Creative Connectivity

What if there is no Covid-19 vaccine?

As most of the world starts to ease lockdown, it seems timely to ask the question of “What next?” Many will believe that the new normal is just a stepping stone back to the old normal, but the reality is that Covid-19 has not gone away. Nor are we likely to see a vaccine in the near future, for which read years. As epidemiologist Mark Woolhouse told New Scientist in early April: “I do not think waiting for a vaccine should be dignified with the word ‘strategy’. It’s not a strategy, it’s a hope.” Which raises the question of what the strategy is?

As long as the virus is around, it will continue to infect and kill. Unlike the Spanish Flu pandemic, it seems to be more discriminating, predominantly resulting in the death of those already at risk. It’s almost as if it’s sticking two fingers in the air to the last century of medical advancement, saying that for all of the machines we now have which go “ping”, the medical profession is as helpless as it was back in 1918.

What that means is that the elderly and those with underlying conditions will remain at risk and society will probably try to be over-zealous in protecting them. Without a vaccine, here in the UK, the implication is that we will probably never see the Queen make a public appearance. In the US, Donald Trump, assuming he doesn’t succumb to the virus, will still be promoting quack cures as he steps down at the end of his second term, and anyone with a parent in a care home may never get to hug or kiss them again, which is a strange definition of care.

Coronavirus Parties, Tupperware and Tinder

I’m old enough to remember being sent to play with other children who had measles and chickenpox. That was before we had vaccines for either. We’d have a happy time picking off each other’s chickenpox scabs, leaving our generation marginally scarred for life. It was an understandable practice – neither disease had a high child mortality rate – it was far more dangerous in adults, so keeping up herd immunity this way had pretty good odds.

We’re about to come out of lockdown and enter the “New Normal”, whatever that may be. It means that as far as Covid-19 is concerned, we’re back in the pre-vaccination world. Throwing technology at the problem appears to be the first choice of most Governments, but we should think about whether there are some pre-vaccination strategies which are worth revisiting.

Bluetooth Covid Contact-Tracing Apps

In the previous article I looked at the tools the UK Government has available to deal with the coronavirus pandemic. Essentially, they have two. The first is to increase the number of ventilators and ICU beds, which gives more people with severe respiratory infections a chance to recover. That means that doctors and politicians can avoid the unpleasant choice of deciding who gets treated and who does not, but only if the number of infections are curtailed in the first place, so that we don’t run out of ventilators.

The second is the lockdown tool. It is currently a crude On/Off switch, which limits infections by keeping everyone at home. At the moment, it’s not flexible – you’re either locked down, or you’re not, unless you’re a key worker or in an essential industry. The hope is that few key workers will be infected, either because they have sufficient Personal Protection Equipment, or they’re able to social distance whilst doing their jobs. Everyone else has to stay at home. A lucky few can continue to work, but most are either furloughed or become unemployed, putting the economy in stasis.

The Government, quite rightly, is desperate to find ways to ease the lockdown. The question is how to do that without immediately seeing infection rates rise?

The flavour of the day is to roll out smartphone apps which can trace whether you have come into contact with someone else who is infected. The theory goes that if you do, you can be alerted and stay at home until you’re tested. If you have coronavirus, you self-isolate. If you don’t, you’re free to go back to work. Like many proposals for phone apps, it sounds simple, which is why it’s so appealing. Particularly to people like Matt Hancock, who has always had a bit of a penchant for phone apps, which he believes will save the NHS. What nobody is mentioning, is that for contact-tracing to work, we will need the ability to provide at least half a million additional tests that can be administered at home every day.

Understanding the Lockdown Exit Strategy

In the UK we’re about to enter a further three weeks of lockdown. There’s growing pressure from Keir Starmer, the Labour Party’s new leader, for the Government to explain how we exit that lockdown. A lot of people are looking to technology to answer that, largely in the form of tracking applications. This article was going to be about how well that approach might work, until I remembered that it’s a good idea to understand the problem before trying to solve it. I’ll go into the details of contact tracking and tracing in my next article, but first we need to look at some history to see why we need it.

Statista, a German online analytics portal, has just published the above graphic, demonstrating better than anything else I’ve seen, exactly why we need to keep away from each other. I would urge you to share it with as many people as possible. The full link is https://www.statista.com/chart/21198/effect-of-social-distancing-signer-lab/. It’s pretty simple maths behind it, but that seems to be lost on most people.

Coronavirus – The UK’s Ventilator Exit Strategy

As the UK moves towards a more major lockdown, it’s becoming apparent that this will not be a short-term disruption. Imperial College have published their modelling plans, on which the UK strategy has been based and it’s clear there is no quick fix. The Coronacrisis looks set to be with us for the next twelve to eighteen months.

It’s a hundred years since the Spanish flu pandemic, for which society had no medical solution. The result was that millions died around the world, as the best that medical science could do was to alleviate the symptoms of the dying. Since then, medical science has progressed to the point that people expect it to save them this time around. The unfortunate truth is that we have no drugs or vaccine available and it will probably be eighteen months before we do. Until then, all we can do to limit the spread is suppression, i.e. keeping people apart to reduce the number of infections.

Where we have made advances is in the technology to treat those who progress to secondary infections which are resulting in the death toll. Again, we have no pharmaceutical cure, but we can use ventilators on Intensive Care Units which can save many patients. Not all, as anyone with underlying health issues is likely to succumb. The following chart, based on US stats from Statista shows the percentage of patients who need intensive care after hospital admission, broken down for different age ranges. It also shows the mortality rate. If you are young or healthy, ventilators have a big effect on survival rate.