Please act with caution, especially in schools. Don't ease up until there is evidence it is safe, and tracing & isolating is in place

I feel there are 2 tests that need to be satisfied before any major relaxation of measures to limit the spread of the virus that causes Covid-19: Test 1. There is EVIDENCE that relaxation won't cause uncontrollable increases in infection. We are fortunate that we can watch what happens in other, similar countries that are further along the trajectory than we are. A mere lack of evidence that it would be unsafe to lift any particular restriction is insufficient. This is especially true in the case of schools, where any given pupil or staff member can interact with dozens or even hundreds of others each week. If the current infection rate is 0.5-1.0% of the population, that means most schools are likely to have one or several people infected. This is far more than most places of work, and is very different from the situation in early March when infection rates would have been much lower. And if as suggested, young people are often asymptomatically infected, then there is a high possibility that the effects of transmission in schools won't become apparent until the virus has been passed on via an unspecified number of intermediate carriers to an adult population more likely to exhibit symptoms. Given the time lags involved with this particular virus, and the relatively low initial seeding, that may be many weeks or months. We should not rush to accept the green light from initial evidence of limited increases in infection, but rely on sufficient considered scientific analysis. This evidence must robustly demonstrate that the relaxation will not result in a situation where latent, delayed rapid spread is possible despite modest early increases in infection. Last October-December, a flu virus in Scotland caused serious outbreaks in schools. At peak, 25% of pupils and staff at my local school were absent. Mortality in Scotland for 2019 Q4 was increased by 6.9% (I don't have figures for how much of this was due to the infection.) Influenza is a virus for which there is a vaccine with a high uptake. Test 2. We have (Test-)Trace-Isolate ready to go, or already operational, to monitor the effects in Scotland of any relaxation I believe it is essential to have a tool that can be deployed when things go wrong. (Reversing the change IS an option to limit damage, but it also prevents progress.) Just as it was deployed in the Home Farm Care Home in Skye, I believe it can, and should be rolled out as widely as possible now before we are in a position of isolated outbreaks. This would allow our teams to gain experience and preparedness, while also reducing the number of current tranmissions. At this time, it is not necessary to widely test in the community to detect infected individuals, as there are 100 or more new cases every day who can be contact traced. If there is limited capacity at present, it makes sense that (Test)-Trace-Isolate should be targeted where the initial relaxations are planned, to increase the chance of the success of these measures.

Why the contribution is important

Given the fragile margins involved, and the pressure to act to move out of lock-down, there is a high risk that we could get this wrong and the virus could spiral out of control depite currently declining case numbers. A robust, considered, and cautious decision making framework is vital to prevent potential a highly harmful outcome, while allowing us to return to normal as soon as it is genuinely safe to do so.

by IanMacD on May 11, 2020 at 09:36PM

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