Lessons to be learnt from the southernmost tip of the British Isles

image source: Creative Commons

The southernmost tip of the British Isles, Jersey, (until recently) had an exemplary track record for its handling of Covid-19. On the tiny island, with a population just shy of 110,000, the authorities started preparing their Covid-19 response before any cases were discovered on the island.

They were monitoring their borders, held meetings with commercial, hospitality, transport, utilities and supermarket representatives and were putting their plans in place on how schools and businesses would operate if the virus arrived in Jersey. There was a public awareness campaign and managers were given clear coronavirus guidance. All this before a single case had appeared on the island.

On 10 March 2020 they identified their first case, in a student returning home from Italy. The local environmental health team worked to identify and get in touch with all of the student’s close contacts, asking them to self-isolate.

Within days, a business support package had been announced and all over-80s were being called by their GPs to discuss how they could protect themselves, and what sort of support they might need. Advice was issued for over-65s to practice social distancing and for anyone with flu-like symptoms to isolate, and all non-essential travel in and out of the island was to stop.

Swift, decisive action

Within a week of the first case being detected, it was announced that all travellers onto the island needed to isolate for 14 days and large gatherings were being limited. The following week, everyone was advised to avoid unnecessary social contact and work from home where possible. Nightclubs and pubs were closed the day the announcement was made, therefore avoiding the ‘last hoorah’ we saw in the UK. Schools closed on 23 March. All non-essential retail, restaurants, beauty parlours and leisure centre were closed later that week – only 14 days after their first case was identified.

Nineteen days after the first case was discovered, the rest of the island went into lockdown. By contrast, it took the UK 53 days to lockdown after the first case was discovered.

On 6 April 2020, the Jersey government advised people to wear face masks when out in public. It wasn’t until 11 May that the UK government issued the same advice.

Jersey and the UK followed a similar path to opening up in May/June 2020, with certain year groups going back to school in early June. However, all children were able to return to school in Jersey on 22June, whereas in England they had to wait until September.

On 30 June, Jersey announced it had had no new cases for a full 7 days. The UK was averaging 650 daily cases. As England was moving into regional tiered lockdowns, Jersey was completing its steps to reopening.

Spend Local

During the summer, while Rishi Sunak was encouraging us to “Eat out to Help out” – a scheme which was only available to people who could afford to eat in restaurants, and went on to cause up to 17 per cent  of new infection clusters – Jersey introduced a ‘Spend Local’ card worth £100 that was given to every adult and child to encourage local spending. An additional £100 was given to those receiving state benefits. This gave the local economy a much-needed boost without contributing to a rise in Covid cases.

By November, the UK needed another lockdown, with around 35 daily cases per 100K, while Jersey’s rate remained much lower, on around 5 new cases per 100K.

By December, Jersey needed to introduce some measures including closing hospitality venues, while keeping shops open and limiting the sizes of gatherings. All non-essential retail was closed at 6pm on Christmas Eve.

Unlike in England, children were able to return to school in January, albeit a week later than normal. Children on Jersey have remained in school throughout 2021. On 3 February non-essential retail opened up, with hairdressers, nail parlours and other close contact services opening a week later. We had to wait until 5 April to get a haircut in England! Hospitality started to open up on 22 February in Jersey, three months before England.

Over the course of March, April and May, Jersey lifted almost all restrictions on things such as limits on gatherings, with gyms opening, spectator sports events resuming, outdoor singing events permitted etc. Despite this, cases remained incredibly low until the start of June, where a small uptick in cases began.

Contact tracing success

One of Jersey’s success stories was its Contact Tracing Monitoring and Enforcement Team. As well as keeping on top of testing and tracing of known contacts, they also performed spot checks on people who were meant to be isolating. Heavy fines were placed on those not following the rules, and this proved a strong deterrent. Unlike in the UK, financial help was available to anyone having to isolate. This locally run system did a fantastic job of spotting and isolating small outbreaks before they became unmanageable.

Jersey has also run a very successful vaccine programme, to date fully vaccinating 58 per cent of the population, a slightly higher percentage than the UK.

Unfortunately, Jersey’s success story appeared to come to a fairly dramatic halt in July this year.

On 14 June, masks became no longer mandatory, other than on public transport.

On 23 June, rules for isolating changed for fully vaccinated adults. They no longer needed to isolate if they were a direct contact, nor if they lived with a confirmed case, as long as they took a PCR test on days 0, 5 and 10, and the day 0 test was negative.

On 29 June, despite a rising number of cases within schools, the decision was made to change the isolation rules for children. Nursery and primary school children no longer needed to isolate if they were direct contacts,  beyond a negative result on day 0. They would need to do a PCR test on days 5 and 10 to check that they remained negative. Secondary students would need to take a PCR on day 0, 5 and 10, but only isolate until day 5 if the result was negative. This led to cases of primary school children who tested negative on day 0, going back to school, only to test positive on day 5 – having then been at school with others while infectious.

On 4 July, all isolation of direct contacts was removed regardless of age or vaccine status, providing you agreed to the PCR testing regime. Isolating while waiting for the first negative PCR was no longer required.

Cases were sky-rocketing by 13 July and the final stage of unlocking, which involved nightclubs reopening, was postponed again. Direct contacts were urged to “think very carefully about the activities they undertake and the places they visit” when deciding whether to mix with others while they awaited their PCR results.

Two days later, it appeared that the test and trace system, which had worked so well, had become overwhelmed. It was then decided that only a day 0 test was required and only non-vaccinated people needed to isolate while awaiting the result. Day 5 and 10 tests were abandoned.

Mask-wearing re-introduced

It is difficult to know whether the removal of mandatory mask-wearing or the relaxation of the isolation rules were responsible for the almost vertical increase in cases during July. None of the other relaxations of restrictions appeared to have had much of an impact on the case numbers, until mask-wearing was dropped. It was announced this week that mask-wearing will be reintroduced in all indoor public spaces from Wednesday (21 July). The final stage of unlocking (large indoor events and nightclubs opening) has been postponed until 5 August.

The rest of Britain could learn a lot from its little southern outpost, both in terms of how to manage a successful pandemic response, and also about what happens when you relax contact isolation rules and remove masks. Jersey has been ‘open’ for many more months than England has, yet has managed to keep cases low through a successful track and trace system and stringent border controls.

In England, we have just removed every Covid-19 restriction, at a point where our cases are already rocketing, and we don’t have an experienced and capable track and trace system, nor proper border controls in place.

Many will argue that we can’t compare ourselves to Jersey due to its size and what with it being an island and everything….!

But I believe there is an awful lot we could learn about pandemic management by looking at what worked well and what has led to Jersey’s catastrophic rise in cases. I don’t know how long it will take for the English government to U-turn on masks, as the Jersey government has just done, but sadly I suspect it will take a lot longer than the 157-minute U-turn on whether Johnson and Sunak were planning to isolate!

So in the meantime, let’s keep others safe by wearing our masks, and think about how our actions may impact others around us.