Is it time to relax the 2m social distancing guideline? (WHO guidance is 1m)

[MikeWM]

Indeed. This is where the incessant hand washing comes in (and I've been opening a lot of doors with elbows etc).

Do you have a link to that report ? It would certainly be a good news read if it turns out that the common cold can bestow some level of immunity ! (I've had enough of them in the past!).

This one

https://www.cell.com/cell/fulltext/S0092-8674(20)30610-3

in particular this part

Importantly, we detected SARS-CoV-2-reactive CD4+ T cells in ∼40%–60% of unexposed individuals, suggesting cross-reactive T cell recognition between circulating “common cold” coronaviruses and SARS-CoV-2.

and here's an attempt to explain what that means (not sure why this is 'India' news, doesn't seem to have been picked up by western MSM)

https://www.msn.com/en-in/news/india/bout-of-common-cold-may-give-immunity/ar-BB1490WU


It may or may not mean immunity, but if not, looks like it would result in a much less serious case.

 

[yorksrob]

Frankly I'd take a "much less serious case" as good news !

 

[Bletchleyite]

I'm particularly interested in ways in which the body can fight a mild infection other than IgG antibodies which is what those tests look for. I remain convinced I had a mild (but still unpleasant) case in February but a lab antibody test (which I paid for) was negative.

Could it be, then, that because I get colds by the minute (if there's one going, I get it - usually 5-6 a year at least - just about the only way I normally get in any way ill), I'm already set up to fight it?

Could this explain asymptomatic cases?

 

[MikeWM]

I'm particularly interested in ways in which the body can fight a mild infection other than IgG antibodies which is what those tests look for. I remain convinced I had a mild (but still unpleasant) case in February but a lab antibody test (which I paid for) was negative.

Could it be, then, that because I get colds by the minute (if there's one going, I get it - usually 5-6 a year at least - just about the only way I normally get in any way ill), I'm already set up to fight it?

Could this explain asymptomatic cases?

I'm getting out of areas I can claim competency in here (!) but to my understanding T cells are another mechanism of the (immensely complex!) immune system, and if they can successfully ward off an infection (eg. because they have been produced in response to a previous, similar infection), there's no need to create the specific antibodies that we're currently looking for in the antibody tests.

It also means that, as you suggest, the antibody tests alone may be seriously underestimating the proportion of people who have already been exposed to the current virus.

 

[Bletchleyite]

It also means that, as you suggest, the antibody tests alone may be seriously underestimating the proportion of people who have already been exposed to the current virus.

It could well mean that London potentially has already reached herd immunity, given that cases there are still falling fairly steeply (the curve is flattening because of growth elsewhere) yet the Tube is back in service with little actual distancing - and the Tube is very much London's petri dish.

 

[Skymonster]

It could well mean that London potentially has already reached herd immunity, given that cases there are still falling fairly steeply (the curve is flattening because of growth elsewhere) yet the Tube is back in service with little actual distancing - and the Tube is very much London's petri dish.

If you believe that, you have just made the case for lifting the lockdown elsewhere and letting this thing run its course.

 

[Bletchleyite]

If you believe that, you have just made the case for lifting the lockdown elsewhere and letting this thing run its course.

I'm starting to err towards the idea that a full reopening but retaining, for now, the 2m thing (but reducing it to 1m over time if cases don't explode) might be the way to go. It seems, by and large, to be working for Sweden.

Indeed, I suspect that had people paid attention to it that might well have been enough to bring cases down rather than a lockdown being needed - but they didn't, it took the lockdown and a load of fear to get them to do so.

 

[Skymonster]

...or indeed it might just prove that with London ahead of the rest of the UK continuing to allow people to pile onto the crowded tube was actually the right approach...

 

[xc170]

...or indeed it might just prove that with London ahead of the rest of the UK continuing to allow people to pile onto the crowded tube was actually the right approach...

I suspect this is correct, unless we build up immunity to Covid 19 by letting healthy low risk people catch it, it'll be with us for much longer, meaning all of this social distancing nonsense will be around much longer.

 

[nlogax]

I'm starting to err towards the idea that a full reopening but retaining, for now, the 2m thing (but reducing it to 1m over time if cases don't explode) might be the way to go. It seems, by and large, to be working for Sweden.

It's just been reported that Sweden's deaths per capita figure has now overtaken that of France. As time goes on Sweden's strategy will be increasingly questioned. If anything we should have been looking at Denmark. It's been three weeks since they halved social distance to 1 meter and their deaths per capita rate is under 25% of their Swedish neighbors.

 

[yorkie]

It's just been reported that Sweden's deaths per capita figure has now overtaken that of France. As time goes on Sweden's strategy will be increasingly questioned. If anything we should have been looking at Denmark. It's been three weeks since they halved social distance to 1 meter and their deaths per capita rate is under 25% of their Swedish neighbors.

I'm not sure that's relevant to relaxing the social distancing rule; in order to have achieved what Denmark achieved we would have had to lock down when we had a similar number of cases, which would have been much, much earlier. I don't see the relevance to the matter in hand, but if I've missed something, feel free to explain it.

I suspect this is correct, unless we build up immunity to Covid 19 by letting healthy low risk people catch it, it'll be with us for much longer, meaning all of this social distancing nonsense will be around much longer.

Possibly but it will not de facto be around for that much longer in casual environments and it's already almost completely gone in my experience, as people are not really bothering any more, at least not with 2 metre distances.

 

[nlogax]

I'm not sure that's relevant to relaxing the social distancing rule; in order to have achieved what Denmark achieved we would have had to lock down when we had a similar number of cases, which would have been much, much earlier. I don't see the relevance to the matter in hand, but if I've missed something, feel free to explain it.

It's pretty straightforward. All through this as a country we've been comparing our distancing and lockdown approach unfavourably with that of Sweden's and looking but they now seem to be experiencing the downside. Denmark seems to be one of the poster children in how to have dealt with C19 (yes - early lockdown a key part that we failed to invoke), and they're now able to reap rewards by reducing their physical social distance and reopening safely. All along we should have been doing that.

 

[Yew]

Edit: removed

 

[The Ham]

With an R rate of 2-3 before the lockdown and around a 5-7 day incubation period, this would be roughly what you would expect to see regardless of whether people visited their mothers or not. As hospitalisation is normally around 2 weeks after infection, and testing was mostly restricted to hospitals at that point, if anything that evidence suggests that the increase you'e mentioned was not caused by mothers day. You would expect to see those cases recorded with a positive test around a week or so later.

The point is that on Mother's Day we should have been on a semi lockdown, as on the 16th we were all told to stay working from home if it were possible, stop non essential contact and to avoid pubs. As such there should have been a dropping off of numbers, because of the changes in the way we were behaving.

 

[yorkie]

The point is that on Mother's Day we should have been on a semi lockdown, as on the 16th we were all told to stay working from home if it were possible, stop non essential contact and to avoid pubs. As such there should have been a dropping off of numbers, because of the changes in the way we were behaving.

I still don't understand how this is related to proposed relaxations of the 2m guideline, but you are incorrect to say that the numbers would be expected to drop off straight after a (semi) lockdown as that's just not the way it works. I think you are fundamentally misunderstanding the issue and it's not relevant to the discussion in hand.

It's pretty straightforward. All through this as a country we've been comparing our distancing and lockdown approach unfavourably with that of Sweden's and looking but they now seem to be experiencing the downside

I don't know what you are saying here, but I can't find any evidence that Sweden are differing from the WHO's standard 1 metre, nor can I see evidence of a "downside" to this. If you have evidence, feel free to present it.

Denmark seems to be one of the poster children in how to have dealt with C19 (yes - early lockdown a key part that we failed to invoke), and they're now able to reap rewards by reducing their physical social distance and reopening safely. All along we should have been doing that.

I don't see how this is relevant to the proposals to relax the social distancing guideline from 2m to 1m. Saying we should have locked down in February or whenever isn't really relevant to this discussion and doesn't really present a valid argument against what @yorksrob proposes.

 

[nlogax]

I don't know what you are saying here, but I can't find any evidence that Sweden are differing from the WHO's standard 1 metre, nor can I see evidence of a "downside" to this. If you have evidence, feel free to present it.

If you'd read the part their newest per capita death rate then I suggest there's your evidence of a downside to Sweden's approach. Four times that of their immediate neighbors. And I'm sure you're aware of this from today;

https://www.theguardian.com/world/2...-strategy-admits-too-many-died-anders-tegnell

Sweden’s chief epidemiologist and the architect of its light-touch approach to the coronavirus has acknowledged that the country has had too many deaths from Covid-19 and should have done more to curb the spread of the virus.

As for arguing for / against what @yorksrob is proposing, I wasn't. To be honest this thread moves so quickly it's hard to keep up.

 

[Class 33]

It is looking likely that by the end of this month that the Coronavirus daily deaths will be down to ZERO. Now the day that actually happens, I'm not expecting the government to scrap the 2 metre social distancing rules immediately. But I hope that within 3 to 4 weeks of that day happening, that the 2 metre social distancing rule will be scrapped completely. As we just can't continue long term like this with these social distancing rules. For many businesses it just won't be financially viable to operate long term with social distancing measures and severely restricted customers they can serve. If this continues long term, many businesses will go bust, unemployment will go through the roof!

My feeling is though that the government will expect us to keep this "social distancing" for many months to come!

 

[yorkie]

If you'd read the part their newest per capita death rate then I suggest there's your evidence of a downside to Sweden's approach. Four times that of their immediate neighbors. And I'm sure you're aware of this from today..

It's too early to judge Sweden's approach but I see no reason why this should be used as justification for us to retain the 2m guideline so I am unsure of the relevance in this thread.

It is looking likely that by the end of this month that the Coronavirus daily deaths will be down to ZERO....

I'm not sure about that, but regardless of that, clearly the 2m guideline cannot be viable beyond the end of the month, or even 15th June in my opinion.

 

[jfollows]

Better than The Times article I quoted in #259 is a Lancet article "Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis" dated 1 June (https://www.thelancet.com/action/showPdf?pii=S0140-6736(20)31142-9), which may be the source for some of the Times article. The Lancet undertook a review of 172 observational studies across 16 countries and attempted to infer common conclusions, and acknowledges a potential lack of rigour because of the differences between the studies. However, its conclusion generally supports the 2m separation guideline:

We found evidence of moderate certainty that current policies of at least 1 m physical distancing are probably associated with a large reduction in infection, and that distances of 2 m might be more effective, as implemented in some countries. We also provide estimates for 3 m. The main benefit of physical distancing measures is to prevent onward transmission and, thereby, reduce the adverse outcomes of SARS-CoV-2 infection. Hence, the results of our current review support the implementation of a policy of physical distancing of at least 1 m and, if feasible, 2 m or more. Our findings also provide robust estimates to inform models and contact tracing used to plan and strategise for pandemic response efforts at multiple levels.

The study also infers a relative risk with increasing distances of just over 2 per m, in other words the risk roughly halves for every extra metre of separation (CAVEAT: Assuming I am reading the report correctly, I think I am!)
This study does at least appear to be good input to the "supported by science" message we get spouted at us by the government all the time.

 

[Jamesrob637]

It is looking likely that by the end of this month that the Coronavirus daily deaths will be down to ZERO.

On Sundays and Mondays maybe. Tuesday to Saturday will still produce some figures even if very low.

 

[yorksrob]

Better than The Times article I quoted in #259 is a Lancet article "Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis" dated 1 June (https://www.thelancet.com/action/showPdf?pii=S0140-6736(20)31142-9), which may be the source for some of the Times article. The Lancet undertook a review of 172 observational studies across 16 countries and attempted to infer common conclusions, and acknowledges a potential lack of rigour because of the differences between the studies. However, its conclusion generally supports the 2m separation guideline:

The study also infers a relative risk with increasing distances of just over 2 per m, in other words the risk roughly halves for every extra metre of separation.
This study does at least appear to be good input to the "supported by science" message we get spouted at us by the government all the time.

I interpret that as 1m - substantial benefit, 2m - possibly more effective, but not conclusive. This seems like an argument for 1m to me.

 

[jfollows]

The Lancet report I quote at #349 was the source for The Times article I quote at #259 , but its conclusions need care.
In particular, The Lancet says that, across a range of studies and viruses, not exclusively COVID-19, comparing a physical distance of >=1m versus a physical distance of <1m, for the shorter distance studied there is a 12.8% chance of viral infection or transmission versus a 2.6% chance for the further distance studied. The Times has this as "The risk of catching coronavirus from an infected person falls from 13 per cent at less than one metre to 3 per cent further away and halves with each extra metre, according to an overview of dozens of studies." So there's a bit of over-interpretation in The Times. And "further away" is 1m or more.
So, indeed, I agree with the "1m - substantial benefit" interpretation.

 

[johnnychips]

Everything is relative. If you eat a lot of bacon and other ‘burnt’ foods you have a 33% more chance of getting bowel cancer. FACT. However, if you look into the stats, this means a 3 in 1000 probability increases to 4 in 1000.

 

[Yew]

Everything is relative. If you eat a lot of bacon and other ‘burnt’ foods you have a 33% more chance of getting bowel cancer. FACT. However, if you look into the stats, this means a 3 in 1000 probability increases to 4 in 1000.

Unlike PPE, one thing we have not been short of throughout this situation is misleading statistics.

 

[jfollows]

I found it interesting to see the Office for National Statistics has put out a report (https://www.ons.gov.uk/peoplepopula...onaviruscovid19infectionsurveypilot/5june2020) on the likely percentages of people testing positive for COVID-19. The highest percentage seems to be for people "working outside of home" of just under 0.75% with a possible figure as high as slightly over 1%. These are the category of people you're more likely to encounter if you're out and about yourself. Also, it's not clear to me that "positive test" always means infectious, although it's probably reasonable to assume so.

 

[Class 33]

I'm not sure about that, but regardless of that, clearly the 2m guideline cannot be viable beyond the end of the month, or even 15th June in my opinion.

Yes, come the 15th June and all the "non-essential" shops re-opening again, I think it's going to be chaos with this 2 metre social distancing still going on. In the town centres, long queues to get in all the shops, one way systems around the shops, lots more traffic and people out and about. It will be very difficult to maintain social distancing. I agree that it really needs to be scrapped by the end of this month. We can't go on like this for many months to come. But sadly I don't think it will be until at least August, if we're lucky. Look at the reports of all the changes pubs, restaurants, gyms, hairdressers, etc are having to make to their premises to adhere to the social distancing guidelines when they are allowed to re-open from next month. They won't be making all those changes and then it turns out the social distancing guidelines will be dropped by then.

"Social distancing". I'll be happy when we well and truly stop hearing and seeing those two words!

 

[The Ham]

="yorkie, post: 4607292, member: 4"]
I still don't understand how this is related to proposed relaxations of the 2m guideline, but you are incorrect to say that the numbers would be expected to drop off straight after a (semi) lockdown as that's just not the way it works. I think you are fundamentally misunderstanding the issue and it's not relevant to the discussion in hand.

Whilst numbers shouldn't drop straight after a semi lockdown it took 4 weeks (of you look at the 7 day rolling average, so you can see the real falls and not just the falls at the weekends where less testing happens) after this for the numbers to do so, with other countries a full lockdown resulted in the numbers falling after 3 weeks, so if everyone did follow the rules of working from home where possible, not going and seeing people, etc. it's reasonable to assume at least a flattening after three weeks. That didn't happen.

How this is relevent to should we ease restrictions is this; people don't follow the rules and so if you relax the rules then people are going to relax more than the rules allow.

For example there'll be parents who'll say, "my child is at school mixing with their classmates, so there's no reason why I can't do likewise and...". As such, before we go to 1m, we should wait a few weeks to see what happens to the number of cases. There's probably an argument for that to be a few weeks after all school children go back. The overall balance is ensuring that we don't open so quicker that we see cases going back upwards whilst trying to allow businesses to get back to doing their thing.

The death figures yesterday weren't overly encouraging going back above 200 when they were well below it the day before, however that's just one day so could just be a blip and may continue back downwards, well have to wait and see what Tuesday's data shows.

Those concerned about the reopening of shops leading to problems in town centres if we don't relax the rules, if say this; whilst with normal shopper numbers it would be there going to be a quote a few who will stay at home rather than go shopping.

The reason for this is that for some they shop socially, well that's not aloud (and whilst some still will many who do won't), add to this the fact that many are now used to shopping online and that there's less parties to go to (less presents, less new outfits, etc.) as well as people are likely to be able to plan ahead more easily. Yes there'll be a few days of it being a bit too busy, but then it'll calm down and it should then work fine.

The other thing to consider is that with less places to eat/drink people are more likely to be doing get in, get out shopping rather than destination shopping (i.e. spending a day with lunch or, a coffee, catching a film, etc.). This would reduce the numbers in the town centers from what is typically seen.

One thing which could be done fairly easily, which would help parents working at home, would be the use of live teaching (the use of zoom). Whilst there'll be some who wouldn't be able to access this, or at least in real-time, saying that we shouldn't do this because a few would be left out. However that means that we're excluding everyone and limiting the ability for staff to work at home as efficiently as they otherwise could. Even a few hours of teaching a week would give parents the ability to be able to work without being so distracted by helping their children.

It could also allow other restrictions to be eased sooner as it would allow the risk from more children going to school to be pushed back until later on. Especially as it's going to be hard to take small steps from bubbles to full classes, it's likely to be an all or nothing thing.

That could allow the relaxing to the 1m distance to come in sooner and therefore help the economy more than just waiting for schools to open or relaxing to 1m whist being at a lower risk than doing both together.

 

[underbank]

Yes, come the 15th June and all the "non-essential" shops re-opening again, I think it's going to be chaos with this 2 metre social distancing still going on. In the town centres, long queues to get in all the shops, one way systems around the shops, lots more traffic and people out and about. It will be very difficult to maintain social distancing. I agree that it really needs to be scrapped by the end of this month. We can't go on like this for many months to come. But sadly I don't think it will be until at least August, if we're lucky. Look at the reports of all the changes pubs, restaurants, gyms, hairdressers, etc are having to make to their premises to adhere to the social distancing guidelines when they are allowed to re-open from next month. They won't be making all those changes and then it turns out the social distancing guidelines will be dropped by then.

"Social distancing". I'll be happy when we well and truly stop hearing and seeing those two words!

If all shops are open, then people will be spread out. At the moment, there may be a queue of 10 people outside a shop, but no others are open. We may well end up with 2-3 people queuing outside every shop, so it's all spread out. Also, there'll be a lot of people who won't be going shopping as often (if at all), so we'll be nowhere near back to pre-covid levels of shopper numbers. There are millions of vulnerable/shielding who won't be going out for non-essentials. Inevitably it'll be busy at first (like the queues at McDonalds and Ikea), but after all the impatients have been and got their fill, I can see numbers dropping quite significantly to find a new, lower, "normal" level.

 

[scotrail158713]

If all shops are open, then people will be spread out. At the moment, there may be a queue of 10 people outside a shop, but no others are open. We may well end up with 2-3 people queuing outside every shop, so it's all spread out. Also, there'll be a lot of people who won't be going shopping as often (if at all), so we'll be nowhere near back to pre-covid levels of shopper numbers. There are millions of vulnerable/shielding who won't be going out for non-essentials. Inevitably it'll be busy at first (like the queues at McDonalds and Ikea), but after all the impatients have been and got their fill, I can see numbers dropping quite significantly to find a new, lower, "normal" level.

Very true. I’m sure the queues at McDonalds will have gone down already. I have no intention of shopping the first few days the shops are open - mainly for the reasons you’ve detailed above, and the fact there’s no date for opening up here yet.

 

[Bald Rick]

Very true. I’m sure the queues at McDonalds will have gone down already.

Round here they have got significantly longer!