Despite the roll out of the vaccine and the gradual easing of lockdown, there’s still a lot of pessimism in the air. Consistently we hear talk about the potential for COVID-19 infections to rise again and further deaths. Whilst the Government are adamant that there is no reason for us to see a reverse of strategy, there are still people talking about a possible 4th lockdown, perhaps in the Autumn.
Now, my personal take, remembering as always, the disclaimer that I don’t write as some kind of expert is that if everything we’ve been taught about viruses and pandemics, everything our experience suggests and everything that reason and logic is true then we should already be moving into a phase where the threat of a further surge in serious cases, hospital visits and high death rates is already diminishing.
When Boris Johnson suggests that the current drop off in COVID rates is dur more than non-pharmaceutical interventions rather than the vaccine, he is of course speaking obvious truth. We have not been circulating at the kind of levels needed for significant transmission of the virus. This also means that at one level we are taking a step into the unknown. We don’t know how the vaccines will hold up in real life contexts until we’ve seem the consequences of re-opening society. We are seeing encouraging signs in Israel but Britain will be the first country will a significantly large population vaccinated, so this summer will be the moment of truth.
However, we need to be very clear about this. If there is a 4th wave that leads to mass hospitalisation and deaths putting a serious strain on the NHS then we are in deep trouble because that would mean that the vaccination programme has failed. Furthermore, it should not take much for us to work out that if a 4th lockdown happens then we are foing to stuck in a cycle of such shutdowns with a 5th and 6th taking us well into 2022. By that stage or society will be completely on its knees.
So, what should we do? Well, first of all, the best thing to do is not to panic. All of the signs point to the likelihood that the vaccination programme will be successful. Alongside that,the Government should have made a risk assessment against the possibility that the vaccine will be ineffective. If the probability of this is high, then a mitigation and management plan needs to be in place. That mitigation plan simply cannot be more lockdowns, that makes no sense whatsoever.
The mitigation plan needs to be one that aims to avoid us going back into lockdown and I suspect that the Government won’t have to look far for this. It is fairly obvious that lockdowns were not the preferred option for our government and civil service last year and I would hazard a guess that this was because it was not the preferred option in previous pandemic contingency planning. This is important as well because even if we are nearly out of the woods with cOVID-19, it won’t be long before another pandemic threatens, so we need to think about how we should prepare for that possibility. Again, I would argue that the planning needs to see national lockdowns as a last resort to be avoided if possible.
My best guess is that such a plan will have included, and should in the future include, the following:
- Infection control at the borders to quickly screen against new COVID variants and other diseases from entering the country.
- The ability to secure care homes and hospitals to minimise transmission into and through such contexts.
- The ability to run an effective contact tracing system that quickly identifies local outbreaks and is able to provide for surge testing into such areas.
- The ability to lockdown a specific location from region right down to neighbourhood in order to prevent a virus spreading from such an area.
- The ability to set up nightingale type facilities but rather than placing them in population centres, these facilities should be away from such major population centres with the ability to locate medical teams for a significant period of time so that patientns and care teams alike are quarantined from the wider public.
- The ability to rapidly deeply new vaccines as required by building on previous vaccine knowledge.
It is this type of approach that will not only enable us to face any resurgence of this coronavirus but enable us to be equipped to face other potential pandemics.