Thread by @chrischirp

THREAD: Will lockdown work?

We're starting several weeks of lockdown in England while we try to vaccinate as many vulnerable people as possible.

Every day more stories drop about the terrible situation in hospitals.

The thing is, I'm not sure lockdown will be enough...

Last spring, we got R down to 0.6-0.7, cases & hospital admissions dropped steadily. Hospital occupancy peaked 3 weeks after lockdown. Even that will place unbearable strain on NHS.

But this isn't March's virus and this isn't (despite what govt is saying) March's lockdown.

Different virus: The new strain (B117) is estimated to increase R by between 0.4-0.7. Even a March lockdown will struggle then to bring R below 1 where B117 is widespread. Some regions might get lucky & stamp out B117 before it takes hold. With Xmas & NYE, seems unlikely.

Different lockdown: we are doing more things this lockdown than last time.

Childcare and support bubbles did not exist in the spring.

More children are in school - both through vulnerability and more parents using key worker status.

Distancing is less rigourously adhered to.

Anyone who cannot work outside the home can go to work (and mix). Anecdotally, more people seem to be doing this than in the spring.

All of this means more mixing. But we are doing some protective things this time too...

Mask wearing on transport and in shops - big difference that should help.

Availability of testing, contact tracing and isolation exist now where they did not before.

For many, lockdown is mandatory isolation anyway. BUT for those working outside the home, less has changed.

For the 10m+ essential workers, contact tracing and isolation remains important. Many are low income and in overcrowded housing. Their kids are in school. Lack of ability to isolate - financial *and* practical - *and* greater exposure to covid means transmission will continue.

For the *best* chance of lockdown working, we need to make their workplaces as safe as possible, both through regulation and govt grants to improve e.g. ventilation. Workspaces include kitchens, factories, warehouses, offices...
independentsage.org/the-covid-19-s…

AND

we need to support isolation: pay a decent wage to isolate, offer accommodation outside the home, help with caring responsibilities, communicate symptoms & need for isolation.

Superb contact tracing & isolation also crucial for safely *exiting* lockdown & crushing outbreaks.

we need to know who is getting vaccinated - and who isn't. If uptake is lower in deprived communities where many key workers live then we are leaving those most as risk unprotected.

we need a plan to vaccinate whole population after most vulnerable groups as soon as possible. First, to prevent illness (and Long covid) & second, to deny covid chances to mutate further and potentially evade the vaccine.

We need to control our borders to prevent continual reseeding of local outbreaks *and* dangerous new strains from gaining a foothold.
e.g. see this piece by @Kit_Yates_Maths
huffingtonpost.co.uk/entry/border-c…

All of this needs to happen together. And all of it needs to happen together now if lockdown is to work and (potentially!) be eased before spring...

I fear that the govt will ignore supported isolation & safer workspaces and that this will mean...

That at best this lockdown brings R to about 1. The NHS just will not be able to cope with such high sustained burden on its health system and many thousands more will lose their lives.

Waiting until vaccination starts to have an affect is weeks and weeks away.

the next few weeks will be very very tough.

Lobby your MP for supported isolation and safer workspaces - these will protect everyone through reduced transmission but - most importantly - those who have no option to shelter at home & their families. /END