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10 February 2021

Why is the UK’s Covid-19 quarantine plan so weak?

By refusing to follow the example of Hong Kong on borders, Britain risks squandering its vaccine success.  

By Stuart Ritchie

A British friend who works in Hong Kong recently returned there from the UK. Upon arrival, along with every other traveller, he had to fill in a health declaration form and take a wristband with a barcode. He was then shepherded into a Covid-19 testing area, swabbed and made to wait for the result (it was negative). He linked up his wristband barcode with a mandatory tracing app on his phone, then signed a Compulsory Quarantine Order stating that he wouldn’t leave a hotel room for 21 days. Then it was off to that hotel room, where he was ordered to report his temperature and any possible Covid symptoms twice a day for the whole three-week period, and get additional tests. He’s there as I write this. A cute little robot brings his Deliveroo orders up from the hotel lobby each day.

Contrast this with what happened when a colleague recently arrived at Heathrow from the EU. She got off the plane. She scanned her passport at the usual entry gate. She saw a sign that told her she should self-isolate for ten days, if she wouldn’t mind awfully and if it wouldn’t be too much trouble. Within minutes she was on the Tube and on her way into London. 

I’m understating things slightly: there is technically a fine for not self-isolating in the UK – though I have been unable to find recent numbers on how many people have been subject to it, and there have certainly been problems with enforcement. Self-isolation seems largely based on a kind of honour system – which might be a good idea for ensuring people return books to the little public library cabinet at the end of your street, but perhaps not for stopping the spread of a deadly pandemic disease.

The news, of course, is that this is all about to change: the UK is finally putting in place a border quarantine, starting on 15 February. The UK quarantine plan is far more limited than the Hong Kong model: only travellers from 33 “red list” countries must quarantine in hotels, and it will only be for ten days. And it comes rather late in the day: Hong Kong has had its quarantine system in place, with a few changes, since last March.

I can’t explain why we’ve not had any sort of quarantine system in the UK until now, more than a year after the first coronavirus cases arrived on our shores. In almost every one of its interventions to try to control the virus, the UK has been like someone trying to swat a wasp with a clenched fist – lunging clumsily towards a target that’s already far away by the time the blow is landed. 

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[See also: Ailbhe Rea: Will Matt Hancock’s new quarantine plan work?]

Except it’s worse than that: the wasp in question could at any time evolve into a newer, quicker, angrier wasp with a nastier sting. I’m talking, of course, about the new, more highly transmissible coronavirus variants – the most worrying of which are those from South Africa and Brazil. The evidence that at least some of these variants will blunt the effectiveness of our growing arsenal of vaccines is getting stronger (though in some cases the fears go beyond the data).

Once you’ve accepted that it’s even plausible that a new variant will evolve some vaccine-resistant features – and this is clearly a major concern among virologists – you can see how important it is to try to hold back that evolution. If we don’t take this task seriously – it’s mainly done by keeping case numbers as low as humanly possible – we risk throwing away the amazing feat we’ve achieved by vaccinating so many people so quickly.

And even if the vaccine-makers can regularly produce booster shots against the new strains, this assumes – as the epidemiologist Deepti Gurdasani has pointed out – that we’ll always be on the back foot, constantly playing catch-up with the virus rather than having it under control. 

Which brings us back to quarantine. This is no time for half-measures, such as a ten-day quarantine for a virus that can have an incubation period of up to two weeks, or a red list that doesn’t include several countries where the dangerous new variants have been found. Think about the consequences of being wrong: if your quarantine is too soft, you risk disaster. If your quarantine is too aggressive – well, you simply lift it sooner than you were planning, with relatively little harm done.

Not no harm, of course: instituting a full quarantine such as that of Hong Kong (or Taiwan, or New Zealand) would be disruptive and expensive – in the short term. But compared to the long-term consequences of allowing another new strain of coronavirus to rip through the country – more lockdowns, more deaths, more school closures, an ever-more-urgent need for new vaccines – the choice should be clear.

Learning from other countries hasn’t been our strength during the pandemic. But we’ve had at least 12,000 new coronavirus cases every day this week (beginning 8 February). Hong Kong has recorded just over 10,500 cases since the crisis began. That’s not all to do with its quarantine system, but keeping out new cases and variants can’t have hurt. Even if we can’t stretch to food-delivery robots, we should seriously consider following Hong Kong’s lead.

[See also: Stuart Ritchie on whether the Covid vaccines will protect against all variants]