Thought of the Day - April 27th - Strategy 2.0

Hi All,

Well it has been a month since I introduced the three main strategies available to tackle Covid-19.

Remember the options (more details in the March 24th Blog).

The outliers:

· Lock ‘Em Down – eliminate cases at all cost – has huge economic and social costs – think China.

· Rapid Herd-Immunity – get to the end-game as fast as possible – has huge health and first-responder consequences – think Sweden.

And in the middle is:

· Slow the Burn – test, trace and contain – the most obvious, but seems very, very difficult to implement, only a few countries are doing this – think Korea.

But we have learned a lot since then:

· Studies are showing in most countries there are about 10 times as many people infected than detected or reported.

· A number of cases are asymptomatic, and thus can become “super spreaders”.

· Mass outbreaks happen mainly in institutions – care homes, prisons, hospitals, food processing plants, tourist attractions, cruise-ships, entertainment/convention/sport/religious mass gatherings, worker camps etc.

· Poor health is the main indicator of mortality.

· As happened in 1918, the only solution is herd-immunity (hopefully accelerated by medical interventions).

· Most countries are still less than 10% of the way to herd-immunity.

· The vaccination, effective therapeutics and mass testing (both antigen and antibody) are still a way off.

· No other new strategies have surfaced that can be generally applied across Canada.

In the meantime our authorities have been busy implementing crisis management practices (with varying degrees of effectiveness):

· Assign responsibility and mobilize task-forces.

· Anticipate Stakeholder impacts.

· Communicate, communicate, communicate.

· Reduce “external” factors.

· Provide short-term economic relief and stimulus packages.

· Ensure funding and supply of critical goods.

· Ensure liquidity in the banking system and stability of the markets.

· Curtail non-essential services.

· Establish monitoring systems.

· Introduce mitigating practices.

· Communicate, communicate, communicate.

So now we have the luxury that in general the Canadian populous has accepted the impact of the first wave, but what now?

As all strategies have real issues, the only option is a combination of the above.

What I suggest:

1. We “lock down” (and where possible keep shut-down) ALL high-risk institutions – focus government effort here. Meaning:

· Formal protocols for ingress and egress to sites;

· Dormitories for workers;

· Automated third-party surveillance and tracking systems;

· Strict PPE, hygiene and air handling protocols;

· Major funding for implementation and penalties for non-compliance;

· Mandatory testing and inspection.

2. We go for “rapid-herd immunity” outside – reduced government effort here:

· Phase-out worker and business-idling subsidies;

· Educate and empower the general public;

· Be clear on hygiene protocols (distancing, masks and hand-washing);

· Provide citizens with the tools to obtain a risk profile, both for infection and mortality;

· Reopen all medical services;

· Establish protocols for “infection clinics” – e.g. plasma from immune subjects, infection bubbles etc.;

· Reopen schools (initial focus on safe child care rather than the curriculum);

· Phased reopening of bars and restaurants;

· Lift restrictions on most businesses.

3. We implement “slow the burn” at the interfaces – targeted government effort here:

· Implement “test, trace and track” swat-teams for outbreaks;

· Scale testing to allow for random sampling of the public;

· Mandatory quarantine for travellers;

· Promote “immunity passports”, “mortality reduction” and “herd-immunity” targets.

With this as a backdrop, the steps we take over the coming months will have a context rather than being a random set of changes with no real target.

Cheers

Cliff