Distancing, Isolation or Lock Down? - A Considered Debate

It is very clear that we are living through an unprecedented situation. We are all fearful of what the future holds and over the impact of this virus. As we consider legislation and actions, the way in which we respond is the topic of the moment. I am a Science teacher by profession. Therefore, looking at fact and data is my fall back position. So, I have tried to put together an analysis of the debate to help inform myself, and perhaps others. The key fact being, this is not easy. It is not simple and there are no perfect solutions. This is what I have been thinking through.

Current evidence tells us this:

1. Most infectious between day 2 to 6 because the coughing is acting to spread the virus. Can be infectious before but less likely to spread as more difficult to pass on. That’s why social distancing is important. 

2. We have a very small sample size of cases. Most models start with 100 cases. We are not there yet. 

3. We are around 2 to 3 weeks behind UK infection rates. 

4. Testing relies on the virus being present in the mouth/throat. If it is not developed there it will not show and can give a negative test. 

5. Therefore, testing all on entry without symptoms will not give the accurate data we may think.

6. When symptoms have subsided, the level of infection also drops as with before the symptoms. 

7. Currently, we are testing 4 times as many per 100,000 as the UK. But this will change as the UK ramps up testing.

8. Social distancing does make a huge impact on infection rates. 75% less contact means less likely to pass on.

9. Social isolation is very effective for stopping the virus spread, but difficult to maintain.

10. Locking down the island will stop Virus in its tracks. But part of that is when we end that lock down. It does not remove the virus. When the lock down ends it could mean a sudden increase in cases.

11. Locking down will need very careful consideration over its long term impact. In terms of wider physical and mental health.

12. We must have mechanisms of support in place before any lock down of our society. They must consider all islanders. 

13. There is not a health care system that could cope with a huge increase in cases with uncontrolled increases. 

14. A vaccine is likely to be at least a year away. 

Lock down Pros and Cons

So let’s try to sum up and compare. This is not perfect. 

And if we are to lock down there are many questions that I would like the answer to. They are in no particular order. There are issues that have to be addressed re the practicalities of lock down.

1. What will lock down actually mean? We need a clear definition. 

2. Will lock down get rid of the virus? Will it disappear for good after a period without infection. 

3. Will all households be expected to stay in their homes at all times? 

4. How will the movement of people to shop for food and essentials be managed? 

5. How will vulnerable people be cared for? Those requiring daily care for example. Will health care visitors still visit? 

6. What happens re emergency situations such as boiler breaking, water leak, Broadband issues, Gas leaks, oil deliveries etc? 

7. Which shops will remain open? Pharmacies? Food shops, takeaways? 

8. What will happen to homeless people? 

9. There is evidence that domestic violence increases in these situations. What will we do to address this? 

10. How do people get emergency treatment in Southampton?

11. What is the time period of the lock down or is it open ended? 

12. Will there be set times for exercise? How will they be managed? 

13. For those that live alone, what support mechanisms are in place? Social isolation is a serious issue. 

14. How will we monitor and address the effects on mental health during the period of household isolation? 

15. What will happen re schools and colleges? Will children of essential workers be at school? Who will supervise and how will this conform to lock down rules? 

16. What happens regarding pets? Exercise and vet care.

17. What will happen for those with learning difficulties who may struggle to cope in the lock down environment? 

18. How and who will police this lock down? Will there be fines? Prison? Do we have the resources for this? 

19. What happens re births, deaths, marriages, divorces, house sales etc?

20. Will all visits to relatives who are ill or even terminally ill be ended? The consequences of this will need to be addressed. 

21. If this isolation is open ended, what are the plans to address the long term economic impact of numerous businesses closing/suspending their activities. 

22. What is the definition of an ‘essential worker’?

23. Will people have to be tested before they come out of isolation? What is the mechanism for this? Is it possible and accurate? 

24. What is the planned outcome end point for the isolation? When a vaccine exists and is available? When infection rates are zero? What are the success criteria? 

25. What is the plan to return to “normality”? 

Possible solutions that can work long term

1. All flight and port arrivals isolate for 14 days in requisitioned hotels. Being tested at the end isolation. Or if symptoms appear.

2. Social distancing is enforced with set times for elderly, essential workers and vulnerable groups to shop for essentials. 

3. Basic provision packs are produced to be accessed when and if needed via a delivery service. 

4. Social distancing can be mandatory with an enforcement undertaken. 

This list is to be added to. But these sorts of measures can impact and be maintained for the long haul that we face. 

So, the decision to lock down is far from simple. Has huge implications both in the short and long term. We need to start listening to understand Not simply to reply. 

Stay safe, stay distanced and wash your hands. 

Rob.