A second Covid-19 surge in winter

Submitted by martin on 22 July, 2020 - 8:14 Author: Martin Thomas

Photo by Nick Bolton on Unsplash

The government seems not to have read the report on pandemic prospects for winter 2020-1 published on 14 July, and commissioned by the government's Chief Scientific Officer.

The report points to several social measures which Solidarity has been campaigning for. It says: "July and August must be a period of intense preparation for… a resurgence of Covid-19" likely in the winter. Otherwise the toll could be twice as heavy between September 2020 and June 2021 as it was in the first wave earlier this year.

Instead of preparing for a winter resurgence, Boris Johnson has advocated that firms recall people working from home... in order to get more traffic for city-centre cafés and pubs.

Working-from-home has many downsides longer-term, but for now this report lists it as the first of the "active containment measures… vital… as we approach winter".

Even the BBC website has flagged up workers' right to refuse workspaces with "serious and imminent danger".

The report argues:

• Testing, tracing, and isolation must be stepped up, with legally-enforceable "pay for those required to quarantine", and "alternative accommodation" for those needing to self-isolate but in crowded housing. Test results must be communicated in "near real time", not with delay. That points to a public-health test-trace operation in place of the current mess of subcontractors.

• For high outbreak risks, it identifies hospitals and care homes, and also homeless hostels; asylum-seeker detention centres; prisons; overcrowded accommodation; workplaces such as food manufacturing; religious gatherings; big social events; Roma, Gypsy, and Traveller encampments. So: workers' control; release people from detention centres and most from prisons; provide alternative accommodation.

• It says "many care homes are privately owned, and therefore oversight is challenging", and points to "issues of funding, wages, and stability of the care sector". So: demand care homes be taken over by the public sector and staffed on secure public-sector pay and conditions.

• It warns that the PPE supply chain is still not ready for new surges. So: emergency public ownership of NHS supply and logistics (at present a web of private subcontractors), with workers' control.

• NHS capacity must be increased in advance. So: private hospitals should be nationalised and brought into the NHS, and NHS pay and funding increased.

• NHS staff vacancies, 100,000 of them, must be filled, and Brexit will "pose additional challenges". So: fight for freedom of movement.

The report also discusses measures to reduce infection within hospitals, especially between staff, saying that China seems to have managed that.

It advocates stepped-up flu vaccination this winter, especially of care-home workers, of whom currently only about 30% get the jab.

Although it considers the evidence on efficacy of masks foggy, it indicates that making covid-distancing rules clear, well-understood, and well-followed can be more important than the fine detail of the rules. It emphasises that rules must be formulated and communicated in discussion with those most at risk, not just thrown out from above.

It proposes simultaneous testing in winter for flu as well as SARS-Cov-2. Otherwise, it says, the testing operation will be swamped. While now about one in ten of those with Covid-like symptoms has that virus rather than another, in winter it will be one in 30 or 40.

There is "high uncertainty" about the coming months. But most viruses are seasonal (no-one really knows why), so this one probably will be. In any case, in winter people are indoors more, with less ventilation, and that increases infection. The NHS has been pushing 95% of capacity in ordinary, non-epidemic winters. Flu could be more severe this winter. As recently as 2017-8, we had some 56,000 excess winter deaths, a number comparable to the Covid-19 toll so far, and worse among the non-elderly.

The report points to Chile as a southern-hemisphere comparison. Infections went up sharply there in June (winter).

It could also have pointed to Australia. The state of Victoria locked down earlier and for longer than other states, has done more testing, and until recently had done better than NSW and Tasmania. It had fewer than ten new cases per day, sometimes none, between mid-April and mid-June. Now, in its winter, it has a surge bigger than its first one. The other states are still ok.

Neil Ferguson, the scientist whose calculations pushed the UK to lockdown in March, did the calculations for this report too; but the report considers a new blanket lockdown an undesirable desperate expedient. Back in March, the government had lost track (official new infections for 12 March: 117. Ferguson’s retrospective estimate: about 30,000). Ferguson argued that there was nothing for it but a blanket lockdown, even though many of the measures included might be ineffective, it couldn’t be sustained long, and it was a delaying tactic rather than an “answer”. With more testing, knowledge, and preparation, more precise measures could work. In particular, the report argues that new school closures should be avoided unless as a “last resort”.

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