“Contain, delay and mitigate any outbreak”

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These words from Public Health England have framed policy so far. The first phase (Contain)  saw efforts to trace, test and isolate anyone carrying the virus and the people they had met. The second phase (Delay) has seen big efforts to impede the spread of the virus by keeping people apart and keeping them from  places of work as well as from entertainment. The final phase (Mitigate) is to learn to live with the disease, limiting its spreads with sensible precautions  with enough capacity to treat patients who do get it whilst we await vaccinations.

Their initial plan played down the extent of the controls needed for the second phase we are now in.  They told us on March 3 that if we got to this stage it would mean “people distancing strategies such as school closures, encouraging greater home working, reducing the number of large social gatherings- whilst ensuring the country’s ability to run as normally as possible”.  They seemed to move on from  the bit about as near normal as possible when they came to design the detail of the lock down. It emerged it entailed closing all physical shops other than food and medicines, stopping the car and homes markets  and much else besides.  They promised  to “implement a distribution strategy for the UK’s stockpiles of key medicines and equipment” . After early issues with inadequate supplies the army was brought in to help and orders stepped up  to business. .

The idea of  delaying the virus  was to reduce “the risk of overlapping with seasonal flu and other challenges that the colder months bring”. This implies they expected to lift the controls come late Spring and early summer.

We now see some other countries deciding to relax their controls progressively  but carefully in the next few weeks. China has done so.  Austria has just set out a timetable starting next week by re opening lots of small shops. Sweden and South Korea have not gone very far in imposing controls in the first place though Sweden is now taking more powers. The issue is what is the trigger to start relaxing the controls? Is it a tailing off in the death rate? A tailing off in the recorded number of new infections? How much value can we place on the numbers for new infections when most people that get it stay at home and are not tested?

We do need greater visibility on how this crucial call will be made. Some will argue the controls must go on for longer to avoid a possible second wave. Others will point to the big economic damage delays in getting back to work creates. As there was always a three phase strategy it would at least be good to know what the trigger is for going to the third phase and putting Shut Down  UK behind us.

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