So what should we do in the meantime? The three-tier system for England is effectively elongated shutdown, designed primarily to avoid the NHS being overrun. Which will cause massive economic and wider social and health problems, for only a relatively small reduction in infections. MPs are rightly worried. Can these problems be avoided? Could we get down to #NEARZERO some other way?
THE NATURAL LIFECYCLE OF THE VIRUS
Ian Jones , Professor of Virology at Reading University stated on BBC Radio Oxford breakfast show last Thursday 19 November breakfast show (at 3hours 32min25s) that "If everybody could live for the next month three metres apart.... the virus would become extinct. There's no doubt about that. "
That can be explained with the virus's lifecycle, as follows:
- People tend to show symptoms between 2 and 17 days after infection, typically after only 5 days
- People become infectious before showing symptoms and remain infectious for some days after showing symptoms.
- People will tend to infect their own household, likely within the first few days of becoming infected
- If
people and their household were to self-isolate as soon as they believe
one of them has been infected, they and their household would no longer
be infectious after about three weeks, certainly by a month
- If everybody in a geographical area was to simultaneously self-isolate for a month, nobody would be infectious and the virus would be eliminated in that area.
- Indeed three weeks would be enough to virtually eliminate the virus in that area
Unfortunately
not everybody would be able to self-isolate for three or four weeks.
Hospitals, care homes and some other organisations MUST stay open
regardless, and staff will need to continue to go to work. Some people
would not be able to store enough food for that period, but many would using what's in their cupboards and freezers.
In the
first lockdown supermarkets remained open. Hence the lockdown did not
achieve complete elimination in the first three or four weeks. A
Lockdown or FireBreak can only be as effective as the level of
restriction on people meeting others.
That suggests that if as many people as possible were to self-isolate simultaneously for three weeks, more stringently than in the first lockdown:
- Infection rates would drop by at least the amount achieved in the first lockdown, where they fell by five sixths from the peak in the first three weeks, after which the fall tailed off. A fall of five sixths would be great news.
- Infection rates should drop further to #NearZero levels, allowing much of the economy to re-open, plus a host of other benefits
That would be a Mass Simultaneous Self-Isolation. Let's call it an Enhanced FireBreak.
The benefits would be:
HOW CAN INFECTION RATES BE KEPT DOWN AFTER A FIREBREAK?
We know from the end of the summer and experience abroad that COVID-19 is so infectious that infection rates can quickly soar. A lid must be kept on the virus by adopting a tough set of controls:
- Continuing with social distancing, using masks and washing hands regularly
- Controls on people and chilled products arriving from abroad
- Bearing down on any outbreak:
- Mass testing as has been adopted in Liverpool, asymptomatic and symptomatic
- Strong local test, trace and isolate measures
However even that set may not be enough to stop infection rates creeping up. So an Enhanced Firebreak may need to be repeated. If that was after three months, then a three-week investment in am Enhanced FireBreak would have provided around ten weeks of the economy being open.
THE EFFECT ON EDUCATION
The lockdown and tiers are intended to keep schools open. But Independent SAGE are reporting more than one in five senior school children were off school last week. The disruption is not sensible for education.
We also know universities have been badly disrupted by COVID-19.
Am Enhanced FireBreak would need to have schools and universities closed to be properly effective. But that would ensure that when they did re-open they could function with little or no disruption. An 'investment' worth making.
WHAT ABOUT THE FIREBREAK IN WALES?
The Firebreak in Wales was 17 days, including three weekends, but only two school and business weeks. It started at half term in October, but allowed most schools to go back after that week.
The result was an overall reduction of infections by about a half. But as that was still quite high in most regions, the virus soon fought back and infection rates have risen again across the country.
An Enhanced FireBreak has to be the full three weeks to be properly effective, with the sharpest of restrictions, including schools closed for the entire time.
WHEN SHOULD A FIREBREAK OCCUR?
Financial support during the Enhanced FireBreak will be vital. But only three weeks, and the Government would quickly recoup their investment when the economy reopens.
This and other aspects of an Enhanced FireBreak will take a little while to organise. December is important for retail and hospitality. University students will generally be going home over Christmas.
So the obvious thing to do is to hold the Enhanced FireBreak in early January before schools and universities re-open. Then maybe again straight after Easter.
It would mean starting with the tiers, and would then look like this:
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