Easing the “lockdown” in England

2 June 2020 by Jennifer

Lots of arguments going on at the moment about “easing the lockdown”.

Some people say: we’re not ready, and it’s dangerous.

Some people say: but look at what it’s costing us to stay at home – people getting lonely and miserable, businesses going bust, parents and carers under stress, school routines disrupted, people who love each other being kept apart.

All these concerns are legit. All these problems are happening at once.

Emergency measure, not long-term solution

Where I think both “sides” can agree is: “Lockdown” is meant to be an emergency measure.

It’s like: if a car’s coming straight at you, you try to jump out of the way, even if you might fall over and get some bruises. Maybe there’s a problem with the road layout in the first place; maybe you could’ve fixed that before, maybe you can fix it later; but in that moment, jumping away is what you’ve got.

If you have a viral epidemic going on, the way you want to be able to handle it is: know where the virus is. Then you can have only a small fraction of people in quarantine, for a few weeks each. This is known as “containing” the disease.

If you do it that way, the only people who need to be in quarantine are the ones who actually have the virus, plus the ones who might have just caught it from them.

And you can manage it like that! if you have a good system for testing people, and following up with their friends and contacts! That’s pretty much what the successful countries have done for covid – assisted by getting everyone to wear masks in public.

Telling everyone-in-general to stay home, when most people actually don’t have the virus – that’s a last resort, for when you haven’t managed to do it “the right way”, and there’s a disaster in progress.

Doing it “the right way” turns out cheaper in the long run.

Words in colour: "the so-called LOCKDOWN is meant to be an emergency measure, & next we need to know where the virus is, & masks4all. Credit: @unchartedworlds.

Well why aren’t we then

Unfortunately for us, our government decided at first they weren’t going to keep up the effort of doing it that way. They were just planning to let most of us get ill. I think at first, they weren’t even going to have the “lockdown” either.

Eventually they twigged that, unlike with a typical ‘flu epidemic, letting it burn straight through the population could easily mean half a million early deaths, which would make them look quite bad. So now they are making some kind of attempt to set up “testing, tracing, supported isolation” like a lot of people had recommended in the first place.

But even after a couple of months of most people staying at home, they still haven’t got very far yet with putting these better systems in place.

It’s a few steps in the right direction, but it’s nowhere near what other countries have already managed.

Numbers

As well as setting up how exactly this all fits together, you have to think about how many people are needed, how many labs for the test results, etc. The resources you have for testing and tracing have to be enough for the current number of cases.

Here again, the government’s earlier slowness is working against us.

Because the UK government waited so long to activate “emergency measures” in the first place,1 the epidemic had already spread to thousands and thousands of people across the country by the time most people started staying at home. Even after two months of slowdown, a month or so past the April peak, we still now have thousands and thousands of people sick with the virus.

We actually have more people dying at the moment than when the so-called “lockdown”2 first started! Known COVID-19 deaths here this last week have been over 200 per day; we’d had a total of about 200 deaths altogether up till the day that schools were closed, maybe fewer.3.

Looking at the numbers of current cases is part of why scientists think the government’s taking a big risk now.

Prof Devi Sridhar of Edinburgh University, a member of the Scottish government’s Covid-19 advisory group, said she feared a rise in coronavirus numbers in England was inevitable.

“The only thing that might save England is the good weather, and the warmth if this virus does indeed die outside quite quickly,” she said. “But it is incredibly worrying, because the numbers are not low enough to have a testing and tracing system take over.”

Not much is different yet

So, when I see the government already talking about “easing the lockdown”, I do think myself that it’s likely to turn out pretty similar to a re-run of March, then April – with the virus quickly spreading further, and thousands more people dying early. Probably more people are aware of the risks now, but other than that, I think not much is different since then.

(It looks kind of like, the government doesn’t want to admit things aren’t ready for the next stage. They want us to think things like, “well, Denmark’s reopening schools, so it must be reasonable for us to do the same” – leaving out how Denmark’s already got their epidemic down to 2 or 3 deaths a day.)

I feel very worried for the people who will be made to go back to work, and for the people who still don’t have a reliable supply of protective equipment. I think everyone who can avoid meetups and travel is best off still sticking to that, or at least being as careful as they can.

My thoughts are also with the medics who have already been through some heavy levels of overwork and emotional strain in the “first wave” of the epidemic, pulling hundreds of people through near-death experiences, and supporting dying people and their families.

I fear, too, that most people are unaware of how exhausted, stunned – shellshocked, even – some NHS staff and care workers are. How daunted we feel as we watch lockdown being relaxed before proper testing, tracing and isolation infrastructure are in place.

Dr Rachel Clarke

Masks for all

On the up side, though…

Evidence from across the world increasingly shows that wearing simple fabric masks does work to protect ourselves, if everyone does it. It’s one of the reasons why Hong Kong, a densely populated place with direct flights from Wuhan, has still had only four known deaths from COVID-19.

And although it would help a lot if our government did get properly behind #Masks4All… that’s one avenue where we can take a lead without relying on them.

This article from Jeremy Howard has a good short explanation of why masks work.

Here’s an “FAQ for skeptics” about wearing masks.

Here’s my own previous article about fabric masks, making them & wearing them. (I might do a follow-up to this at some point, because I have some thoughts on improvements in mask design.)

Here’s a lovely photo of a “mask tree” in Czechia. “Volunteers are making cloth masks at home and hanging them on “mask-trees” for passers-by in need.” How cool is that?!

Statistics & other notes…

1. Waited so long: For example, you can compare the gap between “first death from the virus” and schools closing. Greece closed all schools the very day of the first confirmed death in their country; the UK waited 19 days, 2 March to 20 March.

That is, schools officially closed in England at the end of Friday 20 March (although some had in fact closed before that). I think some further slowdown measures officially began on Monday 23 March, but here I’m using the last school day as a non-wishy-washy point of comparison.

The government’s own figures for 20 March said there’d been 177 known covid deaths in total at that point. I’ve also seen it reported as 194; the gap might be because on the day, some deaths hadn’t yet been documented.

Dominic Minghella wrote about the haunting lost opportunity of that delay, and the fact that he himself was one of the people unwittingly spreading the virus in the days just before “lockdown”.

Tomas Pueyo wrote a very useful analysis around that time, explaining that with the virus spreading as it was then, every death on day X probably reflected about 800 infections on day X. Going by that estimate, there were probably about 140,000 infections in the UK by the time schools closed, compared to 800 infections in Greece when they closed schools.

(I understand TP’s sums, and I still think that’s probably not far off as an estimate for then. Note, though, that you can’t use the same calculation now, because it relies partly on estimating how fast the virus is spreading, which varies depending on what’s happening. And it hasn’t been spreading so fast in recent weeks – not surprisingly, because that was the whole point of having people stay at home.)

We can also note that nearly all the other European countries closed their schools before the UK did. (For clarity: in that sentence I’m talking about the actual calendar date, not the delay from first covid death. I haven’t done a comparison of all the delay-from-first-death stats, though it would be interesting.)

2. When is a lockdown not a lockdown? I keep putting quotes around the word “lockdown”, because I don’t actually think it’s the right word for what happened in the UK. Ours was more of a “slowdown”. Many “inessential” workplaces were still open, even though people working there were fearful of catching the virus – probably many of them equally fearful of losing their job and thereby their home. Italy’s emergency lockdown seems to me to have been much stricter, more actually “locked”. Ours was half-baked.

3. Recent deaths: Official government figures for the last week in May average out around 240 COVID-19 deaths per day. There’s different ways of counting deaths, but I’ve not seen any figures less than that.

For total deaths up to the start of the slowdown, see footnote 1.

Words in colour: "the so-called LOCKDOWN is meant to be an emergency measure, & next we need to know where the virus is, & masks4all. Credit: @unchartedworlds.