Out of lockdown – a further update and more thoughts on masks and contact tracing

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I’m trying to include a regular update on Faithroots regarding the COVID-19 situation and the move towards ending all restrictions here in England and the wider UK. My aim is to try and help church leaders stay abreast of what might be happening and plan accordingly.  Obviously, I’m not an epidemiologist or an immunologist, just a bloke with access to the Government website and a calculator (plus some experience of making risk management decisisons, though obviously on a much smaller scale than the ones the Government are having to call).

First of all, a data update.[1]  The hospitalisation data comes in at different times between the 4 nations and so it takes a little while for all UK data to filter through, English data tends to come in first.  So we’ve now got 3 extra day’s data from England up until last Friday  and it is as follows:

24th June              194 admissions

25th June              206 admissions

26th June              223 admissions

Remember, admissions tend to lag about 10 days behind cases. So we have to go back to the 16th June for the comparable case data and it looks as follows:

16th June              8675 cases

17th June              8853 cases

18th June              9150 cases

This means that the % of hospitalisations to cases for those few days was 2.33%. Over a 5 -10 day period it was about 2.7%.  All of that is in line with the case to admission ratio improving further. That is a relief because the number of cases has increased even more dramatically this week. However, remember that in my last post, I argued that we probably need to see the case load increasing to really test the hypothesis that the link to serious illness, hospital admissions and mortality is breaking or even has broken.  The decision about final reopening will be made on  the 12th July. That’s about two weeks from now, so the data that week will be crucial. If we are seeing hospital admissions at about 400 -600 per day, we are probably going to be okay with making the final move out of lockdown, if it’s over 1000 we are potentially in trouble.  If it’s less than 350, then we are probably about home and dry.

Now I wanted to pick up a little further on my thoughts in the last post about how we make those next moves out of lockdown and pick up on two issues, masks and test and trace.

Masks

A friend involved in leadership at another church helpfully pointed out to me that I’d not really tackled the issue with mask wearing in my previous post. They observed that there were many people who were reluctant to come to church at the moment because they were uncomfortable with wearing a mask for 1 hour.  However, they also suspected that there would be an equivalent proportion of people currently coming to church because mask wearing gives them some security.  We could foreseeably lose some of those attendees even as we gain some of the others.

These are some of the challenges we are facing as we have to consider different and understandable reactions from people (this will also apply to the question of testing shortly).  It is really about weighing up risk and balancing need.  My personal advice is as follows.

  1. This is a good reason for keeping the seating capacity limited over the summer and continuing to provide for bubbles. 
  2. You might then want to advise people to wear masks on entry and exit/when moving about, especially if there are pinch points but to remove masks once seated

Test and Trace

I noticed today that the announcement of a new 18 month contract for test and trae provoked some reaction on social media. The response was “Why do we still need this?” and people were emphatically suggesting that we should dump test and trace once we are through the other side of July 19th. The argument was that  Test and Trace by identifying asymptomatic cases will lead to lots of people having to self isolate which will be disruptive to planning. Concerns nclude that this will still mean 1000s of kids having to stay home over the next year, that people will be reluctant to go to public venues where test and trace is present because of the inconvenience of having to take time off if they get picked up on the radar (though incidentally, this complaint was being voiced at the peak of the pandemic), finally, there are some people who will really struggle emotionally with the prospects of 2 weeks self-isolation.

So, here are a couple of thoughts on contact tracing.  First of all, some reasons on why I think this will be needed for a little while yet. The reality is that pandemics don’t just go away over night and we may have some time to go until we are completely through this.  This means that there could be/will be resurgences and as we’ve seen from the data, the vaccines are not 100% effective, there will still be a risk, the illness is still serious, it’s not just like the common cold yet.  The added risk of a break through variant needs to be considered.   Secondly, test and trace provides a level of data that helps PHE work out the case prevalence in an area and it will also help us to see whether the vaccines are continuing to work at breaking the serious case link.  Thirdly, other countries are not as far ahead with their vaccination programme. This means that whilst high case prevalence may be less of an issue for the UK now, importing cases, especially of the Delta Variant is a massive issue for them. So, whilst for internal purposes, we are watching the hospital and mortality rate, other countries are watching the case rate and how we manage it when deciding to quarantine.  Fourthly, it makes sense to incrementally and gently lift measures. Finally, even if the system becomes less used, you still want it ready and in place against a possible resurgence rather than having to start from scratch.

My views are that incrementally easing test and trace means that we will/should initially adapt how we use the system.  So, initially I’d use the system to continue to identify people who have been in contact with someone who has COVID.  However, I would expect them not to have to isolate for a full two weeks or even seven days but as soon as possible to take a rapid test themselves and if this shows up negative they should not need to isolate (there may be some false negatives but this is about managing risks and probabilities).  The next stage would be to use the system primarily for monitoring and reporting. Where case prevalence is low, you would expect people to just go about their day to day life unless they personally have tested positive.  The next stage would be to mothball the system until needed again. 

Obviously that’s not within  my control as it’s a public policy decision!  However, I would hope that this is the plan.  Our responsibility is to think about our pastoral responsibilities. For those anxious about masks and tests, we need to help them understand the causes of their anxieties and how God’s Word helps us through such worries. I hope as well that by now we have some expertise in supporting those quarantined at home so that physical self isolation does not lead to complete social and spiritual isolation.  Finally, it is probably helpful to talk through with people why we are still having to face inconvenience.  Yes, there’s the risk I’ll have to self isolate if there’s a positive case but if it means that Ethel who aged 72 and with some underlying conditions is able to get back to church with reduced risk, then that’s positive.  It is frustrating that I might have to isolate because the system picked someone up but then remember that there may be other people whose ability to go to work will be affected by them going to places where track and trace isn’t operational.

I hope that these thoughts and updates are proving helpful as you plan ahead.


[1] For data see Daily summary | Coronavirus in the UK (data.gov.uk)