COVID-19: AN ENHANCED FIREBREAK AS PART OF A SUPER-SUPPRESSION STRATEGY

The stated objective of this blog is "...getting back to normality by defeating COVID-19 disease...".  Don't we want to see music, theatres, sports and other mass entertainment open?  With the hospitality industry?  Pantomimes too for Christmas?

The two western-culture countries that have arguably done best in keeping their economies open are New Zealand and Sweden.  Two completely different strategies, but difficult to see how either of their strategies could work in the UK.  That's because of the UK's close ties to the continent on the one hand, and constraints in the health service and the public's willingness to accept another high toll in deaths:

• New Zealand
• Sweden
  

But we can still learn from them, and several of the South-East Asian countries with very different cultures,  that are also said to be shining beacons of how to deal with COVID-19.  

The end result of considering all the strategic options is to agree with Professor Chris Whitty from back in May that:

• Eradication of the virus worldwide is impossible, so we'll always have to live with it to a greater or lesser extent, dependent on the use of vaccines
  
• The second wave could be worse than the first, as the virus is so infectious
• New cases need to drop to the hundreds for the economy to reopen, a 'very low' level of infections
  

A 'very low' level of infections is #NearZero.  The UK has tolerated a 'low' level of infections by following a 'suppression' strategy in the hope of opening the economy, but has since lost control.  If we want to open the economy with a #NearZero strategy then that needs to be a Super-Suppression strategy.

 

A SUPER-SUPPRESSION STRATEGY

A Super-Suppression strategy requires two things:

• Getting infections down to #NearZero
• Keeping infections down to #NearZero

It is worth getting infections down to #NearZero for two fundamental reasons:

• Reducing deaths, LongCOVID and all the other problems of a medium to high level of infections that UK is now experiencing
• Re-opening the economy 

KEEPING INFECTIONS DOWN TO #NEARZERO LEVELS
 

But those two objectives can only be achieved sustainably if steps are taken to keep infections down, including:

• Controls on inbound travellers, be they returning citizens, visiting business people, or tourists
• Controls on inbound goods, especially chilled goods in or on which viruses may have survived
• Spotting and dealing with outbreaks as soon as they arise:
• Testing of those without symptoms being at least as important as testing the symptomatic, who should self-isolate anyway
• Workplace testing, especially riskier industries such as slaughter houses
  
• Monitoring virus levels in sewage system

Even New Zealand, which has far stricter controls on immigration than could be practical here, has had virus get into the country.   Outbreak control is never perfect, so we have to assume that even under super-suppression, infection levels will tend to rise.  

The idea is if the infection level in each area of the country is down to #NearZero levels, it would take weeks if not months before levels rose to force businesses to close.  

 

GETTING TO #NEARZERO

If we can adopt an Enhanced FireBreak by extending Half Term in England now, we could get infections down to a #NearZero level.  Then the best estimate would be three months before further action would be needed, getting to half-term in February, then half-term in May.

The Welsh only expect to get to the New Year with a shorter standard FireBreak, which would then need to be repeated on a more regular basis.

The current three-tier strategy in England is far too complicated.  It is unlikely to bring infections back down to summer levels, now the colder weather is bringing people more indoors.  Neither the British Medical Association nor Professor Chris Whitty, The Chief Medical Advisor, believe the restrictions will be effective.

Diagrammatically, indicatively, the comparison would be:

FINANCIAL SUPPORT

Financial support from the Government is critical if businesses are to be instructed to close down in any form of lockdown.  As you'll see from the diagram, the #NearZero strategy in blue has three advantages for the Treasury:

• Closure times will be minimised, minimising the financial support needed
• A more vibrant economy will minimise Social Security payments
• A more vibrant economy will also maximise VAT and income tax receipts
  

A No-Brainer for the Treasury?

 

IN CONCLUSION

So by adopting a #NearZero super-suppression strategy with periodic Enhanced FireBreaks we could keep infection rates low enough to keep most if not all of the economy open.  Living with the virus much as we live with flu, at least until a vaccine is available.  

Saving Christmas.  Saving Lives.  Saving Livelihoods.  And better for the Treasury.

 

COVID-19: HEALTH MEANS WEALTH. ENHANCING THE FIREBREAK

The problem with a standard lockdown is the damage it would typically cause - economic, educational and living.  Indeed the lockdown that started in March in England has suffered from all those unwelcome 'side-effects'.  Furthermore music, theatre, sports and other mass events are yet to re-open.   A second lockdown of similar ilk would suffer from those same drawbacks.

But what if you could do a shorter, sharper lockdown that provided more benefits, such as allowing most if not all of the economy to re-open, whilst keeping the side-effects to a minimum?   To improve both health and wealth.

I woke up one morning back in late September with an idea for a Mass Simultaneous Self-Isolation that would virtually eliminate the virus from the British Isles if as many people as possible could self-isolate for two to three weeks.  Allowing most if not all the economy to re-open, including mass entertainment.  That has developed into what I am calling an Enhanced FireBreak (EFB), where self-isolation is voluntary, not enforced by legislation.  

A 'hard reboot' for the country.

 

THE WELSH FIREBREAK

So it was with some sense of deja vu that today I watched the Welsh First Minister Mark Drakeford announce a FireBreak for Wales, to start this coming Friday.  He was using much of the same terminology and concepts, such as "short and sharp".  

But the question is how effective would the Welsh FireBreak be?  Not as effective as a sharper Enhanced Firebreak which would preferably be slightly longer.  

 

ENHANCING A FIREBREAK

The objective of a FireBreak is to eliminate the virus.  This is by everyone self-isolating so anyone infectious self-isolates until they are no longer infectious.  But as it takes some days for symptoms to develop, that has to be at least two weeks from onset of the FireBreak. Plus some time in case they infect their household, be it family or housemates.  A total of about three weeks.  Then everyone who has caught the disease stays self-isolated until they could no longer be infectious.  

Self-isolation would need to be voluntary, with an overnight curfew an option.

The more of the country's activities can be closed, the more effective a FireBreak can be.  The lower the infection rate achieved, the more of the economy can be re-opened, and the longer it would take before the inevitable outbreaks mean another FireBreak is required.

There are two ways a standard Circuit Breaker or FireBreak can be enhanced:

• When a Circuit Break or FireBreak is announced, people could voluntarily enhance it by self-isolating.  That can happen in Wales and if a Circuit Breaker or FireBreak were to happen anywhere else such as in England.

• An Enhanced FireBreak should also involve a tighter programme of shutdowns.  A somewhat larger investment, but for far more significant benefits.  

Any shutdown needs to be accompanied by financial support from the Government.  The idea being the greater recovery in the economy will pay back the investment handsomely.

In summary, the differences to a standard FireBreak like announced for Wales would be:

The three-tier system of restrictions in England is far too complicated.  Neither the British Medical Association nor Professor Chris Whitty, The Chief Medical Advisor, believe the restrictions are effective. 

Here's how an Enhanced FireBreak would fit into a strategy for the coming months until a vaccine is available.  Sir Patrick Vallance, Chef Scientific Advisor, told the National Security Strategy Committee this week (19 October) that he thought it "unlikely" that a COVID-19 vaccine would be available for "any sort of widespread community use" before at least spring next year.

 

ACTION NOW

So England should now quickly follow Wales into announcing a FireBreak for this coming weekend, corresponding to Half Term for many schools. But preferably make it sharper, as an Enhanced FireBreak.  A 'hard reboot' for the country.

COVID-19: MAY KEY POINTS BE UNDERSTOOD

Prof Chris Whitty

This was a newspaper headline back on 1 May:

"Ministers warn lockdown could stay for MONTHS until new cases drop to the hundreds - as Prof Chris Whitty says a second peak could be WORSE than the first and eradicating coronavirus is 'technically impossible'."

So let's establish what this means, as the points made are vital for us to understand if we want to defeat the virus:

• "...eradicating coronavirus is 'technically impossible'."  This means there will always be coronavirus somewhere in the world, waiting to re-infect a country even if virus has been eliminated.  We have to learn to live with it.  Sir Patrick Vallance, the Chief Scientific Advisor, recently confirmed this would be the case even with vaccines.
  

• "...lockdown could stay for months..." as we have now experienced, with the music, theatre, sports any other entertainment still locked down

• "...the second peak could be worse than the first..." especially if people get frustrated with the restrictions, or even fight against them as we have seen.

• "...until new cases drop to the hundreds...", at which level most if not all the economy can open.  This is daily new cases under a thousand, around five times lower than the "confirmed new cases" which don't cover all people infected.  So "confirmed new cases" needs to be below around 200 a day, about a quarter of the lowest level reached in England this summer 

Sir Patrick also told the National Security Strategy Committee this week (19 October) that he thought it "unlikely" that a COVID-19 vaccine would be available for "any sort of widespread community use" before at least spring next year.

These are the key aspects behind the idea of a #NearZero strategy.  Whilst elimination of the virus in the British Isles is a good target, it is not a realistic outcome, and we need to learn to live with a very low level of infections below 200 per day.

The benefits of a #NearZero strategy are as follows:

We've then got to get there.  Hence the idea of an Enhanced FireBreak, which aims to eliminate the virus as far as possible in the shortest possible time, to allow most if not all of the economy to re-open for a reasonable period of time.

COVID-19: ECONOMIC AND LIFE BENEFITS IF A "CIRCUIT BREAK" IS DONE PROPERLY

There are three common assertions going around that I believe are mistaken, as quoted from an article in one of today's newspapers:

(1) ECONOMY:  A two-week Circuit Breaker "would cause even more economic and social hardship".  Wrong.  If this is upgraded to a two to three week "Fire Break" where as many people as possible self-isolate, infections will drop substantially and much if not all of the economy could be re-opened.

(2) TEST AND TRACE: "We need Test and Trace to be fixed".  Wrong.  Re-focused, not just fixed.  The current RT-PCR testing takes too long, making large scale test and trace ineffective and extortionately expensive, as we have found.  Current resources need to be re-focused on outbreaks, by testing everyone in the workplace or local area, symptomatic or not.  That is how to keep infection rates very low for as long as possible.  Emerging technology will help, but not until next year.

But outbreak testing will only work if we get infection rates down very low in the first place, #NearZero.  That is only possible with a Mass Simultaneous Self-Isolation, which at short notice nees to be voluntary.

(3) SCHOOLS: "We must keep schools open".  Ideally, but wrong for three reasons.  Parents of younger children need to be taken to school, and inevitably mingle. As do staff.  Children of all ages can carry the disease, and older ones at least can pass it on.  All undermining a mass self-isolation.  Lockdown over half term and the impact on education will be minimised.  That means starting a Circuit Breaker this weekend, when some schools have broken up.

The Government needs to provide adequate financial support to everyone adversely affected. But only for that short period.  That will pay back handsomely in subsequent economic activity, lives saved and in saving Christmas.   

We need a Circuit Breaker as soon as possible.  Everything possible closed down for two to three weeks, with as many people as possible voluntarily self-isolating for the duration.  Let's call this approach a "Fire Break".

COVID-19: A BREAKTHROUGH IN TESTING

 

A few days ago I reviewed the COVID-19 testing regime in the UK and said "Could we spot intact SARS2 with some form of microscope, with AI software optimised for identifying it?  I haven't heard of such an initiative, but hopefully someone is working on it."

Well here it is, folks.  I can barely believe it.  Not only do people read my blog, they do so before I've even written it!

This novel diagnostic method is being developed here in Oxford, a new approach to testing that, according to the research paper:

• "relies on the detection of intact virus particles using wide-field fluorescence imaging". 
• The first step is "binding of short fluorescent DNAs to the surface of virus particles"
• Then "surface-immobilise labelled particles, collect diffraction-limited images containing thousands of labelled particles" to be observed under a visual microscope
• finally use image analysis and machine-learning to identify different viruses, distinctly from others
• "Our assay achieves labeling, imaging and virus identification in less than five minutes and does not require any lysis, purification or amplification steps."  Astonishing.
• Furthermore the method has "... the ability to detect multiple virus types in a single labelling step, and robustness against potential mutations in the viral genome."  Vital.
  

The research group says the equipment is mobile and "Given its simplicity and rapid nature, our technology could also be used outside of specialized laboratories, such as in airports, workplaces and care homes."  Entertainment and sports venues too, helping to reopen those industries.

There's only one problem.  The announcement by Oxford University says "They hope to incorporate the company by the end of the year" [now done], "start product development in early 2021, and have an approved device available within 6 months of that time." i.e late 2021.

Can't wait.  But we're going to have to wait.

WHAT ABOUT IN THE MEANTIME?

There are novel test methods being developed throughout the world.  Two of the most promising also come from other Oxford University departments, using RT-LAMP technology:

• The LamPORE tests from Oxford Nanopore being trialed in Salford
• A faster cheaper test from Oxsed
  

But between now and Chrstimas 2020 we are only going to have RT-PCR tests available. As the new research paper says:

"Reverse transcriptase polymerase chain reaction (RT-PCR) is considered the gold standard for diagnosis; however, RT-PCR takes several hours to provide a result, is restricted to specialized laboratories (as it requires viral lysis and RNA extraction), and can be limited by supply chain issues."

They go on to say "Isothermal nucleic acid amplification methods, such as loop-mediated isothermal amplification (RT-LAMP), offer a promising alternative that does not require thermal cycling and can provide results within an hour2-7; however, these methods are still subject to similar supply chain issues as RT-PCR. Rapid (<30 minutes) immunoassay-based antigen-detecting tests exist for some viruses (e.g., influenza), but generally have low sensitivities8. There is thus an urgent need for new viral detection approaches, particularly ones that can be deployed in non-laboratory settings."  

SO WHAT SHOULD WE DO NOW?

If we are to be able to live within the capacity constraints of the current RT-PCR testing, then we need to get infection levels down to #NearZero.

To do that we need a Circuit Breaker to stem the tide of the second wave, but enhance it with a Voluntary Mass Simultaneous Self-Isolation.  That would get the infection rate down lower.

On testing, the experts say that we should use the time of the Circuit Breaker to "sort out Test and Trace".  Sadly that isn't simply improving Pillar 2 Test and Trace run by SERCO.  As I said back in early August "TTI is therefore impractical and inherently an expensive waste of money if attempted at a national scale, as being done for NHS Test and Trace".

We need to consider cancelling Pillar 2 testing, and expand the Pillar 1 testing within the NHS.

COVID-19: LET'S MAKE IT VOLUNTARY

There's the old joke.  How do you spell it?  I T of course.  Or in this case MSSI - a Mass Simultaneous Self-Isolation.  Adding a V for Voluntary.  A VMSSI.

Let's look at the basics.  There are two reasons to have a "Circuit Break", as SAGE advised back on 21 September:

• Get infection rates down to more manageable levels, especially to avoid the NHS being overrun
• Get infection rates down lower than that, to very low levels, so most if not all of the economy can re-open

Do the latter and we don't have to make a choice between health and the economy, we get both. 

Back in mid-September when SAGE were developing their report, a Circuit Breaker similar to the first lockdown but with schools and universities open would probably have got us down to low rates, like in the summer.  But probably not to very low rates to re-open the economy by removing most if not all business restrictions.

Over three weeks after that report, with infection rates significantly higher, a basic Circuit Breaker simply won't be enough to have any positive economic impact.

We would need to have a Fire Break where we all self-isolate together to get infections as far down as possible in two to three weeks.  I floated the idea for debate at the end of September, with various follow-ups, and am grateful to every person who contributed.  Some in support of the idea, some with concerns.  My conclusion is that MSSI would fly, but only with a V.

 

THE SELF-ISOLATION PRINCIPLE

Currently, if we are contacted by Test and Trace we can be told to self-isolate for 14 days.  This is because the vast majority of infected people will have developed symptoms by 14 days, at most 17.  If they do develop symptoms, then they may need to continue self-isolation, dependent on current advice.  If they don't develop symptoms they can get back to life.

In theory then, if we were to all self-isolate individually and simultaneously, by 2-3 weeks the virus would have been eliminated.  We'd still have to control import of the virus via people or goods, but the whole economy could re-open.  Life back to normal, with many benefits to lives, life and livelihoods:

But we live in households, either with family or flatmates.  Transmission within the household should happen within the first week, so 3 weeks should be enough for elimination.

A total simultaneous self-isolation like this for 3 weeks would let us get to normal, with the economy fully open.   But total isn't possible.  There are some vital activities that cannot shut down - residential facilities such as hospitals, care homes and prisons, and industries like steel furnaces that can't sensibly shut down.

"Vital" would have a tighter definition than "essential".  Schools closed for those 2-3 weeks, and universities working online only.  Possibly closing supermarkets, so people live off their stocks of food in their freezers and cupboards.

 

BEING PRAGMATIC

It is clear that closing food retailing and food supply chains would be difficult, and only with some time for preparation.

So a "vital" Mass Simultaneous Self-Isolation wouldn't be feasible this side of Christmas 2020.  

But if we want to save Christmas, we've got to do something.

COMMUNITY SPIRIT

A polls is showing that more than two thirds of people would support a Circuit Breaker lockdown.  It then struck me that people have been bemoaning the loss of community spirit since the Thursday evening claps for the NHS.

So let's do a Fire Break based on a Circuit Breaker, but with schools closed and people encouraged to self-isolate if they can.  A Voluntary Mass Simultaneous Self-Isolation.  VMSSI.

Not an enforced curfew. But a Fire Break that is as close to it as possible, on a voluntary basis.  Community spirit.  Shame those who flaunt it, supported by the minimum of vital fines.

It then struck me that food banks are based on the age-old principle of the Harvest Festival, except all year round.  Non-perishable foods in cans and packets piled high in church halls.  Let's do that again.  Those people who can survive two to three weeks without buying food helping those who can't, with cans.  [LOL - Ed]

 

TIMESCALES

The infection rates around the country are still rising.  Professor Chris Whitty doesn't believe the toughest tier restrictions will work.  Bolton has effectively been under tier 3 restrictions for weeks, and the restrictions haven't worked.  So we can't wait to see them fail again. 

Schools across England break up for half term this weekend or next.  Let's start a Fire Break this weekend, with legal restrictions as per the first lockdown.  But with people encouraged to self-isolate.  A VMSSI.

A Fire Break will also need financial support from the Government.  But getting the economy running after the Fire Break will pay back the investment very quickly.

That's it.  Save Christmas.  Defeat the virus.  All pull together.  Open the economy.  It is spelt VMSSI.

COVID-19: FINES - CAN'T PAY, WON'T PAY, DON'T PAY

When I was interviewed on BBC Radio Oxford yesterday morning (3hr:22:50), I said there is one reason to download and use the NHS COVID-19 app.  That is to check-in to venues instead of providing detail manually, for two reasons:

• Avoid possibility of venue staff contacting you.  There have been a number of examples of ladies being pestered.
• Given the app keeps you anonymous, avoids risk of a £1000 fine resulting from not self-isolating when asked to from the manual records.  For example because you know you found a quiet corner of the pub well away from other people, or were at a venue for only five minutes, so the chance of catching COVID-19 was remote

This is just one example of where the new COVID-19 fines are counter-productive.  You also potentially expose yourself to a £1000 fine if you are told to self-isolate because:

(a) You have gone for a COVID-19 test and it is positive 

(b) You have answered the phone from a contact tracer who tells you to self-isolate.  Maybe why the Test and Trace stats show so few people are contacted

Obviously we should self-isolate if we are displaying symptoms, or know we have been in close contact with someone who has.  The question is whether we should do so if there is a minimal chance of infection, under threat of a fine few people could afford to pay?

My understanding is that these fines are levied as Fixed Penalty Notices.  Just like parking tickets. Pay them and all is forgotten.  Don't pay them or can't pay them, and it goes to court where you could gain a criminal record.  The same applies to all other COVID-19 fines to individuals and businesses.

We are assured that fines will only be issued as a last resort, but the threat is counter-productive and unacceptable.  These self-isolation fines should be scrapped immediately.

All other COVID-19 fines should be similarly reviewed and scrapped or modified accordingly.

We are going to have to live with COVID-19 for the foreseeable future.  Voluntary compliance is going to be increasingly important.  Fines should only be in place when vital.

COVID-19: ACHIEVING HEALTH AND A VIBRANT ECONOMY

A significant number of Conservative MPs are objecting to the three-tier lockdown system, and would not countenance a short, sharp "circuit break".  This is because of the hit to the economy, with many businesses especially in hospitality and their supply chains going to the wall.  With hundreds of thousands of people out of work.

I agree with them.  Though in some parts of the country the economic affects are already happening, with many businesses forced to close.

However I do not agree with their solution.  We need a different solution that achieves both health and the economy.  That isn't to let the virus 'let rip', as herd immunity would take months or years (if ever) whilst leaving many thousands of dead in its wake.  Plus many more LongCOVID sufferers across all ages, including children where the worst forms are called MIS-C.  

Surely achieving both health and a vibrant economy is impossible?  Let's see.

 

OPENING THE ECONOMY

Herd immunity is a non-starter, as the required level of immunity would take years or at least months, not a few weeks, with immunity not yet guaranteed.   Whilst leaving an horrendous cost in lives and LongCOVID sufferers.  Likewise any variant such as the Great Barrington debacle.

Sweden has kept much of its economy and education open, but it hasn't been herd immunity.  Large gatherings over 50 have not been possible, and education for over 16s has been disrupted.  What has suited Sweden wouldn't work in UK, which is why we went into lockdown in March.

We have to look at the other end of the strategy spectrum for inspiration, at "suppression" and "elimination".

Elimination is being tried by New Zealand and parts of the Far East, but would not work in the UK, having a different culture and far greater interactions with other countries. These other countries have nonetheless each had problems, though have kept infections down to near-zero levels and been able to re-open their economies.  Hugging restored in New Zealand, for example, at least for a while.

Suppression has been the UK's policy, like most of Europe, which we have seen doesn't work as infection rates everywhere surge.  Infection levels in England were low in the summer, and the opportunity to get them very low was squandered.  We needed to get them below 200 per day confirmed new cases, at that level of testing of just the symptomatic.

 

SUPER-SUPPRESSION

We need a practical strategy, in between suppression and elimination.  Nearly as effective as elimination, but stronger than suppression.  Let's call it "Super-Suppression", with infections rates at #NearZero.  Less than 200 official "new confirmed cases" a day nationally across England and UK.  Little chance of meeting someone infectious

That wouldn't be quite as good as elimination, but close.  Official levels went down to about 700 over the summer, and it is a pity the opportunity to get down to very low levels wasn't taken.  That would have unlocked most if not all of the economy:

We know from the summer that with modest business restrictions, infection rates stay down.  At very low rates we might expect rates to stay down for some time with those restrictions removed, albeit with "Space, Face, Hands" in that priority order still being practised.  At least until mass vaccination has taken place, perhaps later in 2021.

 

A SUPER-SUPPRESSION STRATEGY

So the idea is to open the economy by getting infections down and keeping them down.  Controls strengthened on people arriving in the country.  Controls also strengthened on chilled food and other incoming products that are are still suspected as being sources of outbreaks in New Zealand.

But there will always be 'leakage' of viruses into the country, as well as people ignoring advice and otherwise being unlucky in catching the virus.  Local outbreak teams would need to pounce on outbreaks, but we have to assume that infection rates will begin to rise.  The lower we can get infections, the longer that would take.

But how do we get to #NearZero?

FIRE BREAKS

Talk now is of a "circuit breaker" for 2-3 weeks, with similar restrictions to the first lockdown, but schools potentially staying open.  That could be applied locally in areas of high infection, but preferably nationally.

That was what SAGE recommended on 21 September.  But that was more than three weeks ago, and infection rates have risen considerably since then.

If we want to do something for 2-3 weeks now, then something stronger and sharper is needed.  We need to think the unthinkable, in recognition that this is a war against an invisible enemy that is seeking to kill us and otherwise disrupt our economy.

I would call this breaker a "Fire Break".  Working as close to a total lockdown as possible, with a Mass Simultaneous Self-isolation of 2-3 weeks.  Closing as much as possible that wasn't closed in the first lockdown.  Perhaps most people not being allowed out at all.  Using our stocks of food, medicines and other essentials that we all ought to have in stock for an individual self-isolation.

The more that can be closed, the lower the infection rate would go, and the longer it would be before another lockdown was needed.

A SUPER-SUPPRESSION STRATEGY

Businesses, schools, universities and other organisations as well as individuals are complaining they can't plan ahead.  The restrictions keep changing, in an unpredictable manner.  I feel especially sorry for hospitality businesses in parts of the country that have invested in being COVID-secure, only to find they are being closed down indefinitely.

A "Super-Suppression" strategy would be far fairer in applying to everybody across the country.  Doing away with all these complicated and ambiguous rules and threats of fines.  Back to the simplicity of "Stay at Home".

Then unlocking all or most of the economy as soon as the pre-defined period was over. 

The only uncertainties would be quite how far down infection rates would go, and then how long between Fire Breaks.  But everyone will know how important it is to follow "Space, Face, Hands" advice, which will help to prolong the periods when the economy can remain open.

WHY NOT WAIT UNTIL THE NEW THREE-TIER SYSTEM HAS BEEN TRIED?

The problem with the tiers is what Professor Whitty, the Chief Medical Officer, said on Monday that the top-tier measures will not be enough to solve the virus problem in those areas.  They haven't worked in Bolton.

Furthermore, waiting for hospitalisations and deaths means waiting weeks, and by then it would be too late.  We need decisive action now.

 

WHAT ABOUT A CIRCUIT BREAK?

Now infections have risen substantially since SAGE's advice on 21 September, my concern is that a basic "Circuit Break" will simply not be enough.  It will reduce infection rates, to protect us all from the worst of what would otherwise happen over the winter.  That would be very welcome.  But it won't unlock the economy.  The costs of a lockdown with health benefits, but without economic benefits.

 

TWO BIRDS WITH ONE STONE

Tougher Fire Breaks as part of a Super-Suppression strategy would achieve both objectives:

1. Open the economy for considerable periods between Fire Breaks
2. Overall reduce infection levels, deaths and LongCOVID to far lower levels.

Better for Lives.  Better for Livelihoods.  Better for the Economy and Treasury.

Apart from anything else, saving Christmas 2020.

Yes we need a Contact Breaker with rules like the first lockdown.  As soon as possible, while schools are closed for Half Term..  Making it a Fire Break by a Voluntary Mass Simultaneous Self-Isolation.  No longer, and with financial support for all businesses and individuals affected.

.

 

 

COVID-19: THE 360 DEGREE APPROACH TO FINDING A WAY TO LIVE AND THRIVE WITH COVID-19

There is no doubt that we will have to learn to live with COVID-19 for the foreseeable future, with vaccines, with or without medicines.

We will need to somehow open the whole economy, including hospitality, arts and sports.  Live and thrive.

That requires striking a balance between health and the economy.  Achieving one, but not the other?  Or could we achieve both?

Finding the best solution requires looking at the problem from a variety of angles simultaneously, in a 360 degree approach.

Here is my 360 degree experience which I am applying to find a solution to opening the whole economy:

Further details of my experience can be found here.

CV-19: CIRCUIT BREAKER versus FIRE BREAK

This evening Sir Keir Starmer, Labour leader, has asked PM Johnson and the Government to follow the advice of SAGE and organise a "Circuit Breaker".

Sir Keir highlighted that most of the parts of the country that have had special measures are still experiencing rising infections.  His concern, quite rightly, is that the new three-tier system is also inadequate given the SAGE advice.

A "Circuit Breaker" would be a 2-3 week repeat of the first lockdown, with similar restrictions.

But is this enough?  It was suggested back on 21 September when infections were far lower. 

The problem is that 2-3 weeks of that level of restrictions won't produce much of a reduction in infections. Here is the graph from the first lockdown, with a five sixths reduction in the first three weeks:

We need to keep a break to 2-3 weeks, absolutely no longer.  But losing 5/6ths from "new confirmed cases" of now some 15,000 a day, and still rising, would get daily infections down to no lower than 2,500 a day.  It needs to be down well below 1,000, which was where we were in the summer.  That means tougher restrictions that is called a "Fire Break".

"Vital" only, not "essential".

The main distinction with "vital" would be to close as much of society as possible.  Could we close all shops including supermarkets?  People would need to stock up with food, medicines and other essentials.  As they should be doing in case they are contacted to self-isolate.

In other words carry out a "mass simultaneous self-isolation".

Lots of difficult 'dark orange' issues, discussed here.  But given my experience of business process engineering, I don't believe there is a red-flag showstopper.  

We're in a war against an invisible enemy.  We need to think the unthinkable to beat it.  If there's a will there's a way.

We could start a "Circuit Breaker" this coming weekend, and cut it down to a 2-week "Fire Break" a week or so later. That would give everyone enough notice.

Further details and justification is here.

Everyone would need financial support.  But once the Fire Break was over, most if not all the economy could reopen and reimburse the Government with VAT and PAYE receipts.

Better for lives.  Better for livelihoods.  Better for the Treasury.

Saving Christmas too.

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.

COVID-19: OPENING THE ECONOMY. OPENING THE ARTS

Three tiers

UPDATE FROM PRESS CONFERENCE 12 OCTOBER

Three key points were mentioned by PM Johnson and colleagues this evening:

• A repeat of the lockdown like we had earlier in the year is to be avoided because of the harms, such as prolonged harm to education
• Chief Medical Officer Professor Chris Whitty said we need "balance and middleway" between health and the economy
• The Chancellor Rishi Sunak said in respect to the events and nightclub industries that we need to "try and find a way to get your business back to life"
  

This blogpost does exactly that.  The suggestion is a short, sharp 'Fire Break' to re-open the hospitality and night-time industries, balancing health and the economy, without a repeat of a lockdown.

 

 

ORIGINAL FROM EARLIER 12 OCTOBER

PM Johnson has just announced a set of three-tier measures to try to suppress the SARS-COV-2 virus that causes the COVID-19 disease.

The result will be to kill the hospitality industry and kill the Arts across the country.  Affecting millions of people involved directly and indirectly in those industries.  The employed and the self-employed.  Taking the fun out of life for everyone.

At enormous cost to the Treasury in lost tax receipts and extra support costs.  With requests to extend furlough beyond the end of October.

How do you feel about all that?

Is this really the best strategy?  Let's look at the alternatives.  Especially to see what could open the Arts, and thereby open the whole economy.  Getting life re-started.

WITH A VACCINE AND MEDICINES

A key way to get life re-started is to create mass immunity through use of a vaccine.

Back in March there was hope to have a vaccine by September.  September has come and gone.  Those of us who said there won't be a safe and effective vaccine available until 2021 are looking to be more correct.  Indeed the experts have said a vaccine isn't guaranteed.  

That is because a vaccine would need to be safe and effective for a year at least to be a viable option.  Testing that in shorter time scales is very difficult.  Having worked in the biotech industry, developing drugs, I've seen so many high hopes get dashed.  But we must hope.  Fingers crossed. 

Medicines have been tested in hospitals, and Dexamethasone has come out as a good treatment.  However to my knowledge there has been no drug or treatment developed that is for home use, though this is changing fast with potential anti-virals.  Little or nothing to help keep people out of hospital, by which time any body contracting the disease will have been exposed to five risks:

• Initial long illness, often 2 weeks or more

• Second phase of illness, like PM Johnson suffered.  This can include a 'cytokine storm' where the body's immune system over-reacts, and can be one reason for hospitalisation

• Strokes, even in the young and healthy because the virus causes microclotting when it gets into the blood stream
  

• 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

So in the absence of a vaccine, medicines and treatments, it is important to defeat the virus.  For health reasons, in addition to opening the economy and opening the Arts.

 

How can we do that?  Let's examine the options, in increasing order of severity of restrictions:

HERD IMMUNITY

The idea is that rather than create immunity with a vaccine, enough people have caught the virus to create natural herd immunity, which would allow normal activities to resume.  A figure of some 60% of the population would be required.

There are a number of significant problems with this approach:

• To get to 60% of the UK population of some 67 million it needs some 40 million to be infected.  34 million in England:
• At current infection rates of 14,391 per day in England (the latest 7-day average), it would take 2,362 days to reach that target. Taking into account a roughly 5-fold understatement, that would still be 473 days or 1.3 years.  After Christmas 2021.
• To reach 60% by Christmas 2020 the infection rate would need to be some 450,000 new infections per day
• Both options clearly unachievable in any reasonable timescale
  

• The health service would be overrun long before herd immunity was achieved

• Deaths arising would go through the roof, as would cases of LongCOVID

As a result, no country to my knowledge has adopted a herd immunity strategy.  Sweden did not, as covered below.

FOCUSED PROTECTION (THE GREAT BARRINGTON DECLARATION)

This recent paper is a variant on herd immunity, and therefore suffers from the same basic issues.

 

To which they add the suggestion that older and otherwise more susceptible people should self-isolate.  That in itself is unacceptable.

 

The issues this approach is trying to solve are very real.  But the solution? What tosh!  Discussed in more detail here

 

 

SWEDEN'S STRATEGY

 

Back in February and early March I was suggesting a strategy for the UK that turned out to be very similar to the one that Sweden adopted.   I am still prepared to place an each-way bet of a fiver that after one or two winters Sweden's approach will turn out to be one of the three best countries in terms of strategy.  At least as suited their specific circumstances, and considering all factors such as keeping schools open, not just deaths.

The reason being that it recognised the harms of lockdowns that underlie the Great Barrington Declaration.  But rather than go for herd immunity, Sweden adopted a 'balanced' strategy, taking a longer-term view, that involved three main aspects:

• Prohibited large gatherings over 50 people, with obvious implication for the arts and sports industries
• Retained schooling, but only for under 16s
• Made any lockdown voluntary, but with a high emphasis on social distancing

Sweden has been able to continue without a formal lockdown is that the health service there hasn't been overrun.  Though there was been a very high initial cost in deaths.

It was clear by early March that such a strategy in the UK would overrun the NHS, which is why I realised a lockdown was necessary here, and supported it.  

The risk of overrunning the NHS is still the case, and so the Swedish approach is not appropriate for the UK's situation.  Click this link for a more detailed discussion of SO WHY NOT SWAP TO SWEDEN'S STRATEGY?

EUROPEAN LOCKDOWNS AND OTHER RESTRICTIONS - 'SUPPRESSION'

With the exception of Sweden, European countries have followed a 'suppression' strategy, including a formal, legal lockdown.  There are several problems with lockdowns:

• Lockdowns have several nasty 'side-effects', that I documented back in August, many of which we have each experienced in our own lives.  These have been the background to the Great Barrington Declaration, and an increasing number of people thinking it best to let the virus 'let rip'.  As discussed, absolutely inappropriate

• The lockdowns have been long, typically more than six weeks before any relaxation.  For the UK, some parts of the economy have yet to open.

• The tougher the lockdown, the faster the resurgence of the virus, it seems.  Spain had a very tough lockdown, with people being effectively under house arrest for weeks.  They already have more than 10,000 people in hospital in this second wave.
  

Here's a summary of the latest situation (dated 12 October) in countries around Europe.

Each country is desperately trying to avoid a second national lockdown, instead relying on local restrictions.  But these restrictions are clearly not working, and the decision for no second lockdown is more a political one, but understandable given the side-effects.

ELIMINATION

Several countries have attempted to eliminate SARS-COV-2 from their country, and to a certain extent have succeeded.  The result is that they can re-open every part of society.

In New Zealand, hugs were back.  Or were until there were several outbreaks, for which their response has been another long, harsh lockdown.  Despite their relatively distant isolation from the rest of the world.  That geographical distinction and repeated lockdowns would not work here in the UK.  

The problem is that until the virus is eliminated worldwide, termed "eradication", there will always be 'leakage' of the virus into a country.   Despite the tight controls such as New Zealand have instituted on people arriving into the country.  A cold storage for imported food has still not been ruled out as the cause.  With widespread use of a vaccine, global eradication would take several years at least.  We need to learn how to live with the virus.

Countries in South East Asia have also been somewhat successful in eliminating the virus:

• Wuhan Province:  Where the virus first surfaced in the human population, they had a tough 11-week lockdown, yet cases still resurfaced
  
• Singapore has very close ties to Wuhun, so was one of the first places to record infections
• South Korea.  Here is how they control people arriving from foreign countries
  

There is much we can learn from these examples.  But we have to recognise that the culture is different in that part of the world, and the Governments can have much stricter control over their citizens.  What works there will not necessarily work here in the UK.

SO WHERE DOES THAT LEAVE US IN ENGLAND AND THE UK?

There isn't a simple proven way to get an economy fully open without significant 'costs'.  Those 'costs' can be financial, deaths, LongCOVID, or all the 'side-effects' of lockdowns.  

 

Elimination has its attractions, but only at the cost of significant lockdowns.  Best avoided.

The Swedish approach can only work if infections can be kept within the hospital capacity limitations, and then only if natural immunity will last for a significant period of time.  Not suitable for the UK.

But could there be a better way?  Balancing the conflicting objectives to minimise them all?

 

Indeed there is one other option which to date has received little publicity.  Madcap, but we must consider every idea if we are to stand any chance of getting the economy open, including hospitality, and the Arts open.  

Indeed the latest briefing on new cases and hospitalisation today 12 October has shown clearly that action is needed. 

TEARS FOR TIERS

PM Johnson has today announced the UK Government's proposals.  There are three tiers of restrictions that will be applied across England, with each area placed into one of the tiers.  In outline:

• Medium: Such as Rule of Six, possibly strengthened in England to be more similar to that in Scotland
• High: Similar to those already in place in Northern England.  Limitations on households meeting indoors
  
• Very high:  Hospitality industry closed down, but schools and retail to remain open.  Travel restrictions by advice rather than law, though that may change.
  

The Night Time Industries Association is threatening to sue the Government should hospitality businesses be further restricted, such as being closed, citing the lack of scientific evidence for the measures.

 

Indeed the continued rise of infections in Northern England suggests the measures are simply not effective.  Something stronger is needed.

Sir Keir Starmer responded to PM Johnson's statement by saying "We are at a  tipping point...the need for decisive action...question whether the restrictions can bring the country back from the brink...now deeply sceptical the Government has got a plan to get control of this virus... we need to break that cycle and finally get on top of the virus."

So what could we do?

 

WHAT DID THE ORIGINAL LOCKDOWN ACHIEVE?

The lockdown earlier in the year produced a significant reduction in infections, but went on too long, causing major problems from side-effects.  Indeed some restrictions are still in place.

What's the alternative?

 

A MASS-SIM SELF-ISOLATION - 'SUPER-SUPPRESSION'

If we want a significant reduction in infections in a shorter period, the action must obviously be more stringent.  Super-suppression.

Currently the Test/Trace/Isolate system means that any individual must be ready to self-isolate for 14 days if instructed.  People shouldn't be infectious after 14 days.

It simply follows that if we were all to do that simultaneously, after 14 or perhaps 21 days to allow for further infection within households, we would all no longer be infectious.  If we could do a total mass-simultaneous self-isolation that would mean 'elimination' of the virus.  Though with the prospect of re-occurrence as has been found in New Zealand and the others.

But this is the real world.  There are some activities that are absolutely vital, such as hospitals, care homes, prisons and domiciliary care.  There are also industries that are vital, such as water, electricity and internet, and industries that cannot be easily closed down such as steel furnaces.

Indeed the key difference between 'essential' as in the first lockdown and 'vital' is food production and distribution, including shops.  This should all close, with practical arrangements put in place for the supply chain such as milk and imports.

How can we get away with that?  As we've seen, people should be stocked up with food, medicines and other essentials for 14 days in case of a self-isolation request.  Just make sure it is 21 days.  That would allow all retail to be closed.

This "Fire Break" could be an extended Bank Holiday, with online banking taking place but all other banking activities suspended for the duration. 

Whatever the period chosen for the Fire Break, this must be finite and not extended. A guarantee that the economy can reopen as soon as that period has finished.

The result would be a significant reduction in infections.  In theory enough to reopen hospitality, the Arts and potentially every other industry.  Certainly to put England in a far stronger position than we are at present.  For at least some weeks, when we could perhaps do it again. 

Better for lives.  Better for livelihoods.  Better for the Treasury, through improved tax receipts and reduced social security costs.

A Bank Holiday 'Fire Break' wouldn't be easy.  There are a number of 'dark orange' issues that are difficult to overcome.  But if the attitude is that this strategy would be worthwhile, all such issues can be overcome.

Further details are here, and at the very least should be publicly debated.

COVID-19: CREATING A "FIRE BREAK" BY USING A MASS-SIM SELF-ISOLATION

Better for Lives.  Better for Livelihoods.  Better for the Treasury.

BACKGROUND

This isn't an ideal solution, as there isn't one.  This idea is in recognition that:

• The virus is showing no sign of going away, and indeed will be with us for the foreseeable future
• There won't be a vaccine available in any quantity until 2021.  In any case that assumes successful development of a vaccine, which is not guaranteed.
• There therefore needs to be a strategy better than what the UK is adopting at the moment, to let us and the economy get back to some normality
  
• Elimination of the virus, whilst highly desirable, is not a realistic prospect.  We need to live with it.  But how best to do so?
  
• Cultural and geographical differences between South East Asia and the UK, and between Sweden and the UK, make solutions there not necessarily relevant to UK
• No action is not a realistic option.
• We need a strategy and action in England and UK at least as effective as the first lockdown, but in a much shorter time. 
  

 

INTRODUCTION

This is a big weekend for the Government and the fight against COVID-19.  We are going into the winter with infections far too high right across the UK.

In the North of England the infection rate is still climbing despite extensive restrictions, which clearly aren't working sufficiently.  Anger is building, especially amongst local political leaders in those areas.  

On other parts of the country the infection rates are already rising.  Oxford and Oxfordshire for example have reached "Red Alert" status, but because these areas are lower down the league table, less is being done than when the rate reached Amber.  

The thought of a long second lockdown like we had earlier in the year is not attractive.  We know the side-effects.

But doing nothing is not an option.  The NHS is under threat in those Northern areas and across the country, and we're not yet properly into the winter when the risks are far higher.  

However attractive it might be to follow Sweden's lead, with citizens taking their own decisions on what precautions they take, Sweden's approach simply isn't a sensible option for the UK.  Primarily because the NHS would likely be overrun, even with the Nightingale hospitals.  The ensuing dreadful consequences for COVID-19 sufferers and people with other health issues doesn't bear thinking about.

 

THE NEW RESTRICTION TIERS

It seems that the Government is considering three levels of restrictions, either applied nationally or locally:

• Tier 1:  Light-touch restrictions such as the Rule of 6 and mask wearing, tightened as the British Medical Association (BMA) has suggested

• Tier 2: Restrictions similar to already in place in much of Northern England

• Tier 3: Hospitality venues closed, and a lockdown much like in the Spring, but applied locally

Tier 4 would effectively be a full national lockdown.  Tier 0 would be a Swedish style approach, where very few restrictions such as their ban on gatherings over fifty people.

BUT WILL TIER 3 OR A FULL LOCKDOWN BE ENOUGH?

Tier 1 and Tier 2 restrictions are not working adequately.  So what about Tier 3 restrictions or a Tier 4 lockdown?  

The most likely outcome is only a small reduction in infections in anything under a month, but whole industries decimated.  

WHAT ABOUT THE NEW FINANCIAL SUPPORT OFFERS?

Rishi Sunak the Chancellor has just announced an extention to the new Job Support Scheme, terms JSS+, to make it more like the old Furlough scheme which will be ending at the end of October.  There will also be some extra support for some businesses in Tier 3 areas. 

Reimbursed to those businesses in arrears, many businesses will be unable to support the cash flow if they have no income.

Pending further details, this support package is unlikely to be enough to stop many businesses going to the wall, in which case the jobs that were supposed to be saved will be lost.

There has got to be a better way.  So here's an idea for debate.

A SHORT, SHARP MASSIVE "MASS-SIM SELF-ISOLATION"

As explained here, a short, sharp Mass Simultaneous Self-Isolation would act as a "Fire Break" to substantially remove the virus from circulation.  To be done nationally to be both effective and fair.

Not as a last resort, but as a proactive means to improve lives and livelihoods for millions of people. 

This is not just the Tier 3 restrictions, which have been called a "Circuit Breaker", though a proper Circuit Breaker would be far more restrictive.  

A "Fire Break" would be of fixed short length of two to three weeks, comparable to current Self-Isolation rules.  But to be shorter it would have to be sharper than a second lockdown.  The period would have to be fixed, come what may, and announced to the public as such.

It would mean an extended Bank Holiday with all but 'vital' activities stopped.  That means everyone making sure they have enough food and medicines so all supermarkets, high street pharmacies and other shops could close.   

This should be the case anyway, given the possibility of anyone being asked to self-isolate for 14 days.  I have a combination of:

• Fresh and refrigerated foods for around 7 days, plus
  
• Tins and frozen foods for at least another 7 days, plus
  
• Medicines and other essentials for at least 14 days

I suggest everyone does so likewise in any case.  Then if the Government orders a Fire Break would not be an issue for the vast majority of people.

ESSENTIAL vs VITAL vs TOTAL

In the first lockdown, all but "essential" businesses had to close.  This was the graph of new infections, based on testing of those who displayed symptoms:

Infections down by five sixths in three weeks.  But we want to reduce infection rates further in less than three weeks.

A 'total' fire break would be ideal.  Nobody meeting anybody outside their household for a short period.  But that isn't possible.

A 'vital' Fire Break acknowledges we are in the real world.  But taking out as much contact as we possibly can.  For example that would mean taking out food production and distribution.  Closing supermarkets, meat processing plants and storing imports.

A lower level of contacts than a standard 'essential' lockdown would make a Vital Fire Break inevitably faster to reduce infections.  

 

HOW LONG WOULD THE FIRE BREAK NEED TO LAST?

Any request to self-isolate is 14 days.  Most people display symptoms within 5 days, with a few reputed as going as far as 17 days.

If a household self-isolates together, anyone infectious but not yet symptomatic would infect the other household members in just a few days.  

So we might expect most people self-isolating to have displayed symptoms within 14 days, with a few as much as 21 days.  Anyone symptomatic would continue to self-isolate in accordance with guidelines.

Everyone else can then get on with life with the virus best-part eliminated. 

So 14 days, 21 days, or something in between?  Depends what level of residual undiscovered infections would be likely to exist at each duration.  To be on the safe side 21 days, but hopefully a shorter period would be a better compromise.

WOULDN'T A VITAL FIRE BREAK BE IMPOSSIBLE?

Having worked extensively over the years on Business Process Re-engineering, I am well aware that we need to cover a whole host of issues.  These are technical, logistical, financial, people and political.

There's certainly a number of 'dark orange' issues that will be tricky to handle.  But if there is a will, there is a way.  There is nothing that need be a fundamental red-flag showstopper. 

For example, what about cows and the food supply chain generally?  Whatever's necessary to reduce to the absolute minimum.

The same for industries such as steel furnaces, some of which may need to keep going with minimum staff.  Electricity generation would have to continue, and internet would be regarded as vital. Hospitals, prisons, care homes and domiciliary care would need to continue.  

Overall only the "vital".

The big issue is import of people and goods.  Whilst the borders should ideally be closed for the self-isolation period, thereafter there needs to be far more careful control of people and goods arriving.  The level of virus 'leakage' into the community, as New Zealand has found happens, will determine how long the country could go without needing another Fire Break.

 

IMPLEMENTATION TIMESCALES

We are effectively at war with an invisible enemy.  It is amazing what can be done in short order when needed. 

English schools appear to be coming up to half term:

• Some in week beginning 19 October, a week from next Monday 12th
• Some the following week beginning 26th
• Some both
  

Two weeks' notice seems reasonable.   During which time all the public can ensure they have supplies for three weeks, and all business and Government measures can be decided and put in place.

Announce that on Monday 12th, or the possibility of it to be confirmed later,  and some schools would only need to close for an extra week or two.  Delay, and more schooling would be lost.

 

SO WHY NOT?

A proper "Fire Break" in the form of a short sharp Mass-Sim Self-Isolation would be worth a shot.

At best it would allow the economy and life to get back to near-normal at a very low #NearZero level of infections.  That would be for some weeks or months before another Fire Break might be required:

That's at best.  At worst it would put us in a far stronger position going into the winter.

It should save Christmas for everyone, and help ensure students can go home.  Releasing many benefits for us all.

Better for Lives.  Better for Livelihoods.  Better for the Treasury.

Surely an idea worthy of serious consideration?

,