10 2GM Wednesday April 8 2020 | the times
News
The “segmenting” of the population
into different risk groups with enhanced
shielding of the vulnerable could be a
path out of lockdown, experts said as the
pandemic’s peak moved into sight.
Medical staff and others in contact
with people at most risk might have to
accept restrictions until they are given
regular tests to prove they will not pass
on the virus, scientists suggest.
It is understood that ministers do not
yet feel there is significant public pres-
sure to ease the lockdown and the gov-
ernment is not yet focusing on an exit
strategy. Restrictions are expected to
continue to ensure the peak is passed
and there is also reluctance to give dif-
ferent messages to different groups.
However, yesterday the govern-
ment’s chief pandemic modeller said
that Britain would take control of the
coronavirus epidemic over the next
week and must then consider “target-
ed” ways of continuing restrictions.
Graham Medley, who oversees
mathematical modelling for the Scien-
tific Advisory Group for Emergencies,
said that his team was “reassured that
there is something happening” as a re-
sult of lockdown measures and were
hoping for a peak over the coming days.
Even “completely bonkers” ideas
about how to lift lockdown must be
considered because the pandemic had
put Britain in uncharted territory, he
told Toda y on BBC Radio 4.
Professor Medley is chairman of the
government’s scientific pandemic in-
fluenza modelling committee oversee-
ing the modelling of coronavirus trans-
mission, including the best known cal-
culations from Professor Neil
Ferguson, of Imperial College London.
“We knew that it would take three
weeks or so to be seeing the consequen-
ces of that in terms of admissions to
hospital and there are some signs of
that,” Professor Medley said. “The
modelling group are reassured that
there is something happening and that
we will hopefully see over the next
week or so the results of that in terms of
hospitalisations and deaths. Then... we
know we have at least one way of con-
trolling transmission.”
At the weekend Professor Medley
said that Britain had “painted ourselves
into a corner” by locking down without
a clear exit strategy and needed to
weigh the harms caused by restrictions
against disease caused by the virus.
Since his intervention, ministers
have acknowledged such calculations
are being made. Chris Whitty, the chief
medical officer for England, said that
the health impact of the lockdown on
the most deprived people was being es-
timated in an attempt to trade it off
against the direct impact of the virus.
Ideas include easing restrictions re-
gionally so that intensive care capacity
could be used to treat cases one area at
a time, and a stronger testing and con-
tact tracing regime that would quaran-
tine people in contact with a case.
While 1.5 million people at greatest
risk from coronavirus have been told to
“shield” from it by avoiding face-to-face
contact for 12 weeks, some in govern-
ment are looking at enhanced shield-
ing. Estimating that up to 20 per cent of
the population were particularly vul-
nerable to the virus because of age or
illness, Mark Woolhouse, of Edinburgh
University, said: “If it was that other
80 per cent of the country alone, we
wouldn’t have to shut down the country
to cope with it. The reason we have to
shut down the country is to protect the
vulnerable 20 per cent.”
He said that as well as asking the vul-
nerable to stick to social distancing “the
people you need to be careful about are
the people in contact with the 20 per
cent. Hospital workers, social care, car-
ers and members of the family. That is
a lot of people.” Given that the govern-
ment was committed to expanding test-
ing to NHS staff to allow them to get
back to work if they did not have the
virus, Professor Woolhouse said such a
strategy could “start with hospitals and
care homes and extend” as more testing
was available.What others are doing
Austria Smaller shops to start
reopening next Tuesday. All stores
open from May 1 except hotels and
restaurants which will open from
May 15. Masks compulsory.Denmark Adults to return to work
places more in a staggered way to
avoid crowding into trains and
buses. Schools for those aged 10-
are reopening, the rest on May 10.Norway Planning to start easing its
lockdown on Sunday, depending on
figures in coming days. Restaurants
have remained open.Czech Republic Sports facilities
reopened yesterday. Shops will
reopen from next week.Germany Aiming to to reopen
schools region by region and allow
some people into restaurants if the
infection rate stays low.Italy Officials are talking about a
phase two in which people “live with
the virus” and increase free
movement in phases. Masks will be
worn and testing extended.Spain Some economic restrictions
could be lifted after Easter, allowing
some people to return to work.France No dates have been set but
the government is considering a
reopening region by region.Pollution may have caused thousands
of extra deaths because people living in
areas with poor air quality are less likely
to survive after becoming infected with
coronavirus, researchers say.
Scientists analysed data from 3,
counties in the US up to April 4 and
found that a small increase in long-
term exposure to fine particles, known
as PM2.5, was apparently linked to a
large increase in the death rate.
The study is significant because it
suggests delays in measures to improve
air quality in urban areas, such as re-
stricting diesel and petrol vehicles and
banning wood and coal fires, will have
contributed to the Covid-19 death toll.
The team from Harvard University
found that lowering the long-term
average fine particle pollution in
Manhattan by only 1 microgram per
Dirty air puts more lives at risk by damaging lungs, scientists say
cubic metre of air (mcg/m
3
) could have
prevented 248 of the 1,905 deaths
recorded in the area up to last weekend.
Overall, they found that each 1mcg/
m^3 increase in exposure to fine particles
seemed to be linked to a 15 per cent
increase in the Covid-19 death rate.
The study, which is still going
through the peer-review process, could
not prove a direct link. However, the
authors said that fine particle pollution
damaged people’s lungs and hearts and
left them vulnerable to respiratory dis-
eases such as Covid-19.
The study says: “We hypothesise that
because long-term exposure to PM2.
adversely affects the respiratory and
cardiovascular system, it can also exac-
erbate the severity of the Covid-19 in-
fection symptoms and may increase the
risk of death in Covid-19 patients.”
It adds: “The results of this paper sug-
gest that long-term exposure to air pol-lution increases vulnerability to the
most severe Covid-19 outcomes.”
London generally has worse fine par-
ticle pollution than Manhattan, with an
annual average of 13.3 mcg/m^3 and no
area complying with the World Health
Organisation’s recommended limit of
10mcg/m
3
.
The Times’s Clean Air for All cam-
paign, launched 11 months ago, has
been seeking a legally binding target to
improve air quality to WHO levels. The
government has pledged to introduce a
new target but has yet to say what it is
or set a deadline.
Frank Kelly, professor of environ-
mental health at King’s College
London and chairman of the Depart-
ment of Health’s committee on air pol-
lutants, said the study seemed to be “the
most robust” so far on the link between
air pollution and Covid-19 deaths.
He added: “These findings fit wellwith the established relationship
between PM2.5 exposure and many of
the cardiovascular and respiratory co-
morbidities that dramatically increase
the risk of death in Covid-19 patients.
“The Harvard team are first class and
have a reputation for being one of the
leaders in the field. Similar findings
have just been reported by researchers
in Europe.”
The Department for Environment,
Food and Rural Affairs (Defra) called
yesterday on researchers to submit
rapid evidence on air quality and the
pandemic, including whether air pollu-
tion was an aggravating factor.
John Newington, head of evidence
on air quality and industrial emissions
at Defra, appealed to “the research
community to support the UK govern-
ment in its efforts to manage air pollu-
tion risk and impacts during the Covid-
19 pandemic”.Defra is also seeking evidence on
how the lockdown and fall in traffic has
changed public exposure to air pollu-
tion. Levels of fine particles and nitro-
gen dioxide have fallen sharply in Brit-
ish cities since lockdown began last
month.
However, traffic is only one source of
air pollution, with emissions from agri-
culture, home heating and pollutants
swept in from abroad also contributing
to poor quality. The Met Office is fore-
casting a risk of high air pollution in
southern and southwest England on
Friday, due to very light winds allowing
pollution levels to build up.
Researchers at the University of
Bologna have suggested that airborne
pollution particles might help to spread
the virus by carrying it on their sur-
faces. However, this theory has not
been confirmed and some experts have
said there is no evidence to support it.Ben Webster Environment Editor
Test of courage as medical staff
News Coronavirus
55,242 6,
Cases Deaths
Total UK
Daily UK cases
April
01
4.3k
02
4.2k
04 05
3 .7k
03
4.5k
563569
684708
- 9 k
621
06
3 .8k 3 .6k
439
07
786
Daily UK deaths
Top 10 areas
with most casesThe national picture
London 13,
Total
deaths6,
Kent 923
Surrey 1,
Wales 3,
Birmingham
1,N. Ireland
1,Glasgow
and Clyde
1,Essex 938
Hertfordshire 933
Hampshire 989
Latest available
figures as of
7pm, April 7Chris Smyth Whitehall Editor
Shabnum Sadiq
with her
quadruplets,
then five weeks
old, and
daughter
Shireen, six,
in 2006. Ms
Sadiq died on
Monday