Inappropriate to consider a return to lockdown: expert
IT is “highly inappropriate” for the Executive to consider implementing fresh lockdown policies based solely on the number of detected Covid-19 cases, a top Oxford academic has said.
Professor Carl Heneghan said current policy on dealing with Covid-19 is “breaking all the norms” of the established threshold when it comes to dealing with epidemics.
Professor Heneghan said the accepted definition for the declaration of an epidemic is when the rate of GP consultations for influenza-related symptoms exceeds 400 per 100,000 population in one week. At that stage, it is appropriate for intervention, he added.
Chief Medical Officer Michael Mcbride warned yesterday that if the number of positive coronavirus cases hit 80 per 100,000, his recommendation would be for the Executive to impose a second full lockdown.
Health Minister Robin Swann said earlier this week that at present the number of Covid-19 cases here is 16 per 100,000 in the last seven days, and 24 per 100,000 in the last 14 days.
Today the Executive is to meet to discuss reinstating some lockdown restrictions.
Professor Heneghan, who is director of the University of Oxford’s Centre for Evidence-based Medicine, said such policies are being implemented without “evidence”.
“We are breaking all the norms of how we think about acute infections. What’s happening with the current policy is that people aren’t using the evidence to inform their current thinking,” he said.
He stressed not enough consideration is being given to the negative consequences of reimposing lockdown restrictions.
“What people are not understanding is the balancing of all the risks. For instance if you go into lockdown and shut all your schools again, there are huge risks to your population, to young people’s educational attainment and wellbeing,” he said.
“The economy is linked to your healthcare and we know that with the lockdown that people won’t present to hospitals appropriately if they have non-covid issues. Each time you give out a message that we’re going into lockdown again, you’re basically
telling the population it’s unsafe.
“In terms of the impact (of Covid-19) on healthcare, it’s as safe as it’s ever been in Northern Ireland.
“The deaths, the number of people... you’ve got a disease that is not causing an impact in terms of health outcomes.”
According to yesterday’s official figures, there were seven people with Covid-19 in hospital and no ICU cases. No further deaths were reported.
He continued: “Setting policy around cases is completely inappropriate when you’re not taking into account the actual impact of the disease. Without testing you wouldn’t know it was present in the wider population in Northern Ireland.”
Professor Heneghan also emphasised that it not possible to “eliminate” Covid-19.
“It’s not going to happen. You can’t stop what’s called an endemic pathogen which is weakly circulating at the moment at low levels in the population,” he said.
“A high proportion of people are asymptomatic so they will never come forward and it will keep getting passed, and that’s what is called an endemic infection.”
He added: “People have to learn to live with the risk and understand the risk. Somehow people want to reduce the risk to zero, and you can’t do that for anything.
“People drive a car and they have accidents. People think we can take this to zero. The only thing that will eliminate this virus is the virus itself. That can happen if it mutates and becomes more asymptomatic, and what I would just say to people is: just have an open mind about what might happen next.”
Public health policy, Prof Heneghan explained, should focus on protecting those who are most vulnerable to coronavirus within society.
“What people should be thinking about is what’s the strategy to protect those at highest risk and that is people in care homes. If you get that right, then that’s half your problem,” he said. “You should be responding on the basis of the impact of the disease, and not the number of cases.”
The Department of Health said in a statement: “When the number of cases exceeds a threshold in a local area we begin to look at it more carefully.
“We consider cases per 100,000 of the local area population and if that number rises above 30 in 100,000 over the previous seven days then we begin to look at it closely to see what may be happening.
“This does not mean that local restrictions will be applied, but it does mean we need to investigate carefully and that people need to be especially careful to adhere to social distancing and other restrictions,”
However, it said it “will not hesitate to recommend local restrictions in any area where necessary if there is clear evidence of uncontrolled transmission of Covid which is likely to lead significant ill health at a population level.”