[DRAFT] Scenarios for C19 in the UK

WHAT IS THIS?

These are pen portraits of possible scenarios for viral contagion and government response in the UK. They give some broad indication of what the status of contagion will be dependent on accompanying government measures. I am trying to give myself a starting point for thinking how to plan for the next two years. Maybe helpful to you or I welcome your feedback. They are significantly based on Ferguson et al. 2020 and Shen et al. 2020.

SCENARIOS

Keep Calm and Carry On (“Herd Immunity”) – After delaying the UK government’s first strategy was to kick-back and talk about ‘herd immunity’. This meant the government was urging business-as-usual to continue with virtually no measures put in place. The idea was just to let the virus run riot and burn itself out by August 2020. In this scenario, the death-count from C19 would be very high (half a million) over 4-5 months (April-August). Not to mention the astronomically much large number of cases, not all mild. Also, this would set off many knock-on effects, including the total over-whelming of hospitals, which would then affect the treatment of other conditions and so forth. In sum, it would result in many more deaths. A partial U-turn appears to have been made. Still, this necropolitical strategy allowed the virus to spread around the country. One can speculate as to why this aborted scenario was even attempted. An assumption is it was short -term thinking to prioritise ‘The Economy’ over peoples lives. It was likely abandoned not so much because of public uproar, but a belated realisation that it would not work economically anyway.

Nip it in the Bud (“S Korea Model”) – If the UK had (i) set up a ‘viral suppression task force’, (ii) prepared each region of the UK with a customisable plan on virus containment, and (iii) done this early on – then the UK would have seen relatively few cases. By now it may have achieved virtually complete containment of the virus.  This would have left the UK population in a uniquely good situation. With Brexit and “taking back control” underway as well as the foresight from watching other countries become infected, this scenario was well within reach. This could have been someone’s Churchillian moment. By comparison to the last major viral outbreak, Asian scientists reportedly took their initiative this time. They made a concerted effort to publish research early so that other regions could prepare rapidly.

The Long War (“Gradual Mitigation”) – This is the scenario the UK is currently closest to. Herd Immunity has not been put to bed as an idea. Instead its disastrous effects are being dragged out over two years, allowing the status quo to continue. It involves gradually introducing a range of measures to avoid too many cases/deaths in one go. These measures include individual isolation, household quarantine, social distancing of elderly people, social distancing of entire population, closure of schools and universities. In this scenario, the death count between March and August is lower than in ‘Keep Calm and Carry On’. However, the pandemic will continue for at least 21months by which time the UK government hope a vaccine will be available, manufactured and distributed.  A peak and trough of cases and deaths, albeit smaller, than the first one, will occur approximately every three months. Health services will mostly stay just within maximum capacity but will need to be running at breaking point for the whole 21+ months. Also, in this scenario, individual isolation and household quarantine are required throughout for those infected or those at high-risk from the virus. With social distancing and school/university closure being triggered at regular periods throughout. In essence, what we are experiencing now will gradually get worse and worse, except that a small breather will be taken every so often to stop total systemic collapse. Most people will still get the virus (4 in 5?). I would speculate that if you are at risk and self-isolate for 21 months, you will suffer (to some degree) from similar effects being in long term isolated imprisonment. Mutual Aid networks will be crucial to maintaining some degree of survivability for those in isolation. If you are someone already with an underlying health condition or have precarious work, you are going to be much further marginalised. On top that all other countries that have contained and eradicated it will likely have severely restricted travel from the UK.

Meta-Britain (“All Out”) – With the contagion dispersed around the UK, the entirety of society from tip to tail mobilises to voluntarily enact all the mitigation measures including individual isolation, household quarantine, the social distancing of elderly people, the social distancing of the entire population, closure of schools and universities in their entirety. Mutual Aid networks mutate into street by street citizen councils to address the particularities of their area. They go into hyper-drive mitigating the adverse knock-on effects of these measures – as there will be. However, these measures will be subject to refinement over time once in place. In all cases, a voluntary rather than a disciplinary approach is taken. Viral taskforces are organised around the country mass testing, contact tracing and containment follow. After three weeks, some progress will start to be measurable, and measures will be able to tinkered with and relaxed in certain regions. As time progresses, more and more regions emerge out of quarantine. By August the whole of the UK will be virus-free.

Politically Coloured Phoenix (“Total Collapse”) – New crises appear throughout as staff or materials are unavailable due to the pandemic, whether its for water treatment or flood management or its the arrival of malaria or drought. In this case, the ‘The Long War’ scenario will not be sustained, and a vacuum for possible scenarios will open up.

WHAT THIS IS NOT

These rapid sketches do not adequately consider citizen-led initiatives which can have a considerable impact, e.g. The growing success of Covid 19 Mutual Aid UK will help ‘flatten the curve’ (and stop health services from being overloaded) more than anticipated.

Nor do they consider regional variation in precarity, family structure, mobility, residential status and numerous other factors. Factors that each community and its leaders should consider when adapting to this pandemic, e.g. There are various forms of quarantine that have different unexpected effects that can spread the virus or have violent secondary knock-on effects. Both because central commands cannot grasp grassroots complexity and because even if leaders understand they are ‘locked-in’ due to the precarity of the system they cannot change approach within the current system (Read More…) Or if you are a University the mobility of students, the origin of students, term times and various other factors need consideration.

Another framework to consider these variations is through saying that these scenarios only partially consider the 3Ps for modelling. Otherwise, we can witness ‘carnage by computer’ amongst other phenomena. The 3Ps: “process (the way disease population dynamics work), pattern (the spatial spread of disease and the correlation with various factors) and participation (understanding disease dynamics from local people’s perspectives).”

They are also not post-pandemic scenarios, which are something in their own right and crucially important to develop right now. Each of the scenarios above lends itself to a post-pandemic scenario, e.g. The UK Government is reportedly already attempting to impose a two year National Emergency scenario with no oversight or possibly ability to halt it belying authoritarianism. S Korean, on the other hand, off the back of containing this virus is now preparing for even more difficult challenges ahead through enacting a National Green New Deal.

WHAT THIS CAN BE

To fully understand these scenarios and then be ready to act as new circumstances emerge requires the proper elaboration of the many outstanding considerations of interdependencies. This is beyond the remit of this quick sketch. I am working toward an online course bringing together a variety of knowledges that can start to understand where we are and how to prepare including the collective intelligence of people interested in participating.

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