Health

The SAGE files: Shutting UK's borders would have 'little value' in stopping Covid-19 crisis

Scientists steered the Government away from shutting the UK’s borders because it would have had ‘surprisingly little value’ in stopping Covid-19’s spread, secret advice papers published today revealed.  

One of the scientific reports presented to ministers in May to help guide them through the crisis said restricting air travel would have virtually no effect because the damage was already done.

If borders were locked down right at the beginning of the pandemic, however, it could have prevented a full-blown crisis, as was seen in the likes of Australia and New Zealand.

Another study found that giving immunity passports to Covid-19 survivors – a measure touted by Health Secretary Matt Hancock in April – would only be safe if these people were also tested every month for antibodies.

The Government was also told in early May that mandatory mask-wearing could help control the crisis by stopping asymptomatic people spreading the disease.

Some 40 documents were today published by the Government Office for Science, which is headed by Sir Patrick Vallance, England’s chief scientific adviser.

They are among dozens in a tranche of papers presented to SAGE, the Government’s Scientific Advisory Group for Emergencies, over recent months to help guide ministers through the crisis.

And the reports detail all the scientific advice which is being presented to decision-making officials who dictate when and how the country moves out of lockdown.

Files released today revealed scientists told the Government: 

  • Mandatory face masks could help control the epidemic by stopping asymptomatic people spreading the disease, SAGE was warned in early May;
  • Monthly antibody testing should be carried out on anyone given an ‘immunity passport’ because scientists have no idea how long antibodies protect survivors from reinfection;
  • SAGE was warned in April that 90 per cent of care homes would suffer outbreaks of Covid if infection rates continued and care home staff were highlighted as super-spreaders; 
  • Imperial College London predicts 14,000 people will die each day over the coming winter from Covid-19 – even with ‘good compliance’ with Government measures;  
  • Whole household isolation – dismissed as a Covid-containing tactic early on in crisis – would have pushed epidemic curve back 1.5months and should be reconsidered; 
  • Waiting until Easter to shut schools would have risked spike in ICU capacity with another 1,000 critically-ill cases in hospital each week; 
  • Easing lockdown in April would have led to second wave that was just as ‘extreme and much longer in duration’.
SAGE was warned in early May that mandatory face masks could help control the virus epidemic by stopping asympotmatic people spreading the disease. This graph was included in a scientific report by DELVE, showing how mask-wearing countries fared better during the crisis

SAGE was warned in early May that mandatory face masks could help control the virus epidemic by stopping asympotmatic people spreading the disease. This graph was included in a scientific report by DELVE, showing how mask-wearing countries fared better during the crisis

The latest batch of SAGE papers, which are being released in a bid to show greater transparency from the Government, come as 173 more deaths have been confirmed.

There have now been a total of 42,461 people who died after testing positive for the coronavirus in the UK, but many more who weren’t tested haven’t yet been counted.

Here, MailOnline takes a look at some of the stand-out papers from today:  

UK missed its chance to control the epidemic by shutting its borders 

Two separate reports advised the Government not to shut its borders in April and May because the damage was already done in February and March.

One of the studies was a 2006 paper modelling the effect of restricting incoming flights in the event of a highly-infectious flu pandemic.

Researchers from the Health Protection Agency – which ceased operations in 2013 – found ‘restrictions on air travel were likely to be of surprisingly little value in delaying epidemics, unless almost all travel ceases very soon after epidemics are detected’.  

One of the studies was a 2006 paper modelling the effect of restricting incoming flights in the event of a highly-infectious flu pandemic. it found that a blanket ban which saw 99.9 per cent of flights grounded at the start of the epidemic would have halted the pandemic significantly

One of the studies was a 2006 paper modelling the effect of restricting incoming flights in the event of a highly-infectious flu pandemic. it found that a blanket ban which saw 99.9 per cent of flights grounded at the start of the epidemic would have halted the pandemic significantly

SAGE then handed a separate paper to Government in early May reiterating that there was ‘little scientific justification’ for putting restrictions at the border.

The scientists estimated that fewer than 0.5 per cent of new infections were being imported into the UK in April and May. 

It did this by reviewing Home Office data of incoming flights and predicting how many of these passengers were likely to be infectious based on bad epidemics in their home countries were. 

SAGE said that current swabbing techniques were too slow, and temperature checks were too unspecific to warrant being set up at airports and borders.

However, the group said that restrictions may need to be put in place in the event global air travel returns to normal and other countries suffer second waves.

It recommended a 14-day quarantine, which is now being implemented by the Home Office, despite huge backlash.  

People who get ‘immunity passports’ need to be routinely tested

If immunity passports were issued to allow key workers to return to work, monthly retesting would be critical, scientists said.

Imperial College London researchers presented a paper on Covid-19 immunity to SAGE in April.

The team found no available data about how long antibody responses last after SARS CoV-2 infection, beyond about two weeks after recovery.

Imperial College London researchers presented a paper on Covid-19 immunity to SAGE in April. The team found no available data about how long antibody responses last after SARS CoV-2 infection, beyond about two weeks after recovery

Imperial College London researchers presented a paper on Covid-19 immunity to SAGE in April. The team found no available data about how long antibody responses last after SARS CoV-2 infection, beyond about two weeks after recovery 

Based on literature for other coronaviruses, mild infections can result in low antibody responses that wane just a couple of months after infection, they warned.

For this reason, SAGE was told that Matt Hancock’s idea of so-called immunity passports would need to be accompanied by routine antibody testing.

Such passports, where people carry documented proof they have immunity because of a past infection, were touted as a possible way to ease lockdown in April. 

But the idea appears to have been scrapped because scientists cannot pin-point exactly how long antibodies protect survivors for and current antibody tests have so far proved too inaccurate for widespread use.

Face masks DO work and could help prevent asymptomatic spread

A report on May 4 found compulsory mask-wearing could prevent a significant of coronavirus infections in the UK.

The analysis by DELVE – the Data Evaluation and Learning for Viral Epidemics group – said if everyone wore them it could prevent 40 to 80 per cent of transmissions.

The multi-disciplinary group, convened by the Royal Society, based its estimates on the fact that between four in 10 and eight in 10 Covid-19 patients show no signs of infection yet remain highly infectious.

It also highlighted the fact that droplets from the mouths of infected people play a major role in spreading the virus, through coughs, sneezes and even just by talking. 

DELVE found that home-made coverings could catch between 50 and 70 per cent of viral bacteria being dispersed into the air, while surgical coverings could stop nearly 90 per cent.

The group compared outbreaks in countries where mask-wearing is compulsory compared to nations where it is not and found a huge disparity.

But despite strong evidence for their use since May, the UK Government only last week made masks mandatory on public transport and in hospitals. 

Britons are urged to wear them in shops and crowded places, but this is not being enforced. 

At least nine in 10 care homes will suffer outbreaks of coronavirus

University of Manchester researchers warned in April that at least 90 per cent of care homes would report at least one case of Covid-19.

Just 20 per cent of care homes had recorded outbreaks at the time of the researchers’ modelling.  

They warned that staff were importing the disease into the homes unknowingly, highlighting the need for them to be tested rigorously.

Writing in the study, they said: ‘Staff interact with households and community and so infection can be passed to and from care homes in this manner.

More than 11,000 people are confirmed to have died in care homes as a direct result of Covid-19 and many more are thought to have succumbed to the virus without being diagnosed, meaning they are so far uncounted in official death tolls

More than 11,000 people are confirmed to have died in care homes as a direct result of Covid-19 and many more are thought to have succumbed to the virus without being diagnosed, meaning they are so far uncounted in official death tolls

‘Estimates of expecting high within care home attack rate remains highly likely.

‘A natural conclusion is that with no change in disease transmission in future we might expect at least 90 per cent of care homes to report at least one case eventually if current reporting trends are maintained (currently about 20 per cent have reported such).’

NHS hospitals discharged 25,000 people into care homes during the peak of Britain’s Covid-19 crisis without testing them for the coronavirus.

The move was ordered to free up beds for an anticipated surge in seriously ill virus patients. 

Staff were also not being routinely tested for the disease, which has led to more than 15,000 care home residents dying in England and Wales from Covid-19.  

14,000 Britons could die every day in Britain’s worst winter ever

A paper submitted to SAGE on April 25 by Imperial College London looked at how Covid-19 would affect the country during winter.

Even with ‘good compliance’ with social distancing, the team predicted 14,000 people would die every day next January and February. 

The modelling assumes 75 per cent of homes comply with 14-day household quarantine policy, and that general social distancing reduces contacts outside the household and workplace by 90 per cent and workplace contacts by 50 per cent. 

'Good compliance' scenario assumes 75 per cent of homes comply with 14-day household quarantine policy, and that general social distancing reduces contacts outside the household and workplace by 90 per cent and workplace contacts by 50 per cent. The 'poor compliance' scenario assumes school closure increases household contacts by 100 per cent (rather than 50 per cent for central) and social contacts outside the household by 50 per cent rather than 25 per cent. It also assumes general social distancing only reduces contacts outside the household and workplace by 66 per cent (rather than 75 per cent for central)

‘Good compliance’ scenario assumes 75 per cent of homes comply with 14-day household quarantine policy, and that general social distancing reduces contacts outside the household and workplace by 90 per cent and workplace contacts by 50 per cent. The ‘poor compliance’ scenario assumes school closure increases household contacts by 100 per cent (rather than 50 per cent for central) and social contacts outside the household by 50 per cent rather than 25 per cent. It also assumes general social distancing only reduces contacts outside the household and workplace by 66 per cent (rather than 75 per cent for central)

The health service is bracing for its worst winter on record, when it will have to battle an influx of patients with seasonal flu and Covid-19. 

New infection control measures and social distancing will mean it can only function at about 60 per cent capacity, NHS bosses say. 

And ten million people could be stuck on waiting lists by the end of the year due to hold-ups caused by the pandemic, making treatment harder to come by.

Whole household isolation – dismissed as a Covid-containing tactic early on in crisis – would have pushed epidemic curve back 1.5months.

Isolating entire households would’ve led to 40% less deaths 

Lancaster University urged the Government to reconsider its position on whole household isolation in a paper submitted on March 15.

The idea of telling entire families to isolate for 14 days was thrown out by the Government early in the crisis over concerns there would be low compliance. 

The measure would have seen whole households required to not leave home for two weeks, even if they had no symptoms, if one of them tested positive.

Ministers went in a different direction, and encouraged the symptomatic person to isolate in their room alone. 

How the UK's outbreak would have developed if 50 per cent complied with 'whole household isolation' (yellow), versus 100 per cent of people (pink). Blue shows how Britain's epidemic actually played out

How the UK’s outbreak would have developed if 50 per cent complied with ‘whole household isolation’ (yellow), versus 100 per cent of people (pink). Blue shows how Britain’s epidemic actually played out

But the researchers found that even if just half of families complied with whole household isolation, it would be enough to shrink the size of the epidemic by 40 per cent. 

This would’ve also pushed the curve back by roughly one-and-a-half months, the modelling suggested.

Writing in the study, the scientists said they recommend the measure ‘should be re-considered as an intervention to manage the spread of Covid-19 in the UK.’

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