What is the best way to tackle coronavirus in the UK?
Video report by ITV News Health Editor Emily Morgan
Scientists are still split on how to tackle coronavirus in the UK.
On the one hand, you have a group promoting the idea of suppression and the other that thinks "herd immunity" is the answer.
A group of experts led by Trisha Greenhalgh, chair of primary care health sciences at Oxford University, wrote to chief government advisers Professor Chris Whitty and Sir Patrick Vallance to back current efforts to “suppress the virus across the entire population, rather than adopt a policy of segmentation or shielding the vulnerable until ‘herd immunity’ has developed”.
Boris Johnson looks to be backing this policy with raft of new restrictions aimed at limiting the spread of the virus in England.Gabriel Scally, Visiting Professor of Public Health at the University of Bristol and a member of Independent SAGE, was one of 22 signatories to the letter.
“I think it’s interesting that things have polarised into these two academic camps," Professor Scally told ITV News.
"One seems to me to be a group of people who believe we are vastly overestimating the damage that the virus has and can do and that we should learn to 'live with it' is the key phrase they’ve adopted.
“I strongly identify with the academics and public health people because I am, at heart, a public health professional who believes this is a really dangerous virus that we’re still learning about.
"It’s been responsible for one million deaths so far in the last six months and it could be easily responsible for another million if we don’t get a grip on it, including in the UK and we believe that the government needs to take action, not only some social restriction action but they need to take a public health approach."
Coronavirus: 1% of deaths involved Covid in second week of September
UK coronavirus alert should be raised to level 4, say chief medical officers
10 things we learned from Johnson's update on coronavirus rules
Sunetra Gupta, professor of theoretical epidemiology at Oxford University, and Carl Heneghan, director of the Centre for Evidence Based Medicine at Oxford, authored the second letter asking for a more targeted approach.
The unstated objective currently appears to be one of suppression of the virus, until such a time that a vaccine can be deployed, it argues.
“This objective is increasingly unfeasible… and is leading to significant harm across all age groups, which likely offsets any benefits," the letter states.
"Instead, more targeted measures that protect the most vulnerable from Covid, whilst not adversely impacting those not at risk, are more supportable.
"Given the high proportion of Covid deaths in care homes, these should be a priority. Such targeted measures should be explored as a matter of urgency, as the logical cornerstone of our future strategy.”
The prime minister showed his hand by announcing a new raft of measures he hopes will limit virus' spread.
New rules include the closing of pubs and restaurants at 10pm, people being encouraged to once again work from home and limiting the number of attendees at weddings to 15.
Some have argued that the Government are putting the economy before public health and the restrictions do not go far enough.
Prof Scally says: "I think they [the restrictions] will do something, one or two of them are helpful, I am disappointed that there has not been recognition that the two-metre rule should be reintroduced and become the norm again.
"We’ve learned more about the virus and it’s very easily facilitated through proximity and not just via droplets but aerosols in the air, so I am very sorry not to see that. That is one of the key things I would like them to do."
Mr Johnson also announced the doubling of fines for those caught not wearing a mask in those environments where it is required or breaking the "rule of six" regulations.
Additionally, those who fail to self-isolate could be hit with a £10,000 fine.
“I am not in favour of a more punitive approach, if you look across the world other countries have handled this better," Professor Linda Bauld, behavioural science expert at Edinburgh University, told ITV News.
“We want people to get tested and if they know that they may get a fine if they don’t, for example, self-isolate if they test positive, they may be less willing to get a test and they may be less willing to pass on their contacts."
Although those who are against the concept of relying on "herd immunity" generally welcome any guidelines aimed at limiting the infection rate, some think they merely paper over the cracks of test and trace's failings.
“I think the problem is the government has never been committed to a proper system," Prof Scally says.
"They abandoned community test and tracing on the 12th of March and it took them two months to decide we did need something.
"Unfortunately, they opted for a national system of test and trace, which they have paid for at a great price to Deloitte, Serco and others to provide and it’s just not doing the job. It’s failing very badly.
"The one bit of the system that is working is the local system, provided by directors of public health and their teams and Public Health England - they’re doing their jobs. It’s the national system that has all the resources and they need to pivot round and put those resources to the local level and engage communities, engage local authorities and engage the local NHS.
"As cases of coronavirus go up across the country and with no imminent sign of a vaccine, many fear how long the world will be living with this virus.
"Until we have some clear goal of where we are trying to get to and how to get us there, I think we’re doomed to these reactive measures and it’s going to be a very long and bumpy winter," Prof Scally says.