Draconian stay-at-home orders and shutting all non-essential businesses had little effect on fighting coronavirus in Europe, according to ...
Draconian stay-at-home orders and shutting all non-essential businesses had little effect on fighting coronavirus in Europe, according to a study.
But the same scientists discovered closing schools and banning all mass gatherings did work in slowing outbreaks across the continent.
University of East Anglia researchers now say relaxing the stay-at-home policy and letting some businesses reopen could be the UK's first step to easing lockdown.
The findings throw into question whether Britain's total lockdown - announced on March 23 - was necessary.
Other top scientists have claimed Britain's COVID-19 crisis peaked and started to decline before lockdown began, arguing that Number 10's drastic policy to shut the UK down was wrong. Data suggests that transport use had started to fall and fewer people were visiting doctors with coughs and breathing problems in the weeks leading up to the dramatic policy change, that people were obeying social distancing without strict rules in place.
And one Swedish researcher, Dr Johan Giesecke, who has seen his country resist calls for a lockdown but escape relatively unharmed, said the pandemic is unstoppable and everyone will be exposed to the coronavirus sooner or later.
It comes after Boris Johnson yesterday confirmed that strict rules imposed under the six-week coronavirus lockdown will start to be eased on Monday, on the same day that Britain's death toll became the first in Europe to rise above 30,000 and the number of people diagnosed with the disease surged past 200,000.
The Prime Minister will outline a five-step plan for Britain's 'second phase' on Sunday, with the government set to drop its 'Stay at Home' message and replace it with 'Stay Safe'.
But as the UK and other countries in Europe prepare to lift restrictions the World Health Organization has warned them not to be afraid of restarting them it the virus begins to take off again.
Graphs provided by researchers at the University of East Anglia compare how separate lockdown measures affected their 'risk ratio' - an algorithm which predicts how likely the virus is to spread. The gradients show that risk dropped over time after mass gatherings were banned, schools were closed and 'initial businesses ' were shut, including gyms
Gradients which showed less of an effect, or apparently no effect at all, on the risk ratio are pictured, showing that total business closures, staying at home, and wearing masks do not appear to impact the risk of virus spread
A man in a face mask is pictured walking along an empty Regent Street in London today as the country continues to abide by rules not to leave their homes unless it is absolutely necessary
Results of the study - based on data from 30 countries - also showed how the same measures worked to keep death tolls down
Data tracking people's transport around the country showed that there was a 30 per cent drop - and falling - in travel before the official lockdown even started, showing people were voting with their feet and opting to stay at home for safety
Royal College of GP data showed the number of people with flu-like illness in England and Wales dropped by 50 per cent when hand-washing and social distancing was encouraged on March 16. Professor Carl Heneghan, from the University of Oxford, says this is evidence full lockdown was not necessary because infections were already falling when it began
UEA researchers looked at a range of social distancing measures adopted across 30 European countries.
They cautioned that the study, which was funded by the National Institute for Health Research Health Protection Research Unit in Emergency Preparedness and Response at King's College London and Public Health England, is experimental.
Banning mass gatherings, along with closing schools and some non-essential businesses, particularly in the hospitality sector, were the most effective ways at stopping the spread of the disease, the researchers found.
They said that more investigation is needed on the use of face coverings in public, as the current results, which do not support using them in public, were 'too preliminary'.
One of the scientists involved in the research, Dr Julii Brainard, said they found clear distinctions between which measures were more effective.
'We found that three of the control measures were especially effective and the other two were not,' she told BBC Radio 4 this morning.
'It pains me to say this because I have kids that I'd like to get back into education, but closing schools was the most effective single measure, followed by mass gatherings.
'[This was] followed by what were defined... as the initial business closures. So that was the point when, in the UK for instance, they closed gyms and clubs.
'Adding very little additional effect was the stay-at-home measure, surprisingly, and the additional business closures.'
The research adds to claims from Dr Johan Giesecke, of Stockholm's Karolinska Institutet, that total lockdowns are unnecessary because the virus is unstoppable. Although he admits the benefit of preventing hospitals from becoming overwhelmed which, the UK Government says, has been its aim all along.
Writing in an article in The Lancet, Dr Giesecke said: 'Many countries (and members of their press media) have marvelled at Sweden's relaxed strategy in the face of the coronavirus disease 2019 (COVID-19) pandemic: schools and most workplaces have remained open, and police officers were not checking one's errands in the street.
'It has become clear that a hard lockdown does not protect old and frail people living in care homes—a population the lockdown was designed to protect.
'Neither does it decrease mortality from COVID-19, which is evident when comparing the UK's experience with that of other European countries.'
Dr Giesecke explained that estimates in Sweden suggest a quarter of 2.4million people in the capital, Stockholm county, have had the virus already and around 99 per cent of them were never diagnosed. The country has recorded only 2,941 deaths - only a 10th as many as Britain.
He added: 'These facts have led me to the following conclusions. Everyone will be exposed to severe acute respiratory syndrome coronavirus, and most people will become infected.
'COVID-19 is spreading like wildfire in all countries, but we do not see it - it almost always spreads from younger people with no or weak symptoms to other people who will also have mild symptoms.
'This is the real pandemic, but it goes on beneath the surface, and is probably at its peak now in many European countries. There is very little we can do to prevent this spread: a lockdown might delay severe cases for a while, but once restrictions are eased, cases will reappear.
' I expect that when we count the number of deaths from COVID-19 in each country in 1 year from now, the figures will be similar, regardless of measures taken.'
The Imperial College COVID-19 Response Team, which has been advising the Government, estimated in March that the global average R0 of the coronavirus was 3.87. As social distancing and lockdown took effect that number has now plummeted to below 1, potentially as low as 0.5, meaning the virus will die out naturally if this continues
UEA researchers collected data from 30 different European countries, revealing roughly when each of their outbreaks began and when social distancing measures were introduced
Germany's top diseases institute said the closely-watched R rate had fallen from 0.71 to 0.65, meaning the epidemic is losing pace even as the country begins to ease out of lockdown and reopen schools
The University of East Anglia researchers looked at the number of cases and deaths taken from daily published figures by the European Centre for Disease Control.
These were compared with the start dates of different measures including the restriction of mass gatherings, the closure of schools and different types of businesses, stay-at-home orders and the wearing of face masks.
Lead researcher Professor Paul Hunter, from UEA's Norwich Medical School, said the study shows that school closures in Europe had 'the greatest association with a subsequent reduction in the spread of the disease', but it does not clarify the ongoing puzzle of whether children can pass Covid-19 to adults.
He said: 'And it does not identify which level of school closure has the most impact, whether it is primary, junior, senior school or even higher education.
'It's also important to remember that our results are based on total closure, so it is possible that partial school closures could have worthwhile impacts on the spread of infection.'
Banning public and private mass gatherings was another key tool in fighting the spread of the virus.
Professor Hunter noted that the size of the current banned mass gatherings varied between countries and so the importance and impact of the scale of the individual event is still not clear.
Dr Julii Brainard, of UEA's Norwich Medical School, said the researchers were 'really surprised' to learn that stay-at-home orders may not be needed to control the outbreak, provided that this did not lead to more mass gatherings.
It was found that these stay-home policies were not linked with a decline in incidences, and that as the number of lock-down days increased, so did the number of cases.
Differences in how the countries carried out these policies have ranged from them being an advisory notice in some places, while elsewhere they were orders which were enforced by police with penalties.
The shut-down of non-essential businesses, which included places where people gathered such pubs, leisure centres, restaurants and venues, also had an impact on the spread of infection in each country.
Professor Hunter said: 'This suggests that keeping some businesses closed, particularly in the hospitality and leisure sector, would have the most impact.
'However, we also know that while outbreaks of food poisoning are frequently linked with restaurants, outbreaks of other respiratory infections generally in the hospitality sector are fairly rare.'
Dr Joshua Moon, of the University of Sussex Business School, noted that differences in testing rates and strategies in each country would have an impact on the number of cases.
He said the study may indicate that stay-at-home orders could be the first things to be relaxed.
Dr Moon said: 'We have to remember that decisions like this cannot and should not be made on a single finding.
'Nor should policy be made based solely upon science – there are many social, economic, political, and moral factors to consider that science simply cannot answer.
'When it comes to this pandemic, caution is paramount, otherwise we could tip too far and risk a second wave and a return to lockdown.'
The cautious sentiment is in line with warnings from the World Health Organization. Its director-general, Dr Tedros Adhanom Ghebreyesus, said countries must act slowly and be willing to row back if the virus spiralled out of control again.
Dr Ghebreyesus said in a briefing yesterday: 'The risk of returning to lockdown remains very real if countries do not manage the transition extremely carefully and in a phased approach.
'The COVID-19 pandemic will eventually recede, but there can be no going back to business as usual.'
Senior emergency officer at the WHO, Dr Catherine Smallwood, said that moving out of lockdown must be done 'in a step-by-step manner, that it is gradual and it is cautious,' The Mirror reported.
Researchers from the University of Newcastle, the London School of Hygiene and Tropical Medicine and Tshwane University of Technology in South Africa are also part of the study team.
Experts not involved with the research said the difficulty lies in separating the effects of individual restrictions when, in many cases, they were introduced at the same time.
Dr Brainnard addressed this in her Radio 4 interview, saying: 'Because none of the countries implemented all of the measures, and there was variable timing, we can kind of look at separate timings.'
Professor Keith Neil, an epidemiologist at the University of Nottingham, said: 'The main limitation of the study is that in many countries various measures were put in place at the same time making it difficult to disentangle which effects were having an impact. The strength lies in looking at data from 30 countries.
'The more of the lockdown restrictions that have a minimal, if any, benefit in controlling spread that are then relaxed the better the physical and mental health of the country will be.
'They found stay-at-home orders and closure of non-essential businesses appear to have minimal effects on transmission prevention. Relaxing these would therefore likely to have minimal adverse consequences on the epidemic.
'In controlling spread their main finding was that school closures were important. As many schools have now gone, or soon will go, back in Europe the impact of school closures and the re-opening will become apparent and help the UK’s exit strategy with real data.
'Next of importance was the banning of mass gatherings comes as no great surprise and also has little impact on the economy overall if it needs to be continued.
'Overall the paper helps those planning the exit strategy with some more science.'
Despite Number 10 confirming that lockdown will start to be eased on Monday, it is expected the measures will be extended for another three weeks today.
On Sunday, Mr Johnson will unveil a series of 'easements' to the nation, which will be announced after the Cabinet finalises details.
The government's stay at home message will be replaced with a 'be careful when you're out' mantra, according to one Cabinet minister.
The minister added that the easing of lockdown will be based on how much each step of the plan affects the rate of infection - or R.
The government is thought to have drawn up a draft 50-page blueprint to gradually ease lockdown in staggered steps between now and October.
This blueprint is expected to lead to a five-step roadmap to see Britain leave lockdown completely by Autumn.
But an 'emergency brake' could be applied if a second wave of the deadly virus arrives.
A leading Oxford University expert has argued that the peak of Britain's coronavirus crisis was a week before lockdown was announced on March 23, and that the early warnings for people to try to social distance and to wash their hands regularly had an impact on their own.
Professor Carl Heneghan claims data clearly showed infection rates halved after the Government launched a public information campaign on March 16.
Health bosses urged Brits to wash their hands and keep two metres (6'6") away from others before rolling out the unprecedented lockdown.
Professor Heneghan argued ministers 'lost sight' of the evidence and rushed into a nationwide quarantine six days later.
He said that they were instructed by scientific advisers who have been 'consistently wrong' during the crisis.
Professor Heneghan hailed Sweden - which has not enforced a lockdown despite fierce criticism - for 'holding its nerve' and avoiding a 'doomsday scenario'.
He told MailOnline: 'The peak of deaths occurred on April 8, and if you understand that then you work backwards to find the peak of infections.
He referred to a delay in the time it takes for an infected person to fall seriously ill and die - three weeks on average.
Data shows the rate of Britons with upper respiratory tract infections dropped from 20 per 100,000 people on March 15 to around 12 per 100,000 just six days later.
The figures do not relate solely to coronavirus but may be a good indicator because so few people were being tested for the deadly infection.
Explaining the logic behind his claim, Professor Heneghan said: 'The UK Government keeps saying it is using the best science.
'But it appears to be losing sight of what’s actually going on. We’ve been getting scientific advice that is consistently wrong.
'It has failed to look at all the data and understand when the peak of infections actually occurred.'
He added: 'Fifty per cent reductions in infections occurred on March 16, right when hand washing and social distancing was introduced.
'If you go look at what’s happening in Sweden, they are holding their nerve and they haven’t had doomsday scenario. Our Government has got it completely the wrong way around.'
Some scientists have suggested that splitting the lockdown into two 'tiers' based on personal risk could be a more effective way of managing them.
Researchers at the University of Edinburgh suggested that people vulnerable to the disease, such as the elderly and those with serious health problems, should abide by stricter rules than young healthy people who are less likely to die if they catch COVID-19.
They said the approach, dubbed 'segmentation and shielding', is the only way to get the UK back to normal without overwhelming the NHS and causing a second wave.
Healthy Britons would be allowed back out, but stringent contact tracing, social distancing and hand-washing rules would need to be in place.
Anyone with symptoms would need to quarantine along with their entire household for two weeks.
The study, which used modelling to predict the virus's spread after lockdown, did not say how much longer elderly people would need to stay cooped up at home.
The researchers concluded that the best course of action would be the 'two-tier' approach, which would give young healthy adults and children greater freedoms while ensuring that the most vulnerable are protected.
Certain measures would stay in place, such as the use of the NHSX contact-tracing app, social isolation upon expressing symptoms of COVID-19, quarantine of entire households and social distancing.
However, it would allow society's fittest to reclaim some of their lost freedoms.
The most vulnerable – the elderly and those with underlying medical conditions – would still need to avoid anyone potentially infected with the virus.
Dr Bram van Bunnik, a researcher at the University of Edinburgh's Usher Institute, said: 'Easing the measures taken during the lockdown is important as they currently have a tremendous effect on our society, but this should only be done in a way that is both safe for the people that are most vulnerable as well as for the health and safety of NHS staff.
'Segmentation and shielding is a possible way of achieving this: measures could be eased for a large proportion of the population, however the vulnerable population likely still needs to be protected for a prolonged period.'
The team said the risk to non-vulnerable people released from lockdown could be managed via effective clinical care and public health measures as well as ensuring universal high standards of hygiene and hand washing.
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