COVID-19: 'RULE OF 6', 'OPERATION MOONSHOT' AND MORE

Today, Monday 14 June, the new 'Rule of 6' came into effect in England.  I've been waiting for the new regulations, and police reaction, and I wasn't disappointed.  More in a minute.

This was announced at the Downing Street Press Briefing last Wednesday 9 September.  Here's a video of the briefing, with summary notes.

It's worth a look at the Rule of 6’ and other key points arising in the briefing, as apply to England:

• The level of infections and what it means
• Is the 'Rule of 6' enough?
• 'Operation Moonshot' for testing
• COVID marshals

WHAT DOES THE LEVEL OF INFECTIONS MEAN?

The level of infections in the UK, and England in particular, is rising sharply, with the latest 7-day average now even higher:

New infections is an important measure.  Death is not the only obnoxious thing about COVID-19, impacting older people more than young, because much of the damage is done to all ages before hospitalisation.

Indeed younger adults are at far greater risk than they think:

• Long, unpleasant initial infection, often more than two or three weeks
• Risk of strokes that can kill or leave serious damage
• Illness for more than a month
• Plus the risk of feeling lethargic for many months
• The risk of long-term or permanent damage to organs throughout the body, including:
• Heart
• Liver
• Kidneys
• Digestive system
• Lungs
• Brain

As to the data, we need to remember:

• The data lags around a week after the actual infections, as tests are promarily for people with symptoms.  These typically take 5 days to appear (2-14 days).  Looking at a 7-day average, that puts the data even further back, making it nearly 2 weeks behind

• The actual level of infection is much higher than the official "new confirmed cases" graphed above, as not everyone gets tested

• People are infectious before they display symptoms.  As explained here, an estimate of the number of people out and about infectious is 3.5 times the weekly infection rate, or 24.5 times the 7-day average

That means the Government and its SAGE advisors need to be looking well ahead.   Which is what they have tried to do by time-shifting the lines so the UK's infection growth can be more easily compared to France, Spain and Belgium, in the graph below.  UK is following a similar track to France, so action should be taken early.  The hope is to reverse the tide like Belgium:

The New Zealand motto is “go hard, go early”.  They tend to over-do it.  Even if we've gone early enough, is the response hard enough?


DOING ENOUGH?

PM Johnson said that the new "rule of 6" is to avoid a national lockdown, by which I assume he would mean shutting schools and non-essential businesses.

My inclination is to use the lightest possible lockdown, because of the 'side- effects of lockdowns.   These new restrictions are effectively an ultra-light lockdown.

However, I have long campaigned for #NearZero, at a very low level of infection.  This strategy has a number of benefits:

• Lower base in preparation for the autumn and winter, when viral transmission is likely to be easier and more of a problem
• The chances of meeting someone else infectious would be much more acceptable
• Schools could reopen and much more easily stay open.  Even in Scotland, where infection rates are lower than England, schools are starting to have schools disrupted.  Universities too, more difficult as students are susceptible to COVID-19 as young adults.
• Everyone including those who have been shielding could go out with more confidence
• Public transport could be used freely, albeit better with masks.  A special problem for schoolchildren and students
• Offices, factories and other workplaces could be used with little chance of outbreaks
• Deaths and LongCOVID would be far less than at current infection levels
• The Night Time economy could readily implement the NTIA's recommendations 
• Testing would be at a far more sensible scale, without the shortages that have befallen the system.  
• The economy could thereby recover.  Indeed the current level of infections is holding us back economically.

My inclination is that 'the rule of 6', not restricted to 2 households as is the case in Scotland, will maybe stop the rise, but not bring infections down.

There comes a time when sadly the only short-term option is a lockdown.  We should have done it back in the summer, before schools were due to go back.  But now the longer the delay, the worse the situation will be.


THE REGULATIONS FOR THE RULE OF SIX

The regulations were only announced in detail late last night, Sunday, and came into effect ten and a half hours before laid before Parliament.

There was consternation that police would not be levying fines today, but that was simply because the legislation wasn't there in time to be effective, nor for police forces to be adequately trained. 

As a professor of law Adan Wagner commented, "There are loads, and loads, of exceptions, and plenty of room for confusion."  Indeed he goes on to say " I don't see how these are enforceable in any real sense - so many complex exceptions" 

So what have the police said today? The main reaction was from Ken Marsh, head of the Police Federation, who warned "officers will be flooded with calls after the Police Minister encouraged people to snitch on rule breakers".

Assistant Chief Constable Christian Bunt at Thames Valley Police said, before the regulations were released: 

• “Preventing the spread of coronavirus is a shared effort and we at Thames Valley Police will play our part."

• “Our officers will be in the community engaging, explaining and encouraging people to follow the regulations. We will disperse groups of more than six people and will issue fines to those who refuse to comply."

• “Members of the public can expect to see officers out on patrol but we ask that everyone takes personal responsibility so police involvement is a last resort.”

Indeed some MPs have suggested that compliance should be voluntary.  That would be like Sweden.  But that would effectively make the UK have another first wave, with the NHS under threat of being over-whelmed. So the Swedish approach is not appropriate to the UK as things stand.


OPERATION MOONSHOT - A NEW STYLE OF TESTING

LamPORE test equipment

PM Johnson announced that the Government is aiming for a new style of testing that would allow millions of tests a day, so everyone with or without symptoms could be tested.

This is a laudable aim, and indeed one I proposed a couple of months ago.  I wonder who in the Government is following this blog?

I said "To tackle this problem needs ‘Got It’ testing every day, ideally, with immediate results.  Even once every 5 days until (or if) someone tests positive would initially require some 11 million tests a day.  Clearly impractical and horrendously expensive using current testing technology.

We therefore need alternative ‘Got it’ tests that are:

• Simpler
• Quicker
• Cheaper
• Preferably more reliable, by not being based on swabbing
• Yet clearly identify all variants of SARS-COV-2 without counting other coronaviruses"

The technology doesn't yet exist to achieve this vision in full, but as an intermediate step the LamPORE technology is being trialed in Hampshire and Salford


COVID MARSHALS

Again it as some weeks ago I suggested contact tracers should become 'COVID wardens', much like air-raid wardens of the Second World War.

This concept has been launched as "COVID marshals".  The lack of additional funding may however leave this initiative dead in the water.  Let's hope not.





IN CONCLUSION

So there were some good ideas in last week's press briefing.  But too little and again too late.