SARS/CoV2: what to do next?

The UK has the worst of both worlds. We did not stop the virus entering the country and the two crude attempts to contain it have damaged the economy, not to mention social and family life. Those Conservative MPs and members of the Senedd who opposed all restrictions do not seem to have an alternative, apart from the Swedish model. This, as I understand it, involved minimal legal restrictions but plenty of public health advice and an appeal to civic responsibility. But Sweden, faced with a death toll higher than in neighbouring Norway, has had to back-track.

Is it too late? Phil Hammond, in the article cited yesterday, opines:

Taiwan has a third the population of the UK so copying its suppression strategies would be more complex. However, Great Britain and Ireland are islands, and so could enforce Taiwan style border quarantines but have chosen not to do. New Zealand and Australia have much stricter border conrols which allow citizens far more freedom within them. Local outbreaks still happend, but [the State of] Victoria managed to suppress 700 new cases a day to less than a case a day. As they go into summer, the virus should be easier to control. 

The UK let the virus simmer over summer, rather than suppress it, with patch testing and poor public compliance. So the second wave is much bigger than it needed to be. Hence the fears of NHS winter overload and another lockdown. But lockdown is like doing urgent heart surgery with a chainsaw. Don't do it and the patient dies quickly; do it and the patient still dies, but a little more slowly. [...]

Suppressing a highly infectious virus that spreads without symptom in sudden waves is extremely hard, and probably not possible without border quarantines to keep new outbreaks at a traceable level. Across Europe, [track and trace] systems have failed to suppress a second wave. In the UK, £12bn has been spent on a largely outsourced system, but the message that local tracing gets better results is filtering through.

More that 100 local authorities in England now have "tracing partnerships" with Public Health England. Blackburn with Darwen went live at the start of August and reached nine out of ten cases that the national system couldn't get through to; Calderdale council reached 86 percent of cases that otherwise wouldn't have had their close contacts identified.

These partnerships should help provide financial and social support, and access to food or medicines. Local authorities know where their pockets of hunger and poverty are and urgently need the resources to tackle them. 

Local tracing is funded from a share of £300m government funding plus £8 per head of enhanced tracing and enforcement in areas in higher-tier restrictions.  But it's a fraction of what the private sector has been given. Local authorities must be fully funded to trace and support, with the help of local NHS and GPs, so when the numbers come down to a manageable level, we can keep them there. Next time, we have to suppress, not simmer.

And there will be a next time. Chancellor Rishi Sunak, in his announcement about extending the furlough scheme, referred to a "once in a century event". He is profoundly mistaken. He has not learned from the warnings issued by experts before SARS/CoV2 emerged, that zoonoses will become more common. There is time to rebuild the community health and contaact tracing structures, so short-sightedly run down by recent governments, which successfully suppressed traditional infections like TB, so that they are primed for the next SARS if it should evade our hopefully more efficient border controls.