There is a pathway out of lockdown

Mass testing should help to get a grip on coronavirusMass testing should help to get a grip on coronavirus
Mass testing should help to get a grip on coronavirus
Too many mistakes have been made, but we have an opportunity to take great steps forward in living under the shadow of coronavirus, says our new columnist Dr Ali A Smith

We have an evil monster, some tired heroes and a couple of sheriffs.

This Halloween Horror Story should have been easy to write. The evil monster is well known to us. There is no big reveal. Covid has haunted our every move for the past nine months.

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It hasn’t changed much. If anything it’s a little less scary now than it was. We have monitored the early admissions for the second wave and can see that death rates are half what they were in the first wave. That was expected. It’s a great relief.

Unfortunately, it is having some knock-on effects. More survivors take longer to be well enough to go home. Our hospital is getting more full than it did last time. We are already full to bursting. In this story, the evil monster doesn’t even try to hide very much. It’s pretty much everywhere.

My favourite hero is Scooby Doo. He never meant to be a hero. He gets nothing out of it beyond Scooby Snacks. The heroes in this story are much like that.

Frontline workers didn’t sign up for this, but have done it anyway. They are, however, tired. A threat can only stay scary for a while. Eventually you get used to it. You adapt. But it takes a toll.

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Soldiers in battle develop the same battle fatigue. A resigned deadening of emotions. Many organisations have seven per cent of staff off sick at the moment.

Add to that the need for us to swab all our staff and you have a very serious problem with the number of health care staff available to be heroes. Our sheriffs were in charge of the town when the evil monster showed up.

They weren’t expecting it and they didn’t have any monitoring. Actually they had removed some of the public health systems which could have helped prepare.

Just like in any good horror movie, we could all see the future that the sheriffs seemed to ignore.

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For most people, it has been evident that Covid was here to stay. Winter would bring the Covid return we are currently experiencing.

The sheriffs are, however, victims in this horror story too. They were dealt a duff hand. The Covid tests were very poor and catching the evil monster would prove very difficult. Horror movies often have a moment of sudden realisation. That bit where the sheriff suddenly sees the evil monster in its full extent.

That moment happened last week. There is a very accurate monitoring study called REACT. They send out large numbers of tests to random people in the country.

The latest results were available at the end of October and showed numbers of infections were very high and even where they were low, numbers were growing very fast.

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The consequence is the second national lockdown, but as most people have recognised, that only buys time. Given that schools are not closed it will probably bring numbers of infections under control, rather than actually bring numbers down.

The sheriff never gets much more than a bit part in a horror story. They are underpowered and don’t seem to recognise the dangers till it’s too late. As watchers, the drama unfolds without us having any control. We are victims of the plot twists. Dragged along. Intermittently horrified and then reassured. We are in the middle of this horror story.

None of us know if the vaccine will come and save us – though that doesn’t look likely till spring.

On current projections if there isn’t a vaccine before spring at least 20m of us will have been infected – we may simply develop the immunity we need. Until then, we need to know how to get through the time ahead.

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What happened in Liverpool last week looks hopeful. Mass testing of a whole city would enable people to behave appropriately. It solves the problem of schools and who can move about in society. It also potentially improves health care by stopping us accidentally spreading Covid.

Horror stories are resolved when the Evil Monster is defeated and the cast are united. Usually the sun comes out. We aren’t there yet, but there is reason to think that we have a way through the scariest bits.

Better treatment reduces deaths. Mass testing reduces transmission and suggests a way out of lockdown.

Dr Ali A Smith is a senior consultant working at a north west hospital. This is not his real name.

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