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A two-week circuit breaker in December could save thousands of lives and give the UK time to plan its response to the Covid-19 epidemic, Government advisers have said.
Graham Medley, professor at the London School of Hygiene and Tropical Medicine and a Scientific Advisory Group for Emergencies (Sage) member, said it may be too late to implement a two-week national lockdown over the October school half-term.
However, he said that December could be another option for the stringent measure.
On Wednesday morning, the PM introduced a three-tier lockdown approach, with different local alert levels – either “medium”, “high” and “very high” – being implemented across England, depending on infection rates.
But Dr Medley and Matt Keeling, who advises the Government and is a professor of maths at the University of Warwick, said that a short, sharp lockdown would enable Test and Trace to improve.
It would also ensure NHS hospitals do not become overwhelmed with coronavirus patients, they added.
Prof Medley said there was “mixed evidence” that the current three-tier system would work, including a “danger” that places in Tier 3 may not be able to step back down to Tier 2 if measures were not strong enough.
“The alternative way of doing it is to say well, we’re going to have to go into severe measures at some point, so why don’t we do it before we absolutely have to?,” he said.
“Why don’t we do it for two weeks or three weeks, before we absolutely have to, and then that means that we avoid an emergency break?
“So we do a precautionary break to avoid an emergency break.
“There are two advantages of that – one is for sure which is that it reduces the load on the NHS.
“And the other one potentially is… a known break, a known lockdown, is better than an unknown lockdown.
“My understanding is that in terms of mental health – and for businesses – it’s much better if you know it’s going be for two weeks, and you know when it’s going to start.”
He said any circuit-breaker should ideally be timed with school holidays to minimise disruption to education.
“So, half-term or potentially over Christmas,” he said.
“You could even potentially add a week to the Christmas school holidays and potentially get some kind of three-week break, but the whole point is to reduce the prevalence before you actually have to do it.
“The reason that the lockdown (in March) worked, is because it separated households.
“And that’s essentially what we’ve got to do is to make sure that the transmission doesn’t go from household to household, and two weeks is the minimum time.”
Prof Medley said thousands of deaths could be prevented up to January with a circuit-breaker but it was accurate to say that did not necessarily translate into lives saved in the long term.
The modelling paper written by Prof Medley and colleagues sets out that deaths could possibly reduce for the rest of the year from about 19,900 to 12,100. Hospital admissions could be reduced from 132,400 to 66,500.
A limited lockdown, with schools and shops open but hospitality venues closed, could potentially cut deaths to about 15,600, they said.
However, the numbers come with a range of caveats – including how fast the epidemic grows – and the paper has yet to be peer-reviewed.
Prof Medley said: “People have said this is kicking the can down the road, and it is – you’re not saving lives.
“In the paper, we look between October and the end of the year, and what you’re doing is delaying the next wave until after January, so yes it does look as though you’re preventing (Covid) deaths in that time period, but it just means that you’ve delayed (them).”
However, Prof Medley said lives would undoubtedly be saved through the NHS not becoming overloaded and by the health service being able to continue with other routine care, such as cancer treatments.
He agreed that several short circuit-breaks until a vaccine or better treatments arrived could also save lives in the long run.
“If you know there’s a vaccine coming and treatments are going to get better, which they probably are, then yes it will save lives,” he said.
He said regular circuit-breakers that were implemented regardless of case and hospital numbers would give people warning and could have long-term benefits.
Of the need for one soon, he said: “We’re a bit late now for half-term in the sense I don’t know if that’s enough time for business and people to adapt.
“But if you said the first two weeks of December, then… staff can take holidays, businesses can work around that and potentially people can say ‘right, I’m going to go and stay with my sister for two weeks’.
“You won’t be able to leave once you got there, but you could actually make it, I think, quite liveable.”
Prof Keeling said the figures contained in the research paper were in effect a worst-case scenario.
He said the figures were for “illustrative purposes” and were looking at what would happen if the virus was allowed to run with no interventions.
Test and trace could be one of the things that could be ramped up during a circuit-breaker as the number of coronavirus cases fell.
“At the moment, we’re very close to capacity on what test and trace can do so if there’s more capacity in the system, there’s more potential for pushing things down, and it’s easier to investigate little outbreaks that occur,” he said.
“If we end up with too many cases, then PHE (Public Health England) is going to be overwhelmed by the number of outbreaks that will occur.
“So being at low levels means you have the opportunity to keep sort of stamping on any little outbreak that you see.
“It’s also advantageous in that it takes us back – in the best case – it takes us back to some time in August, so we have that sort of extra month of planning… (during which) we could think about alternative control measures.”
Prof Keeling said he was “concerned about the current tiers”, adding that a circuit-breaker may be needed “just to sort of ramp everything down, give us breathing space and also sort of allow us to start really controlling the outbreaks as they’re occurring”.
He said public support would be needed, adding that “controls are only as good as what actually materialises in the real world”.
He added: “We might not want to go to sort of April-type behaviour of locking everything down but we may want to sort of rein back on certain measures and it may just be that, if we did that, we could lower the cases enough that we can then start planning for better and wider controls.”
However, he said the “stronger you can go in and control it for two weeks, the better the impact, the bigger reduction you can get.”