Tuesday 15 June 2021

The Threshold of Exponential Growth

Bailiwick Express reported that:

More than 700 people are in quarantine after being identified as direct contacts of the island's 43 confirmed covid cases. The Government confirmed that there was no unknown spread, with the contact tracing team "able to identify each positive case back to a known source."

It's the direct contacts that are the issue. As we found at Christmas, there's a threshold to that - after which testing the direct contacts, getting results back, and then chasing direct contacts of positive cases takes too long. That's the tipping point after which other measures need to be taken rapidly, but are often delayed in the mistaken hope that contact tracing will succeed in keeping numbers down. The mathematics says that it will not.

By the third of December 2020, direct contacts of active cases had crossed the 3,000 mark and by that time, it was hopeless overwhelmed. Some time in the previous two weeks, there had been a tipping point, probably between  1,500 and 2,000 cases, when track and trace simply could not keep up with the spread, and despite vaccines, with faster variants such as Delta, it will be very much the case again.

We can see the beginnings of this with "seeking healthcare" statistics. Those seeking healthcare have caught the virus before the contact tracing team caught up with them. If it is the Delta variant, they may well have also spread it wider. It is a game of catch-up which will be lost if numbers rise.














The peak was when it approached 4,900 direct contacts of active cases, and as we can see from the 14 day moving average cases per 100,000 that was also rising rapidly. That was around 9 December.















On December 4, the first rules - closing hospitality venues - began, and the increased rules over Christmas began to reverse the trend, until at last track and trace could finally make headway again.

Another factor to consider is that double vaccinated individuals may become - as has been the case - asymptomatic carriers. In this respect, the government policy, which flew in the face of known medical knowledge, of allowing double vaccinated individuals to take a test on arrival, but not need to self-isolate until after a test result, was extremely short-sighted - just as allowing anyone from a green area to do the same last year was almost certainly a cause of the autumn rise in cases.

It must be remembered that while hospitalisations may not  go up at the moment, the threat of long covid, which can affect even healthy young people, is not going to go away - and those are the people doing most mixing, and least vaccinated. We have no published figures in Jersey on long covid, even though in the UK, the Office of National Statistics has published them. Looking just at hospital and death statistics is misleading, because it leaves out an invisible cohort of sufferers from covid, who often need repeated medical interventions. This website has a lot more about it:

https://www.healthline.com/health-news/what-long-haul-covid-19-is-like-for-children-and-teenagers#What-is-long-COVID?

Long Covid affects around ten per cent of 18-49 year olds who get Covid-19, increasing to 22 per cent of people over 70. The researchers also found people with asthma were also more likely to develop long Covid.

And finally, while night clubs seem to be saying we can live with Covid and rising numbers, it should be remembered that while Jersey is an island, it is not, in the words of John Donne, entire in itself. Should numbers exceed 500 cases, it is very likely that anyone leaving Jersey will have to self-isolate for at least 8 to 10 days, and that itself will also have a bad impact on holidaymakers and tourism. This is a lesson that we can see from Portugal, where a spike in cases has led to reclassifications for tourists returning to the UK, and a large number of cancelations to that destination. 

When I met and spoke to an elderly couple at the Golden Sands Hotel, they told me they came to Jersey because it was the only place on the holiday map outside of the UK which was likely to stay green. If that was no longer the case, and there was even a growing risk of turning amber (as case numbers rise), we can say goodbye to summer tourism. And it is only June now, and the school holidays have not even begun. That is something the politicians, with their "safer travel" and "balancing act" need to consider, or they will fall off the high wire and come down to earth with a thud.

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