CAN THE UK AVOID A SECOND LOCKDOWN BEFORE JUNE 2020?

See larger version below

My motto for COVID-19 is “Hope for the best, but prepare for the worst”.

This is especially relevant to whether the UK is going to need another lockdown.

My assessment as I write on 19 May is that there is at least a 50:50 chance of a lockdown being needed before the end of this May.  But I am hoping I am wrong:

• The R factor will almost certainly be above a national average of 1 before the end of May, which means COVID-19 will be rising exponentially again.  It has already risen from an estimate in the range of 0-5-0.9 a week ago to 0.7-1 a week later.  Keeping below 1 in the next two weeks seems rather too optimistic.
• Conversely there will be enormous pressure on the government from their backers and the right-wing press to avoid another lockdown.  Despite the risks of a lockdown and leading to far worse economic damage.
• Yet the government will be keen that the death count will not become even further ahead of the rest of Europe
• Other European countries are having easing issues, so may decide they have eased lockdown too quickly, and may lockdown again in May.  That would set an example to the UK
• Ultimately, public opinion in the UK may be the decider.  So far safety has been seen as more important than other factors

Let me explain further…

WHY LOCKDOWNS?

Personally I was keen for the original lockdown to be a last resort and to be as light as possible.  This was because the ‘side effects’ of a lockdown were clearly going to be serious hits to livelihoods and our way of life, as well as consequent medical issues (like untreated cancer) and a major hit to the UK’s Treasury. 

In hindsight the countries that locked down earlier may have been right.  That's a discussion to have separately.  We are where we are.

But in any case it became clear by mid March that a pretty stringent lockdown was going to be needed in the UK to reduce transmission to avoid the NHS being overrun.  What we had seen in Italy was not something that could possibly be allowed to happen here.

As soon as the lockdown happened, I was keen to see the lockdown eased as quickly as possible.  I still am.  But the same objective applies.  The NHS cannot be allowed to be overrun. 

Now the NHS’s capacity has been increased, that provides more headroom should a second wave arise.  But it is clear that there isn’t enough PPE and probably not enough medical staff for the extra beds to be properly manned.  The increase in capacity is therefore partly illusional.

In any case, some 60,000 excess deaths in the first wave would turn into hundreds of thousands in a second wave if the country were to ‘run hot’ at or near that increased capacity.

As lockdowns are so costly in social, medical and financial terms, another lockdown must be avoided.  That means keeping this R value below one, and avoiding any size of second wave. Yet R has been creeping up near 1.

WHAT IS R?

R is the “Reproduction number”, often referred to as the “Rate”.  Both terms are somewhat misleading.

It is actually the Transmission total.  As this BBC article explains, “It's the [total] number of people that one infected person will pass the virus on to, on average.”  That is a matter of transmission. 

But the number is universally known as R (or officially Ro).  C’est la vie.

As this graph from the article shows, an R number of 1.1, just slightly over 1, means the number of cumulative cases rises dramatically.   The natural R for this Coronavirus is around 3, if not higher. Leaving the virus to its own devices would mean an even higher level of expeonential growth

The reason for this is that people become infectious before they display symptoms for several days. 

An R of 1 means that every infectious person should not infect more than 1 person, on average, either before or after they have symptoms.

In thinking about lockdowns for teh general community, we can ignore infections arising in hospitals and care homes, which need their own special attention.  I’m talking in terms of the rest of the populace.  The general population.

If someone who acquires the virus is living in a household, there is likely to be around 3 other people  they could infect.  If they have been out and about before symptoms and taken no precautions to avoid transmitting the virus, they could have infected dozens.  Indeed on a recent incident in South Korea, one person infected at least 29 in a single night of visits to nightclubs. 

So keeping R below 1 is extremely difficult without some reasonably severe transmission controls.

WHAT ABOUT NOW?

The converse of that statement is it is very easy for R to rise over 1.

A suitable set of precautionary measures need to be put in place to replace lockdown.  As the PM himself said in the presser on Monday 11th, “...carefully to modify the measures, gradually ease the lock down and begin to allow people to return to their way of life, but crucially, while avoiding what would be a disastrous second peak that overwhelms the NHS”. 

Sadly the measures have been highly confusing, as I discussed separately.  In the days before and after the PM’s presentation, the media haven’t helped by suggesting lockdown was going to be relaxed far more than the government intended.  Yet it looks like people have already responded to that false message, and missed what anti-transmission measures are still required.  In practice the lockdown easing simply isn't being done carefully.

The result is that R is already reported as having risen to nearly 1.  I expect this increased R will shortly feed into a rise in the number of confirmed cases.  Not dropping like they were.  The only answer certain to reverse any increase will be another lockdown.

Certainly I am observing a far greater level of activity in my corner of a city.  Sadly few people are wearing a face covering to help reduce transmission.

It doesn’t help that I am meeting people who say they don’t need to socially distance because “there isn’t a virus”.  Others are blaming the disease on other factors such as 5G.  The term for such people is COVIDIOTS, but it is a fact that that there are people like that out there. 

Nor that a lot of people don’t understand R, how difficult it is to keep under 1, nor what we all need to do.

SO WHAT ABOUT A SECOND LOCKDOWN?

The education and communication programme of this government has been woefully inadequate, as I have discussed in a previous post . Relying on “common sense” is ludicrous when people don’t have experience of a coronavirus like this one nor understand quite how it behaves.

Unless the government dramatically improves their education and communications programme, sadly I am expecting a second lockdown before the end of May.  I’d even put a fiver on it.  Let’s hope I am wrong.

But what do you think?  Do comment below.