Lifting of the Lock-down

With mass immunization years away, Covid 19 is here to stay for the foreseeable future so we must learn to live with it as best as we can and accept that fatalities are a consequence. If lock-down, continues the consequences on livelihoods and lives put at risk by increased poverty are inevitable. The nation needs to get back to work.

The five test criteria for lifting the lock-down can be summarized as:
1. Protect the NHS' ability to cope… to provide sufficient critical care ….across the UK.
There is now over capacity of beds in Scotland

2. See a sustained and consistent fall in the daily death rate.
This is now the case across the UK. Some regions are better than others.

3. Have reliable data from SAGE showing the rate of infection is decreasing to be manageable.
HMG are not clear on this, Scotland has done better. More testing required (see below).

4. Be confident …testing capacity and PPE are in hand with supply able to meet future demand.
Two issues here, testing (see below) and PPE is just deplorable. (We have put Care Scotland in touch with mask manufacturers in China and it is progressing.)

5. Be confident that any adjustments to the current measures will not risk a second peak of infections
that overwhelm the NHS.
The NHS has coped well, even with poor PPE and testing support from HMG. There is now over capacity in Scotland and patients should be cared for in a central Covid unit, such as the new unused or the old Childrens' Hospital in Edinburgh which are already equipped with ICUs.

Overall, the outlook is good, but there are caveats.

TESTING - THE ONLY WAY TO GET THE FACTS.
I know at least 20 people, individuals and families, including myself, who may have had Covid 19 and do not appear in the statistics, i.e. not hospitalized.
Testing the public to find out who currently has the disease is both very time consuming (because the analytical process is difficult) and costly. The hope is that most people tested DO NOT have Covid 19 which could be construed as a further waste of time and money. TEST FOR ANTIGENS FIRST - it takes 20 minutes. If positive, ask when and where they think they contracted the disease, if negative, then test for infection. A better demographic data set will result. If the death toll represents only 1% of those who have been infected, then in the UK at least 3 million have already had the disease (including approx 200,000 in Scotland, versus 12000 positive tests).

AGE DEMOGRAPHIC OF DEATHS IN SCOTLAND, 2795 to the first week in May.
Age 0-14 0
Age 15-44 19 0.68%
Age 45 to 64 244 0 .87%
Age 65 to 74 435 15.6%
Age 75 to 84 952 34.1%
Age 85+ 1145 41%

The suggestion is that >95% of all those dying of CV19 have underlying other chronic illnesses such as dementia, cancer, respiratory disease, heart disease, diabetes and even obesity can be a co-factor.
Less than 5% have no underlying issues and this also applies to the <2% of under 65’s who have died.
From these figures we can make some value judgments - it is a disease that targets the old and infirm but the under 65's need to get back to work.

SCHOOLS.
Open schools because, although children may catch Covid 19, they recover.
CAVEAT - If a child shares a house with someone that has an underlying health condition or is elderly then that child should stay at home.

WORK.
Under 65's should go back to work. CAVEAT - Unless they or someone they share a house with has underlying health problems.
If you can work from home then do so.
If a staged "back to work" is required nationally, start with those working outdoors (agriculture, building, fishing, utilities maintenance etc.).

PUBLIC TRANSPORT.
The message must be try to avoid using public transport if possible.

GENERAL TRAVEL.
Only make necessary journeys for work, exercise or to see family and friends.

SPORT AND RECREATION.
Sports clubs need revenue and people need to stay fit.
Golf and tennis for example are ideal open air "distancing" sports.
Young people tend to play team sports, let them get on with it, they are not a demographic at risk.
People should be able to socialize with close friends in their homes. Trust people to be sensible.

FOREIGN TRAVEL.
Banned. This is a two-way street, us infecting them and vice versa. Movement of goods only.

PUBS & RESTAURANTS.
Spaced queuing for well spaced tables, preferably in gardens. Children stay seated.
Customer numbers must be set by the landlords. Maintain government support in the short term.
Government guidelines would be useful.

HOTELS.
No rooms to be let until the all-clear, but use of restaurants and bars as above.

TRAVEL AND WORK.
Stay close to your local area. Conference call rather than visit. Let the post or couriers deliver goods, it has been working extremely well!

HOLIDAYS.
Wait for the all-clear before taking holidays or visiting second homes.

CARE HOMES AND COVID 19 HOSPITAL STAFF.
At the end of April a third of the deaths were in care homes and care homes are still the biggest issue. The workers PPE is still inadequate. The hospital staff seem to be coping well, but vigilance for their safety and all the patients' and staffs' families needs to be maintained. Testing, tracing and isolation should continue.

CONTINUING MESSAGE.
One message to continue at all times, even in 10 years time, if you have a cough or cold STAY HOME, as said in the old Government TV commercial "Coughs and sneezes spread diseases".

Dr. W.R.Simpson

The country needs to get back to work, otherwise we are storing bigger problems for the future, both economically and socially.

The bottom line is that the under 60's are being heavily disadvantaged by something that effects the old and already infirm (ill). Do what must be done to protect the vulnerable and the staff who care for them, but get people back to the new normality.

Covid 19 isn't going away, we must learn to live with it.

Dr. W.R.Simpson