Lifting lockdown – common sense

I wouldn’t start from here obviously, but even in this government-induced mess, there are clear routes back to normality.

There are large differences in UK infection rates, ranging from 400 to 3500 cases per million. The rates correlate very strongly with population density. A one-size-fits-all policy is counter-productive, maximising social and economic damage as well as deaths related to lockdown, without any offsetting gains other than a very weak notion of fairness and simplicity.

In a low infection area, people tend to be more spread out too. There are far fewer infected people, and they are also far less likely to come close to you, so you are doubly less likely to become infected. It is therefore far safer to lift or ease lockdown in low infection areas first. Doing so would get many people and large chunks of the economy returning to normal quickly.

To make this work, it is important to reduce infection rates as much as possible.

Firstly, people should be encouraged to wear masks to reduce their chances of infecting others, and also their chance of being infected. In supermarkets and other areas where people must touch the same surfaces (e.g trolley handles, packaging, handrails in tube trains) disposable gloves should also be encouraged and changed frequently. Public education on how to do so while reducing adverse side effects should accompany it – teaching habits about changing them often, not touching your face etc.

Obviously, until the virus is gone, it still makes good sense to try to keep social distancing. Even if we aren’t perfect at it, keeping distance more than usual will still reduce infection. Every handshake or kiss avoided is another missed opportunity for the virus to spread.

We should strongly restrict travel to and from high-infection areas and enforce testing on any remaining essential travel from high infection areas. In that case, the low infection rate would continue to fall and large areas would return to normal. This would not make infection rates any worse in high infection areas so would be a net benefit.

In high-infection areas, there are still pockets of relatively high and low infection. London has an extremely wide range of infection density for example. The same principle can be applied here, preventing movement between the highest infection areas and less infected ones. Even within shared areas such as city centres, there are ways infection can be greatly reduced by separating the most infected groups.

For example, with traffic on the roads reduced by 75%, there is a lot of free road capacity, so residents and workers from  high-infection areas could be encouraged to use private transport to move around, leaving public transport much less infected for everyone else.

Alternatively or in addition, different trains could be used to separate these groups.

Doing this would reduce infection rates significantly, taking load of NHS, flattening the curve, and accelerating the fall in case numbers, thus reducing necessary lockdown time, total number of cases, total suffering and total deaths.

As rapid testing becomes available, (even cameras looking for people with high temperatures would help somewhat) many infected people could be spotted and removed. It is not essential to test everyone or for tests to be accurate, all that is required is a statistically useful separation to reduce infection rate.

All of the above would reduce infection rates and accelerate progress towards normality.

Lifting or easing lockdown is starting to happen in other countries so we will have the advantage of seeing how well different techniques work, but there are some obvious no-brainers:

Large and dense gatherings such as sports events and concerts should not be permitted until the virus has almost gone.

By contrast, social groups such as families and friends, or even some companies, have a strong self-interest in being open and honest with one another about any potential infections, so it will become safe to allow them to meet up soon using their own discretion.

Restaurants, shops and personal services such as salons also have a strong incentive not to make their customers ill, so they could open next.

There are some problems too though.

The nature of the virus means that many (~35%) people under 40 don’t generate antibodies. To me that implies firstly that it may be very difficult to make a vaccine that will work for everyone, secondly that immunity certificates might not be feasible and thirdly that the virus might behave similarly to HIV, infecting some people for life and essentially infiltrating their immune systems. If that is the case, even if they don’t show strong symptoms on first infection, they might well suffer an assortment of serious conditions later.

These aspects of the virus could well mean that much of existing government policy will not work. No herd immunity, no vaccine and no immunity certificates. Attempts to generate herd immunity will still maximise the number of eventual deaths and maximise the amount of suffering but will not succeed in its intent. I strongly oppose seeking herd immunity as a policy for these reasons.

Deaths resulting from lockdown will accelerate as it continues. Depression, stress, and relationship breakdowns, household violence will all get more frequent and more serious. Undetected cancers and other illnesses will become more serious as well as more numerous.

Economic damage accelerates with lockdown duration. Debts will increase, while ability to recover and repay debts will decrease.

Political damage to democracy will get worse as it continues –  more surveillance, loss of privacy, and contempt for police will all worsen as just a few examples.

So it is imperative that lockdown be lifted as quickly and as broadly as possible. The current one-size-fits-all approach is very poorly designed and should be scrapped as soon as possible, replaced with a sensibly phased lifting and easing using the principles above.