Boris Johnson on Sunday prepared to step up Britain’s response to coronavirus, after 48 hours in which his measured approach to the crisis began to lose public, political and scientific support.
Mr Johnson’s allies insist that new measures such as banning mass gatherings, isolating the elderly or quarantining whole families could be brought forward because the epidemic was developing more quickly than expected.
But the prime minister was also facing an increasingly stark political calculation: if Britain’s death rate started to grow faster than EU countries such as France, Ireland or Belgium – now on lockdown – he would probably get some of the blame.
The first signs of unease in Number 10 came on Friday night when journalists were briefed that mass gatherings would be banned, just 24 hours after Mr Johnson and his advisers insisted such a move would be of little merit.
Indeed Patrick Vallance, the chief scientific adviser, had announced on Thursday that the first set of measures to be implemented in Britain’s “delay” strategy were “actually rather large”.
He said that advising people with a cough or fever to self-isolate for seven days was “a big change”. But that advice, along with a suggestion that school trips should be stopped and the elderly should avoid cruise ships, fell massively short of what other countries were doing.
While much of western Europe prepared to shut down to try to contain the virus, Sir Patrick and colleagues allowed the impression to take hold that Britain was resigned to about 40m or more people catching the disease – and that it would actually be a good thing.
The idea of Britain developing herd immunity over a period of months – where a sufficient section of the healthy population were infected and then became immune – took hold at the end of last week, fanned by official briefings.
Sir Patrick said it was desirable to build up herd immunity in the population to protect the country in the longer term. “About 60 per cent is the sort of figure you need to get herd immunity,” Sir Patrick told Sky News on Friday. That suggested up to 40m Britons might contract the disease under the government’s plan.
As Mr Johnson conceded, many loved ones would die.
David Halpern, head of the semi-privatised nudge unit advising Mr Johnson on behavioural science, said: “There’s going to be a point, assuming the epidemic flows and grows as it will do, where you want to cocoon, to protect those at-risk groups so they don’t catch the disease.
“By the time they come out of their cocooning, herd immunity has been achieved in the rest of the population.”
Jeremy Hunt, former health secretary, highlighted growing cross-party political concern about the strategy, saying he was “concerned” that tougher measures to protect the elderly had not been taken.
The fact that Mr Johnson and his team last Thursday had eschewed the options of closing schools, quarantining households with a suspected coronavirus case, or telling people to work from home added to the impression that widespread infection was part of the plan.
Ministers insisted that herd immunity was never part of the strategy – it did not appear in the government’s “battle plan” earlier this month – but it alarmed many scientists who questioned whether it would work in containing this new disease.
On Saturday more than 200 scientists wrote to the government urging them to introduce tougher measures to tackle the spread of Covid-19.
In an open letter, a group of 229 scientists from UK universities say the government’s current approach would put the NHS under additional stress and “risk many more lives than necessary”.
The World Health Organization’s director-general Tedros Adhanom Ghebreyesus denounced Britain’s decision to stop testing people with mild symptoms – essentially an acceptance that coronavirus would inevitably spread widely in the community.
“You can’t fight a virus if you don’t know where it is. Find, isolate, test and treat every case, to break the chains of transmission,” he said. “Every case we find and treat limits the expansion of the disease.”
While the WHO has lavished praise on countries like South Korea, which have cracked down hard on the disease, the idea that Britain could become an island awash with coronavirus cases alarmed many scientists.
But it also threw up a big potential political challenge for Mr Johnson: how to explain why so many “loved ones” were dying in Britain if other countries were experiencing much lower death rates.
Mr Johnson’s advisers said that those countries taking much tougher action would see the virus “bounce back” later in the year, because their countries had not acquired herd immunity.
But in the short-term, Mr Johnson would have to explain to the British public that his approach – quarantining people at the right time while herd immunity built up – was working, even as the death toll mounted.
Under the government’s own modelling, the disease could have a 1 per cent mortality rate. If 40m people were to contract coronavirus, the death toll could rise as high as 400,000, with the prospect of many people possibly dying in overcrowded hospitals.
On Friday afternoon, it became clear that the political risks of Britain’s strategy of holding back – possibly for weeks – on introducing tougher measures to fight the virus were too high.
While Mr Johnson’s allies and Tory MPs denied it was a “U-turn”, the decision to ban mass gatherings in England was never intended to be implemented so swiftly.
When Scotland’s first minister Nicola Sturgeon announced she was banning such gatherings because of the strain they placed on the emergency services, Mr Johnson made a dig at “resilience” issues in the NHS north of the border.
On Saturday it became clear that Mr Johnson would soon announce measures – such as isolating the elderly for up to four months – that scientists had originally expected to be held back until the disease was nearing its peak.
Then on Sunday Matt Hancock, health secretary, distanced himself from the idea that the government strategy was explicitly aimed at building up herd immunity.
“We have a plan, based on the expertise of world-leading scientists,” he wrote in the Sunday Telegraph. “Herd immunity is not a part of it.” The NHS said it was a byproduct of the government strategy to control the spread of the virus.
Mr Hancock said herd immunity was a scientific concept rather than a strategy. “Our goal is to protect life from this virus, our strategy is to protect the most vulnerable and protect the NHS through contain, delay, research and mitigate.”
He also indicated the government would still take a measured approach to phasing in any new measures.
“It’s about making sure you do the right thing at the right time”, Mr Hancock said. “We are prepared to take, if we need to, all the sorts of measures that you discussed but we will do it based on the science.”
“Of course there’s a lively debate about what’s the best course of action. The scientific evidence is absolutely critical in underpinning our response.”
The sense that Mr Johnson’s science-led strategy was losing contact with politics was reinforced by a YouGov poll for the Sunday Times showing that by a margin of 52 per cent to 26 per cent, people thought the government should declare a state of emergency.