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Will the UK really let people get infected with a coronavirus?
“I MUST be honest with you, with British citizens, many more families will lose their loved ones ahead of time,” British Prime Minister Boris Johnson dramatically told his citizens last week. He reminded some of Winston Churchill and his World War II talk of blood, sweat and tears.
But while other governments of European countries, most severely affected by Italy in the first place, have opted for drastic measures to counter the pandemic of the deadly new coronavirus, the Johnson government has chosen a significantly different and rather questionable strategy.
Questionable reliance on “herd immunity”
The British approach, at least initially, was not to fight with all its might with the deadly virus. Specifically, the British government has reportedly decided not to try to completely suppress the spread of coronavirus among the population, but rather to allow it to spread to the population while protecting the vulnerable population – although the two objectives seem irreconcilable.
Why? For the population to develop “herd immunity in the UK”, explained Sir Patrick Vallance, chief scientific adviser to the British government.
“Herd immunity” is an epidemiological term to denote the inability to spread further in a population when a sufficient percentage of that population is immune. But in the context in which the term is otherwise used, immunity is obtained by vaccination. In the case of the COVIDA-19 pandemic, as we know, the vaccine is not available – and it probably won't be for at least another year.
Johnson changed his mind yesterday, but only partially
Johnson, however, reiterated yesterday and advised citizens to cut social contacts after fierce criticism that Britain was doing too little to fight the coronavirus.
“Now is the time for everyone to cut off unnecessary contact with others and all the unnecessary travel,” Johnson said at a Downing Street press conference. “You should avoid pubs, clubs, theaters and other such places.”
The state, however, will not imprison them, but rely on the responsibility of citizens, without any mention of sanctions. Johnson also made an equally non-binding and, therefore, unreliable recommendation for a 14-day self-isolation of the entire household in case of symptoms and work from home for those who can.
According to the British media, the turnaround appears to be fueled by, among other things, a model of a research team at Imperial College London, which found that as many as 250,000 Britons could die as a result of a loose government strategy. In addition, their analysis showed that the health system would be overburdened because as many as 30% of hospitalized patients would end up in intensive care – thus, on respirators, which are not enough.
(embed) https://www.youtube.com/watch?v=f6jYyCX2aUs (/ embed)
Almost all countries battling coronavirus apply more or less rigorous social distance and quarantine measures – depending on what stage of the epidemic they are in. They do this in order, if it is too late to stop the epidemic, to at least “flatten the curve” of that growth and thus avoid the number of infected and seriously ill flooding the health system's capacity.
Because an overburdened health system cannot treat all patients, doctors are forced to choose who to put on respirators and try to save, and whom to let die, a strategy to reduce the peak of growth literally saves lives. And social distancing is a key tool here, with the control of entry and quarantine of the diseased and those suspected of being infected.
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They fear a new, even heavier wave in the winter
Vallance claims that the British government aims to “reduce the peak, extend the peak, not completely suppress it, because the vast majority of people get mild disease, to build some kind of herd immunity so that people are immune to this disease and to reduce transmission.”
“If you suppress something very, very strongly, when you break those measures, it goes back to the wrong time,” he added. Specifically, according to the Guardian, the British government wants to avoid a scenario in which the coronavirus, if it disappears in spring, would return to full force next winter, when the health system was already burdened by an infectious disease.
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That's why Vallance and Chief Medical Officer Chris Whitty, who appeared with Johnson at a press conference on coronavirus last week, insisted that mass gatherings and major public events should not be banned. They also announced that they would only test hospitalized patients, and that those with symptoms would be recommended self-isolation for at least a week.
But events still started to cancel on the same day, from matches of the first football league to the rest. The Johnson government eventually announced that mass gatherings would be banned from next week.
“Playing Roulette with the Public”
This departure from the initial strategy has certainly been prompted by a number of very harsh criticisms from scientific and medical circles. The editor-in-chief of the renowned Lancet medical journal, Richard Horton, described the approach as “playing roulette with the public.”
Anthony Costello, a British pediatrician and former director of the World Health Organization (WHO), criticized the strategy of “allowing the proliferation of COVIDA-19”, arguing that it raises serious questions, including – whether such infections and deaths will increase in the short term, will immunity the herds will not be established at all or we will be hit by a new coronavirus strain next season that we are not resistant to and whether the UK strategy is in line with WHO recommendations.
Unlike all other countries, the UK strategy aims to build herd immunity by allowing the steady spread of # COVID19. The government argues it will block a second peak in a few months time. Here are EIGHT questions about this HERD IMMUNITY strategy: (THREAD)
– Anthony Costello (@globalhlthtwit) March 13, 2020
In a column for the Guardian, Costello warned that the herd immunity strategy contravenes WHO guidelines and with a proven China strategy, where testing was extensive, testing times reduced from 12 to 3 days, family clusters of infection were identified, and hundreds of millions of people in Wuhanu and elsewhere were quarantined, but at the same time were hired to further gather information on the epidemic and instructed how to behave.
“For me and the WHO people I spoke to, this is absolutely the wrong policy. It would mean that we just let (the coronavirus) invade (Britain),” Costello said.
Epidemiologist: We thought this was satire
Harvard University's epidemiology professor William Hanage even less chose the words in his own column for the Guardian.
“When I first heard about this, I couldn't believe it. My colleagues in the United States, who were themselves overwhelmed by the awkward response of the Donald Trump administration to the crisis, assumed that the reports on British politics were satire,” Hanage commented.
A professor of psychology at the University of Liverpool, specializing in behavioral factors in microbial resistance, Ian Donald has a slightly more positive attitude. He said the strategy was more sophisticated than in other countries, based on scientific models and could be very effective, but at the same time more risky.
In addition, it is based on the unproven assumption that a high percentage of the population, perhaps 80%, will sooner or later become infected with whatever we do, since extreme social distance measures cannot last indefinitely.
Donald, in other words, warns that the strategy of Italy and other countries is not sustainable, because once the quarantine is abolished, there will be a re-expansion, to which the state will only be able to re-introduce the quarantine. He is of the opinion that the British strategy is better between balancing the protection of the vulnerable and the controlled spread of the infection.
But in this context, playing with fire sounds like a fitting metaphor for such an endeavor.
1. The govt strategy on #Coronavirus is more refined than those used in other countries and potentially very effective. But it is also riskier and based on a number of assumptions. They need to be correct, and the measures they introduce need to work when they are supposed to.
– Professor Ian Donald (@iandonald_psych) March 13, 2020
Instead of schools, they will order the old men to close into homes
“Social distancing works in China, Singapore and other countries,” warned professor of micropropic genomics at the University of Birmingham, Alan McNally.
Criticism was also joined by Jeremy Hunt, former Conservative Health Minister David Cameron and Therese May and current chairman of the parliamentary committee on health, calling his successor strategy “surprising and troubling” and “an exception” to the rest of the world. He specifically warned of the decision not to close schools.
Instead of preventing the spread of infections among children, the UK has announced self-isolation for the over-70s as the most vulnerable groups. But the question is how practical such a measure is, given that senior citizens can still become infected by other households.
Recall that in the UK, at this moment, 1553 cases of infection and 56 deaths have been confirmed, and experts warn that the number could continue to grow exponentially and reach the level of Italy, where 24,747 infected and 1809 deaths have been confirmed.
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Will the UK really let people get infected with a coronavirus?