Friday, 17 April 2020

The argument for Stopping the Spread of Infection, as opposed to Slowing it down.

#StopTheSpread #SpreadTheLove

The lock down, keep your distance, no large crowds, stay at home, isolate the elderly and the vulnerable for 12 weeks and wash your hands approach is best described as the top down approach.  Government Advice.

It is imposed or suggested from above.

It is an umbrella policy. 

It is a very broad brush.

It has no detail.

It is partly an order,  and partly an advice, issued by the UK Government.

The policy is to slow the spread of the infection.

As things stand there is no policy in place to stop the spread of the infection.

Two entirely different policy choices, with profoundly different outcomes.

The UK Government's claim is that this slowing of the spread is necessary in order to prevent a potential overwhelm of the NHS as it stands.

Their claim is that by isolating the elderly and those in care settings we can allow the infection to spread among the general population of 'fit' people and thus protect the vulnerable and the NHS.

Sounds good.

What does slow the spread of infection really mean?

It means to allow the spread of the infection, albeit more slowly.

How is that possible?

When we all  carry on as normal, what do we need to do to make the infection spread more slowly than if we deliberately exposed ourselves to the viral infection by continuing with our everyday interactions.

Masks, physical distance, hand hygiene, limits on indoors gatherings, work from home is what is on offer.

What is not available is the resource base for rapid suppression of localised surges and outbreaks - expert effective local contact tracing,  economic support for quarantine, economic and medical support for isolation treatment, local real time data and information so that locally people can see where outbreaks are happening and take action to reduce contact or exposure to infection and then stop the spread of the infection.

What is on offer guarantees that the infection WILL spread, just slowly.

That is what slow spread means. There is a problem - slow spread cannot be controlled, it will always lead to exponential growth at some stage.

The Government ignored calls by responsible health professionals an epidemiologists to properly resource the NHS and the 15,570 care homes across the UK with PPE.

The UK Government ignored calls to make other provisions in advance, calls that were made from early January when the genome of the new virus was sequenced, and the virus given it's name (SARSCOV2). The disease was named COVID-19 (Corona Virus Disease 2019).

Because of that failure to respond to rational warnings,  the NHS frontline staff have been placed in harms way,  they are forced to deal with a multitude of cases of infection without the appropriate protection kit, and other essential supplies amidst staff and bed shortages, and they are suffering the impact of the governments choice, and we can see clearly now that the claim that they are protecting the NHS was and is obviously false.

They knew it was false the day they announced the policy to slow the spread of the infection.

Slowing the spread means infections have already hit care homes, and the entire population within care homes, carers and the cared for alike, are now at serious risk because they do not have the PPE kit and other situational practices to prevent infection spread.

Therefore the claim to be protecting the elderly and the people in care homes was a non-starter, it is demonstrably not the case.

What does slowing the infection spread mean for the 5,000,000 people in the UK with known  chronic compromised immune system conditions?

It means they are guaranteed to be imprisoned, in isolation or in shielding, for as long as the spread is allowed to progress, however slowly.  It means masses of early, painful, horrific deaths within that cohort -  a conservative estimate would be 1% of that population would be 50,000 deaths.

Slowly, over a period of a many months, or more up to a tear - what does that mean?

How many deaths a month is acceptable?

Why not adopt a stop the spread policy?

"We know we can get this under control,” says Dr Anthony Costello, a former Director at the World Health Organisation (WHO), where he headed up maternal, child and adolescent health. “The problem is that Europe has been too slow to act compared with Asia; and America is now facing a huge crisis.”

Costello, who is Professor of Global Health at University College London where he previously headed up the UCL Institute for Global Health, spoke to me via telephone from Yorkshire, where he is currently isolating from his family members, many of whom are experiencing symptoms of the novel Coronavirus.

Having worked at the WHO from 2015 to 2018 before returning to UCL, Costello pulls no punches about the failures that, he says, have allowed the virus to rampage across Western countries.

He is also concerned about tepid Government messaging. “It’s not enough to just have modellers, virologists and behavioural scientists.

You need people who can translate this into action. Social scientists. Public health experts experienced in community mobilisation.

Right now, we are locked into this strange idea that the Prime Minister or President makes a speech and suddenly the entire country changes its mind. That’s just a fantasy.

Throughout my career, I’ve seen that just giving people a few of the right messages won’t necessarily change behaviour. We need a more serious, decentralised approach and to share data with local communities.”

He refers to some of China’s mass communications measures.

“The Chinese managed to suppress the virus in provinces outside Wuhan without the same sort of total lockdown by operating quickly.

They had a TV station giving out information on the virus round-the-clock on a 24-hour basis.

We had policing of supermarkets and pharmacies.

But most importantly we had a comprehensive mass testing and contact tracing programme. And proper protection for frontline health workers. And that’s how this was brought under control within seven weeks.” - a paper outlining how the SARS epidemic was stopped in it's tracks.

Which is to say take the proven steps to eradicate the virus from within the population in any given area, from a village to towns, to cities and entire territories.

Because we have no vaccine we have no time to waste.

There is no lee-way, no room for any margin of error. Every error will cost lives, will cause avoidable horrible deaths.

So here is the protocol to stop the spread of infection.

A) Officially declare a legal shut down, and pay all non-essential workers to stay at home, by providing a Universal Basic Income for the duration of 3 months itwho  would take to stop the spread, and eradicate the virus from the population.

To make this easier to bear, if UBI is not acceptable then consider a pause rents, mortgages, major bill payments and roll out temporary income support for the duration of the program to stop the spread of the infection.

That money will not be wasted, it will  be going back into the local economy.

Support all essential workers - food production, distribution and retail, public transport, utility, health, police, fire brigades, NHS, military and civil service by ensuring they have full PPE and training adequate to their roles, and provide them and their employers with exact and accurate information on the virus, the infection, the disease and the protocols demanded by the situation.

Clear communications that  treat the citizens as rational adults.

B) Roll out fully resourced contact tracing - Trace all the contacts of every case that presents, and meet each and everyone  of those contacts with a team who can gently and firmly assess and test every one of those contacts to see if they

1) have the virus - send for treatment in isolation wards to avoid treatment at home which leads to more spread

2) have the antibody - have survived the infection, are presumed immune

3) have not yet been infected - people who could become infected - they must be protected from contracting the infection and also quarantined for two weeks to see if symptoms emerge.

Use school buildings that are empty as co-ordination centers locally. Distribute testing and organise local contact tracing through these as well.

C) Treat symptomatic people from the contact list and all who present with symptoms in isolation hospitals, rather than leaving them at home, where they can spread the infection, and where the patients condition can escalate without support to deal with that.

(This was observed in Wuhan before the contact tracing and new build isolation hospitals kicked in - in the end they had 1800 teams of 5 people each meeting all the contacts, contact tracing is resource heavy in that it needs lots of people working at it, nonetheless it works really well, and then mobile phone tech was integrated into that to monitor symptoms and spread. Potentially hundreds of thousands of jobs which puts more cash back into the local economy and build community cohesion at the same time.)

D) Quarantine all asymptomatic contacts, and as soon as they show symptoms, move them to treatment hospitals to prevent or reduce escalation to severe or critical  - this also means less pressure on the available intensive care units and general hospital admissions.

E) Everyone who is quarantined is supported financially and monitored for signs of symptoms so that earliest treatment can be given, to reduce escalation of symptoms into severe or critical.

If the Government had taken this route, back in February, or even in Early March, a method which is proven already in 5 largely urbanised states, China, Taiwan, Hong Kong, Singapore and South Korea and is being deployed successfully in others as I write, we would be closer to stopping the spread and then eradicating the infection spread within the UK population.

We know that it would take 8-12 weeks to stop the spread across a large populous state.

Those states that have applied this protocol are experiencing imported cases, that is to say the infection is being carried in by travellers from outside those States are bringing the virus back into those virus free territories.

F) Quarantine all incoming travellers, via Air, Land or Sea, for two weeks, and monitor them strictly.

If the Government were to move immediately to stopping the spread with an eye to eradication, we could clear the infection within three months.

We have the resources, we have the people, we have the desire - but do the Government share this vision?

The aim is to find all infection routes and to chase them down to where everyone infected is known and observed, and no new infections are starting - when the virus runs out of new hosts, it vanishes in that population. Quarantine must be fully implemented upon all incoming  and returning domestic and international air, sea and land travel. Even from Northern Ireland.

We need both the shut down and the bottom out approach.

Instead the UK Government policy is encouraging the slow spread of infection, and pretty much guaranteeing importing extra new infections by way of air, sea and land travellers arriving from other countries where there are serious infection outbreaks, because, as of today, 17 April 2020 is no testing or quarantining of those arrivals.

This is insane.

Let me repeat - within the UK we could, given the fullest resourcing, eradicate the virus in 3 months.

Then a fully funded quarantine must be in place for all incoming or returning travellers to maintain that eradicated status, until a vaccine is available or we have implemented the stop and eradicate policy across the Earths states and communities...

Allowing the slow spread will play out over many,  many more months, possibly years...

In economic terms the difference is between losing three months of GDP or losing a years GDP plus the other costs as various systems reach collapse or stress beyond repair due to continued shut down, re-opening and further waves of infection outbreaks generating a cyclic pattern that persists because there is no vaccine.

It's not just about me, or you my dear reader, it is about all of us.

This situation is about all of humanity as one human family, one society of many cultures and languages, it is about unity across diversity.

Kindest regards


"Do what you love, it's Your Gift to Universe"

Thank you for reading this blog. All we need to do is be really honest, responsive to the evidence we find,and ready to reassess when new evidence emerges. The rest is easy.

1 comment:

Unknown said...

I could not agree with you more on this. It just appears to be 'herd immunity' through the back door!
Shameful inaction from the Tories and thousands extra are dying for it.