key: cord-338516-0x4guveu
authors: Allen, Matilda; Braithwaite, Isobel; Collinson, Shelui; Oskrochi, Youssof; Basu, Anamika
title: A view from UK public health registrars on the challenges of COVID-19
date: 2020-05-27
journal: Lancet
DOI: 10.1016/s0140-6736(20)31058-8
sha: 
doc_id: 338516
cord_uid: 0x4guveu

nan

The quotes from frontline workers in Richard Horton's Comment 1 about COVID-19 and the National Health Service (NHS) make for distressing reading, and the risks currently facing our clinical colleagues weigh heavily on our minds. As public health registrars, we understand that root causes of the current challenges regarding COVID-19 include historical policy decisions that have affected the UK's health workforce and systems, 2 including laboratory capacity. Nevertheless, a pandemic caused by a novel highly pathogenic virus would prove profoundly difficult in any context. Sourcing personal protective equipment, scaling up testing, and increasing hospital capacity are problematic worldwide, and are exacerbated by global shortages. 3 The statement by Richard Horton that "They [UK Government] didn't isolate and quarantine. They didn't contact trace" is inaccurate. Many of the signatories of this Correspondence were involved in Public Health England's extensive early contact tracing, testing, and isolation efforts, done by health protection staff working tirelessly across the country. The transmission dynamics of severe acute respiratory syndrome coronavirus 2 make it challenging to control through these measures alone 4 and, despite these efforts, a proportion of cases went under the radar. By mid-March, 2020, widespread community transmission was evident, precipitating a shift towards advising the public to self-isolate and supporting higher-risk settings such as care homes, prisons, and homeless shelters. We agree that improved testing capacity, combined with innovative ways to contact trace at scale, are vital. 5 However, implementing these strategies presents several practical and ethical challenges 5 and they might not offer a panacea. 3 This pandemic calls for collabo ration rather than division, and we have seen concerted efforts across society to rise to this unprecedented challenge. We must learn from both failings and successes, and seek out solutions, not scapegoats. 

Offline: COVID-19 and the NHS-"a national scandal

A critical moment: NHS staffing trends, retention and attrition

Critical supply shortages -the need for ventilators and personal protective equipment during the Covid-19 pandemic

Feasibility of controlling COVID-19 outbreaks by isolation of cases and contacts

Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing

See Online for appendix