Modelling by Edinburgh College beforehand estimated that, had lockdown been imposed two weeks earlier, the demise toll from Covid by the start of Might 2020 would have been slashed by 80% from 2795 to 577.
However lockdown is just not an answer; it’s a stop-gap when containment fails.
The lesson for future pandemics shouldn’t be “lockdown earlier”, however “how can we keep away from locking down in any respect?”.
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Helpfully – away from the extra headline-grabbing WhatsApp row – there was loads of proof over the previous three weeks masking precisely that.
One of many causes we fared so badly was that we failed to check, hint, and isolate.
As early as January 10 2020, Professor Mark Woolhouse – an infectious ailments epidemiologist at Edinburgh College – was anticipating, based mostly on proof of human-to-human transmission rising from Wuhan in China, that the world was headed for a pandemic.
He warned Scotland’s then-chief medical officer, Dr Catherine Calderwood, that it will in all probability be “fuelled by gentle instances” making it “very troublesome to trace” if you happen to relied on testing solely individuals with signs.
A system of surveillance “must be put in place upfront of the arrival of the virus, so the earlier the higher”, he added in an e mail dated January 25.
Ultimately, Scotland started testing for Covid on February 10 when 57 samples – all unfavorable – had been processed.
Nevertheless, because the inquiry has additionally heard, Scotland’s testing capability remained low – going from a capability to course of 350 per day in mid-February to 780 by mid-March, by which period lockdown had turn into inevitable.
The testing capability was so restricted that hospital sufferers had been being transferred into care properties untested, and community-level testing had been deserted.
Professor Devi Sridhar, a chair of worldwide public well being at Edinburgh College who – like Prof Woolhouse – went on to turn into one of many Scottish Authorities’s Covid advisers contrasted Scotland’s method to different elements of the world.
Denmark saved faculties open “as a result of they had been testing 4 occasions as a lot per capita as Scotland”.
South Korea prevented lockdown altogether by a strict containment coverage reliant on take a look at, hint and isolate.
Whereas the UK’s stay-at-home lockdown “handled everybody as infectious”, nations able to mass testing restricted restrictions to the infectious, mentioned Prof Sridhar.
“For those who had been infectious you weren’t allowed to exit, there have been strict penalties, however you saved nearly all of individuals capable of flow into, to combine, to reside freely,” she advised the inquiry.
The nations which fared finest in 2020 had been these contacting biotech corporations by mid-January to order “hundreds of thousands of exams” whereas imposing border controls to check or quarantine all arrivals on entry, earlier than group transmission had taken maintain.
The UK dithered over the previous and dominated out the latter in order that – precisely as Prof Woolhouse had warned – by the point we began ramping up surveillance it was already too late.
There isn’t any situation wherein mitigations might have been prevented, however they may definitely have been lessened with an efficient take a look at, hint and isolate regime.
For Prof Woolhouse, a mixture of case isolation, an infection management, contact tracing, public messaging, and a few type of social distancing (indoor hospitality curbs, limits on gatherings) would have been mandatory till a vaccine arrived.
Nevertheless, out of doors actions – from walks within the park to journeys to the seaside – ought to by no means have been banned, he mentioned.
“There was by no means ever an outbreak of Covid-19 wherever on the earth linked to a seaside.”
Faculties had been “contributing slightly to the unfold”, added Prof Woolhouse, however “so little that there was primarily no hazard in re-opening” them from Might 2020.
One other key level, made to the inquiry by social psychologist and Scottish Authorities adviser Professor Stephen Reicher, is that the entire level of take a look at and hint is “to get individuals to self-isolate”.
But in some areas compliance was, he mentioned, as little as 18%.
The UK Authorities scheme – a £500 grant – was too small an quantity, just one in eight staff certified, and 67% of people that utilized did not get it.
A Scottish scheme “did slightly bit extra”, he mentioned, however “not sufficient”.
This was “one of many main failures”, he added.
“Elsewhere like New York that they had a wraparound system whereby not solely did you give individuals extra money, you provided them resort lodging, you even provided them help to stroll the canine.”
As for the summer time of 2020, the proof factors to a tragically missed alternative to get a deal with on the (inevitable) second wave, save lives, and keep away from a second lockdown.
Discovering extra instances and strengthening compliance with self-isolation ought to have been priorities, mentioned Prof Woolhouse.
When the Workplace for Nationwide Statistics started its family survey in August 2020 it turned clear that Scotland’s Check & Defend system – which nonetheless relied on individuals presenting with signs – was detecting solely half of instances.
Had mass testing utilizing lateral circulate gadgets been rolled out in autumn 2020 as a substitute of in the course of the Omicron wave on the finish of 2021 “we would not have wanted a second lockdown” in January 2021, he mentioned.
“We might have examined our manner out of it.”
In the meantime, Prof Sridhar bemoaned the failure to make use of these months for “most suppression” of the virus by test-trace-isolate and border controls pending the upcoming rollout of vaccines.
As an alternative we opted for “get again to normality”.
She added: “When the winter wave got here and the winter lockdown and the numbers went up, it was predictable and it was actually miserable as a result of in January vaccines rolled out and also you suppose: ‘what number of of these individuals would have lived, had they only been capable of delay an infection by two months, a month?'”
