My thoughts on the UK government press conference and the hugely challenges the government faces. (THREAD)
GOOD THINGS: 14 days of household isolation for all people with symptoms AND their contacts is a great step forward with quarantine. Likewise self-confinement of people over 70 is a necessary step. (1)
GOOD THINGS: Confinement, social distancing, home working, reduced travel, no mass gatherings, and much reduced social contacts could make a big difference. And timing of school closures is a debatable issue for the future (2)
ISSUES: The big question is are we aiming to suppress the epidemic as in Korea and China? Or manage its course? The UK remains on course to just manage it based on their statement it “needs measures that are effective….and sustainable…”. Both strategies have risks. (3)
ISSUES: The former strategy means the risk of a second wave is real, and whether Korea/China and others can restart their economy without resurgence? (4)
ISSUES: The UK is not following WHO advice to suppress through population surveillance and 'test, test, test'. Dr Tedros says "You can’t fight a virus if you don’t know where it is. Find, isolate, test and treat every case, to break the chains of transmission." (5)
ISSUES: Testing is being scaled but only in hospitals and GP surgeries for diagnosis, not for population surveillance. How will any population data be handled? How will we know if we are flattening the curve if we’re not measuring? (6)
ISSUES: How will this voluntary quarantine recommendation be managed, monitored, supervised and documented? Most people don't listen to press conferences? Will we have community COVID communicators/champions? Will we systematically identify our vulnerable populations? (7)
ISSUES: Health worker safety and health is critical. What is the progress with testing for them to reduce risk to patients? And with protective equipment? (8)
ISSUES: Things seem to be moving faster than implied last Thursday. We're now 3 not 4 weeks behind Italy according to Dr Vallance. And London is heading into the crisis much sooner. Do we have enough ICU staff and ventilators? (9)
ISSUES: Overall the government is moving faster and cranking up. But the greatest political and health threat with 'manage not suppress' is that the NHS will be overwhelmed with cases sooner than expected. We all hope not, but will voluntary quarantine be effective? (10)
They are right to say the biggest gap is the lack of serological data to estimate the scale of asymptomatic infection. If this is high, + the immune response is strong for herd immunity, this will validate their approach. If not, we face a much longer, more severe epidemic. (11)
ISSUES: The economic effects a) on small businesses (not turning a liquidity crisis into a bankruptcy crisis) and b) the spending power of the poorest (those losing jobs in the gig economy, waiting for benefits etc) must have a national plan as soon as possible.(12)
