COVID-19: WHY ARE WE BEING SO RUDDY CAUTIOUS?

Rachel Johnson, sister of PM Johnson, had an opinion piece published in Saturday's iPaper.  Titled "Rules Britannia: health and safety is the new pandemic".

As she says, "We have gone from Rule Britannia to a Britannia enslaved by rules ..."  and suggests "My preference would have been to keep the country running and shield the vulnerable..."

She has a point.  I'm inclined to agree.  But for one thing seemingly overlooked.  That is Britain was following that line, but became under the threat of the NHS being overrun, just like we had seen in Italy.

Lockdowns are nasty things.  Just like an anti-cancer drug, the 'side-effects' of a lockdown are considerable, costing us all in so many ways, including high financial costs.    .

But when you are faced with cancer, you take the treatment. In the case of COVID-19, a lockdown came when there was no reliable alternative to curb the exponential growth in infections.  Here is the graph of new infections, with dates for when later confirmed by a test, showing how the rapid increase in March was halted and reversed by the lockdown:

But the graph is also showing new infections rising since mid July when lockdown restrictions started to be eased.   This now threatens a new rapid increase, a 'second wave' you might say.  Especially as the summer ends and people will stay more indoors where it is easier for the virus to transmit between people.

Stopping that second wave is why we have the rules and restrictions.  Whilst I agree in general when she says "Don't be safe.  Be bold", in the case of COVID-19 we in the UK have no choice but to be cautious.

Indeed the lockdown reduced new infections by five sixths from their peak in just three weeks, with an effective R number estimated at 0.57.  Which is important when considering what the government should do next:

BUT OVERWHELMING THE NHS ISN'T THE ONLY PROBLEM

Death

Journalists love death.  When someone dies, there's a story.  Whether it's an obituary or an airliner crash.  Deaths sell.

No surprise then that death from COVID-19 has been the big story.  The best measure is "excess deaths", which compares total registered deaths to the average of the last few years.

The reduction in infections as a result of the lockdown meant far fewer deaths and other COVID-19 problems than there would have been without the lockdown. Yet "excess deaths" in England still total more than 53,000.

Some say that deaths are so low, as a percentage or in absolute terms, that restrictions are no longer applicable.  Quite the opposite.  It is only because of the restrictions that deaths aren't tens of thousands higher.  That is not a price the country can afford to pay.


LongCOVID and other Problems

Deaths have affected the over 50s much more than the under 50s.  Younger people often think that they needn't be concerned about COVID-19, and the rules and restrictions needn't apply to them.  Let's just get on with life.  If only.

In addition to death, there are another five risks, which are being largely ignored by the media.  Yet all of which can apply to the under 50s, including children.

The biggest issue is a collection of symptoms referred to as LongCOVID, that can go on for months, being:

• Lethargy, as can happen after any major infection

• Pain and other medical symptoms rising from damage to various organs around the body.  This can happen to all ages, including children, as the cells of organs such as heart, liver, kidneys, digestive system and brain have the same ACE2 receptor as cells in the lungs and respiratory tract to let the viruses get in. reproduce and destroy the host cells

• Depression and other mental health problems for the 'longhaulers' suffering from LongCOVID.  Here's one person's experience and some tips for survival

Various studies of LongCOVID have shown that after three months the symptoms can adversely affect over half of people who have had COVID-19, even for people who have not been hospitalised and have had the disease only mildly.  If you have had COVID-19 and not experienced any LongCOVID symptoms, consider yourself lucky!


BUT WHAT ABOUT SWEDEN?

Rachel says "When the spectre of shielding for the over 50s was floated I sent a text [to her PM brother?] 'If you do this I'm moving to Sweden'."

Sweden has been the one country that has done as Rachel suggests and avoided a formal lockdown.  Very few rules, principally to stop large gatherings over 50 people, and stop schooling for the over 16s.

Sweden's chief epidemiologist, Anders Tegnell, is often interviewed, and I watch every new interview video I come across.  He and Sweden took a long term view, particularly that people would not tolerate an enforced lockdown for as long as would be needed, and so left Sweden's lockdown voluntary. 

They were lucky.  Whilst schools and businesses stayed open, the people of Sweden did enough of a voluntary lockdown to avoid their health service being overrun.  Their death toll has been higher than their neighbours, but as they don't need to ease a lockdown, their strategy may mean that after one or two winters, other countries will have overtaken them in deaths per million population.

After a couple of years, Sweden's strategy may yet prove to have been the best in Europe, all things considered such as schools staying open.  Avoiding the ravages of a formal lockdown whilst incurring a death toll comparable or perhaps better than other countries.  I'd even bet a fiver.

So why can't other countries like the UK adopt Sweden's strategy now?  Two reasons:

• The risk for the NHS being overrun
• The culture in Sweden facilitating voluntary measures, whereas the cultures elsewhere in Europe would not be suitable

IN CONCLUSION


So, sorry Rachel.  Whilst lockdowns are very painful, as are the various restrictions we still have as rules, the alternative would be far worse. 

Without those rules we would almost certainly find our health service overrun, we would suffer many tens of thousands more deaths, and have millions suffering from LongCOVID.


Indeed the only way to sensibly release those restrictions is to get the infection rate down to #NearZero, much like New Zealand.  #NearZero because even if you aim for zero, there will always be outbreaks from people or objects arriving from abroad, as New Zealand has found.  But local outbreaks can be managed.  We need a strategy nearer to theirs, but pragmatic for the different situation in Britain.