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expert reaction to the postponement of some of the planned easing of lockdown, as announced by Boris Johnson

Boris Johnson has announced that some of the planned easing of lockdown in England is now postponed. 

 

Prof Robert Dingwall, Professor of Sociology, Nottingham Trent University, said:

“This is really bad news for the revival of social and economic life.  It suggests that the PM has now been entirely captured by the desire of some elements of the public health lobby to micro-manage the everyday life of this country.  Mandating face coverings in supermarkets always showed a lack of understanding of the literature on ventilation and infection transmission – modern supermarkets have efficient ventilation systems that are designed to take all the gunge we normally exhale up and away from the food.  Larger museums and galleries have similar systems to protect the exhibits.  Modern cinemas have equally high standards to promote customer comfort – sucking away the smell of the popcorn.  With the exception of some modern buildings, churches and other places of worship typically have high ceilings and seating arrangements that minimise transmission.

“The problem is the same as with beaches and parks earlier on.  Modellers assume that we act as isolated individuals and there is a lot of random social mixing in these spaces which must be prevented or obstructed.  Social scientists from various disciplines who actually go and look find that these places are typically occupied by collections of social groups – bubbles, if you like – who only interact with each other in quite limited ways.  These groups naturally maintain distance from each other unless circumstances force them into closer proximity.  This research evidence has been around for decades but has not found its way into the deliberations of the advice system that the government has constructed.

“On the advice of its behavioural scientists, who represent a small group even within the discipline of psychology, the government set out to promote a climate of fear from the outset.  Current survey evidence shows that Britons are still the most anxious people in Europe.  It is time to ask about the justifications for this.  We have become obsessed with the number of cases identified rather than asking what this means.  It is increasingly clear that something like 70 per cent of the cases found in community prevalence studies will never cause a problem to the individuals identified, especially if they are under the age of 45.  Are we pursuing the wrong objective in trying to track, trace and control an entire population, as opposed to thinking how best to protect and, if necessary treat, those who are definably at risk because of their age and existing co-morbidity.  Just beating down cases may be misdirecting a lot of effort, forfeiting public goodwill – think about the people who had stocked up for Eid parties and will now see that food wasted – and further undermining the prospects of social and economic recovery.”

 

Prof Jackie Cassell, Deputy Dean, Brighton and Sussex Medical School, said:

“Though they were suddenly announced, there is a consistency in these changes.  They also give us some clues about what might happen in the coming months.  Essentially, there are contrasting approaches between settings where we come across lots of people we don’t know, and those when we are mainly among family, friends and co-workers known to us.  (Facemask policy is, however, a bit more complicated – see below).

“For example, the PM announced that lifting of restrictions will continue for settings where it’s easy to find out who was there, contact trace and isolate.  These include workplaces   can be closed down if they don’t practice Covid-19 secure restrictions.

“Similarly, shielded people are still permitted to increase their social contacts a little to family and friends they have been missing for a while.  Very few will choose to have unrestricted contact in places where they don’t know people, and a pause in shielding is unlikely to be a big driver of transmission.

“By contrast, lifting of restrictions has been halted in settings where we come into contact with many people we don’t know.  This is more because it’s hard to do effective and well targeted contact tracing among large crowds of people unknown to each other.

“The strategy behind these changes is in line with the response to local outbreaks and rises in cases.  The Northern measures are a response to outbreaks triggered by mixing among people who do know each other.  If this happens a lot, there will very quickly come to be a much higher prevalence and spread in the community as a whole.  But at population level, reducing the mixing between households known to each other which is driving this should push cases back down.

“It’s important to note the wider background.  Tests to see how much coronavirus is around (prevalence) show a 25% increase over the past month.  People get symptoms (if they are going to) between 2-14 days.  Severe illness usually takes a while to develop and lags behind by a couple of weeks.  Covid related hospital admissions, ITU admissions and bed occupancy haven’t changed much for a while (https://www.cebm.net/covid-19/covid-19-uk-hospital-admissions/).  So clearly there is a big worry that increasing prevalence is about to lead to an increase in serious illness and in deaths.  The NHS system is gearing up to deal with the huge backlogs that COVID has generated, and keeping the numbers in hospital low and predictable is a major priority.

“So I’m not surprised to see this.

“Interestingly, Chris Whitty commented that we are probably near the edge of what can be achieved through behavioural change, and emphasised the importance of schools.  I would not be surprised to see a trade off between continued or even new lockdown of settings where adults who don’t know each other mix, in favour of opening schools.  We know who is in a school, and even in the same room, every day – contact tracing is relatively easy and measurable.

“The facemask policy is interesting and complex.  The science on this remains complex and contested.  I do have concerns about mandating masks in law given the complexity of this picture.  During lockdown, we saw that enforcement heavily targeted black and minority ethnic groups.  Many genuine exemptions to wearing a mask are invisible, and some people who can’t wear a mask will not have a formal medical diagnosis.”

 

Dr Simon Clarke, Associate Professor of Cellular Microbiology at the University of Reading, said:

“As we see an increase in the number of new infections, it’s worth noting a couple of things.  Firstly, as more people are tested and infections diagnosed, we learn more about how the virus is transmitted.  This is good, but it is important to ensure that the data on number of cases does lead to the right interventions.  The latest measures being introduced do appear to be proportionate given how the numbers are looking.

“Secondly, the intervention to keep certain lockdown restrictions that were due to be eased should be seen as an alternative to going back to a full nationwide lockdown like we saw in March.  We are seeing case numbers rising in specific locations, and unless there is strong adherence to the new guidance, we are likely to see more towns, cities and regions seeing similar lockdowns and ultimately something nationwide.  All of this is ahead of an expected rise in infections as the weather cools in September and October, so only a concerted effort will see the UK succeed in controlling this pandemic.”

 

Prof Keith Neal, Emeritus Professor of the Epidemiology of Infectious Diseases, University of Nottingham, said:

“Given concerns about rising cases in parts of the country and exactly what is responsible for this increase it is prudent to put on hold any new relaxations of COVID-19 control measures.

“We need to know more about what restrictions are most effective and those which will have essentially NO impact on control.  The less change done at a time the easier this is to assess.

“By investigating cases of COVID-19 we will get more information where transmission is occurring and use this to better target control measures.  This sort of information probably informed the action taken in parts of the North of England last night.  Any delay in action of even a day, risked allowing many more people to become infected in these areas.  There is no current rational for extending those measures nationally if cases are not rising and some people will alter their behaviour due to the publicity even if not in that area.

“We know that outside sport where social distancing is easy to maintain there is little if any risk.  I played cricket last night with only minimal changes to a normal game.  Hence restricting social distanced sports is pointless.

“Extending areas where masks are obligatory is prudent.  Wearing a mask is essentially a zero cost activity as people are not be really inconvenienced by this.  The exclusion criteria for mask wearing needs to be re-considered as these people are just as capable of spreading infection.

“I would advise anyone shielding who is worried to have a conversation with the doctor caring for them for that condition.  We are now at a stage where people need to take individual decisions.  Also the risk in parts of the North of England are very many times greater than many other areas of the country.”

 

Dr Daniel Lawson, Lecturer in Statistical Science, School of Mathematics, University of Bristol, said:

“There is no such thing as a ‘slight’ increase in infection rate.  Either the infection is under control with the reproduction number below 1, or if it is greater than 1 the infection will spread rapidly through the population.  The ONS survey data provides some evidence of an increase.

“But there is a difficulty in measurement.  When cases are low, the average reproduction rate can still be below 1 but we can see an increase in cases by chance, because cases tend to occur in bursts within a community, which should be captured if test and trace systems are working.  We can also see an increase in cases by changes in testing or reporting.

“Decisions must be made in the face of this uncertainty, such as the announcement that the UK is pausing easing.  Evidence from Europe implies that we should take the apparent increase seriously, as acting too late can make lockdowns longer and increase mortality.

“The UK is clearly close to the tipping point in which the infection grows.  Whether local lockdowns and other actions are enough is as-yet unknown.  We should be prepared for further rapid action to prevent the infection from getting out of control again.”

 

Prof Dame Til Wykes, Vice Dean Psychology and Systems Sciences, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, said:

“Clearly we need some clarity, so a postponement will allow all us time to understand the rules and get used to wearing mask, so this lull is very welcome.

“Allowing the loosening off lockdown to be led by the data will reinforce trust In the science and in the government.

“We need to be ready for a potential second wave and that means having test and trace up and running and access to timely tests.  When we have that, the government may then have gained further public trust in loosening their guidance”

 

 

https://www.gov.uk/government/speeches/prime-ministers-statement-on-coronavirus-covid-19-31-july-2020

 

All our previous output on this subject can be seen at this weblink:

www.sciencemediacentre.org/tag/covid-19

 

Declared interests

None received.

 

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