How lockdown could soon be eased – and later reintroduced
While we hope the current lockdown will help bring the coronavirus pandemic under control, questions remain over what happens after that. Political editor Will Hayward reports
WE ARE in lockdown. Whether you are working from home, whizzing round the supermarket as fast as possible holding your breath or heading into your workplace because you’re essential you probably have one questions right now: When will it end?
Quite often the answer is simply – “it depends”.
We have spoken to leading experts and looked at the latest science to try to answer these questions as simply as possible.
The lockdown and social distancing measures are attempting to slow the spread of the virus though its death toll continues to rise. The challenge comes when you go about lifting it.
According to Michael Head, senior research fellow in global health at the University of Southampton, he expects the lockdown to come and go over the next few months.
He told us: “The lockdown will go on for at least another couple of weeks.
“Thereafter, we shall see what happens. It would not surprise me to see the lockdown being eased in a few weeks’ time, and then reintroduced later on in the summer. The pandemic response will be ongoing for quite some time yet, and the general population needs to be aware of that.”
In Wales, First Minister Mark Drakeford said last week: “I am saying to people in Wales that now is absolutely not the time to break the restrictions.
“We are committed to a review of the restrictions and will publish today revised regulations but by the time we get into the beginning of next week we need to make a decision as what will happen beyond Easter Tuesday.”
He added that he did not expect the lockdown to be lifted then.
But are we to be restricted to our homes until a vaccine or cure can be produced, tested, mass manufactured and delivered? Not necessarily.
A recent report by leading experts called “National coronavirus response: A road map to reopening” provides some hope. Published by the American Enterprise Institute, it sets out four phases for getting through the crisis. Though tailored to the USA, many of the principles are universal.
There are four phases and in each phase different actions are required. Once certain “triggers” happen we can move on to the next phase.
Phase one – Slow the spread
This is the phase we are in right now. During this phase governments should work to do the following things:
■ Maintain physical distancing.
■ Increase testing capacity and build a data infrastructure for rapid sharing of results.
■ The report says there should be the capacity to test all: hospitalised patients, healthcare workers, close contacts of confirmed cases and outpatients with symptoms.
■ Increase supply of personal protective equipment.
■ Massively scale up contact tracing, isolation and quarantine.
The triggers for moving to phase two are:
■ A sustained reduction in cases for at least 14 days.
■ Hospitals are safely able to treat all patients requiring hospitalisation without resorting to crisis standards of care.
■ Ability to test all people with Covid-19 symptoms.
■ Ability to conduct active monitoring of confirmed cases and their contacts.
Phase two – Reopen gradually
As the study is a US study it suggests moving state by state.
In phase two, the majority of schools, universities and businesses can reopen. Local restrictions should be considered, such as those that limit people from congregating in close proximity. Those at high risk should still be limiting their social contact.
It will also be key in this stage to identify who is immune and study how long this lasts.
Those people can serve in highrisk frontline roles and support those who have to still distance.
We should revert to phase one if a substantial number of cases cannot be traced back to known cases, if there is a sustained rise in new cases for five days, or if hospitals in the state are no longer able to safely treat all patients requiring hospitalisation.
According to the report, once a vaccine has been developed, tested and receives approval, we can move to phase three.
Phase three – Establish protection then lift all restrictions
Once a vaccine or treatment is able to meet demand the vaccination programme can expand beyond priority groups.
There should then be a mass vaccination of large populations. This planning can begin before this phase because preparation can be made regardless of vaccine availability. We should also test the population to check they are protected against reinfection.
Phase four – Rebuild our readiness for the next pandemic
It is highly likely we will face outbreaks of other diseases in the future and we need to learn the lessons from this outbreak. We should do the following:
■ Develop vaccines in months not years.
■ Modernise our health systems.
So when will we have a vaccine? The world is currently hunting for a vaccine which will save hundreds of thousands of lives and bring us out of this weird limbo we are all in.
Around 35 institutions and companies are trying to create a vaccine, with 44 vaccines being evaluated. Vaccines have historically taken several years to develop but Boston firm Moderna is about to start human trials.
According to the WHO, another vaccine has already moved on to clinical trials in China at CanSino and the Beijing Institute of Biotechnology.
In the UK scientists at Imperial College London said clinical trials could take place in a few months’ time following positive research on mice.
“It is a global effort,” Dr Shattock from Imperial College London told The Independent. “We are not racing against each other – we are racing against the virus.”
There are several ways vaccines can be developed, including:
Deactivating the pathogen so it can be used to trigger the immune system in a person without making them sick – this is the traditional way. The Serum Institute of India is doing this.
Another way is to use parts of a virus, such as proteins to trigger and immune response.
These are called recombinant vaccines and are good because you can make the proteins in a lab. Pharmaceutical giant Sanofi is doing this.
A technique that worked on ebola would be to hide the genetic code of Covid-19 proteins inside a virus which humans are not vulnerable to.
Even with the fast progress there is still the daunting testing period that is required as well as then distributing the vaccine.
The fast moving Moderna vaccine is expected to take between 12-18 months to develop.
Moderna president Stephen Hoge told Time. “We have an ethical responsibility to build the data and show the vaccine is safe and effective. Still, every chance we have to continue to demonstrate that we can pull the timeline in, we will take.”
There is also hope for medicines that will treat the virus.
The world’s largest randomised clinical trial of potential coronavirus treatments is well under way in the UK as part of the race to find a treatment.
A number of promising treatments are being tested and, if the science supports it, will be given to NHS patients as quickly as possible.
Definitive results on whether the treatments are safe and effective are expected within months and, if positive, they could potentially benefit hundreds of thousands of people worldwide.
The trial is testing a number of medicines recommended by an expert panel advising the Chief Medical Officer for England. They include:
■ Lopinavir-Ritonavir, used to treat HIV;
■ Dexamethasone, a type of steroid use in a range of conditions to reduce inflammation;
■ and Hydroxychloroquine, a treatment for malaria.;
The trial is being co-ordinated by researchers at the University of Oxford, led by Peter Horby, Professor of Emerging Infectious Diseases and Global Health in the Nuffield Department of Medicine and Martin Landray, Professor of Medicine and Epidemiology at the Nuffield Department of Population Health. commonly