Covid-19: Leading doctors argue against local lockdownsBMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3959 (Published 13 October 2020) Cite this as: BMJ 2020;371:m3959
All rapid responses
Deliberately or not, the Government took the first steps in a coronavirus culture experiment in the second half of September, by enforcing lockdown restrictions on heavily infected student populations, particularly in the Manchester halls of residence. Glasgow, Newcastle, Bristol and Aberdeen are some of the other universities affected. With up to 10 people per flat, all from different households from the four corners of the UK, if not the globe, the restrictions created perfect human viral culture conditions. Entire flats were affected – and have now recovered.
With quick action now, by arranging urgent and systematic antibody testing, we can measure the numbers affected, and give the results to the local public authorities in good time to help inform pre-Christmas political decisions. The study could be quickly widened to include later-year students in private accommodation, as well as non-student youths in the same town. If the results were to show a high level of combined proven antigen and antibody tests, there would then be a potentially large number of immune young adults, quite possibly running into the tens of thousands. This could in turn inform the crucial pre-Christmas political decision – whether to continue a tight city-wide lockdown, or instead open up the night-time economy to allow all those with proven virus exposure to give a desperately-needed pre-Christmas boost to their University town. A recent Austrian study using a combined IgG and IgA approach found SARS-CoV-2 antibodies in 42.4% of those tested – the results in the subpopulations of university students could be far higher still.
Two obvious immediate questions would be the risks of re-infection, and the status of non-student youngsters. Reports of reinfection are steadily increasing – but at present they amount to two dozen or so, out of 37 million confirmed cases worldwide. A Town v Gown conflict could be avoided by then offering the same antibody test to all non-student young adults on demand – and then opening up night spots to those holding proof of infection, with a record of either a positive antigen or antibody test.
Timing is crucial. Time and again the Government has failed to anticipate the blindingly obvious - be it testing for all at symptom onset, the need for PPE provision, the nursing home crisis, the A level fiasco, or the spike which followed student migration in September. Prompt action now – beginning if at all possible in the last week of October – can allow crucial decisions to be made based on the best possible evidence.
Competing interests: No competing interests