In recent years there has been a growth in numbers of people (mostly young people) undertaking physical challenges that involve high risk. One of these is ‘Tombstoning’ – the practice of jumping from height, sometimes considerable height, into a body of water.
Over the sunny weekend of 30/31 May, in Dorset (UK), there was an incident involving ‘tombstoning’ which provides a clear metaphor for the UK government’s decision to relax the strictures of ‘lockdown’.
People were frustrated by being confined, at that time for 10 weeks, and the government had signalled that we could have a degree of freedom to go outside. It began by saying, three weeks previously, that we could travel any distance to enjoy exercise, as long as we maintained the prescribed social distancing of 2m. Predictably, people took that as a green light to go to the ‘seaside’ – in their thousands. Cars streamed to the coast, clogging roads and carparks, disgorging their occupants in confined locations where it was inevitable that ‘social distancing’ would be challenging if not impossible.
Durdle Door, in Dorset, is an iconic and beautiful location where an enclosed shallow bay features a natural arch over the water. It is, or should be, self-evident that an enclosed bay surround by cliffs will have limited access, and the limited space on the beach will be influenced by the fall and rise of the tide. Apparently not. Many hundreds of people arrived and spread themselves on the beach. Amongst them were three who decided it was a good idea to test their bravery by climbing up the cliff, over the arch of the ‘door’, and ‘tombstone’ 70 feet into the shallow water, encouraged by the onlooking crowd shouting “Jump, Jump”. They were all seriously injured and had to be airlifted from the beach to hospital, although it is questionable whether land ambulances would have been able to get anywhere near on the clogged roads. To make room for 2 helicopters to land safely, hundreds of people were compressed into a small space, destroying what remained of any potential social distancing, and were eventually evacuated from the beach up the single access path in a massive ‘crocodile’ file. In this case, amongst the unknowable number of already infected people, any one or all three of the jumpers might have Covid-19, presenting risk to their rescuers and medics, not to mention that flying helicopters into that location is not entirely risk-free either.
This event is where my case for ‘metaphor’ comes in. Over a fairly short time frame UK governments (there are 4 devolved administrations) have decided to shout “Jump, Jump” while we contemplate tombstoning off a lockdown cliff. In the face of conflicting (and in some cases absent) evidence and scientific advice, we are being told we can come out of lockdown but, explicitly, to do our own assessment of risk. The problem with this is that the assessment of risk, in relation to Covid-19, remains, as it has been all along, selfishly focussed on not catching the disease rather than not spreading it. One thing the scientists are agreed on is that we need a robust, fully functional, ‘track and trace’ system to pick up, and isolate, outbreaks of disease. We have seen the value of this in other countries where they had systems for, and experience of, population scale testing and tracking in pandemics. To be robust and fully functional it needs to have adequate capacity, both for carrying out tests and analysing the results, and critically that means speed because outbreaks must be stopped quickly or they rapidly get out of control. At present the UK does not have this and, by all accounts, the statistics on tests carried out are suspect. The evidence, or should I say experience, from other countries where they have had a better grip of Covid-19 is that it keeps coming back. Other countries experimenting with coming out of lockdown have low rates of new infection, in the low hundreds at most. Our daily rate of new infections is stubbornly high, apparently around 8000, of which perhaps 25% are actually confirmed by a test. After 10 weeks of lockdown, which has limited movement and contact, one has to ask why? What is driving community transmission? I have my own theory, which is asymptomatic spread. Asymptomatic infectees will not be picked up by track and trace, or other existing testing, because they fundamentally require self-reporting of symptoms. Those contacted by ‘track and trace’, as having been in contact with someone who is confirmed (by another test) as infected, will be asked to isolate. However, though they may also be infected they may not have, or go on to develop, symptoms. In fact they may be the person who unknowingly gave the infection to the reporting person in the first place!
The science around modality of spread, of viability of deposited virus, of viable infectivity in a person after infection, of any acquired immunity and persistence of immunity, is weak. This brings me back to my metaphor. In a country where some seem only too ready to accept the government’s encouragement to “jump”, while applying their own assessment of risk to them, I fear we are all tombstoning to potential disaster with them.