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The SAGE files: Public toilets may drive Covid-19 spread and the term ‘lockdown’ should be BANNED

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Covid-19 will spread more this winter and public toilets will be one of the riskiest places to catch it, scientists advising the Government say.

The experts warned public toilets can become crowded and are likely to harbour the virus on numerous cold surfaces.

Transmission of the virus through faeces and urine is also a risk, the team said, but admitted more research is needed to confirm this.

In the latest batch of documents released by SAGE today, experts also called for the word ‘lockdown’ to be banned. 

The Independent Scientific Pandemic Influenza Group on Behaviours said the word suggests ‘punishment’ and ‘blame’, which had left Leicester locals feeling like ‘lepers’ and the ‘laughing stock’ of England.     

These are among a treasure trove of papers presented to SAGE, the Government’s Scientific Advisory Group for Emergencies, over recent months to help guide ministers through the crisis.

The newly-released papers released today also revealed:

  • Testing people returning from holiday twice – once at the airport and once several days later – could reduce the need for 14-day quarantine;
  • ‘Local lockdowns’ could damage the economy in the long-term if people stay clear of the area in the future in fear of catching Covid-19;
  • HIV positive people are 63 per cent more likely to die 28 days after getting Covid;
  • ‘Super spreader’ events are most likely to occur in crowded places where people have to talk loudly. 
Covid-19 will spread more this winter and public toilets will be one of the riskiest places to catch it, scientists advising the Government say (stock)

Covid-19 will spread more this winter and public toilets will be one of the riskiest places to catch it, scientists advising the Government say (stock)

The Independent Scientific Pandemic Influenza Group on Behaviours said the word 'lockdown' should be banned because it connotes 'punishment'. Pictured, an information board in Blackburn with Darwen, a Covid-19 hotspot in England

The Independent Scientific Pandemic Influenza Group on Behaviours said the word ‘lockdown’ should be banned because it connotes ‘punishment’. Pictured, an information board in Blackburn with Darwen, a Covid-19 hotspot in England

Shoppers wearing PPE  as they walk in the city centre of Leicester on June 30

A shopper at the St George's retail park, in Leicester City centre, on July 11

Leicester local said they felt like ‘lepers’ and the ‘laughing stock’ of England when they were the only city to be put in ‘lockdown’ while the rest of the country moved on

Spread of Covid-19 will increase in the winter – and public toilets are one of the riskiest places

‘Environmental transmission’ – the spread of Covid-19 outside homes and in public places – will increase this winter, scientists said. 

And the most risky area of all will be public toilets, they believe.

In the 42nd SAGE meeting, held on June 18, experts warned during the winter, the virus can survive for longer surfaces.

There is less sunlight, humidity and hot temperature – all of which are thought to kill the virus by disabling its DNA.

The minutes of the meeting said: ‘SAGE noted that public toilets pose a comparatively high risk of transmission, with the main transmission route in that setting being from surfaces. 

‘This is due to a combination of low levels of natural light, confined spaces an the risk of faecal or urine transmission.’

Numerous studies during the course of the pandemic that suggest the virus can spread between people via excrement.

But there needs to be more research into this area, SAGE said.

There is a low risk of infection from treated wastewater, scientists said, but it become a problem if there is heavy rainfall.   

The term ‘lockdown’ should be banned, as Leicester locals describe feeling like ‘lepers’

The word ‘lockdown’ should be banned as the UK moves towards tackling Covid-19 with a more local approach, it’s been urged.

There are concerns the word, which so accurately encompassed Britons’ lives for months, is associated with ‘punishment’ and ‘blame’.

The Independent Scientific Pandemic Influenza Group on Behaviours (SPI-B) ‘strongly recommend national government, PHE, the media and others cease using the term “local lockdown”‘ and instead switch to ‘area of intervention’. 

The sub-committee of SAGE added: ‘The language of a “lockdown” is inherently punitive. It is critical to start to reframe the issue by moving away from this punitive language as well as from an overall punitive approach.

‘Areas experiencing the reintroduction of restrictions should not be subject to “blame”.’  

Leicester was the first area in England to go into a ‘local lockdown’ on June 30 because infections soared well above the average. 

Since then a number of other hotspots including Oldham, Blackburn and Darwen, have hurtled towards the same fate due to rising cases, with local health chiefs warning if people did not get their act together, a lockdown would come into place. 

SPI-B cited an investigation by the LSE Anthropology team of the local intervention applied in Leicester and how it impacted people that lived there.

It said: ‘The “lockdown,” because of its name and its targeting on Leicester was understood as a “punishment”.

‘People felt that they had been “forgotten” but also had become the “Lepers of Leicester” or the “Pariahs of Leicester”. 

‘They felt “ashamed” and like a “laughing stock” because they were still “in lockdown” after the national day of lessening of restrictions on 4th July.’

The Leicester investigation also supported a number of other problems with the arrangement of local lockdowns highlighted by the SPI-B.

These included mixed and unclear messaging from the Government, confusion over lockdown geographical boundaries and exacerbation of divisions in society, particularly among different ethnicities. 

‘Overall, Government decision-making that led to the intervention divided opinion on perceived legitimacy,’ LSE Anthropology said.  

Testing people returning from holiday twice could reduce the need for 14-day quarantine

Current rules requiring holidaymakers to quarantine for 14 days could be slashed by repeat testing, SAGE said.

In their 42nd meeting on June 18, advisers acknowledged the potential to cutting the self-isolation period by several days.

Passengers arriving at St Pancras International station on August 14 after the Government reimposed a 14-day quarantine period for people arriving from France later than 4am on Saturday

Passengers arriving at St Pancras International station on August 14 after the Government reimposed a 14-day quarantine period for people arriving from France later than 4am on Saturday

The group reviewed several papers that analysed how useful repeat testing was. It would require testing someone on their arrival to the airport and several days later. 

Results showed ‘double testing travellers could enable quarantine duration of less than 14 days’.   

The best day to take a Covid-19 test was between five and eight days after exposure. 

That means if someone catches the virus on the last day of their holiday in Spain, it would likely show up on a test eight days after they come home. Therefore, if it is negative, they are free to leave quarantine.

And, if travellers are tested twice a few days apart, it significantly rules out the possibility of an initial false negative result at the airport, SAGE said.

That is, it makes sure that those who have the virus are definitely spotted and the test was not incorrect. 

It could shave off three to seven days, according to experts commenting on the papers. 

Linda Bauld, a professor of public health at the University of Edinburgh, said if someone was tested a second time on day five, and it came back negative two days later, they may only have to quarantine for seven days, instead of 14.    

If the second test was on day ten, it may only save three days off granted the result came back within 24 hours. 

Keith Neal, an emeritus professor of the epidemiology of infectious diseases at University of Nottingham, said double testing is not likely to be ‘cost effective’.

He said: ‘Testing at one week will only find asymptomatic cases assuming those with symptoms get themselves tested. 

‘As most cases do produce symptoms then testing will only identify the minority of cases that would otherwise be missed.’  

A paper from Public Health England in June for SAGE modelled how ‘double testing’ could work. 

It showed that testing people seven to ten days after arrival was 14 times better at detecting cases of Covid-19 than just once on arrival.

‘Local lockdowns’ could damage the economy in the long-term as people stay clear of the area

‘Local lockdowns’ will ‘inevitably’ cause economic damage in the long term, behavioural experts have warned.

The SAGE sub-committee SPI-B said: ‘An area identified as a Covid-19 “hotspot” may become known as a place to avoid for fear of contracting Covid-19. 

'Local lockdowns' could damage the economy in the long-term, scientists said. Pictured: Shopkeepers in Oldham, where Covid-19 infection rates are the highest in England

‘Local lockdowns’ could damage the economy in the long-term, scientists said. Pictured: Shopkeepers in Oldham, where Covid-19 infection rates are the highest in England

MANCHESTER MAYOR URGES AGAINST OLDHAM LOCKDOWN WHICH WILL HARM THE POOR

Greater Manchester’s mayor Andy Burnham has urged ministers not to ‘overreact’ by sending Oldham into a full lockdown.

He called on Number 10 not to introduce ‘knee-jerk measures’, as coronavirus cases continue to increase in some parts of Greater Manchester. 

It comes just days after Oldham council leaders said they were in discussion with the Government about a local lockdown, which could come into force ‘within days’ if the virus wasn’t controlled.

Speaking at a weekly media briefing last night, Mr Burnham said: ‘What worked in Leicester is not necessarily going to be right for Greater Manchester, given the interconnected nature of the city region, and I think we’re going to have to have a very considered approach to this rather than crude measures which become further divisive among different communities and different boroughs. 

‘We need to be proportionate, targeted and focus on measures that are going to work. 

‘That is the thrust of the letter we have sent to Government today – no knee-jerk measures but work with us to get whatever interventions we do right and obviously make them as effective as possible.’ 

Oldham Council said on Wednesday that despite additional measures being put in place in the borough two weeks ago, the number of positive cases has continued to increase.

Mr Burnham agreed that the figures were a ‘major cause for concern’, but he wanted the town to be given another week to allow more time for current restrictions worked. 

‘While figures have been worrying this week we must also not kind of overreact, there is a danger of doing that,’ he said, according to the Manchester Evening News.  

Mr Burnham said a full lockdown could cause ‘serious difficulties’ for people living in the region.

‘You would have to consider what a lockdown would do to an area like Oldham on the Leicester model,’ he said.

‘It could have serious implications for businesses, serious implications for people’s mental health.

‘Why are our poorest communities being hit? It’s because of the inability of many people in those places to self-isolate and this is a real gap in our defences and we’re leaving poorer communities exposed to this virus if we don’t fix this.’   

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‘If economic decline ensues, people will be less likely to visit the area; an area that people do not want to visit will become an area in which people do not want to live. 

‘If families no longer move there or current residents move away, the area will suffer long term economic damage.’

A reduction in travel in and out of the area and using businesses will ‘further depress local finances’.

Experts warned areas under stricter rules will already be feeling financial strain.

The paper noted local lockdowns so far, including the ones imposed in Leicester, have come at a cost to the area’s economy which have already been crippled by the blanket measures introduced on March 23.

In Leicester, businesses will have invested time and money to prepare to re-open on July 4 before they found out it wouldn’t be possible on June 30.

This expenditure, coupled with a loss of income, ‘will impact local business and also local government finances… meaning less money to spend on services’.  

HIV positive people are 63 per cent more likely to die 28 days after getting Covid

People with HIV are 63 per cent more likely to die 28 days after catching the coronavirus than those who do not have it, a study revelaed.

The research was prompted by an early concern about the lack of data on HIV and COVID-19. 

The analysis included records from 47,539 patients who were hospitalised with laboratory confirmed (or highly likely) COVID-19 from January 18 to June 18.

It covered 207 centres across the UK enrolled into the ISARIC CCP-UK study – an international research cohort.

Around 0.24 per cent of the patients were HIV positive, of which 90 per cent had taken antiretroviral therapy – medicine which suppresses the viral load in the body so it is undetectable.

Researchers led by Professor Anna Geretti, of the University of Liverpool, were primarily looking at how many patients in the HIV negative and HIV positive groups died by 28 days.

It found a 63 per cent raised risk of death among the HIV-positive people once age and state of health on admission were taken into account. 

HIV positive patients whose disease had progressed the most were more likely to die, as well as patients who also had diabetes and obesity. 

But the analysis showed no impact of ethnicity on outcomes after hospitalisation.

Because the study only included 115 HIV positive people, of whom 26 died, it makes it harder to prove the results are statistically significant and not just by chance. 

On top of that, there are likely gaps in information on the HIV patients’ health, including what type of medication they are on.   

Charities the British HIV Association (BHIVA), Terrence Higgins Trust (THT), National AIDS Trust (NAT) and NAM aidsmap welcomed research into the links. 

But they urged the findings, published as a pre-print paper without scrutiny from other scientists, should be interpreted with caution.

Super spreader events are most likely to occur in crowded places where people talk loudly 

‘Super spreader’ events are most likely to occur in crowded places were people have to talk loudly.

It is already known that the gathering of huge groups of people may not return to normality until a Covid-19 vaccine is found because of the risks one singular, highly infectious person spreading the virus to several others.  

But SAGE has further dampened any expectations of events such as music gigs, or the opening of bars and nightclubs in their former glory, returning in the foreseeable future.

Since hospitality venues re-opened in England on July 4, government advice has warned against music and noise – including showing live sport – because people talking loudly or shouting poses a serious risk of spreading coronavirus. 

In any situation where a person has to speak loudly to get their voice heard, such as when there is loud music, there is the potential for them to spread the coronavirus and cause an outbreak, SAGE suggested.

Talking loudly may mean extorting more droplets from the mouth – and droplets are the main route of Covid-19 transmission. 

SAGE said on June 18 said: ‘Environments linked to super-spreading events tend to be internal, crowded locations where it may be necessary to speak loudly.’

On the same section, it said: ‘Studies of cluster tracing have highlighted that schools and possibly universities to not appear to be centres of super spreading events (low confidence).’ 

The meeting discussed the difficulties in managing an outbreak linked back to one highly contagious person.

If a cluster of cases occur after one event – a party for example – it can be assumed it was caused by a superspreader.

However, if that person spreads the virus to dozens of people at multiple different venues, it is difficult to identify where and who the spike in cases came from, making contact tracing challenging.  

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