know, this idea of herd immunity. We should have been looking more to places like Hong Kong and Singapore, and even China to some extent, and New Zealand. These countries were three months ahead of us.

Hugh Pennington
Emeritus professor of bacteriology at the University of Aberdeen
Many of the cases are asymptomatic – or asymptomatic early in the infection. The testing system, it’s been rationed on the basis of symptoms and we should have learned by now that’s not good enough. We have got to roll out more testing, and make it much less dependent on having symptoms. That’s an absolutely crucial, fundamental thing that we’re still coming to terms with.

Dawn Welham
CIEH president
The government is too big to be efficient and effective and they are doing an appalling job. We can get a Nightingale hospital up and running super quick, but if it’s something that has to be sustained and organised across the country en masse, it seems we cannot do it. But I’m more angry and disappointed with people generally. They can’t be bothered to abide by the rules.

Penny Malone
EHP consultant
There was a huge issue of EHPs not having a voice and not being listened to, when we should have been right in the mix from the beginning. Also, when you look at other public health campaigns around AIDS and smoking, they are very graphic and very scary and that seems to be the way people listen and take things on board.

Stephen Battersby
EHP and former CIEH president
The apparent tension is always between the economy and public health. But you can’t have a sound economy if public health isn’t good. It’s not a binary choice. If we’d locked down sooner, we could have also unlocked sooner but with controls; presupposing we had good testing and tracing and you had the local data.
I hope people learn how important EHPs are to public health. It’s difficult to demonstrate [EH’s] value because it’s like proving a negative. While everything goes along, you get taken for granted. Local government has been under pressure and EH has been an easy area to cut. This brings home how it is a false economy.

This is an edited version of an article that appeared in the October issue of EHN (login required).