I'm probably reading too much news, but it is a bit addictive. I awoke last night, around 2am and couldn't get back to sleep so sometime after 3pm I got my iPad out and downloaded and read today's paper. I remember key snippets, but it does rather blur into one. I'm interested in Iceland, where they are relying on a culture of collaboration and cooperation to assure social distancing and have not initiated any European or Chinese-style whole country lockdown, and Sweden, where they seem convinced that the way forward is to follow the track the UK followed initially, asking people to social distance but not imposing any great lockdown. They've banned social gatherings of 50 people or more I believe, and A level students and university students are learning from home. I think the vulnerable are urged to stay home. People can still walk the streets and enjoy restaurants etc. The Swedish medical office says that the damage to the economy would be far worse than the disease. They only have (if I remember correctly) 600 intensive care beds.
I've read other research into how the disease is transmitted, conducted I believe in Iceland. They have followed an intensive track and trace approach, with 60 dedicated officers and medics who track the origin of each infected person. So far they've identified 20 different strains of the virus, some more virulent than others, and traced each infected person back to some foreign contact, with, interestingly, 9 Iclanders having been infected in the UK in January at a particular, but not identified, football match. At that point, the UK didn't realise it even had the virus.
Iclandic researchers have also collected data on where the virus is most likely to be transmitted, and it is little surprise that it is through mass gatherings such as football matches, concerts, theatres. Transmission is rarer at restaurants, and very rare in supermarkets. Walking past people outside is very unlikely to cause contagion, though it is still possible. They also swabbed down a household where multiple members COVID-19 and discovered no traces of the virus on high use areas such as door handles, surfaces etc. I have also read estimates that up to 50% of the population is or has been infected asymptomatically.
We won't know here in the UK as we don't have the capacity to test, thanks to Public Health England's centralised approach to testing and early disinclination to make use of the offers of help from labs and research scientists across the country. PHE have not exactly covered themselves in glory, advising the PM not to undertake testing in the community, restricting it to only those admitted to hospital, when the World Health Organisation were advising community testing and track and trace as a more effective way to manage the disease. However we can use the research from other countries whose public health authorities are more aware of the importance of collaboration and research sharing.
The initial findings from the research into modes of transmission in Iceland has got me wondering at the advisability of continuing this whole country lockdown beyond the 3 week original limit specified by Boris Johnson. This is a rather contentious thought, but I'd like to explore it. I've seen a fair amount of virtue signalling on social media. This cartoon captures it pretty well. People sitting in their extensive gardens with their iPads and laptops disapproving of those who go exercise in a public space. Then you have cases like the Scottish Chief Medical Officer driving 40 miles out of Edinburgh for two weeks in a row to spend the weekend with her family at her bungalow, whilst advising others to stay at home. She has now resigned amid a storm of criticism.But how dangerous is going for a walk in a park. Is it less dangerous than sitting for a moment on a park bench on your own to catch your breath? The police have challenged people for doing just that. Or driving to walk your dog in a more remote part of the countryside, rather than on the pavements outside your house or apartment where you come into contact with loads of other people.
I'm worried about the economic impact. The banks (unsurprisingly) seem unwilling to help out small businesses with loans despite the fact that the Govt. has released money for it. Some businesses are within days or weeks of going under, and the banks are asking them to put up collateral, or explore other avenues for getting a loan. People with mortgages are worried about losing their homes. Mortgage companies are offering a 3 month payment holiday, but if you are made redundant as is happening as businesses go under then this will not help.
So we come to the hard choices. The Imperial study from Professor Ferguson, the same who predicted that the impact of CJD would be huge in 25 years (it wasn't) and who advised the massive cattle culling that many now deem excessive and unnecessary, predicted 250,000 deaths from COVID-19 if the PM didn't impose the lockdown. Yet a recent Oxford paper suggested that this estimate of potential deaths might be excessive. Conflicting advice, but increasing amounts of data from countries who are ahead of us on the curve. I came across @MarkJHandley on Twitter who posts fascinating statistical graphs with freely available data from affected countries. Things are serious, but as yet I'm not sure whether the levelling off of cases is due to lockdown measures, or if the same might happen with the closure of high infection risk places such as football grounds and concert venues whilst allowing people to carry on economic activity with hightened levels of hygene in public transport and public places, and social distancing in other places.
There is no doubt that people are dying horribly in ICUs in hospitals. I read that if you are admitted to an ICU with corona virus you have a 50% chance of dying. However if you are over 80 years old, this rises hugely to something like 80%. And this brings me to the reason I'm wondering about the advisability of this lockdown. It looks like the vast majority of the population can catch COVID-19 with mild to flu-like symptoms.
These people, who would be only mildly affected by the virus, are the people who are losing their livelihoods and who will bear the economic burden of paying for this for years to come. There will be suicides and wholesale misery, as there was to a lesser extent during the CJD crisis when farmer after farmer committed suicide. This current situation is much more far-reaching and will, I think, result in huge numbers of mental health issues caused by the uncertainty and fear.
I wonder if we could return to a semblance of normality, using social distancing together with protection for the vulnerable groups, until we have time to develop one of the potential cures, vaccines and anti-virals that are currently being rushed through development and testing. I'm not sure that keeping the 90% of the population who will be relatively unaffected by the virus from earning money, contributing taxes and keeping the economy afloat is the right long-term solution. We have ramped up the NHS ICU provision with the Nightingale hospitals. It is the metropolitan areas that are the most affected. Why not allow the rest of the country to get back to work, whilst protecting the vulnerable?
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