I really hope I’m wrong about this fluctuating nature being dangerous for us. But I fear it is a sneaky trick that could trip us up badly.
You'd have to provide some proposed method for how or why the 'larger scale fluctuations' happen in order for me to take it seriously.
Not that it necessarily matters, since there are already other reasons why we might expect overall epidemic waves to come and go over time, and for the risk to vary over time. Especially one thats been moderated by human behavioural changes, and where human behavioural patterns will continue to vary over time.
Thinking about this stuff does not make me especially more or less concerned for the future because the way I see the next phases was actually underlined by that shit Hancock today when he went on about future lockdowns at very local levels.
The lockdown and social distancing measures we just experienced were like pulling on the largest handbrake ever in rather sudden fashion, because we were late and had failed to give ourselves other viable options. Even this shambles of a government ought to avoid getting close to that stage again in future, and now they've seen how much it costs in all sorts of ways it is unlikely their priorities will go so far astray next time, even if large sections of the public have lost interest at the time at the broad national level.
As the total number of cases shrinks, the story of this pandemic, and of preventing further hefty waves, maybe even of suppressing the bloody thing to a great extent, is local. There have actually been relatively few stories and data so far during this pandemic so far that could provide a somewhat comprehensive picture of the epidemic in particular locations. There are exceptions such as the stories of individual and family deaths, but this is just a small sampling of all the thousands of stories behind the first wave. If you work in an institutional setting that had an outbreak, or heard about such a thing happening, then thats an example of the sort of stories that, when gathered all together would tell much of the story of this virus coming and going, and where the current risk is to be found. The same front lines that there have been all along, but now the overall community cases have been dropping in many locations for a good while, the opportunities to see the outbreaks that remain more clearly, and tackle them more effectively will keep increasing.
Good disease surveillance at the local level, and an at east partially fit for purpose contact tracing system are essential in order to not squander those opportunities. In the community, and in institutions like hospitals. I will hardly be surrpised if it turns out that the UK, or England at least, fumbles all sorts of things with the surveillance, test, track & trace side of things to start with, but gradually it should get a bit better and will provide us with all sorts of options, and hopefully much better timing of response, next time the virus starts to take off. Or it never even gets the opportunity to begin to take off again because actually we manage to just keep squeezing down on the thing to the extent that even if its not close to being eradicated, it remains sporadic, with the most dramatic stories being of particular individual outbreaks.
Already it seems that the proportion of cases in hospital that caught it in hospital is increasing, even as the overall number is falling, because such infections are not falling as quickly as ones that are happening in the wider community. Indeed some hospital infection situations are the sorts of incidents that can, if not dealt with effectively at that particular location at some point, keep on burning even once community spread has fallen to notably low levels. This is clearly a front that is getting more attention now as circumstances increasingly allow, and, much like effective shielding for care homes, make a real difference to the situation we find outselves in further down the road.
And we dont even have to buy into the idea that we will completely get the virus cornered one day, in order to recognise that we can still get great results by tackling chains of transmission at the local level using a whole array of relatively unsophisticated but practical means. As long as things dont go rocketing up again imminently then there is time for even this crappy government and other levels of establishment and authority to get some of this stuff up and running. And when that stuff is running, how then will the virus trick us into letting our guards down against an unexpected reemergence? With surveillance we will see it coming, or at least be aware that it has arrived, and where. There will likely be times when the response to a particular outbreak is lacking, but there are still many further forms of mass, sustained transmission required between a failure at the local level and the thing running wild across the country again.
Some of the sudden change of priorities the government have been forced into due to this pandemic (and their initial lacklustre response) may be temporary and they will seek to roll back on them ASAP. But various infection control measures are not on that list, even if the public and the nationwide rules get rather loose, other guards will remain. Because all the basic surveillance etc measures the government and local authorities can do in future are so, so much cheaper and attractive to them than the economy-freezing lockdown. It will be many years before establishments around the world are tempted to push pandemics and respiratory diseases and indeed public health in general as far down the agenda as they did in the doomed decades run up to this pandemic.
www.mirror.co.uk
