CoVid-19: the Pros and Cons of the Lockdown. Offering an alternative to the test and trace system.

Our experts, ever sensitive to criticism, have invited people to suggest ways which could improve the management of the CoVid crisis. In this post we discuss the pros and cons of the lockdown and offer our suggestions re how the crisis could be better managed.

Is social distancing effective?

Scientists have modelled the transmission of the virus between people and illustrated that the greater the distance between people, and the use of face masks, partially reduces the transmission of the SARS-COV-2 virus known as CoVid-19 yet such modelling is based upon many assumptions eg it assumes that everyone is equally vulnerable to infection which, for CoVid-19 is clearly not so. Some are immune to infection; others are mildly affected and/or asymptomatic; others a severe infection and recover in abt 5-7 days; whilst others require hospitalisation; and some die. Read on.

Is the testing, track and trace system working?

There is an emerging concensus that it is not living up to expectations but this is not unique to the U.K. It appears that other major European countries are also experiencing significant growth in the numbers being infected, requiring hospitalisation and/or deaths.

Are their test, track and trace systems also working below expectations?

If so should we radically review the fundamental basis of the test, track and trace system to establish what is being overlooked. What happens if someone becomes infected as a result of being in close proximity with infected people who work in the test centres, or in medical clinics, hospitals and clinics? Their test results will be negative yet they are infecting others shortly thereafter.

Is the test, track and trace system inherently flawed? Read on.

In China and many countries in the far east they have used the test, track and trace system very effectively but they have much lower numbers of people in the ‘at-risk’ group (diabetic, obese, etc) so it is far easier to trace and isolate the most significant patient group.

Consider for a second who are the most ‘at-risk’ patients? They are the unfit, sedentary, diabetic/diabetic comorbidities, obese, with breathing difficulties, suppressed immune function. Such groups tend to congregate to a greater extent in pubs and restaurants, as attendees at sporting events so it makes sense to close such establishments during a lockdown but why has the UK government seen fit to close or restrict the activities of those who are least likely to be infected and/or who are least likely to require hospitalisation? Children and adults of any age who are physically active through their work or pastimes have the most robust immune response. They may become infected but are extremely unlikely to require hospitalisation or die.

Why has golf, football, hockey athletics, gymnastics/gymnasiums, etc; or children’s outdoor sports been locked-down?

In doing so the government is reducing physical activity and INCREASING the numbers who are potentially at-risk. Surely these are the activities which should be encouraged!

Will test, track and trace system stop the virus? Only for a short period ie until people gather when the all clear is given and the numbers start to increase once again. It is almost inevitable that there will be further rounds of this virus.

How many are dying from CoVid?

The actual number of deaths from CoVid is debatable. There are few, if any, who die directly as a result of this viral infection. Most people who have died have had pre-existing medical conditions: mainly diabetes, obesity, and related side-effects and/or comorbidities. In such cases CoVid infection worsens their conditions and, for those that require hospitalisation and die, CoVid effectively worsens their pre-existing condition and pushes them ‘over the edge’. In general they die of acidosis and hypoxia which damages the structure and function of the lungs and leads to the most extreme failure of the autonomic nervous system. Accordingly it is not possible to make ‘precise’ and ‘accurate’ conclusions on this matter.

Instead of focusing upon the virus focus instead upon the patient. This is how healthcare deals with the seasonal epidemics of cold and flu - by treating the symptoms. Test, track and tracing is not used in such cases. Why should CoVid-19 be treated differently?

For those that are young and/or healthy CoVid is nothing more than a mild inconvenience so it would make more sense to lock-down and/or isolate the ca 1-5% of patients who are in the ‘at-risk category’ and let the remaining 95-99% of the population go about their lives without hindrance. Indeed, as stated above, this is what happens each year in the cold or flu season. The summer presents a unique set of conditions which has a virucidal effect upon all coronaviruses.

So there is a viable common-sense and scientific alternative. Moreover it would require the NHS to test, trace and track - and isolate - only those in the ‘at-risk’ groups rather than the immense numbers of those who have been infected with CoVid.

What happens if CoVid mutates into different mutations which have different effects? For example the D614 mutation appears to be more infectious than earlier mutations/forms of the virus. Will there need to be tests to test, track and trace each of these different mutations? It’s a thought!

It also requires that there is a scientific concensus of who are in the ‘at-risk’ groups. This requires that patients are thoroughly screened to determine their susceptibility to infection using a convenient and affordable screening modality.

NHS researchers have developed a Screening APP (although the 'scientific' basis of such an APP appears to be based upon hocus pocus rather than a significant scientific principle and/or understanding) whilst the Strannik Virtual Scanning screening technology offers a way of screening the patients health with an extraordinary level of detail than has hitherto been possible.

It also requires that the NHS adopts a preventative focus upon those in the population who are in the ‘at-risk’ groups, in particular those who are diabetic and have diabetic comorbidities. Indeed it is worth pondering whether all diabetics and pre-diabetics should be considered to be at-risk. See the arguments set out in two recent papers.

Ewing GW. SARS-COV-2: Learning the Lessons from our Experiences. A Critical and personal Review. Asian Journal of Pharmacy, Nursing & Medical Sciences 2020;8(4):42-48.

 Ewing GW. Issues which Influence the Etiology of CoVid-19 infection: a Proposed Treatment Protocol based upon optimising the autonomic and immune response. Health Education & Public Health 2020;3(3):290-295. doi: 10.31488 /heph.1421.

The best solution is surely to enhance the physical fitness of those in the ‘at-risk group’ and thereby reduce and/or eliminate their vulnerability to infection, and optimise their immune function and resistance to CoVid infection however this can only be done by recognising and fully understanding the fundamental factors which make someone susceptible and vulnerable to infection.

The WHO has now stated that they do not recommend lockdowns as the primary mechanisms re the control of CoVid. Locking-down the population will just delay the inevitable at least until vaccinations are developed which can control the virus. Moreover it leads to greater demand upon the NHS for other services which cannot currently be delivered by the NHS eg. mental health services including suicides, the screening and treatment of cancers, etc. It does not take into account the stress created by business failures including loss of jobs eg increased rates of domestic violence, failed marriages, etc.

Such episodes provide the opportunity to review the value of healthcare procedures eg fewer deaths of cardiac patients resulting from ‘healthcare’.

It is also worth considering whether a vaccination will have long-term value: (i) will the virus mutate and will the vaccine work with different CoVid mutations? (ii) how long will the immunity persist in different demographic groups? (iii) will each person be required to have repeated vaccinations? (iv) how safe will yet another vaccination (in the long term) prove to be? (v) Will it contribute to other health problems eg increasing susceptibility to other diseases and conditions (bearing in mind that unvaccinated or less vaccinateds often have much better health profiles that those who have been fully vaccinated)? (vi) What will be the overall cost of providing the vaccination? (vi) etc.

The massive number of failed businesses arising from the first lockdown has led to massive financial intervention by government as it tries to prop-up major industries and companies in its efforts to sustain them and conserve jobs. Moreover the money borrowed by government has to be repaid and the funds to do so inevitably come from the taxpayer but of course (money does not grow on trees) there are fewer companies and fewer in employment to pay for government services including healthcare. Something has to give. Savings - massive savings - have to be made from government programmes including expenditure in the healthcare services.

CoVid is only a crisis for the countries with greatest levels of diabetes and obesity. It is mainly a crisis for the healthcare professions i.e. for the people who treat the 'at-risk' groups in medical clinics, hospitals and care homes; and, of course, for those in the 'at-risk' groups. It is not a crisis for the majority of the population. Perhaps it is time for greater emphasis upon (i) prevention and (ii) taking steps to optimise the immune response of patients.

G. Ewing