COVID-19: TOO LITTLE TOO LATE. IT'S TIME TO TAKE DECISIVE ACTION

We all hate lockdowns.  They have all sorts of 'side-effects' as we have experienced.  But they can be essential if the alternative is that an infection as dangerous and disruptive as COVID-19 gets out of control.  Especially if it threatens to overrun the health service.

That risk is why England had its first lockdown, whereas Sweden didn't.  Sweden effectively had a voluntary lockdown, which was enough to avoid overrunning their health service. The situation here in England was and still is different, and now we are faced with a second wave and talk of a second lockdown.  Should we do it?

I have always advocated the lightest possible lockdown, such as keeping outdoor activities open, but indoor activities shut.  Indoors the virus transmits so much more easily by air and via surfaces. 'Superspreader' events infecting 5 or more people are known to be 97% indoors and only 3% outdoors, according to this video from the Independent SAGE presentation on 18 September (1hr00:30).

So can keep pub gardens and outdoor cafes open, whilst closing indoor venues. However the latest 'rule of 6' in England makes no distinction between outdoors and indoors.


WHY BE CONCERNED ABOUT COVID-19?

Apart from death, there are 5 significant risks that can affect people, even if they don't to go to hospital, that makes COVID-19 far worse than 'flu:

• Typically ill for 2-3 weeks

• Sometimes longer illness

• Long term lethargy, which again is disruptive and may mean being off work

• Other LongCOVID symptoms, where the virus has attacked other organs such as heart liver, kidneys, digestive system and brain, which can go on for months if not a lifetime
• Strokes, even in the young and healthy

So COVID-19 isn't a disease we can just shrug off, or leave to do its worst.  Combative action is essential.

Lockdowns do one simple, essential thing, and that is to keep people apart.  That avoids transmission of the disease.   A sledge-hammer when needed, because the problem is far bigger than a nut.



THE CURRENT SITUATION

Local and regional semi-lockdowns have become the norm, with nobody anywhere in the country being able to plan forward.  This half-hearted approach isn't helping anyone, and certainly not helping the economy.


A WORD ON  VACCINES AND MEDICINES

It is now nearly the end of September, just three months from Christmas.  Trials are progressing on a number of vaccines, but there will not be a vaccine proven safe and effective, available in bulk, this side of Christmas.  Until then, and with advances in medicines being only for hospital treatment, other action is necessary to reduce the level of infections for people who can incur life-changing symptoms without hospitalisation.



LEARNING FROM THE FIRST LOCKDOWN

On Friday 13 March, auspiciously, I had heard enough to realise a lockdown in England was essential.  I had a 'last hurrah' on the Saturday evening, attending both a classical concert followed by a pub band, and personally locked down on the Sunday.

The following week beginning 16 March the UK government introduced a few measures but didn't order a full lockdown until 23 March.  At least a week too late.  Too little, and then too late.

The new infection graph, of confirmed cases, looked like this:

There are three things to note:

• From the peak, it took 3 weeks to get to 16% of the peak point, then improvement tailed off
• It took around a week to get back to square one
• It took 4 weeks to get from 1.65 to 0.35, to a point 21% below the starting point, and a lot longer to get to 16%

This means when cases are stable, as they were in England over much of the summer,  5/6ths of the starting infection rate can be wiped off in only 3 weeks.  Whereas if you wait until cases are rising, it takes longer to lose less.

Why it is so important to act promptly and decisively.


EARLIER PROPOSALS

It is still the case that reducing infection rates around the country to a very low level, #NearZero will provide a multitude of benefits.  From HM Treasury's perspective, that includes a stronger economic recovery:

The infection level suggested is under 1000 new cases per day, as suggested by SAGE back in March, and which appears very sensible.  As testing only picks up people with symptoms who volunteer, the real rate has been estimated at around 5 times that level.  So the official "new confirmed cases" needs to be below 200 a day nationally, 1400 a week.

This is the latest view of the UK's "new confirmed cases", most of which are for England:

Through June and July the infection rate was within touching distance of 200 a day.  A second light lockdown then would have achieved that target.  The benefits being:

• A much lower base from which infections could grow again
• Schools could have gone back with little fear of sending kids home
• Living now within the testing system's capacity
• Generally allowing life and the economy to get back to near-normal

The investment in a short, light lockdown would have had major gain.

Indeed this is my letter published in the Financial Times back on 11 June, which highlighted other benefits of a lockdown:

I certainly wouldn't want to be in the front line of the health service now, with a prospect of a repeat in a second wave.  

'Saving the Summer' was that around that time Spain and other holiday destinations had got their infection rates right down below Britain's.  There was a distinct risk that travel from Britain to those countries would be forbidden. Ironic then that the countries of the UK banned travellers from Spain and other countries.  That was because those countries ignored the critical point in the letter that, after a lockdown it is essential to adopt "the best possible anti-transmission techniques to keep COVID-19 at bay".

Apologies, but one correction.  The 'R' number is not a rate.  I do wish people would stop using 'R', and use the daily change % instead!  Currently the daily change rate is between +2% and +7%.  Above zero is equivalent to 'R' above 1.  That means infections are now doubling every 7-8 days, nationally.  Horrendous.

After the FT letter there was then a number of blogposts reiterating that action should be taken early before a second wave, to get to #NEARZERO.  Especially when the rate started to rise from the middle of July, including:

• 26 July:  COVID-19 MANAGEMENT – A BUSINESS APPROACH including notes of the #NEARZERO concept, which had already been used in earlier blogposts
• 31 July:  IF ONLY JOHNSON’S GOVERNMENT HAD LISTENED, written as the lockdown easings scheduled for 1 August had been deferred, and which sets out more depth and breadth behind the FT letter 
• 1 August:  ALTERNATIVE STRATEGIES. WHICH ONE FOR ENGLAND?  looking at New Zealand. Sweden, the other countries in the UK, and other countries around Europe
• 3 August: LOCKDOWN OPTIONS: OVER 50s? UNDER 50s? OR WHAT? when partial lockdowns were mooted
• 6 August: Letter published in iNewspaper for LongCOVID in younger adults: 

• 10 August: KEEPING SCHOOLS OPEN IN SEPTEMBER when time was running out to get infections right down beforehand
• 18 August: WHEN CAN LOCKDOWNS BE JUSTIFIED?  including consideration of the 'side-effects'
• 7 September: WHAT DOES #NEARZERO MEAN? which compares the concept to New Zealand's experience over their winter and Independent SAGE's proposals 
• 16 September: ESSENCE AND BENEFITS OF A #NEARZERO STRATEGY including a new benefits diagram

Nothing if not consistent!


THE GOVERNMENT'S CURRENT THOUGHTS

Newsstand 19 September

PM Johnson had COVID-19, almost died, but still believes a full second lockdown should be avoided at all costs.  That is the problem.  The costs in lives and livelihoods, all things considered such as LongCOVID, will be worse than a second national lockdown, despite its 'side-effects'.

A second national lockdown has been recommended all summer.

Yes, it is worth considering lesser measures.  Especially now the opportnuity in the summer was missed.  But even a full lockdown with equivalent support from the public is going to struggle to get infections down to sensible levels in anything under 4 weeks.  A week or two at October half-term is frankly a joke.

Not least because the half-hearted communication campaign means a substantial proportion of the public still haven't heard of LongCOVID, nor have any real understanding of the other risks of COVID-19.  Leaving too many COVIDIOTS who don't think we should take COVID-19 seriously.  That remains a big problem, as they also tend to be vocal.

The government has set up support arrangements for LongCOVID, but hasn't included LongCOVID in any official communication that I have seen.  Perhaps to avoid panic, but the result is horrendous.  The mass rally in Trafalgar Square today against masks and other measures is the result.  COVIDIOTS en masse threatening our health.


WHAT SHOULD THE GOVERNMENT DO NOW?

So far this year the Government reaction has been too little too late.  Delaying the inevitable lockdown whilst infections are rising simply makes the damage to lives and livelihoods worse.  It's time to take decisive action now.

None of us want a lockdown.  But provided suitable financial support is available to employees, self-employed and businesses, a lockdown will be better than drifting on as we are.

Currently we are unable to plan ahead and are incurring higher numbers of deaths and LongCOVID than necessary.  Evidence from Sweden indicates that LongCOVID is affecting some 15% of all people who catch the disease, not just hospitalised.

From an economic perspective, the recovery will also be stronger after a short financial investment in support measures and loss of tax receipts.  The Treasury should welcome a lockdown.

We need a short 3-4 week second national lockdown now, before infection rates get any worse.  As light as possible, but as tough as is needed.  With a far stronger public education campaign, explaining the whys and the risks, as well as the whats.  So that basic precautionary measures also continue thereafter.