COVID-19 LOCKDOWN EXIT STRATEGY

This paper is an exploration of the best way out of the present situation. At all points we fully endorse the WHO and PHE advice to stay home, keep social distance (SD), and wash hands.

The measures proposed here are all in addition to, not instead of, official advice.

Britain has been on lockdown since 16^th March, and the peak of the infection is predicted by modellers to occur between the 9^th and 16^th of April.

People are understandably beginning to get restless, and are asking when we can expect to be able to get out and about again.

Data from China will give us an indication of what to expect. Deaths peaked in China about 25 days after their very strict lockdown , and are at a level that can be managed by containment (contact tracing etc) 70 days after lockdown. For us, 70 days after lockdown would bring us to the 26^th May. Given that our lockdown is far less rigorous than the Chinese,  we should perhaps add another30 days, bringing us to the 26^th June as a reasonable target date for liberation.

The danger is that there will be a resurgence of infection as soon as the lock-down is lifted.

Media pundits take this to mean that lock-down has to be re-imposed, which raises the possibility of an endless cycle of repeated lock-downs until a vaccine arrives to save us. This gloomy prospect is very bad for morale and compliance, but it depends on the assumption that lock-down is the only weapon in our armory. This is not the case.

Clearly, we must stay in lockdown until the infection in the population has peaked.

While waiting for it to peak, there are several measures that we can bring in to bring stronger downward pressure on transmission of the virus.

1.      Face masks do limit the range of droplet spread, and should be used in all places where SD is not always possible, as in public transport and work situations. Shop staff and those in food preparation and delivery should always wear masks and gloves. Gloves can be sterilised  more frequently and quickly than hands by wiping in disinfectant solution.

2.       Passengers coming into the UK in airports and other points of entry should be checked with a thermometer and questioned about symptoms and whether they have been in contact with a Covid19 case. And cases identified should be told to self-isolate.

3.       Remote temperature sensors can also be used at points of  entry into large buildings.

4.       Digital Contact Tracing technology uses mobile phones to track movements. If a case is identified, phones that have been in the vicinity of the index case can be messaged to say that they are at risk of the infection, and should self-isolate for 14 days.

5.       Shops and supermarkets are now major places where transmission can happen. There are a number of measures that can be brought in to prevent transmission, starting with masks and frequently-sterilised gloves for shop workers.

6.       Unnecessary building work and work on HS2 must be closed down.

Once the peak of the epidemic has passed, we can slowly and carefully begin to move back towards normality. It is vital that people understand that when the peak has passed, the danger is not over. The virus is still present, and therefore we must continue to behave safely, continuing with social distancing,  frequent hand washing, avoiding unnecessary travel and contacts, and using masks if near other people. We must accept localised lock-downs if hot spots are identified.

The sanction of returning to lockdown at any time the virus threatened to break out again would be a good inducement for public compliance with regulations.

Here is how we will move away from blanket bans to allowing recreational and work-related behaviour to take place. The key point to remember is that it is not going outside in and of itself that is risky, but the contact with other people’s breath and places that infected people have touched.

1.       There is a great desire for people to get out into the country for walks and recreation. The problem here is that they may bring the virus with them to remote locations that have been hitherto unaffected by the virus, and pass it on in shops and restaurants. The solution to this would be that shops and restaurants should stay closed. The problem here is that local shops need the custom. The solution here is either that Government compensates the locality for lost revenue, or that visitors are charged an entry fee to enter a community or its car park. In this way, access to the countryside could be restored.

2.       A tried and tested way of reducing traffic movements is to allow cars with number-plates displaying an even number to go out on even numbered dates, and cars displaying odd numbered plates to go our on odd-numbered dates.

3.       There will be a growing cohort of people who have had a Covid-19 infection, and are now presumed to be immune. These people should be encouraged to be economically active, especially in activities which would otherwise require PPE.



The problem is how to certify these immune people (let us call them “Recoverees”).  In the absence of a blood test to certify immunity, a note from the GP, supported perhaps by testimonies from people who nursed the patient through the illness, and NHS111 records would be all that we could do.

The great danger would be that if there is a perception among young people that there is an advantage in being a Recoveree, they might hold Covid Parties in order to try to become infected and therefore immune. There might be a need for primary legislation to make such parties illegal.

The alternative to this ban would be to allow such virus exchange to take place in controlled conditions – to allow young healthy volunteers to get together with a known case, in a protected location, and to stay  there, monitoring how many develop the infection. However, some of them might develop a severe form of the infection, requiring an ICU bed, and even die. Therefore such an experiment would be unethical.

4.       One defensive principle in organising large work forces is to try to create small affinity groups who are relatively isolated. If a team need to meet up to work together, the size of the group must be as small as feasible. If one member of a team of five is found to be infected, only four workers are required to go into quarantine. If one member of a team of fifty is infected, the work may lose 50 workers for a fortnight.

5.       One valuable aspect of Basic Income can be introduced in the difficult economic climate that we face. Necessary work, such as NHS, Social Care, care homes, agriculture, water and sewage services may need to take on new workers to replace those who are self-isolating or even those who have died. Normally, new workers have to jump through many bureaucratic hoops at the Job Centre, and there is a four-week Hungry Gap between the time that benefits end and the first wage check is received. In the post-Covid circumstances it would be useful if benefits could behave as if they were Basic Income, and continue to be paid, so that the new employer would only have to top up the new employee’s waged to the going rate for the job. This would repair some of the economic damage that the pandemic has inflicted on to core services.

Naturally, as the Green Party we advocate a full Basic Income, but we can recommend this aspect as an intermediate measure to address the difficult present situation.

6.       Inevitably, once we start to interact with each other again, new cases will pop up. Once cases are down to manageable levels, these new cases will be able to be contained by classic public health measures of case isolation and contact tracing. If sufficient resources are put into public health, this will be effective in avoiding further lockdowns.

7.       Finally, we should remember that tests and vaccines will appear, maybe sooner than we imagine, to assist us in this great battle. When cases come down to manageable levels, we can re-commence the classic contact tracing and containment procedures. Find a case, find the contacts, and isolate them.

8.       To any that are kicking against the limitations, whether the loud-mouth bloke down the pub, or right wing “libertarians” writing in right wing publications, we say, the more you flout the rules, the longer we all have to endure the limitations.

Conclusion

It will be possible to move out of lockdown in an orderly manner if further measures to  reduce transmission are put in place now, and if people understand that life may begin to return to normal possibly by the middle of June, provided everyone plays their part in avoiding transmission.

Richard Lawson

Churchill

8.4.2020

This paper will be updated as necessary. This is Draft 1.02