The Government and its scientific advisers faced a huge challenge in early 2020 from the international spread of COVID-19, in circumstances where information was changing constantly and decisions about borders had to be made at pace. Almost every country in the world, including the UK, has used border measures at different stages in the crisis to help control the virus. This report examines the UK Government decisions and the reasons behind them to ensure that lessons can be learned as the pandemic continues.
From late January to early March, the UK gradually introduced a series of international travel measures including the quarantining of 273 people mainly from Wuhan, and non-mandatory guidance to self-isolate for 14 days for travellers from designated high-risk countries. The list of countries was incrementally expanded and by mid-March included China, Iran and Italy but not Spain. Advice from SAGE at that time was against introducing wider quarantine measures or testing at the border.
That early introduction of measures was in line with other countries, and the Government was right to adjust and extend provisions as the virus spread. However, it is clear that the border measures in the UK and many other European countries in early March were not sufficient to contain the cross-border spread of the virus. The UK Government did not recognise soon enough the increased risk of importations from European countries, and not advising people travelling from Spain to self-isolate was a problem. Had stronger early measures been taken, we conclude that is likely that the spread of the virus could have been slowed.
On 13 March, the Government withdrew its self-isolation guidance for arrivals from specific countries and for almost 3 months—until 8 June—there were no border measures in place. No reason was given for the withdrawal of the guidance at the time. Other countries at that time were introducing more comprehensive measures, including quarantine, self-isolation, testing and screening. The UK’s approach was highly unusual.
Evidence suggests that thousands of new infections were brought in from Europe in the ten days between the withdrawal of guidance and the introduction of lockdown on 23 March. It is highly likely that this contributed to the rapid increase in the spread of the virus in mid-March and to the overall scale of the outbreak in the UK. The Committee therefore concludes that the failure to have any special border measures during this period was a serious mistake that significantly increased both the pace and the scale of the epidemic in the UK, and meant that many more people caught COVID-19.
We asked the Home Office and other Government departments to provide us with the scientific advice behind its decisions. Their failure to do so despite repeated promises to provide the information is completely unacceptable. It is not clear, therefore, who was making the decisions about borders in March, nor on what basis such decisions were made. We find that this lack of clarity is very serious and may well have contributed to mistakes being made.
It is understandable that the Government did not consider it practical or effective simply to restrict flights, not least because of large numbers of British residents seeking to return home. However, the failure properly to consider the possibility of imposing stricter requirements on those arriving—such as mandatory self-isolation, increased screening, targeted testing or enforceable quarantine—was a serious error. A precautionary approach aimed at continuing suppression of imported cases of the virus should have included more comprehensive measures.
Ministers do not appear to have been given any estimates for the number of people likely to be travelling into the country with COVID-19 during this period. Instead, the Home Office focused on the proportion of circulating cases that were coming from importation, which they told us was less than 0.5% after 22 March. We believe a wider range of estimates and information should have been made available to Ministers throughout March to allow them to make fully informed decisions.
Quarantine measures were introduced on 8 June. These firm border measures were considerably stronger than both the ‘stay at home’ guidance and lockdown restrictions imposed in mid-March. We welcome the Government’s decision to re-introduce border measures and we recognise the difficult task the Government continues to face in ensuring control of the virus at the same time as getting the economy moving, including international travel, in the safest possible way. At a time when COVID-19 infections continue to increase across the world and when hotspots of infection continue to change, all countries are going to need different kinds of border measures to control the spread of the virus for some time to come.
On 29 June, the Government announced that it would introduce “travel corridors” to exempt arrivals from safe countries from having to quarantine for 14 days. We welcome the Government’s attempt to develop an approach to travel corridors which recognises the different prevalence of the virus in different countries and regions, but we believe the Government needs to publish much more information on the analysis behind these decisions. Given that we will need to be able to manage the changing risk of COVID-19 from different countries for some time to come, setting up a sustainable and agile framework that can be adapted quickly is extremely important. However, we also note the warnings from public health experts who advised against mass-market travel in Europe this summer.
On 25 July, the Government announced it was removing the travel corridor with Spain and therefore reintroducing quarantine requirements for people travelling back to the UK. Given the surge in confirmed COVID-19 cases in mainland Spain, a precautionary approach is the right one and we welcome the Government’s commitment to regularly review its quarantine regulations. Given the likely increase in travel during the summer holidays, public health surveillance is particularly important for those countries where passenger numbers are highest.
However, we conclude that the Government needs to be more sensitive to the serious consequences for families and businesses of changing policy with no warning. There should be significant changes to the way these decisions are handled and communicated. The Government has now rightly warned that no international travel is risk-free in the present circumstances. A similar warning should have been given at the time air corridors were introduced in early July.
The Government should also make clear what criteria it applies to assess possible risks. We call on the Government to publish details of its assessments of countries, including a traffic light system, to allow the public to assess more readily the risks of travel to different places. The creation of a Joint Biosecurity Centre ought to represent a step forward in the management of the pandemic, involving regular and comprehensive public health surveillance. However there remains a concerning lack of transparency and clarity about departmental responsibilities and the information provided to Ministers, which the Government needs to address.
We also recommend that the Government investigates further the viability of introducing widespread or targeted tests at the border, as in Iceland, Hong Kong or South Korea. We agree with the Government that a testing and tracing system alone is not currently sufficient to address the risk from overseas travel; however, more work should have been done to develop testing and screening options alongside quarantine and self-isolation measures.
Some sort of border quarantine mechanism will be required for the foreseeable future. We do not take lightly the potential burden on individuals and the economy from closing borders and requiring quarantine, as well as the potential damage to the economy and to public health if the virus takes hold again. Border health measures can only be one strand in a wider, larger strategy of disease control, but they will continue to be a crucial part of any Government strategy to control the virus over the months to come.
Published: 5 August 2020