Stuart Heaver reports on how at least a million air passengers have entered the UK without checks since its first Coronavirus case.
It was a shock for me and my ten fellow passengers onboard BA 028 arriving at London Heathrow airport from Hong Kong last week, when we were not subject to any form of health screening.
The same morning, (7 May) 539 deaths from COVID-19 were reported in the UK but there were no PCR tests, no temperature checks, no health questionnaires, no requests to quarantine and no requirement to leave an address or contact details.
The complete absence of border health controls for international arrivals defies most international guidelines and scientific advice and seems symptomatic of the UK government’s COVID-19 response.
COVID-19 advice provided by London Heathrow Airport’s website states, “we are implementing all processes which the Government deems adequate” but my experience suggests there are no processes.
This may all be about to change, belatedly, with the introduction of a 14-day quarantine requirement for all international arrivals (except lorry drivers and passengers from Ireland) but many scientists are confused why this is being proposed after more than 31,000 coronavirus deaths.
One hundred days of unrestricted entry to the UK from high-risk affected areas have elapsed since the first UK case was confirmed on 29 January. An estimated 680,000 airport passengers passed through Heathrow in April.
“We welcome this measure although it is not clear why there is a delay in implementing it,” says a highly critical report issued on 12 May by the Independent Scientific Advisory Group for Emergencies (SAGE) , led by former chief scientific, adviser David King.
The same report calls for the government to “manage the risk of importing cases” and states “managing the testing, thermal assessment, collection of contact details and quarantine facilities, such as requisitioned hotels, will be essential to stop imported cases.” The approach is consistent with a wide range of expert scientific advice which the UK government appears to be ignoring.
The World Health Organisation (WHO) guidelines recommend that travel measures that significantly interfere with international traffic may only be justified “at the beginning of an outbreak.”
A comprehensive review of scientific research into the effectiveness of quarantine measures published on 8 April states that and that “findings consistently indicate that quarantine is important in reducing incidence and mortality during the COVID‐19 pandemic” and stressed the need for the “early implementation of quarantine”.
Research published on 16 April in the International Journal of Infectious Diseases (IJID) states that “the global spread of the SARS-CoV-2 has clearly been associated with regional and international travel which has contributed to the pandemic.”
That’s why, since 30 January 2020, 180 countries outside the UK have reported to WHO additional health measures that significantly interfere with international traffic (as of 8th April).
Professor KY Yuen is an eminent microbiologist widely credited with identifying the SARS virus in 2003 who advises the Hong Kong government on COVID-19 policy. He explained what an effective border health control procedure like that in Hong Kong looks like.
All incomers are temperature checked, all health declaration forms are filled online then all are immediately quarantined at an airport hotel for one night. Next morning, all arrivals must produce a deep throat saliva sample which will be sent for RT-PCR testing. This takes about three hours and if the result is negative, a wrist band will be prescribed to ensure that person is home quarantined for 14 days. At day 12, another specimen will be tested to ensure the passenger is not infectious before being released from quarantine. If any passenger tests positive, they are immediately sent to the hospital for isolation and treatment.
“These measures have ensured that Hong Kong has a low incidence and a low fatality rate of 0.4%,” said Yuen and the contrast with current procedures at UK airports where staff don’t even wear face masks is alarming.
No-one yet knows exactly what the new UK quarantine procedure will look like but experts have already identified some problems. Home quarantine must be supervised to be effective and the Independent SAGE report highlights the fact that anyone can travel to the UK via Ireland and bi-pass quarantine checks. In Hong Kong, many sick people rushed home to beat the implementation date for quarantine procedures, creating a spike in imported cases which threatened to create a second wave of infections. This policy could backfire badly if testing is not put in place promptly.
The UK border health measures seem part of the familiar “too little or too late” approach to COVID-19 or what the Independent SAGE report calls the “ambivalence in the government’s strategic response.”