Covid-19: UK government must “get its act together” as modelling suggests 85 000 deaths in second wave, experts say
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4242 (Published 30 October 2020) Cite this as: BMJ 2020;371:m4242
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Dear Editor
I also note the article by Carl Heneghan and Tom Jefferson in the Mail on Sunday based on the advice they delivered to the Prime Minister [1]:
“ Our strategy would be to tackle the four key failings. We must address the problems in the Government's mass testing programme; we must tackle the blight of confused and contradictory statistics; we must make real efforts to protect and isolate those who are vulnerable; and we must inform the public about the true and quantifiable costs of lockdown...”
We are in an exceedingly dangerous position while we are at the mercy of endless worst case scenarios which do not have to be proven. Moreover, the wreckage of the policy is far more quantifiable than any benefit i.e we do not really either know how bad Covid is going to be or how much the policy will mitigate it, while we do know the catastrophic damage to everything else. To institute policy on this basis is without rationality.
[1] Carl Heneghan and Tom Jefferson, ‘There is another way to beat coronavirus, PM - and here it is...’, 31 October 2020, https://www.dailymail.co.uk/news/article-8900897/Oxford-experts-DR-TOM-J...
Competing interests: AgeofAutism.com, an on-line daily journal, concerns itself with the potential environmental sources for the proliferation of autism, neurological impairment, immune dysfunction and chronic disease. I receive no payment as UK Editor
Dear Editors
When I last wrote about the need for another lockdown on Sept 23 (ref 1), the UK recorded 4,926 new cases of COVID-19 for the last 24 hours on 22 Sept. I commented that the second movement restriction was inevitable given the emerging numbers then were more than 5 times those when the first lockdown was implemented in March 2020.
Granted there are many noises the UK government is receiving, including SAGE, iSAGE and many armchair COVID-19 commentators (myself included), ultimately the daily numbers (21,915 new cases, 326 deaths from COVID-19 in the past 24 hours announced on 31st October – ref 2) are irrefutable and the hesitancy in putting in place another nation-wide lockdown seems even more irresponsible.
Whatever the original reasons for delaying the announcement to Monday 2 November, it is clear that the government was not ready for a decision to be communicated when a leak on Saturday (from a meeting on Friday) forced Mr Johnson to call for a press conference at 4 pm the same day (ref 3). The last minute negotiation and politicking involved meant that even the announcement for the much-expected-(and called-for)-but-delayed second lockdown was itself delayed for 3 hours, even when the government’s own health advisors have been calling for it apparently since September (ref 2).
Mr Johnson was calling for a 27 day measure but Mr Gove is right to suggest there is no certainty of the lockdown’s 2nd December end-date (ref 4) and that decisions would "obviously be guided by the facts".
Few lockdowns/circuit-breakers worldwide last only 2 or 4 weeks; even Wales’ current 16-day firebreak end-date of 9 November is now in doubt. In New Zealand, Auckland did not return to level 1 restriction until 6 weeks after lockdown measures were re-introduced for a cluster involving 179 cases including 3 deaths (ref 5).
No one derives great joy in saying that they are right about the need for a second lockdown. Nevertheless I think Mr Johnson would have to tread carefully from now on as he seems to have been ignoring health advice since September, and from hereon cannot simply justify any new pandemic measures by saying “it was based on health advice from experts”.
References
1. https://www.bmj.com/content/370/bmj.m3695/rr
2. https://www.bbc.com/news/uk-54763956
3. https://www.abc.net.au/news/2020-11-02/boris-johnson-uk-lockdown-backdow...
4. https://www.bbc.com/news/uk-54767118
5. https://www.theguardian.com/world/2020/oct/08/new-zealand-whole-again-as...
Competing interests: No competing interests
Re: Covid-19: UK government must “get its act together” as modelling suggests 85 000 deaths in second wave, experts say
Dear Editor
Primary care and COVID-19. Reducing community transmission: what is the next step?
We celebrate the fact that there have been no new diagnosed cases of Covid-19 for 10 consecutive days state-wide in Victoria and few new cases nation-wide in Australia. However, it seems certain that localised clusters of community transmission will be part of the ongoing landscape in most places. As we enter this hoped-for maintenance mode of suppression and containment of localised outbreak, we need to ask whether Australia is prepared with trials of strategies, including medicines, for close contacts of people with COVID-19, to prevent or reduce transmission to them or to reduce disease severity? Similarly, are trials of community-based prophylaxis part of the ambulatory strategies that are sorely needed in all settings, including the UK, where this week’s BMJ predicts perhaps up to 85,000 deaths in the present COVID wave(1), and will they be components of the Biden-led COVID-19 initiative in the USA?
Such trials of prevention and disease mitigation should include Ivermectin. An apparent benefit of Ivermectin, alone, or in combination with other drugs, has been reported in many counties and regions, e.g. Peru, Brazil, Bangladesh, India, Egypt, Florida, etc., and in various target groups- the very ill, the mildly ill, exposed contacts, the general public, health care workers and household members. There is already vast global experience in the use of Ivermectin for a variety of other indications, it is easily administered by mouth, is readily available, cheap and very safe. The benefit/cost ratio will be very high even if the drug reduced transmission or severity of only a portion of COVID-19 infections. Such trials should part of a comprehensive community-based management strategy, along with the standard measures and vaccines.
1. Covid-19: UK government must “get its act together” as modelling suggests 85,000 deaths in the second wave, experts say; Source: BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4242
Competing interests: No competing interests