Published 2 November 2020
The announcement on Saturday that England will re-enter a lockdown on Thursday (subject to a vote) came as a non-surprise to anyone watching the data, but will it last just four weeks as planned?
Without spoiling the punchline it is not looking good, but more data would help tremendously. Part of the reason for the decision to re-enter lockdown is the need not to overwhelm the NHS, so this will inevitably be under scrutiny for any decision to remove restrictions. Although the new measures come into force on Thursday the 5th, new hospitalisations will not stop increasing until a week later. As hospital length of stay is around 10-14 days, hospital bed occupancy will peak around the 24th of November. The 24th of November is more or less in line with peak critical care bed occupancy from wave 1 (see chart below), which followed the original lockdown. The previous peak latest until around the 18th of April (about a week) and then slowly started to fall. Lockdown was finally removed on the 4th of July, 104 days after it was imposed.
It is important to remember that the previous lockdown was more severe, including school closures, and had the will of the people on side - the nation is more divided on the need for a lockdown this time. So although cases are increasing more slowly, there is every reason to expect new cases not to slow down as quickly as they did previously - time of year (winter) and schools remaining open.
It is unlikely that the vaccine will be ready and widely distributed in time for Christmas. And even with considerable increases in testing, it seems doubtful that Test and Trace will start to make a substantial enough impact on Rt (especially with cases so high). So does that mean we are in for another +100 day lockdown - perhaps with a long-lockdown-holiday weekend for Christmas? Perhaps the most likely strategy for removing the national lockdown is a gradual reintroduction of regional Tiered restrictions (high in Manchester, low in Cornwall). These will inevitably need some consideration since the current Tier 3 rules seem just about to hold Rt around 1 (as we know from Liverpool) - so expect Tier 4 (very very high) reinforced with some improved Test and Trace, and the hope of a vaccine. So that Tier 4 is as evidence-based as possible, it would be helpful if over the next few weeks (ideally days) more research on the effect of different interventions could be generated. Clearly, the best way that Edge has advocated since March is for the sharing of anonymised data on confirmed cases at an individual level: age, gender, occupation, Covid-19 illness status (home, hospital, recovered), location, believed source of infection (pub, school, work, household), date recovered, and the cluster-ID (if it is collected).
There is a saying that "if you have seen one pandemic..., you've only seen one pandemic". All pandemics may be different, but before this one is over it would be great if the available data could be used more effectively (or just used!).