Belfast in Northern Ireland on October 14th. A circuit breaker interlock is currently available there
Charles McQuillan / Getty Images
With Covid-19 cases rising in most parts of the UK, there is fierce debate over how best to respond. While some people advocate a strategy that will rip the virus apart, others want increasing social restrictions to the point of complete lockdown, as happened in the first wave of the pandemic.
But is there any other way? One idea that is gaining ground is that countries should conduct preventive lockdowns on a regular basis, each lasting around two weeks. They could be timed to coincide with the school holidays to minimize disruption to education. In the UK, this would mean these shutdowns happen roughly every two months.
The concept may sound similar to the short, sharp "breaker" lockout, an idea advocated by some scientists advising the UK government, including senior scientific adviser Patrick Vallance. Northern Ireland started such a lockdown on October 16, and Wales has announced that it will do so from October 23.
However, there is one key difference between these strategies: the idea is that preventive lockdowns would happen on a regular basis, even if a country's coronavirus case numbers are relatively low. Knowing beforehand when they will occur is intended to reduce the impact on businesses, while the fact that they are short and have a specific endpoint could make them more bearable for the public.
It is difficult to find out exactly what impact this would have on virus prevalence, but it should regularly roll the case numbers back to lower levels. At best, it could mean avoiding the lengthy lockdowns seen in the first wave of the pandemic.
This year, there has been a surge in appreciation for mental health caused by people stop mingling with their friends and family. Preventive circuit breakers can slightly reduce this burden. "The fixed amount of time reduces insecurity, and it is insecurity that often promotes anxiety and poor mental wellbeing," said Charlotte Hilton, an East Midlands, UK-based psychologist.
Businesses like pubs, restaurants, and non-essential stores would still have to cope with lost income: if a two-week lockdown were planned every two months, they would close about a quarter of the time. However, if they knew when these stoppages would come, they could potentially be more effective financially planning around them.
Unfortunately, when a lockdown is suddenly announced, companies lose the benefits of planning ahead. Hence, it is too late to take these kinds of benefits from an immediate circuit breaker shutdown that may occur this time.
How do we know if preventive lockdowns would be better than the alternative approach of tightening social restrictions only when cases rise and easing them when the numbers fall? This type of strategy has not been tried anywhere in the world so we cannot yet measure its impact on actual Covid-19 cases, mental health, or the economy.
However, a model study by Graham Medley of the London School of Hygiene & Tropical Medicine and his colleagues suggests that a two-week British lockdown in late October would cut covid-19 deaths in half between that time and the end of this year. Since health is a distributed issue in the UK, the respective governments of the four UK nations would have to make a decision to take such action. When this paper was written, an October lockdown like the one proposed would have been preventative. The work has been put online but not yet published.
With the number of coronavirus cases rising in most of the UK, the debate has centered on whether the current local restrictions are sufficient or whether the four UK states need a full, non-preventive lockdown.
This would be akin to the actions Israel took last month to launch an allegedly brief three-week lockdown in response to rapidly increasing cases. Although it had to be extended by a week, the country has now started easing restrictions.
In the UK, members of an independent coronavirus advisory board called Independent SAGE last week called for a full and immediate lockdown of the entire country for two or three weeks, plus several more weeks with slightly less stringent restrictions.
University College London independent SAGE member Christina Pagel says regular preventive bans would not be required if the UK used this proposed shutdown to overhaul its test and trace system. “We don't want to close any further. Planning that is an admission of failure, ”she says.
Michael Edelstein of Bar Ilan University in Ramat Gan, Israel, says planning ahead is vital. However, instead of locking on set dates, it would be better for countries to have agreed infection thresholds that trigger them. "You don't have time to discuss it for weeks."
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