A few days ago, British Prime Minister Boris Johnson (1) went out to his people to ask them, in a speech that is as little as "the most terrifying" yet, to prepare for the spread of the epidemic, as the numbers indicate that he will not stop moving forward in injuring more of them, He explained that it is not like the flu, but it is the most dangerous challenge that a generation can face, and then threw a huge bomb on the table when he added: "Many families, very many families, will lose their loved ones before the date."
The situation around the world is not far away, Trump is stepping out of the Oval Office, in a rare initiative, to say in what looks like a speech of war (2) that they have to unite to confront. Macron causes more panic, Angela Merkel (3) expressly says that 60-70% of German people will get sick. The Prime Minister of Norway announces (4) that speeches are great and the country must be closed entirely, the shelves of markets in almost all of Europe are empty, the streets are preparing for a similar atmosphere, and no one knows what to do.
But the British response to this in particular has caught the attention of the global media in the past two days, and has caused widespread controversy both on the media and in the corridors of universities. After Johnson finished his speech, the government's chief scientific adviser, Sir Patrick Valance, was allowed to explain Britain's plan to confront the new Corona, and unlike usual in circumstances such as these, where the procedures are to close schools and universities and prevent gatherings as possible, the British government decided that this would not happen, The disease will be allowed to move forward within the country!
The pandemic is here
Well, the matter is very complicated, as soon as that plan appeared in public, some even began to repeat that the British government was throwing its people into perishing in order to overcome the political, economic and social crises expected from the pandemic, others welcomed the plan desperately, as this view says that as long as the epidemic It is coming, and it has no cure yet, so let's get over it anyway as soon as possible and start thinking about the stage after the epidemic, in addition to the famous extremist group that says that some must be sacrificed in order for the group to live.
In fact, all this is inaccurate. To understand this idea, we must consider some data (5). We now stand at the edge of the 150,000 cases. The number of deaths exceeded the 5 thousand, but more importantly is to know the number of days to pass before the numbers double. Globally, it took 26 days. The reason for this is that the daily infection rates are decreasing in China. As for the rest of the world, it happened without embarrassment. The multiplication rates reached only two days in some countries, and three days in most of them.
When public health professionals reflect on results like these, the first thing that comes to mind is that the time is not right to contain, it is almost over and the disease cannot easily stop spreading. Mostly, the next hit will come from a place you wouldn't expect, the primary reproduction number (6) R0 for the new SK is, on average, with a value equal to 3, meaning that each person can infect three other people, it's a massive number, an employee or Someone, who will carry the virus to his home, to the supermarket, and to his friends in the cafe, and each of them will do the same.
For this reason, what we are talking about now, globally, is not ending the spread, but flattening the curve. This term means that the health system in any country takes all measures that can reduce the number of daily casualties as much as possible in proportion to its capabilities. And the number of emergency beds in its hospitals, if the expected number of injured is 100 thousand, for example, then we have this number by the end of the month is better than we reached it in five days, the health system must have time to deal or it will collapse itself.
There is a painful, realistic experience that explains what would happen if the state was not able to flatten the curve. On March 11th, the Italian College of Anesthesiology, Reanimation, Resuscitation and Intensive Care (SIAARTI) published new guidelines for doctors in Italian emergency hospitals, including new standards: in case Catastrophe medicine The doctor may have to make a difficult choice by leaving some patients to die and treating those with a better chance of life. There is a huge shortage of resources that Italian hospitals face after the number of patients reaches more than 15,000 cases.
What is followed in circumstances like this is that the one who first enters the hospital is treated first, but the last report finds (9) that this is ineffective, and doctors must take into account the age, the older age groups may not tolerate the disease such as the young, so the doctor must amend its standard Getting started with young people as a priority, then the elderly If resources enabled him, just think a little!
Herd immunity
One of the most important measures of flattening the curve, in the whole world, is social distancing. We do not yet have a cure or vaccine for the disease as a benefit -19. Everyone hopes that the human chain will be cut as much as possible so we can reduce the number of daily cases. Hence the importance of closing schools And universities and gatherings in general, but Britain - in its plan - and if it aims for the same thing, nothing more, nothing less, it depends to get rid of the disease on the creation of herd immunity (10) Herd Immunity.
To understand this term, let's suppose that a city has only 100 citizens, there is an infectious disease that spreads in the city, each person can transmit the disease to two other people, this means a huge opportunity to transmit the disease through all people through a long series of cases within that space Geography, however, what if 60 people in the city are insured from the disease and cannot contract or transmit it? This radically reduces disease transmission in the city because it simply cuts the chain of injuries in the same area.
When a group of people gets a new SK, only a small percentage of them can be infected again with the same disease, only about 14%, according to the examination of (11) Chinese and Japanese cases, so this means that if the disease can penetrate into 60% of the country, it This people will give the herd immunity status, as it will be very difficult for the disease cycle to continue in Britain, and its rates will drop to regular seasonal flu, at which point you will probably wonder about that measure. Does this mean that Britain is pushing its people to the new corona?
Dangerous standards
In fact, this herd immunity-based plan is based on strict additional procedures. We now know (12) that more than 80% of people with new coronavirus experience simple symptoms without the need for therapeutic intervention in hospitals. Likewise, the criteria for serious risk to date relate to age. In addition to chronic diseases such as cardiovascular diseases, diabetes, lung diseases and cancer, the British government decided to isolate these groups, that is, to keep them at home as much as possible.
Besides (13), the government raised its awareness tools, and demanded that citizens stay at home with no slight symptoms of fever or a dry cough, meaning that those wandering in the city will be only one of the groups that will overcome the disease, when the disease spreads among those groups It will pass safely, then give it sufficient immunity to save the vulnerable groups, the reservation of which will help flatten the curve of new cases, and thus serve the country in its endeavors to bypass the matter.
This plan is based on several other criteria. Experts, from multiple domains such as virology, immunology, public health and mathematical modeling, assure that Britain will not reach the peak of the new Corona wave until after 14 weeks, it is a very long period of closure of public life, and an additional unit has been developed by the Department David Cameron (14) is called a "nudge unit" - and is interested in giving an opinion from the social and behavioral psychologist - she has made an additional opinion on this issue. Academics in that unit suggest that with a prolonged closure period, citizens may respond easily to instructions in the first three weeks, but after that they will start to revolt and bypass instructions, which may bring us back to a situation in which the virus spreads again.
Also, Johnson's team of scientists relied on the idea that the new corona is spread by direct infection, that is, it does not circulate in the air of the city and therefore must be in the vicinity of 2 meters from an infected person, and for several minutes, until it picks up the infection, this means that large gatherings - in Its danger - as small groupings because the disease does not spread in all of the grouping, so the flattening of the curve is still valid even in large groupings, and here specifically refers to schools and universities.
On the other hand, the issue is related to the return of the disease in the next winter with a second wave. Actually, public health and virology experts do not think that the new corona will be finished soon, but rather it will be closer to a seasonal picture of the infection that returns in the winter every year, and we are not sure at all. That it - like some other coronavirus - does not stand up in the high temperature. The following waves may be more violent than the first at times, so the matter - according to the British plan - extends to protect people in the future.
Johnson's Big Adventure
The situation, then, is not that Britain wants to throw its people into the mouth of the Koruna. All over the world everyone treats the issue as a matter of time before the virus reaches 60-70% of the population. It is only a dispute over the implementation mechanism of the task of flattening the curve. Britain did not respond. That the curve flattens to more than required, only at the boundaries that lie precisely when the health system is able to shoulder the burden of the epidemic.
Johnson said that families must prepare for the loss of their loved ones. The British Prime Minister is in the largest and most dangerous adventure in the world.
The British government says that these decisions are taken based on science and science only, as there were several models from a group of British universities, and according to the group of scientists chosen, this plan is the best to save the British, although a lot of skepticism appeared (15) Basically, it depends on our predictions of a virus behavior that we do not know much about yet, a display of what we do not realize may appear, and a category might hit what we did not know about, for example.
In addition, the criteria adopted by countries such as China, which include the utmost social isolation, have been successful in its mission so far, so why should the risk of making the curve flattening stand on the edge when the health system can bear the endurance? Doesn't that threaten to cause the whole system to fall and enter the country in a situation Similar to Italy? Some describe what is happening as more hopeless than optimistic about the future, and others say it is about saving the economy by risking the lives of people. For this reason, Johnson said that families should prepare for the loss of their loved ones. The British Prime Minister is in the world's largest and most dangerous adventure undoubtedly.
In any case, we are a few months away from testing the solidity of Johnson's plan to save the British from an imminent danger, and we also hope that our Arab countries will witness similar activity in which medical, administrative and statistical sciences are intertwined with the political decision, because we are not isolated from the pandemic, conditions are developing in our country Increasingly, this is a stage where the difference between calamity and safety is the delay in making a decision for only several hours.