Stay home to save lives

P Gunasegaram

Modified 22 Mar 2020, 10:35 am

COMMENT | The movement control order (MCO) the government has chosen to use to fight Covid-19 has already caused problems which will result in a reduction in its efficacy and may even contribute to the spreading of the outbreak.

To some extent that’s only to be expected because such a thing as Covid-19 has not happened since the 1918 flu pandemic, according to experts some of whom grimly report that hundreds of thousands of people in the US and UK will die from it.

There is an urgent need to put more thinking heads together to ensure better anticipation of problems related to this unprecedented MCO, which is in effect a partial lockdown to reduce contact between human beings undertaken at great cost to the people and country.

But before we go into the mistakes, let’s look at the strategies currently available for fighting Covid-19. The latest publicly available report is one done by the Imperial College of London released on March 16. This is reported to have caused a major shift in the way the UK is handling the crisis.

According to the report, there are two fundamental strategies possible for controlling the virus: (a) mitigation, which focuses on slowing but not necessarily stopping epidemic spread – reducing peak healthcare demand while protecting those most at risk of severe disease from infection, and (b) suppression, which aims to reverse epidemic growth, reducing case numbers to low levels and maintaining that situation indefinitely.

We have already been mitigating by identifying victims and isolating them to slow the spread of the virus but that may no longer be enough.

As the report says: “We find that that optimal mitigation policies (combining home isolation of suspect cases, home quarantine of those living in the same household as suspect cases, and social distancing of the elderly and others at most risk of severe disease) might reduce peak healthcare demand by 2/3 and deaths by half. However, the resulting mitigated epidemic would still likely result in hundreds of thousands of deaths (in the US and UK) and health systems (most notably intensive care units) being overwhelmed many times over.

“For countries able to achieve it, this leaves suppression as the preferred policy option. We show that in the UK and US context, suppression will minimally require a combination of social distancing of the entire population, home isolation of cases and household quarantine of their family members. This may need to be supplemented by school and university closures though it should be recognised that such closures may have negative impacts on health systems due to increased absenteeism.”

This suppression is what we are trying to do via the MCO – to reduce contact between human beings by basically forcing most of them to stay at home and reduce human-to-human contact. The first mistake is that this has not been properly conveyed to the public in the PM’s announcement...

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