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Belfast, Northern Ireland on 14 October, where a circuit breaker lockdown is currently in place

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With cases of covid-19 rising in most parts of the UK, there is fierce debate over the best way to respond. While some people argue for a “let the virus rip” strategy, others want increasing social restrictions, up to and including full lockdown as happened in the pandemic’s first wave.

But is there another way? One idea gaining ground is that countries should hold regular pre-emptive lockdowns, lasting about two weeks. They could be timed to coincide with school holidays, minimising disruption to education, which in the UK would mean having these shut-downs about every two months.

The idea may sound similar to the short sharp “circuit-breaker” lockdown, which has just gone ahead in Northern Ireland and has been advocated for elsewhere by some UK government scientists, including chief scientific advisor Patrick Vallance.

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But there’s a crucial difference: the idea is that pre-emptive lockdowns would be planned to happen periodically, even when a country’s coronavirus case numbers are relatively low. The advance knowledge of when they are due to happen is supposed to reduce the impact on businesses, while the fact that they are short and have a definite end point could make them more bearable for the public.

It’s hard to work out exactly what effect this would have on virus prevalence, but it should regularly reset case numbers to a lower level. At best, it could mean avoiding the longer kind of lockdowns seen in the pandemic’s first wave.

This year there has been growing appreciation of the mental health toll of stopping people mixing with their friends and family. The benefit of pre-emptive circuit breakers is that it’s easier to put up with something unpleasant if you know it will be short-lasting and there’s a definite end in sight. “The specified length of time reduces uncertainty and it is uncertainty that often promotes anxiety and poor mental wellbeing,” says Charlotte Hilton, a chartered psychologist in the East Midlands.

Businesses like pubs, restaurants and non-essential shops would still have to cope with a loss of income: if the schedule was two weeks of lockdown every two months, they would be shut a quarter of the time. But if they knew when these shut-downs were coming, they could better plan around them financially.

Unfortunately, if a lockdown is suddenly announced, then firms lose out on the advantages of such forward planning. So it is too late to gain those kinds of advantages from any circuit breaker lockdowns that may be about to happen this time around.

How can we know if pre-emptive lockdowns would be better than the alternative approach, of tightening social restrictions only when cases rise and loosening them when numbers fall? This kind of strategy has not been tried anywhere in the world, so we cannot yet measure its effects on actual covid-19 cases, mental health or the economy.

But a modelling study by Graham Medley at the London School of Hygiene and Tropical Medicine and his colleagues suggested a two-week UK lockdown at the end of October would halve deaths from covid-19 between then and the end of this year. Because health is a devolved matter in the UK, a decision to take such action would have to be made by the respective governments of the four UK nations When that paper was written, such an October lockdown would have been a pre-emptive one. The work has been put online although not yet published.

With coronavirus case numbers now seemingly climbing inexorably in most parts of the UK, the debate has turned to whether current local restrictions are enough or if the four UK nations need a non-pre-emptive full lockdown.

This would be similar to the actions of Israel last month, which began what was supposed to be a short three-week lockdown in response to rapidly rising cases. Although it had to be extended by one week, the country has now started easing restrictions.

In the UK, members of an independent advisory panel on the coronavirus called Independent SAGE said last week there should be an emergency two or three-week full lockdown across the whole of the UK plus several further weeks of slightly less severe restrictions.

Independent SAGE member Christina Pagel at University College London says regular pre-emptive lockdowns would not be needed if the UK used the proposed immediate shutdown to revamp its testing and tracing system. “We do not want to keep closing things. To plan for that is an admission of failure,” she says.

Michael Edelstein at the Bar-Ilan University in Ramat Gan, Israel, says planning ahead is vital, but rather than lockdowns happening at set dates, it would be better for countries to have pre-agreed infection thresholds that trigger lockdowns. “You don’t have time to debate it for weeks.”

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source: newscientist.com

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