Discussing COVID-19 At Interview

COVID-19 Background

As aspiring Medics, you should already know about the COVID-19 coronavirus, how it became a pandemic, and the public health measures taken around the world to try to stem the spread.

The following resources will help you stay up-to-date on this topic:

• Balance your news consumption between the BBC, the Guardian, and other outlets
• Get the latest from the NHS on its COVID-19 page
• Learn some key statistics from the WHO and Statista
• Find out more about COVID-19 vaccines on our website

COVID-19 Transmission In The UK

The first two cases of coronavirus in the UK were confirmed on January 31, 2020 – but some think the first cases predated this.

Take a look at the WHO’s dashboard to see how the number of COVID-19 cases changes weekly and daily.

How Did COVID-19 Reach The UK?

Scientists have combined large-scale data and genomic sequencing to map the lineage of different strains of COVID-19, to get an understanding of which countries the virus came from. They found that a third (34%) of transmission lineages came from Spain, 29% from France, and 14% from Italy. It’s important to note that the results are preliminary and the research hasn’t been peer-reviewed.

Question: At the start of the pandemic, why were there so many more cases in countries such as Brazil and India as compared to Europe?

When answering this question, think about the following issues:

• Countries of greater economic disparity tend to experience higher fatalities and those with weaker, absent leaders experience a higher rate of viral transmission. How do Brazil and India fit into this?
• Brazil and India have porous internal borders – so what could European countries do that Brazil and India couldn’t?
• How are their governments different to those in Europe?
• How could high-density housing and poor nutrition contribute to the spread of coronavirus?

When you sign up for one of our interview prep courses, we give you our Ultimate Guide To Interview Prep book that explains in detail how you can answer questions on COVID-19.

Further Spread and New Variants

UK Variant

A new variant of COVID-19 was detected in the UK back in September. By November, a quarter of all infections in London were caused by it, which grew to two-thirds in December. According to a study by Imperial College London, the new variant tripled cases despite there being a second lockdown. It has a higher R rate of 0.7, instead of 0.4 of the original COVID-19 virus. In reaction to the news, more than 40 countries closed their borders to the UK to stop the variant spreading, but the decision was swiftly lifted.

See quotes from experts about the discovery of the new UK variant.

South Africa Variant

Another variant was also discovered in South Africa, in December – and Europe halted travel to the country as a result. See what experts think about the variant here.

How Are The Variants Different?

“Both variants share the N501Y mutation in the viral S gene which lies in the receptor-binding domain (RBD) – where the virus binds to the host cell – and where vaccine-induced antibodies bind to the virus,” explained Dr Julian W Tang, Honorary Associate Professor/Clinical Virologist at the University of Leicester.

Commenting specifically on the UK variant, the BMJ explained: “One of the most significant [changes] is an N501Y mutation in the spike protein that the virus uses to bind to the human ACE2 receptor. Changes in this part of spike protein may, in theory, result in the virus becoming more infectious and spreading more easily between people.” Read more.

Government Response and Lockdowns

The First Lockdown

On 23rd March, Boris Johnson announced via a live television broadcast that strict lockdown measures were now being introduced to protect the NHS and to mitigate any further viral spread.

These measures meant you could only leave your home to shop for food and medicine, take one form of exercise a day, or care for a vulnerable person. The lockdown was enforced by law, under a stay-at-home order which was initially due to last for three weeks and to start from 26th March.

On 15th April, Northern Ireland extended their lockdown period until 9th May; and on the 16th Dominic Raab followed suit. At the time the announcement the recorded UK deaths had reached 13, 729 and the number of confirmed cases exceeded 100,000, at 103,093.

Lockdown started to be lifted from May 10, when people were told to stay alert instead of stay at home. In June, shops began to re-open.

Read the full lockdown timeline on the Independent for more detail of what happened, and when.

The Second Lockdown – November 5 to December 2, 2020

The second lockdown was announced in November and scheduled to last a month. The big difference from the first lockdown was that schools, colleges and universities were allowed to stay open – and you were permitted to meet one other person outdoors while remaining socially distant.

The government hoped that this would drive infections down enough that people could gather for Christmas. That didn’t happen: plans to allow three households to mix over a five-day period were scrapped with just a few days’ notice. Households in tier four couldn’t mix, and the rest of the country was permitted to mix on Christmas Day alone.

The Third Lockdown – January 6, 2021

Just a month after the second lockdown, the UK was put into its third. The announcement was made on Monday 4th January, when schools, colleges and universities were told to close after some re-opened following the Christmas break. GCSE and A-Level exams were also cancelled, with teacher assessment replacing them.

On the day the lockdown came into force, the daily COVID-19 death toll exceeded 1,000 for the first time since April 2020. The government also reported 62,322 new COVID-19 cases that day.

Question: Did The First Lockdown Work?

You may be asked during your interview whether you think lockdown worked. Remember that the interviewers are looking for you to weigh up both sides of the argument, rather than share your personal opinion.

Things to consider:

• What was the purpose of lockdown? The first lockdown drove infection numbers down, so if that was the goal then it could be said to have worked. It also stopped the NHS from being overwhelmed – but at what cost in the long-term?
• It’s been suggested that lockdown in the UK and Europe didn’t save any lives. Read the study by Thomas Meunier here.
• Without a suitable test and trace system, there’s no way to limit the transmission of coronavirus – was lockdown the only option?
• Can people be trusted to uphold social distancing and follow lighter guidelines – or do we need lockdown to force this behaviour?
• Lockdown delays transmission, which buys a population time that can be used to slow the spread of COVID-19. That delay means drugs and treatments can be developed to lessen the future effects and reduce future fatality rates.
• Sweden didn’t have a lockdown and they didn’t see their national rates of transmission spiking uncontrollably, or their healthcare system becoming overwhelmed. Read more about Sweden’s approach.
• How many extra deaths are caused by lockdown? Fatalities as a result of suicides and drug overdoses spiked, as did incidences of poor mental health, domestic abuse and the anguish in those suffering as a result of social isolation and new maladies inspired by lockdown poverty (from the enforced loss of income). Increasing fatalities are also recorded from subgroups dying from the denial of ‘elective’ medical care, which was cancelled as hospital beds and services were repurposed for the sole treatment of those infected with coronavirus.
• If it was successful, why were future lockdowns needed?

Herd Immunity As A Strategy?

At the start of March 2020, the UK Government’s chief scientific advisor, Sir Patrick Vallance, told Radio 4 that ‘one of the key things we need to do is to build up some kind of herd immunity, so more people become immune to the disease and thus we can reduce overall transmission.’

What Is Herd Immunity?

Herd immunity describes a population that’s resistant to the spread of a contagious disease, which can only be achieved if a sufficiently high proportion of individuals are immune to it. This method is usually introduced via widespread vaccinations – but with no COVID-19 vaccinations, it meant infecting 60% of the population, according to Vallance.

This stance was heavily criticised by scientific experts, almost immediately, with 200 of them urging the government to rethink this plan in the form of an open letter that stated that it would result in many unnecessary deaths, as well as overwhelm the NHS and other public infrastructures.

Later, the Department of Public Health and Social Care caveated Sir Patrick’s sentiment by stating that ‘herd immunity was a natural by-product of any epidemic.’

Question: How was the approach by most European countries different to that of the herd-immunity approach by Sweden?

To answer this, you should verbalise as you think through the following points:

• What did Sweden do? Read about their Coronavirus strategy on the BBC.
• While this appeared successful at first, support for this approach has since waned. Andrew Ewing, a professor at the University of Gothenburg, thinks their approach was wrong. That may be true, as Sweden has started to apply tougher restrictions.
• Sweden hasn’t achieved herd immunity yet. The Public Health Agency of Sweden found that just 7.3% of Stockholm residents had developed COVID-19 antibodies by late April—and that was the largest number of positive results found in the country. Read the report in the BMJ here. This is a similar percentage to that emerging from Spain and France, two countries which chose to both go into lockdown, along with the rest of Europe.
• What is the key difference between Sweden and the rest of Europe? Sweden trusted its population to act responsibly and follow the guidelines out of their own volition.

Question: Did The UK Government Handle The Pandemic Well?

You should show balance when you answer this question. When considering that the crisis hasn’t been handled well, you may want to know about the following key issues:

• A YouGov poll showed that three million adults had gone hungry in the first three weeks of lockdown, with 1.5 million going an entire day without eating
• Doctors were told to wash and reuse PPE if stocks were running low
• Johnson said we had moved past the peak of the disease on April 30th 2020
• The UK death toll became the highest in Europe on May 5th. Here’s what you should know about these statistics
• The Dominic Cummings scandal undermined public trust in the government
• The damning criticism from Dr Richard Horton, editor of The Lancet – and many others
• In December, 57% of people said they didn’t trust the government to stop the spread of COVID-19

This should be balanced by discussing the positive moves made by the government, including:

• The economic support offered by the government
• The Nightingale Hospitals – and what happened to them
• The daily briefings that communicated directly to the public
• The first country to approve COVID-19 vaccines
• The launch of the biggest vaccination programme in the history of the NHS

Test Your Knowledge

Have you picked up enough COVID-19 knowledge to be confident discussing this in your interview? Try our quick comprehension quiz to check.

More Interview Help

Once you’ve reviewed the COVID-19 information and questions, it’s worth reviewing other hot topics and working through the Interview Question Bank.