What led to the UK's COVID-19 death toll? - An insight into the mistakes made and the current situation.

Dear Editor,

The COVID-19 pandemic has brought many countries into disarray and tested the ability of the governing bodies to respond to a crisis. Notably, economically developed countries such as the United Kingdom and the United States of America who have the two highest death tolls in the world with 34,466 and 85,860 deaths respectively as of May 17th, 2020 [1]. In this letter, we have carried out a multifactorial analysis of the UK's response that has led to such a high death toll.

One of the factors includes late initiation of lockdown. The UK commenced lockdown on March 23rd with 5687 confirmed cases with a population of 68 million, roughly 1 case per 12,000 people [1]. In comparison, Italy locked down on 9th March, Spain on 14th March and Netherlands on 16th March [2]. In addition, Germany has one of the lowest death rates in the world, having commenced lockdown measures on March 13th and implemented full restrictions in public places by March 22nd [3]. At this point, the UK was not even in lockdown. Furthermore, Germany's confirmed case number at the time of lockdown was 2369 with a population of 83 million, roughly 1 case per 35,000 people [1].

Another issue is the lack of testing in the UK has done compared to other countries. The first official COVID-19 case in the UK was reported on 29th January. Yet by March 16th the UK had not even tested a cumulative total of 40,000 people. Contrast this to Germany who had already tested over 400,000 by this time despite Germany's first confirmed case identified just 2 days earlier than the UK on 27th January [4]. This shows a staggering divide between the countries and there is significant worry that due to this lack of testing, the UK actually has a far higher true number of COVID-19 related deaths than reported.

A clear indication that the UK has failed in its approach of managing COVID-19 is in comparison to the sports industry. From Saturday 16th May the German Bundesliga was given the green light to restart matches behind closed doors, showing the significant progress in managing COVID-19. Meanwhile, UK Prime Minister Boris Johnson announced initial easing of lockdown to commence on May 11th with non-essential shops to open in June “at the earliest” [5].

As of May 17th, the UK has reported 34,466 deaths, almost five times Germany's 7914, illustrating vastly different outcomes [1]. It is clear from the numbers that a low number of testing, as well as late commencement of lockdown has led to this blatant discrepancy. This is especially poignant given that so many deaths could have been avoided, had the UK taken a more proactive approach in containing the coronavirus outbreak.

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Author contribution

S Khan conceptualised and wrote this letter to the editor.

SO Cheng edited and helped to gather the information for this letter.

Guarantor

S Khan and SO Cheng accept full responsibility for this work.

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Not Commissioned, internally reviewed.

Data statement

The data in this correspondence is public and not sensitive in nature.

Declaration of competing interest

There are no conflicts of interest.