0609-Corona virus

The unintended consequences of the UK lockdown and why millions of people could already be infected

The scientific advice on which the Government has based its coronavirus strategy has been released, giving a grim insight into the expected progression of the virus and calling into question some of the strategies. Documents studied by the Scientific Advisory Group for Emergencies (Sage) showed that social-distancing “lockdown” measures to keep people apart may need to be in place for most of the year to control the spread, and millions may already be infected, according to worst-case modelling. The Government published the advice after Boris Johnson, the Prime Minister, said he expects the tide to be turned in the fight against Covid-19 within 12 weeks. Yet modelling shows the crisis could last far longer, with the virus potentially returning next winter. Many of the measures enacted may also have unintended consequences.  Here is what we now know.
The number of Britons who have already been infected by the virus may be anywhere up to 23 million, new modelling suggests. Calculations by the London School of Hygiene and Tropical Medicine (LSHTM) estimate that, for every single death, many more cases are likely to be present in the population. Health experts are increasingly concerned that hundreds of thousands of people may be infected with a mild form of disease without even knowing it, and could be inadvertently spreading the virus (the so-called “super spreaders”, see video below) while they think they are healthy.
The Department of Health is keen to roll out an antibody test that could tell if someone had already been infected and  built up immunity, meaning they would no longer need to adopt social isolating or distancing measures. The team at LSHTM ran 25,000 epidemic simulations for different death and infection rate scenarios ranging from 1.5 to 10 per cent death rate in the population and someone infecting between one and three people. For a scenario with a death rate of 1 per cent, where each infected person infects three more – which is closest to what is currently thought to be happening – the team at LSHTM found that one death points to a minimum of 37 cases, a maximum of 138,624 and a median average of 1,733. With the current number of deaths at 167, it means that between 6,179 and 23 million people could already be infected, with an average of nearly 290,000.

Scientists at the Universities of Oxford, Warwick and Lancaster found that contact tracing could reduce the transmission rate from 3.11 people to 0.21 – enabling the outbreak to be contained. They carried out a postal and online survey, asking 5,802 people how many social interactions they had on a given day and found the average number of contacts over a 14-day period was 217. Of these total encounters, an average of 59 contacts (27 per cent) met the definition of a close contact (within two metres for 15 minutes) and 36 (61 per cent) could be traced. However, the team said that even with contact tracing, they would still expect 15 per cent of all infected people to generate at least one case that could not be identified. Separate modelling by the LSHTM also found that if an infected person infected another 1.5 people, tracing fewer than 50 per cent of contacts was enough to control the outbreak. However, once it reached an infection rate of 2.5 people, health officials would need to trace 70 per cent, and by 3.5 people, they would need contact nine out of 10 people that the infected person had met.  The team at LSHTM  also found that tracing and isolation was only feasible when fewer than 1 per cent of transmissions occurred before the onset of symptoms. Currently there is no data on how many people are becoming infected before symptom onset. The team concluded that “highly effective contact tracing” and case isolation is enough to control a new outbreak of Covid-19 within three months.
Modelling from the Universities of Exeter, Bristol and Warwick showed that, without any measures, the epidemic would have peaked around 133 days after the first person-to-person transmission in Britain, which occurred around Feb 28. So without intervention, coronavirus would have peaked in late June to early July. The research teams also found that an outbreak starting in Brighton, or the South East England, would peak in London and the South East first, with North East England, Yorkshire and Humber and Wales following with a 10-day lag.
New research by Imperial College London found that people suffering from coronavirus may experience a wide range of symptoms, not simply a fever and a dry cough. Other symptoms included fatigue, fever, chill, headache, diarrhoea and nasal congestion. A few cases also suffered confusion, dizziness, nausea, difficulty walking and vomiting.  The team looked at 107,000 cases from mainland China, Hong Kong, Japan, Singapore and South Korea. They found that among people hospitalised from the onset of symptoms, patients developed pneumonia within five days, and needed ventilation within eight days.
School closures 
The closure of schools and other public venues actually risks inadvertently spreading coronavirus, Sage behavioural scientists warned the Government. House parties and rendezvous in parks were among the scenarios predicted as a result of a lockdown. Longer queues in takeaway shops were also warned about. In a document dated March 4, the Scientific Pandemic Influenza Group on Behaviours (SPIG-B) conceded: “Empirical evidence for the behavioural and social impact of, and adherence to, each of the strategies is limited. We are not aware of any evidence on their interaction.”
On Thursday, March 19, the Prime Minister told the nation: “I think, looking at it all, that we can turn the tide within the next 12 weeks and I’m absolutely confident that we can send coronavirus packing in this country.” Up until Wednesday, March 18, the Government’s policy had been to keep schools open, partly to ensure that key NHS and other frontline care workers could remain in work rather than having to take time off to care for children. However, Mr Johnson said the Government was forced to change tack because the rate of Covid-19 infections was increasing faster than anticipated.

0608-Corona virus

Foto: Koning Willem-Alexander tijdens zijn toespraak over het coronavirus

“Within a few weeks our life has changed drastically. The coronavirus affects us all. In the Netherlands in the Caribbean parts of the kingdom and around the world. The people most affected are the seriously ill and their families. We sympathize intensively with the relatives of the people who have died and with all corona patients at home or in a hospital. We are thinking of you in this difficult time.
The measures to slow down the spread of the virus are necessary and drastic. I understand your grief when you cannot visit your loved one your mother / father / grandfather or grandmother in a nursing home. Right now you only want to hold one hand, give comfort. People deliver exceptional performance, doctors and nurses. You will receive a lot of appreciation from society. We are proud of our healthcare professionals and the entire medical sector.
Thousands of former caregivers and volunteers enroll en masse to assist. That’s fantastic. We can also be proud of the experts from RIVM, GGDs and all other institutions and experts who show us the way on the basis of scientific research and experience. They are under high pressure. It is important that we continue to trust them and follow all directions. They have only one goal in mind, which is that we get through this crisis as best we can and that the risks for vulnerable people remain as small as possible.
We also realize only too well how indispensable people are who prevent our society from coming to a halt. People in logistics, supermarkets, cleaning, IT, education, childcare, public transport, the police and all those other places. You carry us through this difficult time. It simply cannot work without you. Thank you very much.
Our heart also goes out to everyone who is concerned about the continuity of his company. Whether you are an exporter or self-employed. This situation comes pruning heart. It is terrible to see your own company, which you have invested so much time and love in, for years. This also applies to people in the culture sector who cannot realize their beautiful projects now.
I also think of all children in the Netherlands. I really understand how you feel. It may be exciting to be free at first, but that will pass quickly. Not going to school, not going to football or ballet lessons, birthday parties that are canceled. That is quite difficult. Also for parents, suddenly you are at home with your whole family. Forced to work from home, hardly any possibilities to go out, because almost everything you looked forward to has been canceled. That demands a lot from all of us.
If you are unsure or afraid, the need for contact with other people is great. You want to tell your story, you prefer familiar faces around you. If possible, forget the worries together. This has become much more difficult in the current circumstances. We miss our regular patterns and especially the people who belong to them. Your working environment, the sports club, the coffee morning, the music association, the family weekend, the church service. The lack of this makes this situation extra difficult for everyone, but especially for elderly people who are vulnerable.
Fortunately, there is a lot we can do. After all, we all know who needs attention in our immediate environment. This is something we have to go through together. A lot of people realize that. They keep a watchful eye on others and help each other where possible. We cannot stop the corona virus, but the loneliness virus can. Let’s work together to make sure no one feels abandoned. Fortunately, if a visit is not possible, there are the online means of communication. The phone or the mail.
The Netherlands would not be the Netherlands if people were to act everywhere. Neighbors who are ready for the residential and care center in the district. People volunteer to join a helpline. Students who offer childcare to parents with vital professions. Corona unleashes an incredible amount of decisiveness, creativity and humanity. It is those qualities that we really need. Not only now, but certainly later when circumstances may become even more challenging.
All of you ensure that, despite the paralysis of public life, the heart of our society continues to beat. Alertness, solidarity and warmth. As long as we keep those three, we can handle this crisis together. Even if it takes a little longer. 2020 will be a year that each of us will remember for a lifetime. Everyone has their own experiences and experience it in a different way. But I hope and expect that a sense of togetherness and pride will continue to connect us right through this difficult time.”

0607-Corona virus

  • Leave your home only when necessary;
  • Theaters, concertbuildings and cinema’s are closed down;
  • Kindergaten, primary & secondary schools, universities cosed down;
  • Restaurants, cafés and hotels are closed down;
  • Only supermarkets and pharmacies are open, with strict visiting rules;
  • Supermarkets have special opening hours for people >65y;
  • All housings for elderly peoples are closed for family members and/or visitors;
  • Churches broadcast the services via the internet;
  • Bankers postpone the cashing of loans for the next 6 months;
  • Gatherings of any kind of more than 20 people are forbidden;
  • Bankers postpone the cashing of mortgage instalments;
  • Paying with cash money is forbidden; use your bank card or credir card;
  • Public transport (railways and busses) will be reduced to 1 service per hour, and these trains/busses stop everywhere (Intercity services and international traffic is suspended);
  • When possible, work at home;
  • Emergency points at hospitals have a triage system, to pick out people with a possible corona infection;
  • Cancelation of the European Song contest;
  • Cancelation of the Formule I races at Zandvoort.

All these measures apply at least till 6 April, but can be that date can change if necessary.