I read there are 15 of the most acute beds in England, I calculate it’s more like million people will need these beds. I don’t believe our politicians and medical staff have grasped the nature of this coronavirus pandemic. I thought I would work out what would be a viable plan.
1) Confine
Quarantine of the UK
After at first ignoring those calling for borders to be secured, I have finally decided that the scale of the problem requires drastic measures. So, I am saying tht all people who come into the UK from abroad should be tested for CV and quarantined until they are clear.
Pro-active testing for CV
In addition to quarantine, I would set out to “sample test” the UK population AS A WHOLE (so not jut those with symptoms although that may be the priority focus). The aim would be to assess the scale of the pandemic in the UK and to determine and detect any “hot spots”.
Reduce intra-UK movement
Key to this strategy is to maintain CV in relatively small regional pockets. As such I would ban all events like football matches, concerts, political gatherings, that tend to cause large groups of people to travel and congregate. I would also request/require people not to travel around the country to meet others both for work or leisure. This should dramatically reduce the spread of CV so that any outbreaks are contained in a region which can then be quarantined.
Reduce the spread of common winter illnesses
It is vitally important to reduce common illnesses that spread and can complications that increase the need for hospital beds. So, whilst flu doesn’t kill in anything like the same numbers, it is important to tackle the flu & other easily spread illnesses. As such I would require anyone with a cold, cough, etc. to stay at home.
For similar reasons, I would ban any activities or sports which are known to cause large numbers of injuries to again reduce the workload on the NHS.
Confine – discussion
I would introduce the following measures immediately , with the intention of reviewing them in about two weeks to see what the situation is globally. If they prove too stringent for the actual problem, we can relax them, but we cannot retrospectively introduce them after problems arise.
2 Prepare
This is not so much a separate phase to confinement as an additional activity that is required. The simple trade off here, is that the number of hospital beds and particularly intensive care units AND STAFF needs to match the worst anticipated level of the crisis.
If there is no quarantine and CV spreads like wildfire, then we may need of the order of 1million acute beds (there are 15 currently available). If we stop CV spreading and we get a long drawn out epidemic over 10 months (if patients need 14 days in hospitl) then that 1million become 1million / 20, so we need 100,000 beds. If we drop it down to 3 years, then it is closer to 10,000.
My plan would attempt to block the spread of CV so that perhaps 10,000 acute beds were needed, not because I think a 3year quarantine is desireable, nor that 10,000 acute beds are the ideal number, but because we now have so little time and I don’t see any evidence we will get 100 extra beds, let alone 1000 or 10,000. But note, these are acute beds with specialist staff and high intervention equipment like ventilators. In addition I assume we will need 5x as many low interverntion beds. I am hoping that staff can be rapidly trained to deal with this perhaps from University students.
And if we aim for that and the CV crisis is not as bad, then we can relax the measures easily, but if it is as bad as I’m suggesting, we cannot stop the pandemic when it is already swamping the health service.
3 Quarantine
Because it seems likely that hte UK is like Italy and already has CV here and spreading, I think we will fairly quickly find that we have gone beyond the “confine stage” of this plan. The plan now is very simple:
100% area quarantine
Areas identified as “hotspots” above will be quarantined, meaning that entry and exit will be strictly regulated and only those with approved protective gear and means to self-isolate will be able to cross the border.
Within the quarantine area all group gatherings will be banned including schools, churches, etc.
Level 1 quarantine
The first level of quarantine will be introduced where it is felt practical to “seek out an isolate” those individual with CV. The quarantine needs to limit rather than stop person-to-person contact, so some degree of normal life in some aspects may be possible.
Level 2 quarantine
Where level 1 quarantine has failed, & medical services cannot cope, level 2 quarantine will prohibit person-to-person contact except by people trained to use and given personal protective equipment. Normal life will be limited to use of non-face-to-face contacts (phone, internet). Food will be delivered by suitably trained delivery drivers.
Level 3 quarantine
If people continue to meet (illegally) and flout level 2 quarantine, then level 3 is effectively the imposition of marshal law with the authorisation of deadly force & other suitble measures. (In China they welded shut front doors of blocks of flats).
Quarantine discussion
The main aim of quarantine is at the early stage to limit the spread of CV, but at a later stage to totally clamp down on spread to reduce the scale of the pandemic so that hospitals can cope. It is possible that if CV becomes widespread, that quarantining to isolate areas will no longer have any benefit. Instead quarantine will be used purely to try to limit the number of new cases to keep them at a level where the health service can cope.
Details
For quarantine to work, there are a lot of details that need planning from where to put the quarantine boundaries to how someone gets a necessary repair like a broken heating system.
