By Chris York
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As things currently stand, there is only one way to avoid a second wave of the coronavirus outbreak in the UK – keep the lockdown measures in place until a vaccine is found.
In practice, this would mean keeping restrictions as they are until at least the end of this year, or perhaps indefinitely – but with soaring unemployment, the prospect of economic depression and concerns about the general welfare of the population, this simply isn’t an option.
Professor Ravi Gupta, of the Cambridge Institute for Therapeutic Immunology and Infectious Disease, told HuffPost UK: “All the economic analysis is showing we will need to do some kind of easing [of restrictions] in the relatively near future.
“We will then have to prepare for an increase in the number of cases.”
What do we know about a second peak?
A more appropriate question right now is: how much do we know about coronavirus? The answer is: not very much.
Because the disease is so new, scientists are still collecting data on a number of factors, which means making any predictions about how it will spread is extremely difficult.
For example, much has been said about the possible immunity of those who have already had the disease but this is still mostly based on assumptions – not enough time has elapsed since the first people recovered from the disease to know if, and for how long, they are immune.
Have we passed the first peak yet?
According to health secretary Matt Hancock, we are “at the peak” of the Covid-19 outbreak.
Speaking in the Commons during PMQs on Wednesday, he added: “I just want to thank everyone from across the country for their steadfast commitment in following the rules, including in this House.”
If Hancock is correct, cases of coronavirus can be expected to keep dropping, although deaths – which lag behind new infections – will still rise.
Reaching the peak is a milestone in the fight against the pandemic but is far from the end of the crisis and Hancock refused to specify what it would mean in terms of ending the lockdown.
“It’s a question of degree,” he said.
“The fewer new cases, the more effective ‘test, track and trace’ are as a way of keeping the disease down, and therefore the more of the social distancing measures can be lifted.”
Can we avoid a second peak?
It’s a relatively safe bet that when the lockdown is eased, there will be more cases of coronavirus – though whether or not there will be enough to cause a second peak is still uncertain.
Much of it will depend on how the lockdown restrictions are lifted and what is done to track the virus.
“The size of a second peak is difficult to predict and will depend on the amount of social mixing that is permitted,” says Prof Gupta.
“It sounds like, with social distancing and use of masks, that you might expect the second peak to be smaller because people are going to be much more careful about contact.”
Dr Peter English, a consultant in communicable disease control, told HuffPost UK technology would likely play a large role in managing the disease after the lockdown is lifted – but will mean everybody has to abide by a completely new set of rules.
“What you would need is a way of telling someone: ‘You have been in contact with a case – you must on pain of prosecution self-isolate for 14 days,’ and some system of making sure that happens,” he said.
Didn’t the government abandon contact tracing?
Yes, but it was being done manually in a very labour intensive way that became unsustainable as the number of cases grew.
Back in February a team of 400 Public Health England staff was on standby to trace those people who had been infected with the virus, but that was when there were only 36 confirmed cases.
There are now around 130,000.
Health secretary Matt Hancock told MPs last week contact tracing was part of the future strategy and would be introduced again, admitting that “it wasn’t possible when we had a small number of tests”.
The government is hoping that a contact tracing app being developed by NHSX will enable larger-scale contact tracing and will “assist individuals to do contact tracing themselves”, Hancock said.
Why contact tracing must be our next national mission: my video today pic.twitter.com/0HNQECY1CM
— Jeremy Hunt (@Jeremy_Hunt) April 20, 2020
Former health secretary Jeremy Hunt took to social media on Monday to say contact tracing “needs to be our next national mission” but also highlighted that not everyone can download an app.
How will the restrictions be lifted?
It’s almost certain it will be in a gradual fashion rather than all at once.
“It seems likely there will be ongoing restrictions once the strict lockdown we have now ends,” says Dr English.
“You can go to work and go to school but not have the clubs, pubs and sport venues running.”
This has already been mentioned by the government. Earlier this week Michael Gove confirmed pubs, restaurants and hotels will be among the last to reopen when the government relaxes lockdown.
The Cabinet Office minister said on Sunday ministers would make a “balanced judgement” about what changes could be made to the current social distancing measures.
Does the timing matter?
Yes, and not only because people want it to happen sooner rather than later.
“My personal view is that this should happen earlier and well before the winter flu period,” says Prof Gupta.
“Because what you don’t want is the huge issue of people having influenza and other viruses as well as Covid-19, it will make diagnosis and management very difficult.
“So I think we need to plan for that second wave to be completely outside of the winter period and maybe a lockdown again over the winter months.”