It's time for a lockdown and extensive COVID-19 testing: an open letter to the UK government

20 March 2020

As of 20th March Italy’s Covid-19 death toll rose to 3,405 overtaking China’s, with 41,035 confirmed cases. Two weeks ago the number of cases in Italy was 2,502, fewer than the number of confirmed cases in the UK today. The UK is losing a very small window of opportunity to minimise the morbidity and mortality from the COVID-19 outbreak and to prevent a health system collapse. The government needs to enforce measures to reduce community spread and give time for the health system to prepare and cope.

Lessons learned in terms of public health response from those countries ahead of the UK in the epidemic curve need to be seriously considered and implemented without any further delay. These experiences, along with data, modelling and international guidance are clearly in favour of a package of enforced social distancing measures, extensive case finding, isolation and contact tracing.

Therefore, in response to this unprecedented national health emergency, we urge the UK government to implement an urgent enforced lockdown in the areas highly affected by the virus, while ensuring those most vulnerable in society are fully supported. This should be accompanied by building capacity to upscale testing, case isolation, contact tracing and strategies to identify asymptomatic carriers, starting with our dedicated healthcare professionals and then wide-scale community testing, in line with the World Health Organization’s recommendations. Also of utmost urgency and importance is ensuring adequate protective equipment to frontline healthcare staff. The specific steps towards achieving these actions need to be clearly and transparently communicated. Transparency is crucial to reduce public anxiety and ensure trust and solidarity.

Available knowledge and evidence from countries that have tackled the virus must be used, and be transparently and periodically reviewed to inform immediate and subsequent public health actions. Compassion and science both support the immediate actions we are advocating.

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Nisreen A Alwan, Associate Professor in Public Health, University of Southampton
Deborah Ashby, Director of the School of Public Health, Imperial College London
Rochelle A. Burgess, Deputy Director, UCL Centre for Global Non-Communicable Diseases; Lecturer in Global Health, UCL Institute for Global Health
Rona Campbell, Professor of Public Health Research, University of Bristol
Tim Colbourn, Associate Professor of Global Health Epidemiology and Evaluation, Institute for Global Health, University College London
Anthony Costello, Professor of Global Health and Sustainable Development, University College London
Luis E Cuevas, Professor of International Health and Epidemiology, Liverpool School of Tropical Medicine
Matthias Egger, Professor of Epidemiology and Public Health, University of Bristol
Paul Elliott, Chair in Epidemiology and Public Health, School of Public Health, Imperial College London
Majid Ezzati, Chair in Global Environment Health, School of Public Health, Imperial College London
Valentina Gallo, Honorary Associate Professor in Epidemiology, London School of Hygiene and Tropical Medicine
Mark S Gilthorpe, Professor of Statistical Epidemiology, University of Leeds
Keith Godfrey, Professor of Epidemiology and Human Development, University of Southampton
Trish Greenhalgh, Professor of Primary Care Health Sciences, University of Oxford
Christopher Griffiths, Professor of Primary Care, Director (Acting) of Institute of Population Health Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London
Andy Haines, Professor of Environmental Change and Public Health, London School of Hygiene and Tropical Medicine
David Hunter, Richard Doll Professor of Epidemiology and Medicine, Nuffield Department of Population Health, University of Oxford
Shabbar Jaffar, Head of Department of International Public Health, Chair of Epidemiology, Liverpool School of Tropical Medicine
Ruth Jepson, Professor of Public Health in Social Science, University of Edinburgh
Claudia Langenberg, Public Health Medicine, University of Cambridge
Nicola Low, Professor of Epidemiology and Public Health, University of Bern
Azeem Majeed, Professor of Primary Care and Public Health, Imperial College London
Adrian Martineau, Professor of Respiratory Infection and Immunity, Institute of Population Health Sciences, Queen Mary University of London
David McCoy, Professor of Global Public Health, Queen Mary University of London
Martin McKee, Professor of European Public Health, London School of Hygiene and Tropical Medicine
Miriam Orcutt, Senior Research Fellow, Institute for Global Health, University College London
Bharat Pankhania, Senior Clinical Lecturer, University of Exeter
Julian Peto, Professor of Epidemiology, London School of Hygiene and Tropical Medicine
Richard Peto, Emeritus Professor of Medical Statistics and Epidemiology, University of Oxford
Hynek Pikhart, Professor of Epidemiology and Medical Statistics, University College London
Elio Riboli, Chair in Cancer Epidemiology and Prevention, School of Public Health, Imperial College London
Paul Roderick, Professor of Public Health, University of Southampton
Gabriel Scally, Honorary Professor of Public Health, University of Bristol
Nicola Shelton, Professor of Population Health, University College London
Devi Sridhar, Professor of Global Public Health, University of Edinburgh
Stephanie Taylor, Professor in Public Health and Primary Care, Queen Mary University of London
Peter WG Tennant, University Academic Fellow in Health Data Science, University of Leeds
Paolo Vineis, Chair in Environmental Epidemiology, Imperial College London
Helen Ward, Professor of Public Health, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London
Nick Wareham, Director, MRC Epidemiology Unit, University of Cambridge
Anne Wilson, Lecturer in Epidemiology, Liverpool School of Tropical Medicine

**If you are a public health specialist, epidemiologist, scientist in a relevant field or healthcare professional and would like to publicly support this letter, please add your name, specialty and affiliation below**

Full list of signatories will be available to view here: https://docs.google.com/spreadsheets/d/1D7G2Rwn_9JFWZJxTu1jYOsZK5FAvxH20gPJPcsnQP8Q/edit?usp=sharing
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