Coronavirus conundrums (Dr Philip D Welsby)

There is a lot of information out there and numerous contributions by official and unofficial organisations, never mind individual contributions. There are too many people who think their “single issue advice” should be followed. No one individual and this includes myself has the expertise required for management of all the complexities. Our government has the committees that have the responsibility to synthesize decisions affecting the whole country when, especially when, information is imperfect. Such committees include microbiologists, infectious diseases doctors, public health doctors, epidemiologists, hospital and GP representatives, epidemic mathematical modelers, and economic advisers etc. None of whom in isolation could provide comprehensive advice.
Government committees will need to know how many people would be infected if we did nothing, what the epidemic curve would look like in various situations, what proportion of those infected would infect others in various situations, how many of which population groups would require what extra services in various situations, what the effect of various measures at various times might be, what the economic impact might be, what the doubling time of the viral load of those infected is, and whether the severity of the illness is affected by the infecting dose etc.

The official advice in the United Kingdom differs from elsewhere, especially about self-isolation for only a week if you live alone (two weeks for all those living together). I suspect that after a week most recovering sufferers will have significant but reducing viral loads such that those infected from them will receive a lower infecting dose than if they had acquired infection earlier from those infected. This lower infecting dose might mean that the illness acquired will be milder (the virus probably needs several doubling times to exert its effects but during this gained time the host response will be in a better position to combat the infection). And this effect would be repeated with each transmission. In summary it is possible I do not know that low dose exposure to coronavirus might lead to milder infections.

If this speculation is correct (and it may not be) and our government’s decision to limit self-isolation to one week do reduce the severity of infections (although not necessarily the infection rates – the virus is highly infectious) – then this would be a world game changer and those who introduced it would win Nobel prizes. Several assumptions underlie this “if” however. However if this speculation were incorrect and given that 80 percent or so of us are going to get it anyway then hardly anything would be lost.
I was a Consultant in Infectious Diseases so I can comment on previous infectious diseases but cannot have overmuch insight on any other aspects as mentioned above. I would stress it is important to realise that we, for better or worse, have to rely on official government sources. For Scotland we have https://www.gov.scot/coronavirus-covid-19/ and https://www.hps.scot.nhs.uk/a-to-z-of-topics/covid-19/

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