Rolling 50/30-day cycle of lockdown and relaxation suggested

International researchers have proposed a strategy for reducing COVID-19 deaths.

Report suggests rolling lockdowns

An alternating cycle of 50 days of strict lockdown, followed by 30 days of easing, could be an effective strategy for reducing the number of COVID-19-related deaths and admissions to intensive care units, according to an international team of researchers.

The coronavirus pandemic has imposed an unprecedented challenge on global healthcare systems, societies and governments.

The virus SARS-CoV-2, which causes COVID-19 disease, has been detected in every country, with more than 4.6 million confirmed cases and a death toll of 312,000 worldwide to date.

There are currently no effective treatments for the disease and a widely available vaccine is likely to be at least a year away.

The principal strategy to control the disease globally has focused on measures that minimise person-to-person transmission of SARS-CoV-2 through social distancing; including isolating suspected infected individuals, shielding vulnerable groups, school closures, and lockdowns.

While such measures are effective at slowing disease spread and preventing health systems becoming overwhelmed, these measures can also lead to significant job losses, financial insecurity and social disruption. As such, there is a growing concern that these interventions may be unsustainable over the long term.

An alternative approach may be to alternate stricter measures with intervals of relaxed social distancing (with measures of effective ‘test-contact trace-isolate’ and shielding of the vulnerable kept in place).

However, it is unclear what the frequency and duration of such dynamic interventions should be, and which strategy could be adapted globally across countries with diverse health and economic infrastructures.

To address these uncertainties, an international team of researchers from the Global Dynamic Interventions Strategies for COVID-19 Collaborative Group modelled three scenarios across 16 countries, from Belgium to India, that vary in setting and income.

In particular, the researchers were interested in the difference in impact between strategies aimed at mitigation and those aimed at suppression.

Mitigation measures reduce the number of new infections, but at a relatively slow rate. These might include a combination of measures, such as general social distancing, hygiene rules, case-based isolation, shielding of vulnerable groups, school closures or restricting of large public events.

On the other hand, suppression measures lead to a faster reduction in the number of new infections by applying additional interventions such as strict physical distancing, including lockdown.

The first scenario modelled the impact of imposing no measures. As might be expected, the number of patients requiring treatment in intensive care units (ICUs) would quickly exceed the available capacity significantly for every single country, resulting in a total of 7.8 million deaths across the 16 countries. Under this scenario, the duration of the epidemic would last nearly 200 days in the majority of the countries included.

The second scenario modelled a rolling cycle of 50-day mitigation measures followed by a 30-day relaxing. Such a strategy would be likely to reduce the R number (the number of people each infected individual goes on to infect) to 0.8 in all countries. However, it would still be insufficient to keep the number of patients requiring ICU care below the available critical care capacity. While proving effective for the first three months for all the countries, after the first relaxation, the number of patients requiring ICU care would exceed the hospital capacity and would result in 3.5 million deaths across the 16 countries. In this scenario, the pandemic would last approximately 12 months in high-income countries, and about 18 months or longer in the other settings.

The final scenario involved a rolling cycle of stricter, 50-day suppression measures followed by a 30-day relaxing. Such intermittent cycles would reduce the R number to 0.5 and keep ICU demand within national capacity in all countries. Since more individuals remain susceptible at the end of each cycle of suppression and relaxation, such an approach would result in a longer pandemic, lasting beyond 18 months in all countries. However, a significantly smaller number of people – just over 130,000 across the 16 countries modelled – would die during that period. 

In comparison, the team found that after a continuous, three-month strategy of strict suppression measures, most countries would reduce new cases to near zero. Looser, mitigation strategies would require approximately 6.5 months to reach the same point. However, such prolonged lockdowns would be unsustainable in most countries due to potential knock-on impacts on economy and livelihood.

Dr Rajiv Chowdhury, a global health epidemiologist at the University of Cambridge in the UK and lead author on the paper, said: “Our models predict that dynamic cycles of 50-day suppression followed by a 30-day relaxation are effective at lowering the number of deaths significantly for all countries throughout the 18-month period.

“This intermittent combination of strict social distancing, and a relatively relaxed period, with efficient testing, case isolation, contact tracing and shielding the vulnerable, may allow populations and their national economies to ‘breathe’ at intervals – a potential that might make this solution more sustainable, especially in resource-poor regions.”

The researchers say that the specific durations of these interventions would need to be defined by specific countries according to their needs and local facilities.

The key is to identify a pattern that allows countries to protect the health of the population not only from COVID-19 but also from economic hardship and mental health issues.

Professor Oscar Franco, from the University of Bern in Switzerland, said: “Our study provides a strategic option that countries can use to help control COVID-19 and delay the peak rate of infections. This should allow them to buy valuable time to shore up their health systems and increase efforts to develop new treatments or vaccines.

“There’s no simple answer to the question of which strategy to choose. Countries – particularly low-income countries – will have to weigh up the dilemma of preventing COVID-19 related deaths and public health system failure with the long-term economic collapse and hardship.”

Do you think strict testing should stay in place until there are no new cases or do you favour this system of rolling lockdowns?

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    COMMENTS

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    Triss
    26th May 2020
    10:26am
    Sounds sinister to me.
    Priscilla
    26th May 2020
    10:40am
    Very!
    Hairy
    26th May 2020
    10:53am
    Yes im still thinking covid is manufactured to eliminate all the aged,infirm ,pensioners .all of these categorys have been persecuted and discriminated against horendously in the last couple of years,sorry but i trust no one least of all goverments the peons starve while they live it up on tax payers money. and even have enough to hide some in caymans and places like that.billionares abd trillionares they could rid the world of poverty .but you might as well hold your breath and die now because they like gov . Do not care .after 50 years at work and i might add for years in unsafe conditions no health and safety in lots of jobs You WANT A PENSION hahaha go away and die ok ,your a burden on the health system and Welfare of our country
    Macheke
    26th May 2020
    2:14pm
    Oh dear. Conspiracy theories abound.
    Greg
    26th May 2020
    10:54pm
    Yeah sure, that's what's going on - except we've had 101 deaths, the US 98,000 out of 329M, not making much of a dent in the older aged population.
    Janus
    26th May 2020
    10:59am
    Alarmingly, the original plan for Scomo was to allow a certain number to catch CV to gain the so called "herd Immunity", with a certain "acceptable" number expected to fall off the perch, but delay with just enough time to build capacity to maintain our medical services to cope with "normal" usage. Hence Scomo's early cry of "I'm off to the football".

    Things changed when the advice became different as more was discovered about the disease. At the cost of some of our young people's future wealth and education, the process we followed was considered acceptable and achievable. Sweden went the other way, to their cost in lives, but not in dollars. US is still confused, and some others have a long way to go to get past this. Who is right?

    Us oldies should not forget the price our young are paying for us living longer. How can we make it up to them?

    BTW, I still dislike Scomo, because it is all about the dollars, and his re-election, but I am impressed with Greg Hunt, and one or two others. As for the orthers, they have not changed one bit. it's all about them.

    I am still confused as to why Scomo listened to the medical scientists, but ignores most other scientists. Only the politics provides an explanation, but surely they wouldn't be so stupid as to ....or would they?
    Macheke
    26th May 2020
    2:24pm
    It is easy to criticise Scomo. The issue is that it is very difficult to know what to do when facing something like this where there needs to be a careful balancing act between the health risks and the economic risks. There is little knowledge about the virus and no known cures and vaccines. Yes there are "experts" everywhere coming up with ideas and models everywhere. You have to take advice consider it and make a decision. That's what he was elected to do. Taking pot shots from the stands is easy to do.
    sainter
    26th May 2020
    11:01am
    50 days strict lockdowns followed by 30 days of easing......can't see the point,easing lockdowns gradually monitor it sounds better...no use taking one step forward to go 4 steps back.Easing restrictions is always going to tricky with virus.
    Sundays
    26th May 2020
    11:49am
    I agree sainter. The proposal would be detrimental to the economy and the education of children. Social distancing rules should be eneough in Australia now we have flattened the curve
    KSS
    26th May 2020
    4:46pm
    OFGS! People whinge now after just 8 weeks of separation, and complain about how hard and confusing it is. If this were to be brought in, just think of the whinge-fest they would have; never knowing wither they should be in lockdown or not, go to school or not, get on a bus or not, go grocery shopping or not.........

    Far better to look at what happens as we s.l.o.w.l.y bring things back to near 'normality', and take action when/if there are cluster outbreaks. Shutting down a suburb say for 2 weeks after the cluster is identified, is a far better option for everyone both health and the economy.
    sainter
    26th May 2020
    11:01am
    50 days strict lockdowns followed by 30 days of easing......can't see the point,easing lockdowns gradually monitor it sounds better...no use taking one step forward to go 4 steps back.Easing restrictions is always going to tricky with virus.
    Horace Cope
    26th May 2020
    11:16am
    "Do you think strict testing should stay in place until there are no new cases or do you favour this system of rolling lockdowns?"

    I think the time has come to start relaxing the rules on public gatherings and commence our normal lives. A cold, hard look at the pandemic suggests that the annual 'flu season takes more lives and causes less disruption to our way of life. This in no way suggests any disrespect to the memories of those who have died. Australia's economy is suffering, a huge debt has been raised and the sooner normal work practices are resumed, the easier it will be for the bulk of the population. Sure, some rules need to be followed but, really, the rules are similar to the way we would conduct ourselves during 'flu season.

    I don't favour a rolling lockdown. It smacks of being another plan devised by academics who don't all live in the real world and who never are called upon to be responsible for anything they suggest. Let's just bite the bullet, get back to a normal life and make decisions on what will confront the community as it happens.

    26th May 2020
    11:21am
    Nuch better just to put the spot fires out when they occur.

    26th May 2020
    11:21am
    Nuch better just to put the spot fires out when they occur.
    Roscoe77
    26th May 2020
    12:38pm
    Hi Retiring Well,

    I think that approach was the expectation during the bushfires earlier this year. Didn't work real well when the fires were growing, changing and overwhelming resources. Don't forget the damage done to the people, dwellings, flora and fauna in the fires is the equivalent of the damage being done to people's lives and livelihoods of this disease now and as it continues to spread.

    Without the containment we had imposed upon us, we too could have ended up like Italy, Spain, UK, etc
    Roscoe77
    26th May 2020
    12:38pm
    Hi Retiring Well,

    I think that approach was the expectation during the bushfires earlier this year. Didn't work real well when the fires were growing, changing and overwhelming resources. Don't forget the damage done to the people, dwellings, flora and fauna in the fires is the equivalent of the damage being done to people's lives and livelihoods of this disease now and as it continues to spread.

    Without the containment we had imposed upon us, we too could have ended up like Italy, Spain, UK, etc
    Anonymous
    26th May 2020
    2:20pm
    Your chances of catching Covid-1 and dying of it is 0.003% which is less than the flu. After all it is only a mild cold. Even people with comorbidity die of the common cold so please don't tell me it is worse than getting the common cold.
    Sundays
    26th May 2020
    7:21pm
    Mild cold? Tell that to the nearly 100,000 Americans who have died in the last 3 months for example
    Greg
    26th May 2020
    11:04pm
    My God, another one with low intelligence.

    The only reason the death rate has been so low is......because of the RESTRICTIONS we've had.

    Think about it...just think.

    The whole world bar a couple of countries have been shutdown, many far harder than us hence the virus has not spread as much as it would have.

    Look at Sweden, very few mandated restrictions, people doing what they want mostly and they have a death rate of 409 per 1 million, we have 4 per 1 million. If we didn't restrict our movements we too could be at the 409 or higher point which would amount to over 10,000 deaths and 85,000 cases
    Anonymous
    27th May 2020
    3:29pm
    No it is simple maths. I have no fear at all of catching Covid-19. Flu is far more dangerous.
    Anonymous
    27th May 2020
    3:31pm
    100,000 Americans if only 0.06% of the population many of who died had comorbidity issues. If healthy you chance of dying of Covid-19 is very low indeed.
    Lescol
    26th May 2020
    12:17pm
    It aint ever gunna happen that way. The lockdowns will be gradually eased and life return as before. Personal awareness has improved and so cases will be more isolated. However you cant quarantine stupitidy of some persons and so this virus in time will fully move through the entire community.
    Anonymous
    26th May 2020
    2:24pm
    Best thing that can happen if for it to move through the community which is better than any vaccine. I can't see a vaccine being developed myself after all they still haven't got one foe the common cold. Also remember the flu vaccine at best is only 40% effective which is no better than good health and nutrient.
    adbob
    26th May 2020
    2:39pm
    @Retiring Well

    Big Pharma thinks the flu vaccine is fantastically effective.

    Even though it doesn't really work (or at least only slightly) they manage to sell
    it to almost everyone - and they get repeats every year.

    That's their idea of effective - it makes them a lot of money.
    Anonymous
    26th May 2020
    3:09pm
    That's why certain drugs are effective against Covid-10 but they are telling they are not as they have no patents on them o can't make money out of them. No sense in selling a $17 drug when you can make millions out of something that may not be as effective.
    KSS
    27th May 2020
    6:22am
    Where did you get your medical, pharmacology and immunology degrees Retiring Well? Really interested to know.
    Youngagain
    27th May 2020
    9:13am
    It's disturbing to think RW might be right, and I sincerely hope he is wrong, but we don't have a health industry in our world. We have a sickness industry. Masses of money is being made from denying people available and needed treatments. One company working on a COVID-19 vaccine admitted the vaccine would cost less than $20 per person to make, but said it would be priced at over $4000 per person, and they can do that because of the patent system and global demand.

    Someone suffering a bad back can go to the doctor every week and take enough pain-killers to destroy their body, or can let a surgeon cut them open and put metal bits in their spine (at high risk according to a surgeon I spoke with), all generously funded by the taxpayer, but ask for more than 5 visits per year to a physiotherapist or chiropractor? NOPE. Not allowed. Want a GP to prescribe tranquilisers. No problem. Taxpayer will subsidize both the visits and the pills. But prefer counselling? No. Strict limits on that. How about health supplements like fish oil and turmeric instead of arthritis medicine? Sure, but pay for it yourself. The taxpayer only helps with the cost of patented drugs.

    You don't need a medical or pharmacology degree to know that the system is skewed to denying people the best health treatment and lining the pockets of drug companies instead.

    And I agree with adbob on the flu vaccine. I have never had one and I have only had flu twice in my life - and very mild doses that I recovered from quickly.
    Youngagain
    27th May 2020
    9:15am
    Well, if COVID-19 doesn't kill half the population, rolling lockdowns for 50 days at a time most certainly will! Look how much damage one lockdown has done. The economy would collapse completely if we had to repeat the exercise.
    Steff
    27th May 2020
    12:15pm
    To all these people decrying the death rate of the US and Sweden its good to keep in mind that the majority of these deaths were of the elderly and in most cases nothing was done to protect them.New York governor Cuomo even inssting of moving infected patients back inti nursing homes.Here we've had the newmarch house debacle where infected patients were left to infect other patients instead of moving them to hospitals which have remained mostly empty.
    Lookfar
    27th May 2020
    5:26pm
    In any attempt to control a pandemic, it is normal to look at the "Vectors," ie the ways that the disease, virus, etc. may spread.

    Obviously major vectors, - International travel, cruise ships, Big gatherings, ie in Football matches, etc. must be made safe, - some can not, - those may have to be limited.

    But the major vector no politician wants to talk about is Supermarkets, - or even worse, Shopping centres, where all sorts of people from all walks of life, including our youth, and our Older folks, Congregate.

    - some might say "Supermarkets. the Church of the modern day, - the temple of materialism"

    Whatever,

    The thing is, that is our major weakness, Supermarkets, the Un-acknowledged vector, - we have to eat, so we have to go to the supermarket, - most of us anyway.

    How to make it safe?

    We have the technical ability to close off the main current vector, - Supermarkets, by requiring the customer to relate to the staff inside through clear and relatively inexpensive two way audio-visual electronic screens, that can connect via the stores current internal wi fi.
    This allows personal conversation, - jokes, etc. eye contact, - although as with any electronic communication, needs to be good quality.

    You get a summary of your order and pay.

    So no one goes into the building except the staff, who fill orders and package them. - then the orders come out through a schute.
    No-one breathes any air from an infected person.
    No-one can cough on another.
    No-one can inadvertenly infect another.!!


    Certainly the movement of customers outside the building needs careful design, but it can definitely be done so therefore no physical or aerosol contact between each other nor the staff.

    Main vector closed. - opposed no doubt by the super rich wanting us all back to work at no danger to themselves, but irrelevant as anyone can go to a supermarket any time, - esp as they can now open 24/7

    Relatively small cost to the supermarket, - can be phased in gradually

    Please tell all your friends and your local MP. about this idea, - otherwise how would they know?
    It is in your interest to get this idea happening..
    Lookfar
    27th May 2020
    5:36pm
    V 2..

    In any attempt to control a pandemic, it is normal to look at the "Vectors," ie the ways that the disease, virus, etc. may spread.

    Obviously major vectors, - International travel, cruise ships, Big gatherings, ie in Football matches, etc. must be made safe, - some can not, - those may have to be limited.

    But the major vector no politician wants to talk about is Supermarkets, - or even worse, Shopping centres, where all sorts of people from all walks of life, including our youth, and our Older folks, Congregate.

    - some might say "Supermarkets. the Church of the modern day, - the temple of materialism"

    Whatever,

    The thing is, that is our major weakness, Supermarkets, the Un-acknowledged vector, - we have to eat, so we have to go to the supermarket, - most of us anyway.

    How to make it safe?

    We have the technical ability to close off the main current vector, - Supermarkets, by requiring the customer to relate to the staff inside through clear and relatively inexpensive two way audio-visual electronic screens, that can connect via the stores current internal wi fi.
    This allows personal conversation, - jokes, etc. eye contact, - although as with any electronic communication, needs to be good quality.

    You get a summary of your order and pay.

    So no one goes into the building except the staff, who fill orders and package them. - then the orders come out through a schute.
    No-one breathes any air from an infected person.
    No-one can cough on another.
    No-one can inadvertenly infect another.!!


    Certainly the movement of customers outside the building needs careful design, but it can definitely be done so therefore no physical or aerosol contact between each other nor the staff.

    Main vector closed. - opposed no doubt by the super rich wanting us all back to work at no danger to themselves, but irrelevant as anyone can go to a supermarket any time, - esp as they can now open 24/7

    Relatively small cost to the supermarket, - can be phased in gradually

    Please tell all your friends and your local MP. about this idea, - otherwise how would they know?
    It is in your interest to get this idea happening..
    Steff
    27th May 2020
    8:16pm
    You are off your head.Sounds as if you are so terrified of this Scamdemic you are prepared to enslave the rest of us in order to save your own skin
    Lookfar
    28th May 2020
    9:53am
    Steff, I have proposed a cheap and convenient way for people to do their shopping without being exposed to covid-19, - or any other infectious diseases, whilst still keeping audio and visual contact with the checkout person.

    A suggestion that would definitely save lives, and if we get the possible second wave, Hundreds of Australian lives, and easy for any other country to copy as well, - and you accuse me of being off my head/?

    That is not good enough Steff, shame on you!
    Steff
    29th May 2020
    7:09pm
    I would rather risk dying of this bullshit disease than to erode my freedoms to such an extent that i cant even go to a store and have a face to face transaction with the staff.
    Yo can stay under your bed
    Lookfar
    31st May 2020
    8:37am
    Steff, a good idea is to read other people's comments before answering them, - for example, my plan does include face to face looking each other in the eye, talking directly to, the staff, but just an electronic barrier to stop you infecting them.
    Why would you want to infect people in your own community?
    If you wish to die, why can't you go somewhere no one can get hurt by your so doing? - perhaps that bed you think others should hide under..


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