COVID-19 pandemic in England

On 31 January, two members of a family of Chinese nationals staying in a hotel in 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 Hospital to a specialist isolation facility, a designated High Consequence Infectious Diseases Unit in Newcastle upon Tyne's Royal Victoria Infirmary.[4][5]

On the same day, an 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.[6] 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.[7][8] Some British nationals in Wuhan had been informed that they could be evacuated but any spouses or children with mainland Chinese passports could not.[9] This was later overturned, but the delay meant that some people missed the flight.[6][10]

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.[11][12] 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.[13]

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.[14][15] Globally, the virus had spread to 28 countries.[16] 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.[16] That day, the Arrowe Park Hospital, Merseyside, and the Kents Hill Park hotel and conference centre, Milton Keynes became designated isolation units.[17][16] The following day, two of the eight confirmed cases in the UK were reported by BBC News to be general practitioners.[14] A ninth case was confirmed in London on 11 February.[18]

The effects of panic buying in a Morrisons supermarket in Wetherby, West Yorkshire

Grounded aircraft at Leeds Bradford Airport in April 2020

On 1 March, further cases were reported in Greater Manchester of which some are believed to be contacts of the case in Surrey who had no history of travel abroad.[19][20]

On 2 March, four further people in England tested positive. All four had recently travelled from Italy; they are from Hertfordshire, Devon and Kent.[17] The total number of UK cases was reported as having reached 40, though this was revised to 39 after additional testing.[21] The following day, when the total 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.[17]

On 2 March, also occurred the first corona-virus death in a care home, but at that time care home data were not yet published.[22]

On 3 March occurred the first three hospital deaths in Nottingham, Essex and Buckinghamshire.[22]

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 in England would be postponed from 15 April to free up 30,000 beds.[23] Also on 17 March, Chancellor Rishi Sunak announced that £330bn would be made available in loan guarantees for businesses affected by the pandemic.[24]

On 18 March over 750 patients were in hospital with COVID-19, this number rapidly grew and by 31 March the number of patients had increased by around 10,000.[25] Admissions to hospital grew from around 600 a day on 20 March to more than 2,750 a day by 31 March.[26] Taken together, these data suggest that at least 4,500 patients were discharged from hospital in March. By 31 March, England was the worst affected country in the United Kingdom with over 21,000 confirmed infections[27] and at least 3,850 deaths in hospital.

ONS data for England and Wales[28] suggests that by 31 March England had seen over 200 COVID-19 deaths in Care Homes and more than 200 deaths at home.

A closed public house offering a takeaway service

On 2 April the maximum number of hospital admissions was reached at more than 3,150 patients per day;[26] the number of hospital deaths was around 600.[29]

By 12 April the number of daily admissions with COVID-19 had reduced to less than 1,900[26] and the number of patients in hospital peaked at around 17,150;[25] more than 680 hospital deaths were recorded on that day.[30] Hospital deaths in each of the seven NHS England regions peaked around 9–13 April, except for the North West which peaked on 16 April.[31]

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.[28] Of these deaths, 1,149 occurred in Wales.

On 29 April the method of reporting deaths in England was changed.[32] 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:

1. data supplied to NHS England by the Hospital Trusts,
2. data from Public Health England Health Protection teams (mainly deaths not in hospitals),
3. 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 there were in total 19,740 deaths reported by NHS England. 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 11,250;[33] at least 54,700 patients were admitted to hospital in April.[34] The total number of deaths in hospital during April exceeded 17,000;[25] these data suggest that there were around 36,400 patient discharges in April.

A mural during the COVID-19 pandemic in Pontefract, West Yorkshire.

By 3 May, daily admissions to hospital had further reduced to around 900, discharges continued to exceed admissions and thus the number of people in hospital was now less than 10,550.[34]

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.[35] The GMB union told members not to use the Care Workforce app; they said that managers could identify staff who have complained about pay, testing and personal protective equipment through a chat feature.[36]

On 7 May the number of people in hospital finally fell below 10,000, with every region showing a reduction from the previous day;[37] the total number of deaths in hospital since 1 March has grown to at least 22,432.[29]

On the 10 May the measures introduced in late March were amended in England to allow people to spend more time outside for recreation and in some cases return to work[38].

On 11 May the COVID Alert Levels were published by the Government[39] 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 15 May the number of hospital patients was below 8000 and daily admissions were around 700[40]; hospital deaths were less than 200 a day[41].

On 27 May, Matt Hancock announced NHS Test and Trace.[42]

The number of patients in hospital with COVID-19 has continued to reduced and on 31 May it was around 5,300.

During May at least 22,300 patients were admitted to hospital with COVID-19, the total number of hospital deaths exceeded 5,250 and around 23,000 patient were discharged[43].

By 15th June the number of people in hospital had fallen steadily to around 3500, daily admissions were down to around 300 patients but each day there were still around 50 deaths being reported[44].

• 
  'Working together stay safe'
• 
  'Practice good handwashing stay safe'
• 
  'Catch it bin it kill it'
• 
  'Cover your nose and mouth on buses and trains'
• 
  'Retail businesses get your recovery pack'
• 
  'www.wakefield.gov.uk/stayingsafe'

During the second half of March, 1 million British workers applied for the Universal Credit benefit scheme.[56][57] On 20 March the government announced a Coronavirus Job Retention Scheme, were 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.[58] Following a three-week extension of the countrywide lockdown the scheme was extended until the end of June 2020.[59][60] 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.[61] On the first day of operation 140,000 companies used the scheme.[62] 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.[63] 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.[64]

In March the Self Employed Income Support Scheme (SEISS) was announced.[65] 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.[66] The scheme went live on 13 May.[67] 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.[68] By 15 May, more than 1 million self employed people had applied to the scheme.[69]

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.[70][71][72] £12.33 billion in funding was committed to the SBGF and the RHLGF schemes with another £617 million added at the start of May.[73] By 25 April only around 50% of eligible business had received funding.[74]

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.[75] The government banned banks from seeking personal guarantees on Coronavirus Business Interruption loans under £250,000 following complaints.[76][77] Coronavirus Large Business Interruption Loan Scheme (CLBILS) was announced on 3 April and later tweaked to include more companies.[77][78] 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.[79] 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.[80] 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.[81][82] The loan was 100% guaranteed by the government and was designed to be simpler than the CBILS scheme.[83] More than 130,000 BBLS applications were received by banks on the first day of operation with more than 69,500 being approved.[84][83] 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.[85][86] On 12 May almost £15 billion of state aid had been given to businesses.[87] The Treasury and the Bank of England on 17 March announced the Covid Corporate Financing Facility (CCFF).[88][89]

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.[90] 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.[91] 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.[92]

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.[93]

A Coronavirus 'pod' at Hull Royal Infirmary

In March, hospitals in England began to cancel all elective procedures.[94] 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.[95] 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.[96] For advice, the public were told to use a dedicated online self-assessment form before calling NHS 111, the non-emergency medical helpline.[97]

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.[98] 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.[99]

The NHS England freed up 30,000 beds by discharging patients who were well enough and delaying non-emergency treatment,[100] and acquired use of 8,000 beds in private sector facilities.[100] Emergency building work was undertaken to add capacity to existing hospitals, 52 beds in Wigan, for example.[101] An additional capacity of almost 20,000 beds was created with NHS Nightingale Hospitals in major conurbations across the United Kingdom.

In March police forces in each nation of the UK were given powers to arrest and fine citizens who broke lockdown rules.[102][103][104][105][106] 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.[107] By 31 March, some police forces and individual officers, were being criticised by a variety of people including,[108] former Supreme Court judge Lord Sumption,[109][110] former Justice secretary David Gauke,[108] former Chancellor George Osborne and privacy and civil liberties group Big Brother Watch for over-zealous and incorrect application of the new powers.[108][111] New guidance was released by the National Police Chiefs Council.[109][112]

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.[113] National Police Chiefs’ Council figures from 27 March to 11 May (the date when fines in England increased[114]) 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 April 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.[115][116][117]

There have been 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.[118][119] In addition there have been reports of young people deliberately coughing and spitting in the faces of people, including an incident involving health workers.[120][121][122][123][124]

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.[125] 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.[126] Protests took place in London and Southampton, with several protesters arrested and fined at the London demonstration.[127]

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.[128] 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 and council workers depending on their target along with fake IT workers.[129]

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.[130][131]

The government released specific guidance to prisons in the event of coronavirus 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 7 days".[132] There are around 83,000 prisoners in England and Wales.[133] On 24 March, the Ministry of Justice announced that prison visits would be suspended and that inmates would be confined to their cells.[134] 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.[135] 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.[136] 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 jails: HMPs North Sea Camp, Littlehey, Hollesley Bay, Highpoint, Moorland, Lindholme and Humber.[137] Following a COVID-19 case in HMP Manchester, public services think tank Reform called for the release of 2,305 "low-risk" offenders on short sentences to reduce the risk of coronavirus on the prison population.[138][139] Former justice secretary David Gauke echoed similar sentiments, citing the "churn" of prisoners going in and out of prison as a risk.[140] Up to 4,000 prisoners in England and Wales are to be released.[141] Amnesty International's Europe Deputy Director of Research said that authorities in UK should consider releasing those who are more vulnerable to COVID-19.[142]

On 18 March, the first coronavirus 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.[143] 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.[133] 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.[144]

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.[145] Later, airlines including British Airways and Ryanair announced a number of flight cancellations for March.[21]

On 25 March, London City Airport announced it would temporarily close due to the coronavirus outbreak.[146] Heathrow Airport closed one runway from 6 April, while Gatwick Airport closed one of its two terminals, and said its runway would open for scheduled flights only between 2:00 pm and 10:00 pm.[147]

On 20 March, Southeastern became the first train operating company to announce a reduced timetable, which would come into use from 23 March.[148]

On 19 March, the Stagecoach Supertram light rail network in Sheffield announced that they would be switching to a modified Sunday service from 23 March until further notice.[149] 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.[150] National Express suspended all its long-distance coach services from 6 April.[151]

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.[152] The Mayor of London and TfL urged people to use public transport only if absolutely essential, so it could be used by critical workers.[153]

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.[154] 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.[155]

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.[156] Since London entered lockdown on 23 March, Tube journeys had fallen by 95% and bus journeys by 85%.[157] On 7 May, it was reported that TfL had requested £2 billion in state aid to keep services running until September 2020.[158] 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 going bust.[159] On 14 May, the UK Government agreed £1.6bn in emergency funding to keep Tube and bus services running until September.[160]

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.[161]

The coronavirus 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.[162] The British training mission in Iraq, part of Operation Shader, had to be down-scaled.[163] An air base supporting this military operation also confirmed nine cases of coronavirus.[164] The British Army paused face-to-face recruitment and basic training operations, instead conducting them virtually.[165] Training locations, such as Royal Military Academy Sandhurst and HMS Raleigh, had to adapt their passing out parades. Cadets involved were made to stand 2 metres (6 ft 7 in) apart in combat dress and there were no spectators in the grandstands.[166][167] Ceremonial duties, such as the Changing of the Guard at Buckingham Palace and the Gun Salute for the Queen's Official Birthday were either scaled-down or cancelled.[168][169] The Royal Air Force suspended all displays of its teams and bands, with some replaced by virtual displays.[170][171] The British Army deployed two experts to NATO to help counter disinformation around the pandemic.[172]

Elsewhere in defence, air shows, including the Royal International Air Tattoo at RAF Fairford, were cancelled.[173] Civilian airports, including Birmingham Airport, were used to practice transferring Coronavirus patients to local hospitals via helicopter.[174][175] Several defence and aerospace companies contributed to the national effort to produce more ventilators.[176] BAE Systems, the country's largest defence company, also loaned its Warton Aerodrome site to be used as a temporary morgue.[177] The Government's defence and security review, named the Integrated Review, was delayed.[178]

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.[179][180] On 23 March 2020, Joint Helicopter Command began assisting the coronavirus 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 supported the Midlands and Southern England.[181]

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 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.[182][183]