COVID-19: "R". RIGHT OR WRONG?

At presser 12/10/20

PM Johnson said it last night.  So did Professor Chris Whitty, England's Chief Medical Officer.  The Chief Scientific Adviser, Sir Patrick Vallance has also been known to say it.

"As long as 'R' is below one".

That's where we have gone wrong.

Because what that means is "As long as infections are not rising."  In the belief that means the economy will be better, and provide the best balance between the harms of COVID-19 and the harms of taking action.  Mistaken.

As Denys Bennett says "...UK policy has been to attempt to keep the number of infections down to a level which does not overwhelm the health service and to keep the value of R to just below 1 to keep it that way. It appears to be an attempted compromise between wanting as few casualties as possible and wanting as little restriction on the economy as possible."

As a result the Government's approach to COVID-19 has been to do too little too late.  Let me explain.

WELL, WELL, WELL

Mistaken because the economy can best thrive if infections are at a very low level, not just not rising.  So the attitude should have been "As long as 'R' is well below one"

Why?  Because 'R' has two major issues:

• 'R' is a composite average for the country or region.  'R' just below one is probably hiding that it is well below one in some places within a region, whilst in another place there's an outbreak where infections are soaring.  Those local outbreaks then spread more widely, and all of a sudden the average 'R' in the region is well above one.  
• In any case, 'R' doesn't have any aspect of time, and isn't a rate.  Better to say "As long as the daily growth rate is well below zero"

Infections rising across an area is exactly what is now happening.

So the fundamental mistake the Government has made is to be complacent about 'R' being just below one.  It had to be well below one acrpss each region, and must now continue to be well below one. 

Indeed in the context of managing infections, 'R' makes you take your eye off the outbreaks ball, and so is best forgotten.

 

WHAT SHOULD WE BE DOING?

What we must do is to stop the rise and get infections down to a very low level, #NearZero.

Professor Whitty and Sir Patrick Vallance are co-chairs of the Government's advisory SAGE group.  We now know that on 21 September SAGE advised a 2-week "Circuit Break".  That was being bandied around as just shutting hospitality.

We now need something tougher than that. Tougher than a "lockdown" if it is to be short and sharp, less than three weeks.

Hence this proposal for a 'Fire Break'.  As I am a business professional who has implemented tough and innovative solutions, this would just be another.  Not easy.  But I believe well worthwhile to substantially reduce infection rates and get most if not all the economy open.

A full 'Fire Break' would be a far better balance of the harms of health and economy.  And bypass all the complexity of the three tier system.

Let's debate.