UK approach ‘led to 1000s of avoidable COVID deaths’

Early in the COVID-19 pandemic, the failure of UK government advisers to follow World Health Organization (WHO) advice that suppression could bring the virus under control quickly led to avoidable UK deaths, according to a paper in The BMJ.

Suppression aims to avoid national lockdowns and maintain economic activity for most of the population by introducing surveillance systems to bring new outbreaks under control quickly, thus reducing the reproductive rate of infection (R0) to below 1 and causing the epidemic to wither.

Anthony Costello, professor of global health at University College London said: ‘Had the UK followed a suppression strategy, it might have prevented thousands of deaths.

In January 2020 the global threat from COVID-19 was clear and the WHO advised countries to focus on rapid suppression to avoid the immediate threat from the spread of the virus.’

The UK government’s Scientific Advisory Group for Emergencies (SAGE) unanimously chose a response based on pandemic flu that ignored the different characteristics of coronavirus transmission.

Nor did SAGE change its advice after reports of rapidly falling cases and infection rates in several East Asian countries that had focused on suppression. Instead, in March 2020, the government published its ‘contain, delay, research, mitigate’ plan based on influenza that would allow the virus to spread to achieve ‘herd immunity.’

SAGE’s unwavering decisions were based on three arguably mistaken assumptions: that COVID could not have been suppressed, that a huge second wave could follow even if it was, and that suppression required prolonged national lockdowns.

Costello points out that, five years on, many of the people who developed the UK’s flawed response are still in post; they have not changed their views on suppression, and little has been done to improve government pandemic advice committees or to introduce detailed governance rules for the UK’s future pandemic response and resilience.

Costello A. BMJ 2025;389:e082463 https://www.bmj.com/content/389/bmj-2024-082463