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COVID-19 pandemic The COVID-19 pandemic, also known as the coronavirus pandemic, is an ongoing Pandemic#COVID-19, global pandemic of COVID-19, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The viru ...
was first confirmed to have spread to
England England is a Countries of the United Kingdom, country that is part of the United Kingdom. It shares land borders with Wales to its west and Scotland to its north. The Irish Sea lies northwest of England and the Celtic Sea to the southwest. En ...
with two cases among Chinese nationals staying in a hotel in
York York is a cathedral city and unitary authority, unitary authority area, at the confluence of the rivers River Ouse, Yorkshire, Ouse and River Foss, Foss, in England. At the 2011 census, the borough population was 198,051 and the population of th ...

York
on 31 January 2020. The two main public bodies responsible for health in England are NHS England and
Public Health England Public Health England (PHE) was an executive agency of the Department of Health and Social Care in the United Kingdom which began operating on 1 April 2013 to protect and improve health and wellbeing and reduce health inequalities. Its formatio ...
. NHS England oversees the budget, planning, delivery and day-to-day operation of the commissioning side of the NHS in England while PHE's mission is "to protect and improve the nation’s health and to address inequalities". As of 7 April 2021, there have been 3,818,665 total cases and 111,666 deaths in England. In January 2021 it was estimated around 22% of people in England have had coronavirus. Unlike in
Scotland Scotland ( sco, Scotland, gd, Alba ) is a Countries of the United Kingdom, country that is part of the United Kingdom. Covering the northern third of the island of Great Britain, mainland Scotland has a 96-mile (154 km) Anglo-Scottish bo ...
,
Wales Wales ( cy, Cymru ) is a country that is Countries of the United Kingdom, part of the United Kingdom. It is bordered by England to the Wales–England border, east, the Irish Sea to the north and west, and the Bristol Channel to the south. It ...
and
Northern Ireland Northern Ireland ( ga, Tuaisceart Éireann ; Ulster Scots dialects, Ulster-Scots: ') is #Descriptions, variously described as a country, province, or region which is Countries of the United Kingdom, part of the United Kingdom. Located in the ...

Northern Ireland
where it is administered by the devolved governments, healthcare in England is the direct responsibility of the
UK Government The Government of the United Kingdom, domestically referred to as Her Majesty's Government, is the central government of the United Kingdom of Great Britain and Northern Ireland.
. As a result of each country having different policies and priorities, a variety of differences now exist between these systems.


Timeline


September 2019 - January 2020 : Suspected cases

In May 2020, the reported that several members of a choir in
Yorkshire Yorkshire (; abbreviated Yorks), formally known as the County of York, is a Historic counties of England, historic county of Northern England and the largest in the United Kingdom. Because of its great size in comparison to other English counti ...
had suffered COVID-19-like symptoms shortly after the partner of one of the choir members returned from a business trip to
Wuhan Wuhan (, ) is the capital of Hubei Province in the People's Republic of China China, officially the People's Republic of China (PRC), is a country in East Asia. It is the List of countries and dependencies by population, world's most pop ...
, China, on 17 or 18 December. Earlier, in March 2020, it was reported that a 50-year-old man from
East Sussex East Sussex is a county A county is a geographical region of a country used for administrative or other purposesChambers Dictionary, L. Brookes (ed.), 2005, Chambers Harrap Publishers Ltd, Edinburgh in certain modern nations. The term is de ...
fell ill, also with COVID-19 symptoms, on 20 January after he returned from Ischgl in
Austria Austria (, ; german: Österreich ), officially the Republic of Austria (german: Republik Österreich, links=no, ), is a landlocked Eastern Alps, East Alpine country in the southern part of Central Europe. It is composed of nine States of ...
, the resort was under investigation because it allegedly failed to report possible cases. Three members of his family, two friends from
Denmark Denmark ( da, Danmark, ), officially the Kingdom of Denmark, da, Kongeriget Danmark, . See also: The unity of the Realm is a Nordic countries, Nordic country in Northern Europe. Denmark proper, which is the southernmost of the Scandinavian c ...
and one from
Minnesota Minnesota () is a U.S. state, state in the north central region of the United States. It is known as the "Land of 10,000 Lakes". Its official motto is , French for "The Star of the North". Of the U.S. state, U.S. states, Minnesota is the List ...
, US had same symptoms. In June 2020 BBC reported it was found COVID-19 in UK had at least 1356 origins, mostly from COVID-19 pandemic in Italy, Italy (late February), COVID-19 pandemic in Spain, Spain (early-to-mid-March), and COVID-19 pandemic in France, France (mid-to-late-March). In the same month, it was reported that 53-year-old woman fell ill on 6 January, two days after returning from Obergurgl resort in Austria. In August 2020 the Kent Coroner#England and Wales, coroner reportedly certified that the death of Peter Attwood (aged 84) on 30 January had been related to COVID-19 ('COVID-19 infection and bronchopneumonia', according to an email on 3 September, after COVID-19 was detected in his lung tissue), making him the first confirmed England and UK victim of the disease. He first showed symptoms on 15 December 2019. Attwood had not travelled abroad. In November 2020 it was reported that a 66-year-old had experienced symptoms of COVID-19 shortly after returning from holiday in Italy in September 2019, and his 44-year-old daughter had experienced similar symptoms. Scientists had previously speculated about COVID-19 in Italy as early as September 2019.


January 2020

On 31 January, two members of a family of Chinese nationals staying in a hotel in
York York is a cathedral city and unitary authority, unitary authority area, at the confluence of the rivers River Ouse, Yorkshire, Ouse and River Foss, Foss, in England. At the 2011 census, the borough population was 198,051 and the population of th ...

York
, one of whom studied at the University of York, became the first confirmed cases of COVID-19 in the UK. Upon confirmation, they were transferred from Hull University Teaching Hospitals NHS Trust, Hull University Teaching Hospital to a specialist isolation facility, a designated High Consequence Infectious Diseases Unit in Newcastle upon Tyne's Royal Victoria Infirmary. On the same day, an evacuations related to the COVID-19 pandemic, evacuation flight from Wuhan landed at RAF Brize Norton and the passengers, none of whom were showing symptoms, were taken to quarantine, in a staff residential block at Arrowe Park Hospital on the Wirral Peninsula, Wirral. There had previously been contention over whether the government should assist the repatriation of UK passport holders from the most affected areas in China, or restrict travel from affected regions altogether. Some British nationals in Wuhan had been informed that they could be evacuated but any spouses or children with mainland Chinese passports could not. This was later overturned, but the delay meant that some people missed the flight.


February 2020

On 6 February, a third confirmed case, a man who had recently travelled to Singapore prior to visiting a ski resort in the Haute-Savoie, France, was reported in Brighton. He had been the source of infection to six of his relatives during a stay in France, before returning to the UK on 28 January. Following confirmation of his result, the UK's CMOs expanded the number of countries where a history of previous travel associated with flu-like symptoms – such as fever, cough and difficulty breathing – in the previous 14 days would require self-isolation and calling NHS 111. These countries included China, Hong Kong, Japan, Macau, Malaysia, Republic of Korea, Singapore, Taiwan and Thailand. On 10 February, the total number of cases in the UK reached eight as four further cases were confirmed in people linked to the affected man from Brighton. Globally, the virus had spread to 28 countries. On the morning of 10 February, the Secretary of State for Health and Social Care, Matt Hancock, announced the Health Protection (Coronavirus) Regulations 2020, to give public health professionals "strengthened powers" to keep affected people and those believed to be a possible risk of having the virus, in isolation. That day, the Arrowe Park Hospital, Merseyside, and the Kents Hill Park hotel and conference centre, Milton Keynes became designated isolation units. The following day, two of the eight confirmed cases in the UK were reported by BBC News to be general practitioners. A ninth case was confirmed COVID-19 pandemic in London, in London on 11 February.


March 2020

File:Depleted lavatory rolls during the 2020 Coronavirus outbreak, Morrisons, Wetherby (20th March 2020).jpg, The effects of panic buying in a Morrisons supermarket in Wetherby, West Yorkshire On 1 March, further cases were reported in Greater Manchester, some of them believed to be contacts of the case in Surrey who had no history of travel abroad. On 2 March, four further people in England tested positive. All had recently travelled from Italy; they were from Hertfordshire, Devon and Kent. The total number of UK cases was reported as having reached 40, though this was revised to 39 after additional testing. The following day, when the number of confirmed cases in the UK stood at 51, the UK government unveiled their ''Coronavirus Action Plan'', which outlined what the UK had done already and what it planned to do next. On 2 March, the first coronavirus death occurred in a care home, but at that time care home data were not yet published. On 3 March, the first three hospital deaths were reported in Nottingham, Essex, and Buckinghamshire. On 15 March, the COVID-19 Hospitalisation in England Surveillance System (CHESS) was initiated across all NHS Trusts. On 17 March, NHS England announced that all non-urgent operations would be postponed from 15 April to free up 30,000 beds. Many of these patients were discharged into care homes, but few were tested for COVID-19 which resulted in the spread of the disease into many care homes. Also on 17 March, Chancellor of the Exchequer, Chancellor Rishi Sunak announced that £330bn would be made available in loan guarantees for businesses affected by the pandemic. By 18 March, over 1,000 patients were in hospital with COVID-19. This number rapidly grew and by 31 March exceeded 11,000. Admissions to hospital grew from less than 700 a day on 20 March to more than 2,400 a day by 31 March. By 20 March, genome sequencing had identified ten viral lineages of COVID-19 in England (A, B, B1, B10, B10.2, B11, B12.1, B5, B8, B9). The research, which was at an early stage, concluded that the data were consistent with a large number of independent introductions into the UK, from places around the world, particularly Italy and other European countries. It was very likely that the true number of independent introductions was substantially higher. By 31 March, England was the worst affected country in the United Kingdom with over 21,000 confirmed infections; In March there were around 4,500 deaths in hospital but more than 6,700 patients who had recovered were discharged. Office for National Statistics, ONS data for England and Wales suggests that by 31 March, England had seen over 200 COVID-19 deaths in care homes and more than 200 deaths at home.


April 2020

On 2 April the maximum number of hospital admissions in a day during the first wave was reached (around 3,000 patients); the number of daily hospital deaths was now more than 600. On 12 April the number of patients in hospital, for the first wave, peaked at 18,974 and the number of daily admissions due to COVID-19 had reduced to less than 1,900; more than 700 hospital deaths were recorded. Up to 24 April, ONS death registrations for England and Wales showed 19,643 had occurred in hospital, 5,890 in care homes, 1,306 in private homes and 301 in hospices. Of these deaths, 1,149 occurred in Wales. On 29 April the method of reporting deaths in England was changed. Data from three sources are now cross checked against the list of people who have had a diagnosis of COVID-19 confirmed by a Public Health England or NHS laboratory. The three sources are: # data supplied to NHS England by the Hospital Trusts, # data from Public Health England Health Protection teams (mainly deaths not in hospitals), # Information obtained by linking the Second Generation Surveillance System (SGSS) to the NHS Demographic Batch Service. After checking, the records are merged into one database and duplicates removed so there is no double counting. The new method of counting deaths results in higher numbers than the previous method. On 29 April the total of deaths reported by NHS England was 21,400. The new method identified 23,550 deaths of people who had a positive test result confirmed by a PHE or NHS laboratory. The number of patients with COVID-19 in hospital steadily reduced until on 30 April it was around 12,900; at least 54,100 patients were admitted to hospital in April with COVID-19. The total number of deaths in hospital during April from COVID-19 exceeded 17,500; this data suggest that there were around 36,000 patient who had the disease were discharged in April.


May 2020

By 3 May, daily admissions to hospital had further reduced to around 1000, while discharges continued to exceed admissions and thus the number of people in hospital was now around 10,500. An app for the adult social care workforce in England was launched on 6 May to support workers during the COVID-19 outbreak. The Care Workforce app was developed by NHSX and the NHS Business Services Authority. The GMB union told members not to use the app, saying that managers could identify staff who had complained about pay, testing and personal protective equipment through a chat feature. On 12 May the number of people in hospital fell below 10,000 and the total number of deaths in hospital since 1 March had grown to at least 24,500. On 11 May the COVID Alert Levels were published by the Government and many restrictions in England were eased; people who were unable to work from home were encouraged to return to work, but where possible avoid public transport. By 21 May the number of hospital patients was below 8,000 and daily admissions were around 700. On 21 May the lockdown lockdown rules were amended in England to allow people to meet one other person from another household, outdoors, but to remain 2 m (6 ft) apart. Outdoor sports such as golf or tennis were allowed with members of your household or with one other person from another household, while maintaining social distancing. Households were allowed to drive any distance in England to destinations such as parks and beaches but not to Wales or Scotland. On 27 May, Matt Hancock announced NHS Test and Trace would begin operations the following day. The number of patients in hospital with COVID-19 continued to reduce and on 31 May was around 5,900. During the month at least 22,400 patients were admitted to hospital with COVID-19, the number of hospital deaths was around 5,200 and around 23,900 patients were discharged.


June 2020

A study published on 8 June which included genome sequencing data concluded that in mid to late February travel from Italy resulted in the majority of importations. By 1 March this had changed to Spain and by mid-March it changed again to France; because of the travel restrictions imposed, importations after mid April were at very low levels. It was estimated that around half of the importations were by UK nationals returning to the UK. In the period up to 3 May, approximately 34% of detected UK transmission lineages arrived via travel from Spain, 29% from France, 14% from Italy and 23% from other countries. Less than 0.1% were from China. By 15 June the number of people in hospital had fallen steadily to around 3,900 and daily admissions were down to around 360, but each day there were still around 50 deaths reported. On 30 June the government imposed the Timeline of the COVID-19 pandemic in the United Kingdom#29 June, first local lockdown in the UK after 10% of all positive cases in the UK over the past week were found in Leicester. Non-essential shops in the city had to close, and the public houses and restaurants hoping to reopen on 4 July had to delay opening for at least two weeks; schools would also be shut for most pupils. By 30 June daily COVID-19 hospital admissions were fewer than 200 and COVID-19 daily deaths in hospital were around 30; the total number in hospital with COVID-19 was fewer than 2,700.


July 2020

On Friday 24 July 2020 The Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) Regulations 2020, new regulations made it compulsory to wear face coverings in most indoor shops, shopping centres, banks, post offices and public transport hubs. Those breaking the rules could be fined up to £100. Face coverings remained optional in other indoor public places including museums, cinemas and hairdressers. Excluded from the regulations were venues where wearing a mask might be 'impractical', such as restaurants and gyms. Exemptions were available for children under 11, individuals with physical or mental illness or disability, and for anyone to whom it would cause significant distress. On 24 July it was reported that, as a result of the pandemic and job losses, almost 1,000 people applied to a restaurant in Manchester advertising a vacancy for a receptionist. Indoor gyms and pools started to re-open on 25 July. During July the total number of COVID-19 hospital admissions fell to around 3,050, the number of deaths in hospital from COVID-19 fell to around 480, and around 4,200 patients with the disease were discharged from hospitals.


August 2020

August saw the fewest monthly hospital admissions (1,600) since the start of the pandemic and hospital deaths (208); the number of patients in hospital on 31 August was under 500. Throughout August the daily hospital death rate was essentially in single digits. The rules aimed at stopping the spread of the virus were eased on 15 August: casinos, bowling alleys and conference halls were among a range of venues allowed to reopen across much of England. Also permitted were indoor performances with socially distanced live audiences (including in theatres and sports stadiums), wedding receptions for up to 30 people, skating rinks and beauticians as long as they had measures in place to reduce COVID-19 transmission. Beauticians, tattooists, spas and tanning salons could offer additional services, including front-of-face treatments such as eyebrow threading.


September 2020

On 2 September the minimum number of hospital patients since the start of the pandemic was recorded (451); hospital admissions were around 60 a day at the start of the month. Until 12 September, the number of deaths in hospital was essentially in single digits but thereafter rose until it was around 40 a day by the end of the month. On 8 September, following a rise in case numbers, the government published new social distancing rules to come into effect in England from 14 September. These restricted gatherings of separate households to groups of six or few people (the so-called "rule of six"), excluding work or educational settings. By 18 September, the COVID Symptom Study estimated the Basic reproduction number, R_0 value in England to be 1.4, meaning that cases were doubling every seven days. Hospital admissions in September were around 5,900. There were around 560 deaths and more than 3,750 discharges.


October 2020

Between July and September 2020, ever more extensive and increasingly rigorous ad hoc local regulations were introduced, which in many areas proved unsuccessful in controlling the spread of the virus. In England, all of these local regulations were swept away on 14 October, and replaced by new First COVID-19 tier regulations in England, tier regulations with three levels of restrictions. The easing of restrictions and emergence of a second more infectious variant of COVID-19> resulted in a second wave of the virus becoming well established. Hospital admissions rose from less than 6,000 in September to over 25,000 in October. Almost 3,500 people died in hospital from COVID-19 but more than 14,700 patients were discharged.


November 2020

After further forecasts predicting unsustainable pressure on the healthcare system, new uniform national restrictions were put in place from 5 November to at least 2 December. Despite these tighter regulations, the number of hospital admissions during November was more than 41,200; deaths in hospital approached 8,300 with 29,000 patient discharges. On 30 November there were 13,700 people in hospital. It is now known that, in London, the new variant of COVID-19 accounted for around 25% of the cases.


December 2020

From 2 December, the national restrictions were replaced by a The Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020, second version of tier regulations, again with three levels; 57% of the population was placed in Tier 2 and 42% in the strictest Tier 3. The government also announced that, from 23 December to 27 December, a 'Christmas bubble' would be permitted, allowing people from up to three households to meet in private homes and/or gardens, and travel between tiers for the purpose of meeting others in the same bubble. After the existence of the new variant – referred to as Variant of Concern 202012/01 – was announced the government issued new public health guidance and were expected to impose transit restrictions. By mid-December around two-thirds of the cases reported in London were the new variant. On 19 December it was announced that a new "tier four" measure would be applied to London, Kent, Essex, Bedfordshire, Buckinghamshire and Hertfordshire, and Christmas season relaxation would be limited to only Christmas Day. These attempts at controlling the second wave had limited success: the total number of hospital admissions rose again during December to more than 58,600, and deaths in hospital approached 10,600. Although almost 39,000 patients were discharged there were still more than 22,700 people in hospital on 31 December.


January 2021

On 1 January, the government announced that all primary schools in London would remain closed. This caused uproar from many headmasters and teaching staff in other areas. On 4 January the majority of primary schools opened. That evening, Boris Johnson made a televised address to the nation, announcing a third lockdown in England. The rules were similar to the first lockdown in March 2020 and schools would close for most pupils on 5 January. In view of the increase of hospitalized cases, the government's slogan was changed back to "Stay Home, Protect the NHS, Save Lives." On 25 January, Boris Johnson said the government would give an update on when schools can reopen in England as soon as they could. On the same day, the Health Secretary Matt Hancock said there are early signs that the current restrictions are working, but it was not a moment to ease them. The peak of hospital admissions occurred on 12 January at 4,134 patients; the peak number of people in hospital occurred almost a week later on 18 January at 34,336, this is over 80% higher than that recorded in the first wave of the pandemic. In January, the total number of patients with Covid-19 admitted to hospital exceeded 100,000, more than 22,000 patients died but there were over 73,200 discharges. On 30 January 2020, a group of economic asylum seekers created havoc and ran riot at Napier Barracks, where they were housed temporarily by state authorities pending resolution of their cases. The barracks were beset by COVID-19 at the rate of one person in four and the victims were unhappy enough to burn the place down. Priti Patel was cross and Coventry South MP Zarah Sultana called on government to "provide good, safe and liveable housing instead". The barracks would now be subject to a deep clean.


February 2021

On 1 February, door to door testing was announced to identify cases of the South African variant. There would be around 80,000 tests across 8 different areas of the country where the 11 cases were found that had no travel history. On 22 February, Boris Johnson announced the roadmap out of lockdown. Starting on 8 March with schools and colleges reopening and the lockdown ending on 21 June with nearly all restrictions being lifted. By the end of February, daily cases were as low as they were during September 2020, with 5,080 cases being reported in England on 28 February. In February, more than 35,800 people were admitted to hospital with COVID-19, around 9,400 patients died from the disease but more than 44,200 patients recovered and were discharged.


March 2021

On 3 March, there were less than 10,000 patients in hospitals for the first time since 1 November 2020. Students returned to face-to-face education in schools and colleges on 8 March, with rapid testing being carried out in secondary schools. By 13 March, over 20 million people had received their first dose of vaccinations, as well as over 1 million people having received their second dose. There had been a surge of infections in many countries of Europe, however the current roadmap out of England's lockdown would still go as planned. On March 29, the next phase of easing the lockdown took place, with people being able to meet up in groups of 6 or 2 households outdoors, and outdoor sporting facilities could reopen. Cases began to drop towards the end of March, with less than 3,000 people getting infected a day. In March, just over 11,400 were admitted to hospital, around 2,090 people died in hospital and more than 17,000 people were discharged.


April 2021

On 5 April, Boris Johnson announced the next phase of the lockdown easing would go as planned, with pubs and non-essential shops reopening from 12 April.


Hospital death statistics

Statistics for deaths in hospital up to 30 December 2020 showed that those with a pre-existing condition – especially diabetes, chromic kidney disease, dementia or ischemic heart disease but also asthma, chronic neurological or pulmonary disease – were around twenty-three times more likely to die than those who did not have one. Age and sex also influenced the risk of death, with men between 60 and 79 showing a death rate almost double that of women. Men over 80 were over 30% more likely to die than women in the same age group. The percentages in each category have shown only small changes through the year.


ONS data


Registered deaths

The Office for National Statistics, Office of National Statistics publishes data on weekly deaths in England and Wales, which include information on deaths from COVID-19. These data give the number of deaths recorded in England during a seven-day period; the total number of deaths will be greater as there is normally a delay between the day of death and when it is recorded.


2020

Up to and including the week ending 6 March 2020, the number of deaths in England was on average 442 fewer each week than the five-year average (2015-2019). The number of deaths above the average is generally referred to as 'excess' deaths, in both 2020 and 2012 the data were influenced by many factors including the lockdowns, social distancing, mask wearing, reduced elective surgery and less medical diagnosis and care. This resulted in very few deaths from influenza, slightly less from road traffic accident but more because people did not seek or were unable to get healthcare. The total number of excess deaths in the whole of 2020 was 71,677 but if the starting point of the pandemic is taken as 6 March, the total number of excess deaths would be more than 76,000. The registration data were affected by closure of the registry offices over bank holidays, Christmas and the New Year. In addition, 2020 was a 53-week year.


2021

For the first nine weeks of 2021 the total number of excess deaths in 2021 has continues to increase but since 12 March it has started to reduce, this in part is because some of the peope who died prematurely from COVID-19 would have seccumbed at a slightly later date. The data for 2 April will be lower because of the Bank Holiday.


Deaths by place of occurrence


13 March – 4 September 2020

The ONS data includes information on deaths by place of occurrence. During the first wave of infections, the majority of deaths were in hospital (63%) but deaths in care homes was also high (30%). The percentage of deaths in each setting remained essentially constant from mid June to early September.


11 September 2020 – 1 January 2021

During the second wave there was a significant increase in the percentage of deaths in hospital, and a corresponding decrease in care-home deaths.


2 January 2021 -


COVID-19 deaths by age in 2020

ONS Data are only available for England and Wales; the differences in the percentage of all deaths with age between the two waves of the pandemic were small. Almost three-quarters of the deaths occurred in those over 75 years (around 11% of the population) while those aged between 70 and 75 accounted for a further 9% of the deaths. Some differences were observed between the genders, with a generally higher percentage of deaths for men; the exception was those over 75, but this reflects the greater number of older women in the population.


Vaccination programme

A programme of mass vaccinations began on 8 December 2020, with priority given to the elderly, their carers and frontline health and social care workers. The vaccine takes around 21 days to become fully effective and the exact number of people over 75 vaccinated each week has not been published. Although there is a lag between catching the disease and mortality, the ONS data provide a way of identifying the effectiveness of the vaccination programme; only combined date for England and Wales are available. Although there is some variation in the data in December, it would appear that since the beginning of 2021 there has been a reduction in deaths in the 75+ age group which were the first to be vaccinated. An alternative source to investigate the effectiveness of the vaccination program is the deaths in hospital data released daily by NHS. The caveat when considering this information is that around 30% of all deaths from Covid are not in hospitals and the majority of these deaths are people who are likely to be 80+ years old. However, since 1 January 2021 there would appear to be a significant and continuous decrease in the weekly number of hospital deaths being recorded in the 80+ age group and a corresponding increase in those aged 0-59 and 60-69. The data for 19 March woud appear to show an increase in deaths in the 80+ age group, there are a number of reasons this could occur including a significant reduction in total hospital deaths, the effects of lockdown, vaccination of younger vulnerable adults asw ell as medical and care staff who are more at risk of exposure to COVID-19.


Regulations and legislation

The government published the Health Protection (Coronavirus) Regulations 2020 on 10 February 2020, a statutory instrument (UK), statutory instrument covering the legal framework behind the government's initial containment and isolation strategies and its organisation of the national reaction to the virus for England. Other published regulations include changes to Statutory sick pay, Statutory Sick Pay (into force on 13 March), and changes to Employment and Support Allowance and Universal Credit (also 13 March). On 19 March, the government introduced the Coronavirus Act 2020, which grants the government discretionary emergency powers in the areas of the NHS, social care, schools, police, the Border Force, local councils, funerals and courts. The act received royal assent on 25 March 2020. Closures to pubs, restaurants and indoor sports and leisure facilities were imposed via The Health Protection (Coronavirus, Business Closure) (England) Regulations 2020 (SI 327). On 23 March the Government announced a number of restrictions on movement some of which were later enacted into law, these included: # Shopping for basic necessities, as infrequently as possible; # One form of exercise a day - for example a run, walk, or cycle - alone or with members of your household (was not enacted in law); # Any medical need, to provide care or to help a vulnerable person; # Travelling to and from work, but only where this is absolutely necessary and cannot be done from home. The full regulations are detailed in: *Health Protection (Coronavirus, Restrictions) (England) Regulations 2020 **amended on 22 April by The Health Protection (Coronavirus, Restrictions) (England) (Amendment) Regulations 2020 ***and further amended on 13 May by the Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 2) Regulations 2020


Local lockdown regulations

In England, up until 14 October 2020 most of the COVID-19 The Health Protection (Coronavirus, Restrictions) (No. 2) (England) Regulations 2020, lockdown regulations covered the whole country, but some local areas of particular concern are or have been subject to more restrictive rules at various times, namely Leicester, Luton, Blackburn with Darwen, Bradford, Tameside, Bury, Greater Manchester, Bury, Manchester, Oldham, Rochdale, Salford, Stockport, Trafford, Wigan, Borough of Pendle, Pendle, Hyndburn, Burnley, Calderdale and Kirklees. In most cases, the effect of the local regulations had been to slow down the gradual easing of the lockdown regulations which applied to the rest of the country.


Tier regulations

In England the local lockdown regulations were swept away on 14 October 2020, and were replaced by the first COVID-19 tier regulations in England. The restrictions were enforced by three statutory instruments, as follows: * "Tier 1": The Health Protection (Coronavirus, Local COVID-19 Alert Level) (Medium) (England) Regulations 2020 (SI 2020/1103) * "Tier 2": The Health Protection (Coronavirus, Local COVID-19 Alert Level) (High) (England) Regulations 2020 (SI 2020/1104) * "Tier 3": The Health Protection (Coronavirus, Local COVID-19 Alert Level) (Very High) (England) Regulations 2020 (SI 2020/1105) These are referred to as the 'first tier regulations". The regulations relate to England only. Following the November lockdown, a new framework of tiers, known as the second tier regulations, were introduced in The Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020. The regulations apply from 2 December 2020 until 2 February 2021, with special arrangements over the Christmas period, 23–27 December 2020. In December 2020, a new Fourth Tier was added to the second tier regulations. Households in this tier were subjected to further restrictions including a ban on travel outside their area, a ban on international travel and a ban on meeting more than one person outside. The Christmas regulations were changed, so that only households in Tiers 1-3 could mix with up to three other households only on Christmas Day only; Tier 4 households could not mix over the festive period.


Impact


Finance and the economy

During the second half of March, one million British workers applied for the Universal Credit benefit scheme. On 20 March the government announced a Coronavirus Job Retention Scheme, where it would offer grants to companies to pay 80% of a staff wage each month up to a total of £2,500 per a person, if companies kept staff on their payroll. The scheme would cover three months' wages and would be backdated to the start of March. Following a three-week extension of the countrywide lockdown the scheme was extended until the end of June 2020. Initially the scheme was only for those workers who started work at their company on or before 28 February 2020; this was later changed to 19 March 2020, the day before the scheme was announced, allowing 200,000 additional workers to be part of it. On the first day of operation 140,000 companies used the scheme. Later the scheme was extended until the end of October with the Chancellor saying that from August companies would have to contribute towards the 80% of employees wages that the government was covering. It was stated that the scheme was costing £14 billion a month to run, with nearly a quarter of all workers in Britain furloughed by their employers within two weeks of the start of the scheme. The decision to extended the job retention scheme was made to avoid mass redundancies, company bankruptcies and potential unemployment levels not seen since the 1930s. In March the Self Employed Income Support Scheme (SEISS) was announced. The scheme paid a grant worth 80% of self employed profits profits up to £2,500 each month, for companies whose trading profit was less than £50,000 in the 2018-19 financial year or averaged less than £50,000 over the last three financial tax years. Her Majesty's Revenue & Customs (HMRC) were tasked with contacting those who were eligible and the grant was taxable. The government also had announced a six-month delay on tax payments. Self employed workers who pay themselves a salary and dividends are not covered by the scheme and instead had to apply for the job retention scheme. The scheme went live on 13 May. The scheme went live ahead of schedule and people were invited to claim on a specific date between 13 and 18 May based on their Unique Tax Reference number. Claimants would receive their money by 25 May or within six days of a completed claim. By 15 May, more than 1 million self employed people had applied to the scheme. The government announced Retail, Hospitality and Leisure Grant Fund (RHLGF) and changes to the Small Business Grant Fund (SBGF) on 17 March. The SBGF was changed from £3,000 to £10,000, while the RHLGF offered grants of up to £25,000. £12.33 billion in funding was committed to the SBGF and the RHLGF schemes with another £617 million added at the start of May. By 25 April only around 50% of eligible business had received funding. On 23 March the Government announced the Coronavirus Business Interruption Loan Scheme (CBILS) for small and medium-sized businesses and Covid Corporate Financing Facility for large companies. The government banned banks from seeking personal guarantees on Coronavirus Business Interruption loans under £250,000 following complaints. Coronavirus Large Business Interruption Loan Scheme (CLBILS) was announced on 3April and later tweaked to include more companies. In May the amount a company could borrow on the scheme was raised from £50 million to £200 million. Restrictions were put in place on companies on the scheme including dividends payout and bonuses to members of the board. On 20 April the Government announced a scheme worth £1.25 billion to support innovative new companies that could not claim for coronavirus rescue schemes. The government additionally announced the Bounce Back Loan Scheme (BBLS) for small and medium size businesses. The scheme offered loans of up to £50,000 and was interest free for the first year before an interest rate of 2.5% a year was applied, with the loan being paid back within six years. Businesses who had an existing CBILS loan of up to £50,000 could transfer on to this scheme, but had to do so by 4 November 2020. The scheme launched on 4 May. The loan was 100% guaranteed by the government and was designed to be simpler than the CBILS scheme. More than 130,000 BBLS applications were received by banks on the first day of operation with more than 69,500 being approved. On 13 May the Government announced that it was under writing Trade credit insurance, to prevent businesses struggling in the pandemic from having no insurance cover. On 12 May almost £15 billion of state aid had been given to businesses. The Treasury and the Bank of England on 17 March announced the Covid Corporate Financing Facility (CCFF). The Resolution Foundation surveyed 6,000 workers, and concluded that 30% of those in the lowest income bracket had been affected by the pandemic compared with 10% of those in the top fifth of earners. The foundation said that about a quarter of 18 to 24-year-olds included in the research had been furloughed whilst another 9% had lost their job altogether. They also said that 35 to 44 year olds were least likely to be furloughed or lose their jobs with only around 15% of the surveyed population having experienced these outcomes. Earlier research by the Institute for Fiscal Studies concluded that young people (those under 25) and women were more likely to be working in a shutdown business sector. ''The Guardian'' reported that after the government had suspended the standard tender process so contracts could to be issued "with extreme urgency", over a billion pounds of state contracts had been awarded under the new fast-track rules. The contracts were to provide food parcels, personal protective equipment (PPE) and assist in operations. The largest contract was handed to Edenred by the Department for Education, it was worth £234 million and was for the replacement of free school meals.


National health service response


Appointments and self-isolation

In March, hospitals in England began to cancel all elective procedures. On 22 March, the government announced that it would be asking about 1.5 million people (everyone in England with certain health conditions that carry serious risk if infected) to "shield" for 12 weeks. They were to be notified by mail or text messaged by their NHS general practitioners, and provided deliveries of medication, food, and household essentials, delivered by pharmacists and local governments, and at least initially paid for by the UK government. Members of the public were told to stay at home, should they suspect they have symptoms of COVID-19, and not visit a GP, pharmacy, or hospital. For advice, the public were told to use a dedicated online self-assessment form before calling NHS 111, the non-emergency medical helpline. To allow vulnerable patients with underlying conditions to still be able to attend for routine blood tests without having to come to a hospital, from 8 April, the Sheffield Teaching Hospitals NHS Foundation Trust opened a drive-through phlebotomy service operating out of a tent in the car park of Sheffield Arena. This allows patients to have their blood tests taken from within their car, in a similar manner to how COVID-19 swabbing drive-through stations work. Following the success of the service, it was expanded to cover all patients registered with any GP in the Sheffield area from 27 April.


Beds

NHS England freed up 30,000 beds by discharging patients who were well enough and by delaying non-emergency treatment, and acquired use of 8,000 beds in Private medicine in the United Kingdom, private sector facilities. Emergency building work was undertaken to add capacity to existing hospitals, 52 beds in Wigan, for example. An additional capacity of almost 20,000 beds was created with NHS Nightingale Hospitals in major conurbations across the United Kingdom. Only a small amount of the capacity was used, and most of the hospitals were put on standby as the situation progressed. On 18 October 2020, The Guardian reported that according to the National Health Service (NHS) report, the Greater Manchester is at risk of running out of hospital beds during the pandemic. NHS data revealed that before Friday 211 of the 257 critical care beds were occupied in Greater Manchester, and 82% of the total supply was in use by Covid-positive people or people admitted for other critical cases.


Law and order

In March, police forces in each nation of the UK were given powers to arrest and fine citizens who broke lockdown rules. The National Police Chiefs' Council said police had issued their first fines for people breaking lockdown rules on 27 March. The fixed penalty notices were £60 but would be reduced to £30 if paid within 14 days. By 31 March, some police forces and individual officers, were being criticised by a variety of people including, former Supreme Court of the United Kingdom, Supreme Court judge Jonathan Sumption, Lord Sumption, Lord Sumption, former Secretary of State for Justice, Justice secretary David Gauke, former Chancellor of the Exchequer, Chancellor George Osborne and privacy and civil liberties group Big Brother Watch for over-zealous and incorrect application of the new powers. New guidance was released by the National Police Chiefs Council. According to data from the National Police Chiefs' Council, around 9,000 people were issued fines for breaking lockdown rules in England and Wales, between 27 March and 27 April. National Police Chiefs’ Council figures from 27 March to 11 May (the date when fines in England increased) showed that more than 14,000 fines were issued for breaking lockdown rules in England and Wales. There were 862 repeat offenders in the figures with one person fined 9 times. The Easter weekend (11 and 12 April) had the highest amount of fines issued within the period. The crown prosecution service stated 56 people were wrongly charged with offences related to the pandemic. This was mainly due to Welsh regulations being applied in England and vice versa. There have been Xenophobia and racism related to the COVID-19 pandemic#United Kingdom, reports of hate incidents against Italian and Chinese persons and a Singaporean student was assaulted in London in an attack that police linked to coronavirus fears. In addition there have been reports of young people deliberately coughing and spitting in the faces of people, including an incident involving health workers. On 9 May, Police broke up an anti-lockdown protest took place in London consisting of around 40 people. It was thought to be the first such protest in the UK following protests in other nations. It was reported that around 60 protests had been planned on the weekend of the 16 May, with police saying that they were preparing to break them up. Protests took place in London and Southampton, with several protesters arrested and fined at the London demonstration. In October, police broke up a wedding with 100 guests at the Tudor Rose, Southall, breaking social isolation laws. A police spokesman said the owner could be fined £10,000.


Fraud

During the contact tracing app trial on the Isle of Wight the Chartered Trading Standards Institute found evidence of a phishing scam. In the scam recipients would receive a text stating that they had been in contact with someone with COVID-19 and were directed to a website to input their personal details. Local councils found fake goods being sold including testing kits, face masks and hand sanitiser. There had also been reports of scams involving the replacement school meals scheme and incidents of people posing as government officials, council staff or IT workers.


Courts and prisons

On 17 March, trials lasting longer than three days were postponed until May in England and Wales, Those cases already running would continue in the hope of reaching a conclusion. The government released specific guidance to prisons in the event of COVID-19 symptoms or cases, specifically the rule that "any prisoner or detainee with a new, continuous cough or a high temperature should be placed in protective isolation for 7days". There are around 83,000 prisoners in England and Wales. On 24 March, the Ministry of Justice (United Kingdom), Ministry of Justice announced that prison visits would be suspended and that inmates would be confined to their cells. In order to maintain communication between prisoners and their families, the government promised 900 secure phones to 55 prisons, with calls being monitored and time-limited. In a committee meeting on the same day, Justice Secretary Robert Buckland suggested that 50 pregnant inmates might be given early release, and another 9,000 inmates awaiting trial could be transferred to bail hostels. On 14 April, the Ministry of Justice ordered 500 modular buildings, reportedly adapted from shipping containers, to provide additional single prison cell accommodation at seven prisons: HMPs HMP North Sea Camp, North Sea Camp, Littlehey, HM Prison Hollesley Bay, Hollesley Bay, Highpoint Prison (disambiguation), Highpoint, HMP Moorland, Moorland, HMP Lindholme, Lindholme and HM Prison Humber, Humber. Following a COVID-19 case in HMP Manchester, public services think tank Reform (think tank), Reform called for the release of 2,305 "low-risk" offenders on short sentences to reduce the risk of COVID-19 on the prison population. Former justice secretary David Gauke echoed similar sentiments, citing the "churn" of prisoners going in and out of prison as a risk. Up to 4,000 prisoners in England and Wales are to be released. Amnesty International's Europe Deputy Director of Research said that authorities in UK should consider releasing those who are more vulnerable to COVID-19. On 18 March, the first COVID-19 case was reported within the UK prison population. The prisoner, who had been serving time in HMP Manchester (commonly referred to as Strangeways), was moved to a hospital. While no other prisoners or staff tested positive for the virus, thirteen prisoners and four members of staff were put into isolation as a precaution. On 26 March, it was reported that an 84-year-old sex offender had died from COVID-19 on 22 March at HMP Littlehey in Cambridgeshire, becoming the first inmate in the UK to die from the virus. On 28 April, Public Health England had identified around 2,000 "possible/probable" and confirmed COVID-19 cases; outbreaks had occurred in 75 different institutions, with 35 inmates treated in hospital and 15 deaths.


Aviation

From the latter half of January, Heathrow Airport received additional clinical support and tightened surveillance of the three direct flights it receives from Wuhan every week; each were to be met by a Port Health team. Later, airlines including British Airways and Ryanair announced a number of flight cancellations for March. On 25 March, London City Airport announced it would temporarily close due to the coronavirus outbreak. Heathrow Airport closed one runway from 6April, while Gatwick Airport closed one of its two terminals, and said its runway would open for scheduled flights only between 2:00pm and 10:00pm.


Public transport

On 20 March, Southeastern (train operating company), Southeastern became the first train operating company to announce a reduced timetable, which would come into use from 23 March. On 19 March, the Sheffield Supertram, Stagecoach Supertram light rail network in Sheffield announced that they would be switching to a modified Sunday service from 23 March until further notice. Local bus operators First South Yorkshire and Stagecoach Yorkshire, which operate across the same area, announced that they would also be switching to a reduced timetable from 23 March. National Express Coaches, National Express suspended all its long-distance coach services from 6April. Transport for London (TfL) services were reduced in stages. All Night Overground and Night Tube services, as well as all services on the Waterloo & City line, were suspended from 20 March, and 40 tube stations were closed on the same day. The Mayor of London and TfL urged people to use public transport only if absolutely essential, so it could be used by critical workers. In April, TfL trialled changes encouraging passengers to board London buses by the middle or rear doors to lessen the risks to drivers, after the deaths of 14 TfL workers including nine drivers. This measure was extended to all routes on 20 April, and passengers were no longer required to pay, so they did not need to use the card reader near the driver. On 22 April, London mayor Sadiq Khan warned that TfL could run out of money to pay staff by the end of April unless the government stepped in. Since London entered lockdown on 23 March, Tube journeys had fallen by 95% and bus journeys by 85%. On 7 May, it was reported that TfL had requested £2 billion in state aid to keep services running until September 2020. on 12 May, TfL documents warned it expected to lose £4bn due to the pandemic and said it needed £3.2bn to balance a proposed emergency budget for 2021, having lost 90% of its overall income. Without an agreement with the government, deputy mayor for transport Heidi Alexander said TfL might have to issue a 'section 114 notice' - the equivalent of a public body becoming bankrupt. On 14 May, the UK Government agreed £1.6bn in emergency funding to keep Tube and bus services running until September. In April, Govia Thameslink Railway re-branded three trains with special liveries to show its support for the NHS and the 200,000 essential workers commuting on GTR's network every week.


British Armed Forces

The COVID-19 pandemic affected British military deployments at home and abroad. Training exercises, including those in Canada and Kenya, had to be cancelled to free up personnel for the COVID Support Force. The British training mission in Iraq, part of Operation Shader, had to be down-scaled. An air base supporting this military operation also confirmed nine cases of COVID-19. The British Army paused face-to-face recruitment and basic training operations, instead conducting them virtually. Training locations, such as Royal Military Academy Sandhurst and HMS Raleigh (shore establishment), HMS ''Raleigh'', had to adapt their passing out parades. Cadets involved were made to stand apart in combat dress and there were no spectators in the grandstands. Ceremonial duties, such as the Guard mounting, Changing of the Guard at Buckingham Palace and the Gun Salute for the Queen's Official Birthday were either scaled-down or cancelled. The Royal Air Force suspended all displays of its teams and bands, with some replaced by virtual displays. The British Army deployed two experts to NATO to help counter disinformation around the pandemic. Elsewhere in defence, air shows, including the Royal International Air Tattoo at RAF Fairford, were cancelled. Civilian airports, including Birmingham Airport, were used to practice transferring COVID-19 patients to local hospitals via helicopter. Several defence and aerospace companies contributed to the national effort to produce more ventilators. BAE Systems, the country's largest defence company, also loaned its Warton Aerodrome site to be used as a temporary morgue. The Government's defence and security review, named the Strategic Defence and Security Review 2020, Integrated Review, was delayed. The armed forces assisted in the transportation of coronavirus patients in some of the country's remotest regions, such as Shetland and the Isles of Scilly. On 23 March 2020, Joint Helicopter Command began assisting the COVID-19 relief effort by transporting people and supplies. Helicopters were based at RAF Leeming to cover Northern England and Scotland, whilst helicopters based at RAF Benson, RAF Odiham and RNAS Yeovilton (HMS Heron), RNAS Yeovilton supported the Midlands and Southern England. On 24 March 2020, the armed forces helped plan and construct a field hospital at the ExCeL London conference centre, named NHS Nightingale Hospital London. Further NHS COVID-19 critical care hospitals, critical care field hospitals were later built with military assistance in Birmingham, Manchester, Harrogate, Bristol, Exeter, Washington and Glasgow. These hospitals were staffed by military medics, alongside the NHS.


See also

* COVID-19 pandemic in the United Kingdom * COVID-19 pandemic in Northern Ireland * COVID-19 pandemic in Scotland * COVID-19 pandemic in Wales * COVID-19 pandemic in London * COVID-19 vaccination programme in the United Kingdom


References

{{COVID-19 pandemic in the United Kingdom, Crown Dependencies and British Overseas Territories, state=collapsed COVID-19 pandemic in England, Disease outbreaks in England COVID-19 pandemic in the United Kingdom, England 2020 in England 2021 in England