Scientists have suggested a rolling cycle of 50 days of lockdown, followed by 30 days of “normality”, may help officials manage the coronavirus outbreak.
Britons have spent weeks cooped up indoors as government authorities work to protect the NHS and save lives.
With the weather warming up and other countries opening their borders, “lockdown fatigue” has set in for many.
Severe concerns have also been raised about how the “stay at home” message is impacting the economy, with a huge rise in the number claiming unemployment benefits.
While many are keen to get back to some form of normality, officials have warned this could risk a dreaded “second peak”.
To avoid this, scientists from the University of Cambridge have suggested we alternate between lockdown and “breathing intervals”.
Early research suggests the coronavirus is mild in four out of five cases, however, it can trigger a respiratory disease called COVID-19.
Coronavirus: ‘There’s no simple answer’
“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,” said lead author Dr Rajiv Chowdhury.
“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”.
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Officials often talk about how Britons will have to adapt to a “new normal” until an effective vaccine or treatment becomes available.
Social distancing in the forming of working from home, closing schools and isolating the highly vulnerable is known to help stem the spread of infection.
This comes at the expense of job security and socialising, however.
Alternating strict restrictions with relaxed social distancing has been suggested as an alternative approach.
How long this would last and the ways in which different countries would adapt, however, was unclear.
To learn more, the Cambridge scientists modelled three scenarios across 16 countries, ranging from Australia and Belgium to India and Ethiopia. The UK and US were not included.
Scenario one modelled the impact of no measures.
As might be expected, the number of patients requiring intensive care would be expected to quickly and significantly exceed capacity in every country.
It may also result in 7.8 million deaths across the 16 nations, wrote the scientists in the European Journal of Epidemiology.
Under this scenario, the outbreak would be expected to last nearly 200 days.
The second approach modelled a rolling cycle of 50-day mitigation measures, followed by 30-days of “relaxation”.
Mitigation aims to reduce the number of new infections, but at a relatively slow rate, like by restricting public events.
This strategy would likely reduce the basic reproduction number to 0.8 in all 16 countries.
The basic reproduction number, or R number, is the number of people a patient statistically goes on to infect.
For example, if the number is three, every patient would be expected to pass the virus to three others.
When an R number is more than one, an outbreak grows. When it is less than one, an outbreak dies out.
Despite its benefits, scenario two is not projected to be effective beyond the first relaxation, when the number of patients requiring intensive care would exceed capacity.
This would be expected to result in 3.5 million deaths.
The pandemic would also last around 12 months in high-income countries and 18 months or longer in developing nations.
The final scenario involves a rolling cycle of strict 50-day suppression measures, followed by a 30-day relaxing.
Suppression leads to a faster reduction in new infections by imposing strict physical distancing, like lockdown.
This approach would be expected to reduce the R number to 0.5 and keep intensive care demand within capacity.
Since more individuals would remain susceptible to the infection, it would be expected to result in a longer pandemic, lasting more than 18 months in all countries.
Significantly fewer would die, however, with just over 130,000 fatalities expected across the 16 countries.
The scientists found a strict three-month lockdown would reduce cases to almost zero in most countries, while looser strategies would take around 6.5 months to reach the same point.
They argued, however, prolonged restrictions would be unsustainable in most countries due to the impact on the economy.
Specifics of the “lockdown cycle” would need to be adjusted according to a country’s resources, added the scientists.
“Our study provides a strategic option that countries can use to help control COVID-19 and delay the peak rate of infections,” said study author Professor Oscar Franco from the University of Bern in Switzerland.
“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.”
What is the coronavirus?
The coronavirus is one of seven strains of a virus class that are known to infect humans.
Others cause everything from the common cold to severe acute respiratory syndrome (Sars), which killed 774 people during its 2002/3 outbreak.
Since the coronavirus outbreak was identified, more than 4.8 million cases have been confirmed worldwide, according to Johns Hopkins University.
Of these cases, over 1.8 million are known to have “recovered”.
Globally, the death toll has exceeded 319,000.
The coronavirus mainly spreads face to face via infected droplets expelled in a cough or sneeze.
There is also evidence it is transmitted in faeces and can survive on surfaces.
Symptoms include fever, cough and slight breathlessness.
The coronavirus has no “set” treatment, with most patients naturally fighting off the infection.
Those requiring hospitalisation are given “supportive care”, like ventilation, while their immune system gets to work.
Officials urge people ward off infection by washing their hands regularly and maintaining social distancing.