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Mon, 3 August 2020

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Coronavirus
By Dods Monitoring
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Will lifting the lockdown now contribute to a second wave of coronavirus?

Will lifting the lockdown now contribute to a second wave of coronavirus?

A major concern about lifting the lockdown now is the risk that it may cause a second wave, writes Dean Sabri.

Dean Sabri | Dods Monitoring

6 min read

Dods Monitoring's Dean Sabri explores the Government's level of success in meeting the required five tests needed before it can be considered safe to relax lockdown rules.

This weekend, the restrictions preventing us from going out for dinner or grabbing drinks in a pub will finally be lifted.

Three months ago, the Prime Minister appeared on our television screens to ask us to stay at home, protect the NHS and save lives. He is now encouraging us to end our “long national hibernation.” But, as Leicester becomes the first city to enter a local lockdown, many fear it is all too soon.

Saturday marks the greatest easing of lockdown restrictions to date. An occasion which has been celebrated in some quarters, whilst causing anxiety in others. An anxiousness that it precedes a second, deadlier, wave of the virus.

The Government have always stressed their willingness to put areas where there are outbreaks into lockdown.

At every stage of this pandemic, Government Ministers have assured the public that their actions were led by science. The decision to ease out of lockdown is no different. This plan dates back to April when the Business Secretary, Alok Sharma, set out the five tests which needed to be met before it was considered safe to relax lockdown rules.

Test one was the assurance the NHS could provide sufficient critical and specialist treatment across the UK.

There are now under 500 covid hospital admissions per day, down from the peak of 3,000. We are also beginning to see routine, elective procedures restart in hospitals across the country.

There are three new ventilator production lines supplying hospitals with vital technology. Nightingale hospitals have been commissioned at a rapid pace and they sit waiting to be used if necessary. Recently retired medical staff have been re-registered and brought back onto the frontline, working alongside student nurses.

There is an undeniable, new resiliency built into the NHS to provide specialist, critical care. Although doubts remain over its long-term sustainability.

The second test required a sustained and consistent fall in the daily death rate.

As of May, the seven-day rolling average of people, sadly, dying from covid-19 has shown a consistent downward trend. There are now around 100 deaths per day, down from a peak of over 1,000. Although every death is, of course, a tragedy, it is important to also recognise that the number has significantly reduced.

Test three sought reliable SAGE data showing a decreased rate of infection (the R rate) to manageable levels. Whether this has been achieved remains contentious.

The Government have insisted the R rate needs to be below 1 to allow restrictions to ease. Many are concerned, though, that it may be above this threshold in the North West. The R rate for the entirety of England currently sits between 0.6 and 0.9.

This test is not currently being met in Leicester where there were 944 positive tests in the two weeks up to June 23rd. This meant that 1 in 16 of all the country's cases of coronavirus came from Leicester during that period.

The Government have always stressed their willingness to put areas where there are outbreaks into lockdown, and this week proved their resolve to do so.

Meanwhile, the total new cases of the virus is clearly reducing. The latest Office for National Statistics surveillance study estimates around 22,000 people are infected per week. This is a huge decrease from the peak of 100,000 per day.

The fourth test, to ensure adequate PPE and testing capacity to deal with future demand, does seem to be in hand.

The Government have secured capacity for over 200,000 tests per day and ensured that anyone who needs a test can get one. The UK now carries out more tests than almost every other country.

On PPE, a dedicated unit was set up, incorporating the Ministry of Defence, to negotiate contracts with suppliers across the world. The unit has secured 10bn items of PPE and Local Authority and NHS bosses have both reported pressure on supplies to have eased.  

The fifth and final test requires any adjustments to the current measures not risk a second peak of infections that overwhelms the NHS.

This will always be difficult to meet without a vaccine or effective treatments. In the meantime, the Government have set up a thorough testing regime and a contact-tracing system – Track and Trace. Importantly this test does not rule out the possibility of a second peak of infections. Instead, it caveats this possibility by stating that it should not “overwhelm the NHS.” Through increasing the resiliency of the NHS, the threshold for overwhelming it has also increased.

Early evidence suggests the system has failed to trace the contacts of at least 60 percent of people who are infected with coronavirus.

A major concern about lifting the lockdown now is the risk that it may cause a second wave. To counter this risk NHSX last month unveiled Track and Trace. The goal of the service is to disrupt the rate of infection.

Early evidence suggests the system has failed to trace the contacts of at least 60 percent of people who are infected with coronavirus. This raises questions about the service’s ability to prevent a second peak of infections.

Underpinning the service was the Track and Trace smartphone app. The app would, anonymously, alert users when they had come into close contact with an infected individual and instruct them to self-isolate. However, after a pilot on the Isle of Wight, testers discovered the Government’s app experienced issues working on Apple devices.

Meanwhile, the alternative app released by Apple and Google struggled to calculate the distance between users. Matt Hancock announced that they would be pursuing a new app which combined both platforms. As a consequence, the new app is unlikely to be ready before the winter.

Although we cannot be 100 percent sure that all five of the Government’s tests are met, there is growing confidence that the mitigations the Government have introduced will protect the NHS against a second wave.

Ultimately, the country has faced a pandemic the likes of which unseen for generations. Unlike some of the countries held up as examples of best practice, the UK is inexperienced in dealing with these situations.

Whilst we cannot be certain that lifting measures now will not result in a second wave, the steps the Government took to meet their five tests have put the country in a better place to react to the risks a second peak poses.

 

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