The path is clear, a proportion of the UK population will be infected by COVID-19. Echoing China and Italy the vast majority of people infected will present with no or mild symptoms and recover quickly. Others, largely people over 60 years of age or those harboring pre-existing medical conditions, may present with severe disease and suffer a high rate of mortality.
In the past days the UK has seen a surge in COVID-19 infections moving into the hundreds per day, with a death toll of 71 as of March 17th. While the numbers are similar to other countries during early stages of the outbreak; one notable difference between the China and Italy epidemics versus the UK is the apparent lack of a major outbreak epicenter. Is this a blessing or a curse? Will the geographical distribution of UK infections flatten the infection curve? Will it contribute to slowing the spread of infection and thereby lower the regional burden on the health care system? Or will this merely result in multiple large outbreak epicenters?
Instead of waiting to find out, lessons learned in China and Italy suggest the time to act is now, before the curve goes exponential. Without a vaccine or effective antiviral agents, rigorous social distancing measures: such as self-quarantine (especially for Individuals in high-risk groups), cancelling public events, closing schools and work from home or paid leave programmes should be put in place. Additionally, widespread infection testing, beyond probable cases, should be implemented to assure accurate surveillance.
While difficult to implement, these strategies have proven successful at slowing the spread of infection, not only with COVID-19 but with Smallpox and the 1918 influenza pandemic. Italy, Spain, France and Germany have already implemented these strategies and the UK should follow suit. This may give the UK the time needed to build population level immunity which will serve to shield the most vulnerable and decrease mortality rates. This will buy the precious time needed to fully understand the progression of the disease and develop much needed antiviral responses. In this of age of social media, video conferencing and multiple alternatives means for non-face-to-face communication this is a small price to pay in order to fulfil our social responsibility, flatten the curve and shut the door on COVID-19.