COMMENT

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24 June 2020

Easter Monday proved to be more or less the time of peak consequences of the disease in Britain.

Science has not necessarily been definitive since but knowledge about the disease amongst doctors has improved markedly since and they have a body of practical experience to draw on.

A reduction in the percentage of ill patients being placed on ventilators is one development. Steps to reduce blood clotting early appears to be another and the appearance of the steroid dexamethasone as a treatment to reduce mortality is another.

In the event of Covid-19 getting a second wind what might be the shorthand steady state steps used to control it?

Allow people to rearrange their lives and travel as they think fit but insist on one metre separation and not meeting more than three people in one day outside a bubble except where the person's job requires it. Fine tune the bubble principle into multiple different permutations.

This would maintain liberty and individual judgement and reduce transmission of the disease whilst stopping short of lockdown.

It could allow months or years of coexistence with the disease.




SOCIAL DISTANCING


Reviewed by ANDRE BEAUMONT


Britain must face certain realities.


It is Easter Monday 2020 and we may not have reached the worst for Covid-19.

In economic terms this quarter must be written down if not quite written off. Planning for recovery should be for the next one and beyond. This one must concentrate on minimising deaths.

There is no point in announcing Britain open for business if it then becomes a pariah as a reservoir of infection.

China has largely coralled Covid-19 but no one is seeking to travel there even if the borders were open. Desirable business that can be done remotely will be but it would still be surprising if it had the same output this quarter as it had in the same quarter last year.

Australia is getting its Covid-19 outbreaks under control and as an island we should look to it for example.

Full social distancing in Britain should be kept in place for a further six weeks at a minimum. This is because it cannot reach the comprehensiveness of testing of cases that Australia and South Korea are getting to. This is about geography in the first comparison and about culture in the second.

What it can do is set up hotlines in advance of relaxing social distancing so that those who get symptoms can give lists of their recent contacts. This, however, would have to be accompanied by a certain type of social distancing relaxation and still be voluntary as people may have reservations about listing contacts. At the minimum, though, those mapping clusters of Covid-19 would be alerted with lower latency.

The type of relaxation is outlined below.

Particular age groups should not be prioritised. Asymptomatic cases are a real problem in the spreading of the disease and those at most risk are those least likely to be asymptomatic and involved in spreading the disease in its tail off phases.

Children might be allowed to return to school after the time already scheduled for summer half term, not before, to allow for a supervised revision period and (non-national) examinations, both of which could be instituted with degrees of social separation.

Open plan office working should ideally not be permitted, in my opinion (as an architect). Certain places have very poor fresh air circulation in terms of complete air changes - aeroplanes, open plan offices including those that have air-conditioning, and the inside spaces of bars and restaurants. People could, however, be permitted to return to offices on a rota basis to keep densities low and to office spaces that used individual rooms and to laboratories with low density occupation.

It is fast approaching summer and restaurants and bars might be allowed to reopen using outdoor spaces and spilling out a little onto pavements as on the Continent but keeping indoor spaces shut except for the use of washrooms, cloakrooms and the like.

Travel restrictions could be relaxed but on the basis that you only meet one person at a time at your destination.

This could also apply to workplaces, restaurants and bars and would be why you would be able to give a list of your contacts on a hotline - if you meet one person at a time it is safer in terms of reducing transmission and you can also remember who you met more easily.

Some categories of economic activity look lost for this quarter - all forms of entertainment in public, for example.

There are many other cases of activity, economic and otherwise, where the government will need all of a month or more to decide and plan - what happens to university students, for example. You are not going to send final year medical students back into the examination hall when they are better suited to their vocation in hospitals.

Spain, which still has too high a casualty rate for comfort, is to undertake some relaxation but mainly in directions Britain already permits - allowing construction and manufacturing, areas of activity where good procedures can ensure you need only meet one person at a time close up or not at all.

In a nutshell, if medical opinion is not strongly against, in June or beyond, the two metre distance rule could be replaced by a one person at a time rule.