Saturday, September 19, 2020

Can we avoid lockdown?

I considered briefly the magnitude of the response needed to address the COVID-19 pandemic, and concluded that - roughly - a factor of 10 reduction in social activity was required.

The question then becomes - how to achieve that?

Clearly, lockdown works (although the fact that our decline was slower than it should have been indicates that it wasn't working optimally - lacklustre leadership, being two weeks late into lockdown, and a significant selfish minority who clearly thought the restrictions weren't for them, contributed in part.

There are massive negative economic and societal consequences of lockdown, so it would be better to avoid it if you can. Can we?

What are the options?

  • Working from home: this dramatically eliminates both the work contact and public transport contact elements. It's a sufficiently large component that if you don't do it, you can't win. So, where possible, people should work from home. There's still going to be a set of people for whom this isn't possible.
  • Avoid public transport: yes, this helps a bit, but has negative impacts. Remember, we have a climate disaster looming on the horizon. If the majority work from home, then that reduces the occupancy - and thus the risk - for those that need to travel.
  • Eliminate large-scale events: the sheer number of people, and their closeness, surely indicates that live theatre, sport, concerts, and the like, simply can't be contemplated for a while.
  • Rethink large-scale events: large scale events have a couple of problems, first you're putting a huge number of people in direct contact at the event, and you're having a lot of mixing on the way in and out (and many will visit other social venues as part of the event, making things even worse). But if you only had isolated boxes - and many venues already have some provision like this, after all - with no way for people in different boxes to mix, then you can get to a point where it's not really any worse then the groups meeting to watch the event on TV in a bar or at home.
  • Shut down bars and restaurants: there's a massive economic and social hit from this. This is a smaller version of the question about avoiding total lockdown.
  • Rethink bars and restaurants: how far can you eliminate the risk by having isolated groups (bubbles), table service only, one way routes, and ramping up the restrictions? I think you can actually go a long way from the norm. Having visited a few bars and restaurants, most are doing a pretty good job. The fundamental problem again is those in the selfish subclass who won't obey the restrictions and ruin things for everyone. You're going to have massively reduced occupancy (simply by spacing people out) which reduces the risk. Which also reduces the risk because the reduction in capacity means people won't be able to go out as often.
  • Testing: if you test everyone continuously, and just barricade the infected, then you should allow everyone else to get back to normal, right? Not so fast. The point here is that a single negative test doesn't mean anything. Worse, any contact means you need to get retested - over and over. That's the sort of thing you have to do in hospitals, it's simply not feasible to cover the whole population at the required density.
  • Early closing: I've seen the suggestion that bars should close early. I'm not at all sure that this will help much, as it just pushes people into packing more densely into the hours that places are opening. If anything, you want to expand opening hours (presumably early opening) to spread customers out as much as possible. The only way I can see this helping is if it discourages people from going out at all.
  • Ban pub crawls: this seems to me like a no-brainer, to be honest. Restricting people to a single venue massively reduces the mixing effect. (And it seems likely that there's a strong correlation between pub-crawlers and selfish superspreaders.)
  • Track and trace: essential, but only works if you massively reduce your interactions in the first place. If you try and carry on as normal, then everyone ends up potentially coming into contact with an infected person and you have to lock everybody away as a result.
  • Social distancing: taken as a given, but not enough alone unless you push it well beyond 2 metres. Doesn't matter how far apart you are if you have to share the same door handle, though.
  • Face coverings: again, unlikely to be enough on its own. Really, you should be thinking about face coverings, social distancing, and similar precautions as being an extra level of protection if you can't avoid an activity at all (such as shopping for groceries). You shouldn't take face coverings as an excuse to enable you to partake in riskier activities.
  • Redefined infrastructure: take the things that we have to do and eliminate risk. Examples include automatic doors (you don't touch anything that someone else has), foot or knee operated taps rather than turning by hand. Individual lifts, and likewise travel compartments rather than massive open carriages.
There's no silver bullet here. Saying "if we all just did X" won't work, no single action is enough. This has to be a concerted attempt, all the options need to be pursued together.
I think we could avoid lockdown, but it requires a huge amount of work. You need to go fo the big hitters - working from home as much as conceivably possible, scrapping all large events entirely. Then you need to layer on every single measure and precaution you can. And you need a high level of adherence to make it work.

Sadly, we have a government that hasn't the gumption to do the big things or the eye for detail to do all the little things, and the great british public has far too many gormless prats to expect the measures necessary will be followed.

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