COVID19, the UK and Herd Immunity

FAST FACTS

• UK: 1,551 cases and 35 deaths per Hopkins COVID19 Tracker on March 16, 2020
• Health officials in UK “say they believe the actual number of people infected could be between 5,000 and 10,000.” [i]
• Guidance from the NHS website on March 16, 2020[ii]:
  • Stay at home for 7 days if you have either:
  • A high temperature – you feel hot to touch on your chest or back
  • A new, continuous cough – this means you’ve started coughing repeatedly
  • Do not go to a GP surgery, pharmacy or hospital.
  • You do not need to contact 111 to tell them you’re staying at home.
  • Testing for coronavirus is not needed if you’re staying at home.
• Called “Stay at home advice” [iii] from the NHS website

• • if you have symptoms of coronavirus infection (COVID-19), however mild, do not leave your home for 7 days from when your symptoms started. (See ending isolation section below for more information)
  • this action will help protect others in your community while you are infectious
  • plan ahead and ask others for help to ensure that you can successfully stay at home
  • ask your employer, friends and family to help you get the things you need to stay at home
  • stay at least 2 metres (about 3 steps) away from other people in your home if possible
  • sleep alone, if possible
  • wash your hands regularly for 20 seconds, each time using soap and water, or use hand sanitiser
  • stay away from vulnerable individuals, such as the elderly and those with underlying health conditions, as much as possible
  • you do not need to call NHS 111 to go into self-isolation. If your symptoms worsen during home isolation or are no better after 7 days, contact NHS 111 online. If you have no internet access, call NHS 111. For a medical emergency dial 999

• The term “Nudge” theory has been applied to this concept
  • “Nudging” uses insights about our mental processes to change our behaviour through coaxing and positive assertion. Rather than forcing us to do things, nudging tweaks the environments in which we make choices[iv]
• Sir Patrick Vallance is a leading British public health expert and serves as UK Chief Science Advisor
• On Friday, Sir Patrick suggestedmanaging the spread of the disease so that the population gains some immunity to the disease was a part of the government strategy.[v]
• This idea, known as “herd immunity”, means at-risk individuals are protected from infection because they are surrounded by people who are resistant to the disease.
• Sir Patrick said the new coronavirus was likely to become an annual seasonal infection and that officials were aiming to reduce the peak, “not suppress it completely”.[vi]
  • Publication of their epidemiology models are pending
• “Herd immunity is not part of our action plan, but is a natural by-product of an epidemic. Our aims are to save lives, protect the most vulnerable, and relieve pressure on our NHS,” he said[vii]
• This is not without concerns and cautions from other public health experts.[viii]
  • These public health scientists advocate for more restrictions supporting social distancing
• This approach has been in contrast to other areas of Europe
  • Italy has been on lockdown since March 9^th
  • Poland is set to close borders for two weeks
  • Spain has ordered a national lockdown as of March 16^th
  • France closed all non-essential public locations as of March 14^th
• The major downside of herd immunity, according to Birmingham University’s Prof Willem van Schaik, is that this will mean that in the UK alone at least 36 million people will need to be infected and recover[ix]
• NHS Website on COVID19 Plan on March 16, 2020[x]
  • The overall phases of our plan to respond to COVID-19 are:

• • • Contain: detect early cases, follow up close contacts, and prevent the disease taking hold in this country for as long as is reasonably possible
    • Delay: slow the spread in this country, if it does take hold, lowering the peak impact and pushing it away from the winter season
    • Research: better understand the virus and the actions that will lessen its effect on the UK population; innovate responses including diagnostics, drugs and vaccines; use the evidence to inform the development of the most effective models of care
    • Mitigate: provide the best care possible for people who become ill, support hospitals to maintain essential services and ensure ongoing support for people ill in the community to minimise the overall impact of the disease on society, public services and on the economy

• The UK has not finalized their strategy and appears to be still debating a unified and national plan as of time of writing

PERSONAL OPINIONS

• Herd immunity can work and is proven via vaccines
  • This is not a vaccine but a wild type virus that is unpredictable
• We do not yet know how long immunity from wild type SARS CoV-2 lasts, if at all
• If 1 million people face a 2% death rate, there will be heavy price to pay
• 60% infection of UK’s 66 million people is 39,600,000 positive COVID 19 cases
  • 2% death rate of positive cases is 792,000 deaths

[i] https://www.bbc.com/news/uk-51865915

[ii] https://www.nhs.uk/conditions/coronavirus-covid-19/

[iii] https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance/stay-at-home-guidance-for-people-with-confirmed-or-possible-coronavirus-covid-19-infection

[iv] https://www.theguardian.com/commentisfree/2020/mar/13/why-is-the-government-relying-on-nudge-theory-to-tackle-coronavirus

[v] https://www.bbc.com/news/science-environment-51892402?SThisFB

[vi] https://www.bbc.com/news/uk-51865915

[vii] https://www.bbc.com/news/science-environment-51892402?SThisFB

[viii] http://maths.qmul.ac.uk/~vnicosia/UK_scientists_statement_on_coronavirus_measures.pdf

[ix] https://www.bbc.com/news/science-environment-51892402?SThisFB

[x] https://www.gov.uk/government/publications/coronavirus-action-plan/coronavirus-action-plan-a-guide-to-what-you-can-expect-across-the-uk