When will the UK lockout end? The four potential exit strategies

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On April 23, the United Kingdom joined the United States – which currently has two studies – and China, to begin human trials for a vaccine. However, the Prime Minister and his cabinet say they believe there will likely be no preemptive boost in this calendar year.

Earlier this month, Professor Neil Ferguson, the government’s key epidemiologist, said: “The only way out of this long term is vaccination or some other kind of innovative technology. “

Professor Sara Gilbert, who leads the University of Oxford team in vaccine development, said a working vaccine may be available in the fall, but it would take some time to intensify it. Even when it becomes widely available, it will initially be reserved for frontline workers and the most vulnerable in the first place.

However, the government has confirmed that if Britain first develops a vaccine, it will then be administered to the British, which means that those in the United Kingdom may be in the lead.

Development of treatments could be faster, with dozens of trials underway to see if antivirals already used for other conditions, such as malaria and HIV, could work. Plasma from the blood of recovered victims could also be injected into patients.

If a work cure becomes available in the weeks or months to come, the lock will be lifted much sooner.

Imperial College has consistently warned that large-scale restrictions and surveillance should remain in place until a vaccine is available, to avoid a second wave.

However, intensification will be a problem and it is likely that only frontline workers will receive vaccines initially.

Dr. Jeremy Farrar, member of the Sage government group and director of the Wellcome Trust, said the disease would not go away anytime soon and future waves were likely.

“I believe it is now an endemic human infection. It’s likely that it’s here with the human race for the future. We’re going to have to find ways to manage this.

“The real breakthrough is that we have to have new tests, we have to have drugs to treat this infection, and we absolutely have to have vaccines so that we can prevent what we should assume are future waves.” “

Professor Hunter added, “In the fall, we could have effective drug treatments that, if taken early enough, could reduce the severity of the disease and reduce the need for hospitalization, intensive care beds and ventilatory support.

“If this is the case, it would also be a reason to relax social distance. “

Countries that have lifted certain lock-in areas, such as Germany, have started to see reproductive rates increase again and fear that they will have to re-impose restrictions to avoid a second wave.

Angela Merkel warned that hospitals could be swamped by the end of June if the numbers continue to rise, and said a second “shutdown” would be inevitable if the cases did not start to decline.

Below are questions about locking out our readers to which Sarah responded on Wednesday, April 8. YesYou can send your questions for our next Q&A to [email protected]

“What if the lock had been initiated earlier?” “

Our first question from Howard Williams asked:

“If the lockout had been triggered a week or two earlier, once we knew we were being spread in the community, is it possible to model the time we would have needed for the lockdown and the number of infections we would have avoided?

“The strategy for tackling Covid-19 has focused on safeguarding the NHS from failure due to excess demand exceeding capacity. How does the pattern of an earlier foreclosure impact the NHS?

“Does an earlier lockdown only prolong the duration of the epidemic by slowing the acquisition of collective immunity?” “

Here’s what Sarah has to say:

Hi Howard. This is an interesting question and I have yet to see any modeling on it. I am sure it could be done. It would seem logical to think that if a lockdown had been achieved earlier, the disease would not have spread so far and an exit strategy could have been adopted more quickly.

However, one of the reasons for delaying a lock was to flatten the projected peak rather than crushing it completely as if we were doing it, we will see another huge peak once we emerge as no one will have immunity . That way, by the time we get out, a lot of people will probably already have the virus, and a second peak will be much weaker.

“Why was the worst scenario not communicated? “

Our next question from Roger Steer:

“It seems that part of the reason why no objective economic analysis of the costs and benefits of the coronavirus policy has been conducted is a reluctance to inform people of the full extent of the worst-case scenario.

“Therefore, I would like to ask why the worst case scenario was not communicated properly? “

Here’s Sarah’s response:

Hi Roger, yes good question. I keep asking the government for that and I’m told the treasury models it, we hope, we should do it soon.

Many in government now fear that the economic, social and health impact of the foreclosure may be far worse than the benefits. Yesterday, Chris Whitty, the Chief Medical Officer of Health, spoke of the “unintended consequences” of diverting so many NHS resources to fight coronaviruses. We know that many operations and treatments are canceled and the fallout could be enormous. I fear that the remedy is worse than the long-term illness.

“Is blood plasma the way to go?”

Our next question from John Doe regarding possible treatment for coronaviruses:

We knew that the coronavirus was originally mutated into two strains, nasty and very nasty. This morning on Radio 5 Live, a virologist admitted that he has now undergone many transfers. As a result, has making a vaccine become much more difficult, and is immunity a problem now because of the strength of the variations?

Also, given the mutations, will the immunity be short-lived and we might regret seeing many more waves of the virus? In this case, blood plasma, with all its risks perhaps the way to go?

Here’s what Sarah has to say:

Hi John. Yes, mutations can make it difficult to make a vaccine. It depends on where the mutation occurred. Many vaccines in production cling to the “peak protein” on the surface of the coronavirus – it looks like a small rod with a small crown on top, hence the name “corona” – If DNA mutated to changing this structure would hamper vaccine development. But other vaccines use different mechanisms.

The blood plasma looks pretty good so far, and there are also ongoing trials that use T cells from healthy people to boost the immune system. These do not target a specific virus, so if it mutated, it would not matter.

“Have things started to improve?

Our next question from Mitch Klattle:

Is the situation improving now that we are locked out?

Sarah has the following to say:

Hi Mitch, yes, it looks like it’s good that it’s in its infancy. The number of new hospital admissions is decreasing, which means that death rates are also expected to start declining soon. We expect a peak in mortality around Easter Sunday or a few days later. If we follow how China has progressed after that, we should start to see rapid declines and we could think of an exit strategy around mid-May..

“Will the lock become tighter?

Our next question from a reader who wishes to remain anonymous:

“While the lock is in place, will the severity of the lock remain the same as it is today, or will it become more stringent? “

Here’s what Sarah has to say:

Hi. The government is keen not to impose a more stringent foreclosure and for the time being this seems unlikely. The number of cases seems to be stabilizing and if we reach a peak when expected – in the next week or so – then there will be no need as it will be clear that the lock is working.

Modeling shows that we only need 75% compliance to be effective and we are well above that.

“How long will the UK be locked out? “

Katrina Allen asked the essential question:

“How long will the UK be locked in for?” “

Here’s Sarah’s response:

Hi Katrina, no one really knows for the moment and the government is waiting for the peak of death before deciding on an exit strategy or timetable.

However, if the virus peaks in Britain as expected – Easter Sunday or soon after – the lockdown could be lifted in May. China started to lift the restrictions about a month after the peak of their cases, and it looks like the situation is now under control. Ministers and scientists are closely monitoring other countries at this time and what is happening elsewhere will help inform our own exit strategy.

“Will London stay locked up any longer?”

Our next question from W FLETCHER:

“In early May or at a time when the daily death rate falls below 150, then remove the lockout for people under the age of 45 as long as they don’t live with someone over the age of 60.” isolation in central London for two or three weeks beyond the rest of the country. ”

Here’s what Sarah has to say:

Hi! Yes, I think the government is probably planning a gradual exit where the least vulnerable members of society will be allowed to exit the lockout sooner. Paradoxically, London could leave earlier than the rest of the country, because new evidence shows that the capital has strengthened its immunity.

I suspect there will be a general release of the lockout in May, and then certain areas will be asked to return, if it appears that the virus is getting out of control in specific areas.

“Should the elderly be cocooned longer?” “

Our next question from Edward Hogan:

“Perhaps now is the time to shift the approach of the hospital crisis (where they themselves will admit that it is very difficult to eliminate infections) to other sectors such as manufacturing which have developed sterile and aseptic techniques for making their products that could be used to create “virus-proof cocoons” for the elderly and other vulnerable groups until medical science develops effective drug therapy? ”

Here are Sarah’s thoughts on this:

Hi Edward. As long as the elderly and vulnerable are isolated, I don’t think we should go that far, although that is a very interesting idea.

“Can antimalarials be used to fight coronaviruses?” “

Stephen Keay asks: “What’s wrong with using chloroquine as a first-line treatment? “

Here’s what Sarah has to say:

Hi Stephen,

The antimalarials chloroquine (CQ) and hydroxychloroquine (HCQ) have been shown to be useful against a number of virtual infections, including Ebola and dengue, and are currently undergoing clinical trials in the UK.

Antivirals usually need to be given at the start of an infection and we know that the coronavirus is asymptomatic for a while, so it might not be as useful as it seems.

The University of Oxford is currently conducting trials on coronavirus patients using hydroxychloroquine, lopinavir-ritomavir – and treatment for HIV – and dexamethasone – a type of steroid, and the results should be known soon. . The administrative formalities are eliminated. Once deemed safe and effective, they could be deployed fairly quickly.

“Will vulnerable groups still have to be careful when traveling after the lockout is completed?” “

Ask Geoff Doven: “When the world returns to normal and overseas vacations are back on the agenda, would it be safe for people of traveling age to be able to travel before having an anti-virus vaccination?” “

Of Sarah: Hi Geoff – I would advise to keep an eye on the advice of the Ministry of Foreign Affairs on this subject because they evolve quickly. In the coming weeks, I imagine the Ministry of Health will also be publishing advice on what vulnerable people should do in terms of travel or just travel. It looks like vulnerable people can be isolated longer in any case, which means that by the time you break out of the lockdown, the world will likely be a much safer place and a vaccine or treatment may be available. Maybe avoid cruise ships and resorts for a while!

“Will we need masks after locking? “

John Crone says: “My wife and I are in our 40s and (although not in the medically vulnerable category), we are at high risk until a vaccine is released.

As the lock progresses in the meantime, it seems to me that people like us could break out of isolation if they were wearing PPE quality masks. And of course, observe hand hygiene.

Although experts say that normal masks do not give complete protection, surely we could buy masks offering 100% security? Do you have an opinion on this? ”

Sarah: Hi John! There does not seem to be much evidence that masks prevent people from being infected although it appears that they prevent people from being infected from further spreading the disease.

I think by the time the lockout is removed – which may be later for the most vulnerable – the virus will have dropped tremendously in the community and the risk of infection will be very low.

So, as long as you maintain your good hygiene and social distancing practices, I don’t think a mask will be necessary. It should be noted that there is no evidence yet that the coronavirus has ever been transmitted outside, but there is ample evidence of transmission inside.

“What about the other countries behind us?”

Nigel Wheatcroft said: “We all hear about the end of the lockdown here in the Western world, but everyone seems to forget that the virus has not yet really hit the most vulnerable, that is to say in Africa and South America . It has only just started there and will only get worse, they are lagging behind infections and will pose a threat to continue to spread. ”

Sarah said: Hi Nigel, yes, there are a lot of concerns about vulnerable countries and the government has sent funding and public health experts to help it respond.

“Why do some countries, like America, find it difficult to test? “

Susan Killion asks: “Why is it so difficult for the United States to test the entire population to isolate the positives and negatives and ultimately get rid of the virus? “

Of Sarah: Hello Susan, I think many countries are struggling to speed up testing due to the lack of testing equipment. The tests require two enzymes which are generally only produced on a small scale.

Demand is normally very stable and relatively weak, so it takes time for massive amounts of global demand to increase. In addition, quality checks should be carried out to minimize the risk of false positives / negatives. A bad test is worse than no test at all because it could allow an infected person to enter the community.

Governments have also struggled to obtain the swabs needed for testing, as a very large number are produced in Lombardy, Italy, which is currently locked.

But yes, testing is crucial, and it is vital that countries get their hands on more testing.

“Will the current lockout be completed in a month?” “

This is the million dollar question!

Charlotte reilly request:Is it likely that the lockout will end in a month or will it be longer? ”

Sarah: Hi Charlotte. If we follow what China has done, we could expect the restrictions to end about a month after the peak of the epidemic. The government expects that next week or so, in about six weeks, this seems like a likely release date. But it would change if the trajectory of the epidemic changed.

“When will the lockdown in Northern Ireland end? “

Leah Steele said: “I live in Northern Ireland. How long do you think the lockdown here will last? “

Sarah: Northern Ireland seems to be following a similar trajectory to that of the United Kingdom and the Minister of Health, Robin Swann, warns the public that “the worst is yet to come”, so it will be a few weeks after the peak before the lifting of closure

“Will women be allowed to go out before men?

This is fun but also a very interesting point (sorry, gentlemen).

Laura Giuliani said: “I have read that, in addition to the fact that young people are a protective factor, women are less vulnerable than men in Covid-19. Do you think that an age limit can be set at an older level for women, as part of a gradual relaxation of a lock? ”

Sarah says: Hi Laura. Yes, you are right, the infection and death rates seem to be much higher for men than for women – about three times higher in some cases. I think this is a really interesting and very sensible suggestion, but I suspect it might be a politically unpopular decision to only allow women to go out. Could cause a riot!

“Are people going to try to catch the virus if they helped it out of the lock?” “

It’s pretty wild, but a valid point nonetheless.

Mark reeve request: “Would some kind of certificate that you had the virus not cause people to try to get the virus, so they can return to work / normal life earlier, and therefore be counterproductive?” “

Sarah: Hi Mark, yes, there is always the possibility that some people will try to catch the virus to get out early, but since it is blindly lethal, I hope most people would be more susceptible.

“Is it time that only vulnerable groups are isolated? “

Carp Jugulum said: “The modellers have gone from 250,000 deaths to 7,000. The case fatality rate seems to have been overestimated with the basic number of SARS-cov-2 reproductions. Why do we listen to this model?

Wouldn’t it make much more sense to simply isolate the elderly and vulnerable and perhaps continue to have the means to benefit from a national health service? ”

Sarah: Hi. The number of cases has decreased due to the lockdown. The original modeling was largely based on allowing the virus to pass through the population. Although the virus disproportionately affects the elderly and vulnerable, it also kills the young, so it is probably best to keep everyone indoors until the number of cases is much lower.

“Should the government force us to download a tracking app?” “

Oliver norwell said: “If a workable solution is an application that knows exactly where we are and allows us to report symptoms, then alert others who have been within a few meters of us in the past five days … would this be doable for the government?” to demand that we download and run the app (I know in China they have something similar).

“It would be an epic nightmare for privacy watchdogs … but it could allow us to resume a normal life, which itself was worth billions for the economy, many for our mental health, and test the effectiveness of the system for future pandemics. ”

Here is Sarah’s verdict:

Hi Oliver,

The government has already declared that its application will be voluntary but hopes that a large number of people will download it. A survey released today suggests that 78% of people would give up some privacy to fight the virus. But I don’t think it would be necessary in this case. All data will be anonymous and will disappear after 14 days. It will be up to people to do the right thing and self-isolate rather than being forced or forced to download the app.

“Won’t there be privacy issues if we are asked to use contact tracking apps?

Chris Wichard said: “Hi Sarah, you may or may not have a particular opinion or insight on this, but do you have any opinion as to whether GDPR concerns can prevent the effective deployment of contact tracing applications? “

And here is Sarah’s response:

Hi Chris. The government is working with civil rights groups to ensure the data is anonymized. The NHS has promised that it will not use it to track people but to alert them if they come in contact with someone who then tests positive for coronavirus so they can do the right thing. It will be entirely voluntary.

Officials are keen not to allow other countries or companies to access data from UK citizens, which is why we are developing our own anonymized version online with other countries, including Norway and Germany.

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