Wednesday 21 July 2021

Covid Commentary: The Summer of Freedom?


 



"CHIEF Minister John Le Fondré has defended his handling of the pandemic – saying that even with hindsight he would not have done anything differently." (JEP, January 2021)

Benefit of Blindsight?

The chief defence I hear on social media is that it is easy for an armchair commentator to be wise about rising Covid cases, with the benefit of hindsight, and the Competent Authority Ministers do not have that benefit. But they should! 

Travel and Isolation

One of the obvious things they have failed to do is to learn from their mistakes. For instance:

2020: Letting travellers come in and not having to self-isolate until after the test result laid the Island open for seeding in the Community. Lesson: PCR tests and self-isolation until at least the first test result are needed to stop community spread.

2021: Letting vaccinated travellers come in and not having to self-isolate until after the test result laid the Island open for seeding in the Community. The science was clear that someone vaccinated could still transmit the virus. It was ignored. Lesson: PCR tests and self-isolation until at least the first test result are needed to stop community spread.

Contact Tracing

As Jersey prepares to enter Stage 6 of the Reconnection Roadmap on 10 May, and the Vaccination Programme prepares to open to the next cohort of under 40s, we look forward to enjoying a summer of freedom compared to the restrictions we have followed. Due to these increased freedoms, it is vital that any potential spread in the community is limited and controlled. The way to achieve this, is through regular, widespread testing. (John Le Fondre)

Deputy Medical Officer of Health, Dr Ivan Muscat said: "Testing and diagnosis remain an extremely important measure to avoid uncontrolled spread of virus while we continue to learn and understand how to best respond, treat, and manage COVID-19 in both the short and the long term. At least 30% of COVID-19 cases are asymptomatic. And patients who go onto to be symptomatic can also transmit infection before they develop symptoms."

2020: As numbers rose to 1,000 it was clear that a strategy of containment by track and trace was not working as the number of direct contacts were overwhelming the system. Lesson: you cannot control an exponential rise in cases by track and trace alone.

2021: As numbers rose to 1,000 it was clear that a strategy of containment by track and trace was not working as the number of direct contacts were overwhelming the system. A relaxation of rules for potentially asymptomatic people reduced numbers (direct contacts not showing symptoms) and allowed it to succeed for a while, but at the cost of further community spread. Further relaxations were taken to make numbers manageable again. They are now rising and will again overwhelm the system.  Lesson: you cannot control an exponential rise in cases by track and trace alone.

Masks: An Ineffective Message

2020: "We strongly urge you to wear masks". Ignored by a good many people until it became law. Lesson: a lot of people understand "strongly urge" as something for other people to do.

2021: "We strongly urge you to wear mask". Ignored by a good many people until it became law. Lesson: a lot of people understand "strongly urge" as something for other people to do.

Hindsight is not an excuse

And I'm sure there are other cases which come to mind, where the first and second lockdowns should have taught the government what the rest of us thought was blindingly obvious in 2020. It's not to do with hindsight: it is blindsight - the inability to see the lessons of just one year ago.

New Lessons from 2021

And there are new lessons to be learnt. One is that opening up the economy so rapidly and depending on vaccines will only work if you have decent herd immunity from vaccination - that is around 80% of the total population, not around 50% as with Jersey.

The lesson is that the more people with Covid in circulation, the greater the chances of breakthrough cases. There may be less deaths, but even double vaccinated people can suffer from Long Covid, which I predict will be the long term damage from the pandemic. 

Moreover as numbers rose, the question became what to do with positive cases. Even our CAM is not stupid enough to think that a positive case should not self-isolate, and of course that has had a knock on effect on schools and businesses.

Fake News: Living with Covid

The false identification of Covid with influenza, something we have to "live with", downplays the very real differences, and the severity of Covid compared to most cases of influenza.

We hear so much about living with coronavirus, much as we do with seasonal flu.

Ian Sample Science editor notes that:

"There are striking differences between coronavirus and flu that matter for public health. It spreads faster than influenza and can cause far more serious illness. The symptoms of coronavirus can take longer to show, and people tend to be infectious for longer, making them more prone to passing it on."

And Sarah Pitt notes:

"While we do need to find some way of living with COVID-19, the numbers suggest we’re still a long way from being able to treat it in the same way. There have been over 180 million cases around the world since early 2020, and at least 4 million people have died from the disease. On top of this, we’re not sure of the real effect of long COVID yet, but lasting symptoms are common, with one in ten people still experiencing illness 12 weeks after their infection. Currently, the health effect of COVID-19 across the population is much greater than flu."

"Knowing what we know about these viruses, these plans should consider controlling SARS-CoV-2 more like we would norovirus than flu. With norovirus, we keep people with the infection away from others. We ask parents whose children have symptoms to keep them off school. And in hospitals and care homes, patients with norovirus are nursed separately from others, staff use PPE for protection, and surfaces are deep cleaned. Handling COVID-19 in the future should be more interventionist like this. It should be more akin to living with norovirus than the flu."

References

https://www.theguardian.com/world/2021/jul/05/why-living-with-covid-would-not-be-the-same-as-flu

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