ABSTRACT
Countries around the world had used different approaches to tackling the pandemic. Some had closed down their societies hard and early while others relied on advice that they hoped their people would adopt voluntarily. This chapter focuses on the scientific research that caused the UK government to shift its perspective to managing the pandemic from a soft touch approach grounded in advice and guidance to the public about changes in personal behaviour concerned with hand washing, face touching and avoidance of crowded spaces to a more draconian range of interventions that amounted to closure of much of society. The publication of epidemiological modelling that predicted up to 500,000 excess deaths from COVID-19 unless more stringent interventions were deployed such as closures of schools, most workplaces, retail outlets, entertainment, leisure and sports venues, restrictions on public travel, bans on mass gatherings and quarantining of symptomatic cases were implemented. The modelling was based on a study of early COVID-19 pandemic data from 11 European countries. The study had a powerful and immediate impact on the UK government and yet its modelling made a number of unproven assumptions about the impact of specific interventions. One significant assumption was that each implementation would have the same impact as each other. Evidence emerged elsewhere to show that this assumption was wrong. A second assumption was that each intervention had the same impact in every country in which it was used, which again presumed that each intervention was implemented in the same way in every country, when this was not the case. The chapter ends with reports of other studies that demonstrated that non-pharmaceutical interventions can be effective, but the way they are used is critical. While NPIs can control the rate at which a virus spreads, they also have significant costs for societies. Some of these costs can be measured in terms of public health impacts. These interventions can also cause deaths when they put people under considerable stress and remove health service resources from treatment of other life-threatening diseases and health conditions. The impact of interventions can also be mediated by indigenous risk factors already present in populations and health systems. These cautionary points are primers for more detailed critiques of these variables in later chapters.
