The Covid Conundrum: Endless Lockdowns, Let It Rip … or What?

Covid is airborne, which means that much as unprotected sex is a risk for HIV, unprotected breathing might result in Covid.

Over two years into the Covid pandemic, and with yet more anti-pandemic measures introduced by the Hong Kong government, it surely seems like we’re in a perpetual state of déjà vu all over again (as US baseballer Yogi Berra put it), and no closer to “normal”. It’s tiresome, incredibly frustrating, yet as a Los Angeles Times article noted in February 2022, many might say they are “done with Covid,” but Covid’s not done with us.

Perhaps, then, it might be worth a look at how science suggests Covid may pan out, and ways we might respond. Firstly, as I’ve written before, Covid spreads efficiently from the walking well, before there are even symptoms, so there is no real pressure to evolve towards being less dangerous, or simply disappear as Trump suggested. Then, Covid is airborne, which means that much as unprotected sex is a risk for HIV, unprotected breathing might result in Covid.

            Worldwide, responses to Covid vary, with few anywhere near as draconian as here in Hong Kong. Even before the 8 February 2022 announcements of even more stringent measures, there were multiple suggestions on social media that the government measures were unduly restrictive, and severely compromising Hong Kong’s former role as a “world city”. [And now, posting on 22 Feb – with schools about to shut for early “summer holiday”, mass testing and more…]

            Like other places, the Hong Kong measures include some with a scientific basis, others that look more questionable. The 21 days of quarantine on arrival, for instance, were longer than science indicates is necessary – and a recent outbreak was traced to a woman who caught Covid late in her quarantine stay. Plus outdoor facilities like barbecue pits and campsites are closed, though evidence reveals little Covid transmission outdoors, even while permitting indoor banquets for up to 240 people. 

If not zero, what?

            Perhaps a strict local zero Covid approach would be wise if it appeared Covid can be exterminated worldwide. Yet the approach hardly seems viable ad infinitum: how long can you keep playing whack-a-mole to stop small outbreaks, locking down major buildings and so forth while the former world city is almost hermetically sealed from the outside world. Another year? Five years … ten years…? And that’s even supposing current measures restore zero Covid, while now seeming like King Canute trying to stop the incoming tide.

But if to turn away from zero Covid – even mysteriously branding a new strategy “dynamic zero Covid”, is the alternative simply to “let it rip”, as I’ve seen suggested.

            How tempting that is! No more masks, no disrupted schedules; unrestricted travel, time to party like it’s 2019, let alone 1999. Bye-bye fines, quarantines, lockdowns. Hooray! What’s not to like?

            Ongoing deaths, long Covid, recurring infections and pandemic waves and all the disruptions these entail – that’s what. 

            Of course, there are strong, persistent messages to the effect I’m writing nonsense: Covid is just like a cold or regular flu; and even if it isn’t, we can soon arrive at “herd immunity”, including with the “milder” omicron variant. Yet here, I’m reminded of a cartoon showing a long queue of people for a booth with Comforting Lies, while no one wants Unpleasant Truths.

Throughout the pandemic, the disease experts with more alarmist messaging have proven better with predictions than those peddling “hopium”; Covid has not disappeared as Trump, say, forecast during 2020. And now, “milder” omicron is causing surging cases, and more deaths, in places with relaxed measures such as Denmark and Sweden. In February 2022, the Financial Times reported, “A quarter of UK employers say long Covid is now one of the main causes of long-term sickness absence among their staff.”

            Ben Cowling, Chair Professor of Epidemiology, School of Public Health, the University of Hong Kong, has tweeted that most of the Hong Kong population may be immune to Covid within around 4 months, thanks to vaccines and/or infections. However in response to a question from me – mentioning reports of reinfections with omicron, he noted re immunity, “Not sure how long it lasts, but should be months, although new variants might be able to escape it.”

            With uncertainties regarding immunity, governments in the US and the UK have come up with a wheeze for minimising Covid: less reporting of cases and deaths. Dr. Eleanor Murray, an Assistant Professor of Epidemiology at Boston University School of Public Health, US, has likened this approach to the weather station saying they’re no longer going to track storm cells and issue tornado warnings.

            In reality, Covid will continue causing major issues, especially at a population level. And the impacts extend well beyond those of respiratory diseases: “long Covid” and “Covid brain fog” are increasingly common terms, while a paper published online by Nature Medicine on 7 February covered, “evidence that the risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial.”

Counter measures versus airborne Covid

            Happily, along with reports on its impacts, we have also learned far more about how to combat Covid. Vaccines are a huge step forward, of course, with the best of them greatly reducing the chance of severe infections or even death. Then, it appears Covid mainly spreads by an airborne route, indicating where to focus counter measures.

            Evidence and even common-sense show face masks work; and with omicron, it’s advisable to switch to the more effective N95 or K94 masks, which can be reused perhaps four times. Indoors, ventilation is important, and carbon dioxide meters can indicate how much people’s breath is accumulating. Use of HEPA filters can help clean air of Covid along with other undesirable particles, and there are now designs for DIY versions – Corsi-Rosenthal boxes – online. It’s surely also best to optimise quality of life, with more science-based quarantine, encouragement of outdoor dining and so forth; plus countering disinformation.

            I was lucky to grow up in a world that made huge efforts to tackle once widespread diseases like smallpox, measles and polio. Now, maybe boosted by empathy from leaders and society at large, equipped with science-based strategies, we can surely find ways to combat Covid. As some experts have suggested, in future we might normalise clean indoor air just as we have clean drinking water.

[Written for the South China Morning Post; published on 12 February 2022: Hong Kong’s Covid-19 measures must be driven by scientific fact, not fear]

Covid articles by DocMartin

References

Airborne covid:
https://www.thelancet.com/article/S0140-6736(21)00869-2/fulltext

LA Times: https://www.latimes.com/business/story/2022-02-08/is-covid-over-yet

Length of quarantine / transmission:
https://www.france24.com/en/live-news/20220128-hong-kong-outbreak-exposes-flaws-in-21-day-quarantine-policy

Outdoors, less transmission: https://www.npr.org/sections/goatsandsoda/2022/01/21/1069904184/omicron-outdoor-transmission-risk

  • Still on FEHD site (as I wrote article): https://www.fehd.gov.hk/english/events/covid19/vaccine_bubble_FP.html
    Maximum 240 participants in any one banquet. At least two-thirds of the total number of participants must have received the first dose of COVID-19 vaccine.

“dark money” and Covid denialism:
https://www.dailyposter.com/how-the-koch-network-hijacked-the-war-on-covid/

Scientists blast herd immunity:
https://www.medpagetoday.com/infectiousdisease/covid19/89127

For covid cases and deaths, can just type “sweden covid cases” – for instance – into google, and see chart as a top result

Re long covid and uk workforce: https://www.ft.com/content/33444f29-bab1-4655-85b5-c0b1f68d9653

Predictions: I’ve mentioned Eric Feigl-Ding; “MOTHER OF GOD” tweet and more, before

This lady seems on the money to me, I also follow; this from end of 2020:

Deepti Gurdasani

A brief summary of the very precarious situation we are in now, and why we have a very narrow window to act in the UK. If we don’t act now, it’s likely the window for containing COVID-19 will pass- not just for the UK but globally. Here’s why. Thread.

cognitive decline, for instance:
https://www.webmd.com/lung/news/20210730/study-finds-covid-19-may-lower-intelligence

WHO re omicron, inc
Fact: The end of the pandemic is not yet in sight.

https://www.euro.who.int/en/health-topics/health-emergencies/pages/news/news/2022/01/the-omicron-variant-sorting-fact-from-myth

brain fog

Can COVID-19 Cause Brain Fog?

mask reuse

DIY boxes:

not sure where to find just now,

Seen one or more #covidisairborne proponents saying [twitter?], one big change for future may be to cleaner air much as strive for clean water; not just rebreathing others’ air in way too many  buildings.

Aha, found an article by a chap at an Aussie univ:
https://www.fastcompany.com/90719867/an-investment-in-clean-indoor-air-would-do-more-than-help-us-fight-covid-it-would-help-us-concentrate?partner=rss&utm_source=twitter.com&utm_medium=social&utm_campaign=rss+fastcompany&utm_content=rss

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