What will stop a second wave?

[candle18]

Once lockdown restrictions are relaxed why won’t there just be another huge increase? Is that because a lot of people will already have been infected?

While the R0 is below 1 it shouldn't spread. Once it goes above 1 it will take off again.

There will be another huge increase. Not straight away but probably before the end of the year. Then we’ll get locked down again.

What Mustbetimeforachange said

SO

When our Government gets a bit more proactive and stops heading for the worst fatality rates amongst the public and health care workers

I don't know how they can lift the lockdown without the R going above 1 - all it takes is for a few people to pass it on to more than an average of one and we are back where we started.

We are going to be on some form of lockdown for a while I fear.

I think the strongest tool we have to help prevent it is the contact tracing app - if it's fit for purpose and adopted widely enough.

Nothing

R0 below 1 will keep it down but it’s a hard task to do that.

Contact tracing and doing what should have been done at the start I. E contract tracing with lockdown of specific communities if necessary and much more control on borders. Plus, testing testing testing!

Nothing.

BUT what would reduce the number of deaths when the virus spreads is widespread testing, contract tracing and isolating; increasing supplies of PPE to the NHS, social care, transport, shop and other essential services; maintaining hand hygiene and social distancing; closing monitoring the new daily cases and restricting movement quickly when R>1; using the above data to isolate hot spots and take regional action; 14 day quarantine for people arriving in the UK; quick treatment with oxygen therapy and increased capacity for health services to provide this at home.

Unfortunately, this would require a competent, honest and ideologically coherent government so unlikely in the UK tbh.

Nothing

Look how we went from zero to whatever the rate is now ... in what? Two months? It'll be slower this time as no massive horse races or footie matches, and we might even do some testing, but the second wave was built into early lockdown models and we haven't gone for full lockdown with quarantine/contact tracing so we are not going to lift lockdown with zero cases

If you can control R you avoid a spike

So social distancing stays
Keeping work from homers working from home
Keep shops limiting number in store and other potentially crowded places
Keep hygiene high
Possibly face masks

Plus keeping potentially infected people at home ideally isolated from their family until they have the all clear
Which means identifying them quickly, before they show symptoms and start shedding virus
Which could mean temperature checking people
Lots of community testing
Contact tracing

1/ Herd immunity (we could have it in 1-2 months if we opened everything up, and shielded the elderly and vulnerable)
2/ Vaccine (realistically 1 or 2 years away)
3/ Locking down until vaccine created

I agree with everything you have said @Bflatmajorsharp.

It's so depressing, isn't it?

Most ordinary people who have been living through CV19 and lockdown and have so much as watched the MSM programmes/read the MSM news could come up with a better plan on the back of a Greggs vegan sausage roll in 5 minutes than the inevitable dogs dinner the current govt will make of it.

I don't know how they can lift the lockdown without the R going above 1

That's what confuses me, I thought the only reason the R was below one was because of the lockdown. They say they'll lift lockdown when they're sure it won't risk a second peak? I don't see how that can ever be the case. I'm absolutely not in favour of a prolonged lockdown, I'm just a bit confused as to why that is one of their five tests when it seems a given that cases will rise once lockdown ends.

I think they're getting ready for the second peak. Hence the Nightingales.

They wont lock us down again. This will be when their herd immunity will come into play...

That's my thoughts anyway. Why are there pretty much empty Nightingales around the country??

The fifth rule now allows for a second peak if under NHS capacity.

However I agree with Meredith, lockdown is keeping R0 under 1. It will be hard to make even slight changes without big effect. But we’ll see what they propose next week I guess.

Although, if R0 under 1 we will see a decline not another peak regardless of fifth rule.

The App in South Korea works well, it makes sense to me, that and testing. Is it worth giving up our privacy for? I think so

Bflatmajorsharp has it exactly. The fear, panic and knee-jerk reactions of the Government have not been a pretty sight.

quick treatment with oxygen therapy and increased capacity for health services to provide this at home.

This, had it been available, would have helped to reduce fatalities. Not the initial strategy, borne out of panic, of instructing 111 and paramedics, to 'screen out' all but those at death's door. Put the money into early intervention. Once a patient is ill enough to be put on a ventilator, their chances of survival are, of course, massively reduced. Some people would still have eventually required ventilation, but many, many would not, given earlier, and less invasive, oxygen treatment.

How on earth will contact tracing work now the cat is out of the bag? I can see it would have worked if we had done it at the outset but now?

I think we have had it in my household but where and when we caught it? I have no idea. I would have to be either from deliveries or from the supermarket. How long did we have it before we showed symptoms? Who else was in the supermarket on that day... Which delivery person was it.... Thats in lockdown conditions.

I think if we had an effective antibody test available to everyone (thats a huge undertaking for 60 million people) and we continue to shield the most vulnerable then we might have some chance of managing it. But it still requires adequate protection and first rate cleaning regimes for all hospitals, care homes, domiciliary care workers, supermarkets, transport and other facilities used by the general public.

Thinking about it. There's going to be a second wave.

Those who don't download the NHS contact tracing app won't be permitted to leave their homes. Mass surveillance of the population under the guise of trying to control viral spread.

*ventilating

Pretty much what midgebabe has said. Everyone of those measures will reduce R a bit. Together it will hopefully stay below 1. If R gets above 1 we will see a second wave. No matter how you look at it there is not enough herd immunity yet for the second spike to come down to manageable levels. You will not be able to build your way out of it by getting more hospital capacity (but that may help to shorten the time until heard immunity if that is still the goal).

Some maths:

• If in some hotspots already 20% have had it (and are now immune) that will reduce R by 20%. i.e. from 2.5 down to 2.0. Still far to high.
• How successful a tracing app is depends on how many people have the virus and spread it while being truly asymptomatic. Tracing will not find or eliminate them. Say 50% are symptomatic then tracing can get R down by 50%. If only (as in some estimates) 10% are symptomatic it won't work so well.
• hopefully summer weather (more UV) will give us a few more percent, mask wearing another few. Social distancing would likely get R down below 1 by itself if people would be serious about observing it without a formal lockdown.

What I keep thinking - although this maybe ridiculous- is that does anyone know if you are immune if you have knowingly or not been infected.
If people were immune wouldn't we be well on our way to the much touted herd immunity by know?
They have only really tested hospital patients up until very recently so by definition the most unwell people.
The numbers of community people who have had the illness in all likelihood but not been tested must be huge? Can think of several people I know who have had symptoms as I guess we all could.
Also I saw a study from Kings that thinks people may have had Covid-19 as early as December/January
So could the UK be ahead on this at least?
Am I living in hope only?