An exit strategy

sir – Treating the Covid‑19 epidemic, instead of its clinical consequences, is turning a tragedy into a disaster. To flatten the epidemic peak by lockdown will destroy the economy and social life, but do nothing for the disease.

The problem is horrible, but simple. Covid‑19 is very contagious: most of us will get it and suffer little, but 1‑2 per cent will die, and if the few who respond badly are ill at the same time that would swamp the NHS.

It is that explosion of serious disease in a minority that we must prevent, not the spread of virus to the remainder who will suffer little.

And because severe disease occurs in the elderly and immune‑ compromised, we can prevent that explosion by ensuring their complete, compulsory isolation. This action, and this alone, would control the primary danger of the Covid‑19 epidemic.

There is no reason to isolate the other 80 per cent of the population. The infection will spread to most of them, but few will get other than a temporary, mostly minor disability, and they can continue normal activity.

However, the severe risk to the isolated susceptible will remain, and a programme of staged, age‑based release will be needed to optimise their treatment.

How rapidly this can be done will depend on availability of NHS facilities, infection rates (which herd immunity could influence) and the development of drugs and vaccines. This will entail a rationalisation of drug‑testing procedures, which are as much about legal responsibility as patient harm.

Controlled release of susceptible people will optimise their treatment. Sam Shuster

Emeritus Professor of Dermatology Woodbridge, Suffolk