It is estimated that the elimination of all epidemic prevention methods is equivalent to increasing the spread of the virus by about 25% to 80%.
Written by | Ling Jun
Source | "Medical Community" public account
On the road to lying flat against the epidemic, the UK has taken a new step.
(Yesterday) On February 21, British Prime Minister Boris Johnson announced that all epidemic prevention measures in England will be phased out from this week. On the same day, the UK government released a document naming the programme: COVID-19 Response: Living with COVID-19, making the UK the first European country to allow infected people to go to work, shop and use the bus system as usual.
This move also caused widespread doubt in the academic community. "'Coexistence with poison' does not mean total disregard for viruses." Professor Chaand Nagpaul, president of the Board of Governors of the British Medical Association, believes that' but the UK government clearly understands it that way.
Can people with COVID-19 travel at will?
As early as last month, the United Kingdom has gradually cancelled a number of epidemic prevention measures, including mandatory wearing of masks, and according to Living with COVID-19, england will be further liberalized from February 24:
Infected people are no longer required to self-isolate;
Employees are not obliged to ask their employer if they need to quarantine after infection;
No longer requires the tracking of close contacts;
Abandoning routine nucleic acid testing for most educational and childcare staff and students...
By April 1, nucleic acid testing was no longer available free of charge except for at-risk groups. Johnson said it marked the end of "two darkest years."
Is it really over?
From the relevant data, the new plan seems to have a certain realistic basis:
Since 2022, the number of new coronavirus infections in the UK has dropped rapidly, and the vaccination rate of about 85% has strengthened the government's "coexistence with drugs". According to data previously released by the UK Security Agency UKHSA, the proportion of the population in various regions of the UK has COVID-19 antibodies as high as more than 96%. At the same time, about two-thirds of the positive infection cases were no longer contagious by the fifth day of isolation, and by the 7th day, it dropped to 1/20.
Boris's government further explained that the removal of various restrictions was based on higher immunization levels and low mortality rates in the UK, and that large-scale nucleic acid testing did not make much sense due to the relatively "mild" Omicron. Last year, the UK government allocated £15.7 billion for testing and tracing.
This view fits with an article published Jan. 19 in The Lancet by American expert Christopher Murray, who notes that contact tracing efforts appear to be futile given the intensity of Omicron's spread. Expanding testing will only disrupt many people's lives.
But this obviously cannot dispel the doubts of many experts. On the same day (21st) of the promulgation of the new plan, the famous medical journal the BMJ published a view, saying that the cancellation of testing for the new crown virus was unreasonable and criticizing the government's decision.
The article believes that the reason why the previous tests have had little effect is because the government does not arbitrarily carry out tests based on scientific strategies, allowing private companies to earn billions of pounds. But now the remedy is "simply cancel"?
"Like the Omicron sub-variant BA.2, new variants of Covid-19 keep popping up, and we have no reason to think the trend will stop anytime soon. Instead, we are likely to continue to see new strains emerge and cause infections. ”
At the same time, a number of papers have been published in recent years, suggesting that at present, we must not be overly optimistic about the virulence of Omicron. On February 7, an article published on the preprint platform medRxiv showed that Omicron's case fatality rate, although lower than Thatta's, was still higher than that of the Alpha strain; on February 14, Japanese researchers published a study on BA.2 animal experiments, showing that in addition to increased transmission, BA.2 may cause the same serious disease as the Delta strain.
How effective was the previous "lying flat" experiment?
This is not the first time that the United Kingdom has announced "lying flat", nor is it the first time that European countries have opened the "naked run" experiment.
In the summer of 2021, the United Kingdom claimed to treat the new crown as an "ordinary flu", lifted the "close contact quarantine" and "wear mask" orders, and provided the world's first sample of "lying flat" social experiments. It was followed by Denmark, which lifted restrictions on epidemic prevention and control in September last year, saying that the "new crown virus" was no longer a threat.
When the lockdown was first lifted, the epidemic situation in both countries was relatively stable. But when Omicron came in November, the number of new confirmed infections in both countries exploded, and the death toll in Denmark rose sharply.
So the United Kingdom and Denmark called a halt to the "experiment." Late last year, the United Kingdom announced that people in England must resume wearing masks in public, while Denmark reintroduced the "coronavirus passport".
Subsequently, the academic community found that Omicron's virulence was relatively "mild", coupled with the fact that the epidemic in the United Kingdom had declined after experiencing the peak of Omicron, the British government announced again last month that there was no need to wear a mask and gradually lifted all remaining restrictions.
Professor Maggie Rae, president of the Public Health Institute England, was ruthless in his assessment of this, arguing that the British government has not scientifically formulated an effective and long-term strategy to combat the new crown virus, and that policy decisions are usually rushed.
In fact, in the long run, the new crown virus is unlikely to disappear completely, and "coexistence with poison" has also reached a consensus among many Western scholars, and the point of contention is nothing more than how to coexist. When do they coexist? To what extent do they coexist? But this time, the British government directly chose to "run naked on the spot", and the experts of the British health system could not sit still.
According to a number of British media reports, a survey showed that the head of 3/4 of the British NHS in england did not agree with the government's removal of self-isolation measures.
The British Medical Journal has recently published several articles. With an average of more than 20,000 confirmed cases a day and hundreds of deaths every day, professor Penelope Toff, president of the British Medical Association's Public Health Medical Branch, said: "We have the right to question whether there is a scientific basis behind the government's decision to make this decision." ”
But the logic behind Living with COVID-19 clearly goes beyond medicine. According to the new plan, strict anti-epidemic measures have imposed unusually high socio-economic costs on the UK and have had an unprecedented impact on public services and private enterprises. The "Associated Press" issued an article that Johnson's implementation of the new epidemic prevention plan is also for certain political purposes to please Conservative lawmakers.
In this regard, the British Medical Journal said that the formulation of epidemic prevention policies should be determined by the "virus itself", not politics.
Abandoning prevention and control is equivalent to increasing the spread of the virus by 25 to 80 percent
Why is it not yet the stage where you can completely lie flat?
On Sunday, several British doctors and scientists issued a joint open letter warning the government:
It is almost certain that the lifting of anti-epidemic measures will increase the spread of the virus and is not conducive to scientific monitoring and analysis of the new coronavirus variants.
There is no reason to assume that all new variants in the future will be mild, and that higher prevalence will provide more opportunities for virus evolution.
To date, none of the SARS-CoV-2 strains have reached population saturation, replaced by a new dominant variant. If left unchecked, personal illness and healthcare system burdens will persist.
According to the letter, it is estimated that the elimination of all epidemic prevention methods is equivalent to increasing the spread of the virus by about 25% to 80%. At present, more than 3,000 academics have signed the open letter.
At the same time, research on the after-effects of COVID-19 is further suggestive that the power of the virus should not be underestimated.
On February 7, a study published in Nature Medicine showed that people infected with the new crown virus have an increased risk of cardiovascular diseases, including cerebrovascular diseases, arrhythmias, myocarditis, heart failure, etc., and may continue to be affected by the burden of cardiovascular diseases within 1 year after recovery;
On 16 February, the BMJ released a large-scale analysis of the mental health outcomes of people living with COVID-19, which showed that after covid-19, the risk of developing anxiety, depression, neurocognitive decline and sleep disorders increased significantly compared with healthy people, ordinary flu patients, patients admitted to hospital due to influenza, and patients admitted to hospital for other infectious diseases.
Professor Chris Whitty, England's chief medical officer, said the lifting of restrictions should be a gradual, steady change over time, rather than a sudden stop to everything.
In fact, warnings and suggestions have been around since last month, but the Boris administration is clearly sticking to its own "big gamble." Throughout the outbreak, the government's recommendations and information have been informed of the best scientific evidence from health agencies, academics and experts, according to the new plan documents.
At the same time, as an alternative to easing restrictions, the government will continue to protect people at risk by providing vaccines and antiviral drugs, and support seven national key clinical trial platforms to monitor, prevent and treat COVID-19.
"We no longer need to use the law to force people." Johnson said, "Instead, we should rely on everyone's sense of responsibility, learn to live with the virus, and continue to protect ourselves without restricting freedom." ”
Resources:
1.Removing free access to covid-19 tests is incomprehensible，https://www.bmj.com/content/376/bmj.o449
2.Boris Johnson: Do not throw caution to the wind on Covid，https://www.bbc.com/news/uk-60446908
3.Boris Johnson scraps remaining COVID restrictions in England，https://mainichi.jp/english/articles/20220222/p2g/00m/0sc/006000c
4.Covid-19: Show us evidence for lifting restrictions, doctors tell Johnson，https://www.bmj.com/content/376/bmj.o383
Source: Medical community
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