Social contact 'diet plan' and the four other lockdown options

The public could be asked to adopt a ‘social contact diet plan’ to ration the number of interactions they have in a week as a way of limiting the spread of coronavirus.

Government advisers are understood to have discussed the possibility of introducing individual “contact budgets” if the pandemic continues for months to come.

These would balance limits on interactions with still allowing people a certain measure of morale boosting leisure and social contact with others.

The contact budgets would be calculated in a similar way to an individual’s calorie counting diet or a household’s carbon footprint, with more numerous, “cheaper” casual meetings offset by fewer “expensive” interactions.

Behavioural scientists have suggested that just as a dieter might allow themselves one slice of cake a week as reward for daily soup and salads, an “expensive” contact could be classed as a prolonged meeting indoors, with a number of people from another household, which should happen more rarely than “cheaper” gatherings like a regular brief walk in the park with a single friend.

Similarly if a parent arranged for their child to see a grandparent in a given week – an interaction that would not only be classed as “expensive” but would also carry a high risk of serious consequences, they may be asked to cut back on all other contacts in the days leading up to that meeting.

Someone who worked from home would in theory have more “contact points” to spend than an individual who had returned to the office.

The concept of contact budgets was discussed at the government’s Scientific Pandemic Influenza Group on Modelling (SPI-M), a sub-committee of Sage, in August  – before the blanket measure of the rule of six came into force this week.

Scientists are concerned that some people are viewing policies like the rule of six as a quota that can be met every day, rather than an upper limit.

There is no suggestion at this stage that the plan would be compulsory, it could be encouraged as another way to bring infections down.

Dr Adam Kucharski, associate professor in epidemiology at the London School of Hygiene and Tropical Medicine and a member of SPI-M, said: “Just as if people are following a diet, some things work out more expensive and some things are cheaper. So if you are going to have a large gathering you can offset that by not having too many smaller gatherings along the way in the same week.”

He said that there was a challenge for the public in “working out how to manage risk at the individual level” and that contact budgets would help people better understand their own exposure to others.

Dr Kucharski told the i: “There has to be greater understanding of contact and risk because this is going to go on for a prolonged period of time. At an individual level people do have more awareness of various behavioural changes that we need to encourage, as well as top down policies [like the rule of six].

He said that Sweden, which had not imposed a full lockdown but kept in place social distancing measures and strict limits on gatherings all the way through the pandemic, had seen a flatter curve of cases, although the country has suffered a relatively high number of deaths in the earlier weeks of the initial peak, as shown below.

Swedes had had “more practice of this [limiting contacts] and therefore more awareness of what they need to do individually,” he said. “Countries that have more practice at doing that and are more able to sustain that balance are going to fare better over the coming weeks.”

Other possible measures that could be taken over the next few weeks, include:

Curfews

Night time curfews could be adopted as a way of further limiting contact between groups of people, especially the young, in town and city centres.

Health Secretary Matt Hancock told the BBC that under a short 'circuit break' lockdown to curb rising infections hospitality venues would be closed to allow schools and workplaces to remain open, noting that the "vast majority"of transmission takes place in "social settings".

Already a curfew in Bolton has seen pubs, restaurants and other hospitality venues being limited to takeaways and closing to customers between 10pm and 5am and bars and restaurants Newcastle have been told to shut at 10pm as part of new restrictions to fight a surgeon cases.

Professor Kevin Fenton, London director of Public Health England, said last week that similar restrictions could be imposed in the capital to avoid a return to a more stringent lockdown.

He said: “In some areas which have seen resurgence there have been limits placed on the amount of time you can spend socialising. In some it might be local curfews so you’re not out drinking until the wee hours of the morning.

“By limiting that you also limit the amount of time people are spending in close contact with others.”

Tightening the rule of six?

People across swathes of the North East and North West of England are currently banned from meeting people who are not a part of their household or support bubble.

That rule could be extended as part of new national restrictions on social contacts.

Government advisers fear people have begun to regard the rule of six, which allows as many as six different households to meet indoors or outdoors, as long as the individual limit is not breached, as a daily target.

Dr Adam Kucharski, associate professor in epidemiology at the London School of Hygiene and Tropical Medicine, said: “With fixed numbers people see it as more of a quota than a limit – they think: ‘I can fill it every single day’… There is not a magic number that makes it not safe or safe.”

As a result further limits may be imposed on how many other people individuals can meet at one time. Alternatively these meetings may be allowed to continue if they are offset by fewer contacts in other circumstances.

“If people were stricter about self-isolating then limits on social contacts could be increased,” said Dr Kucharski.

More working from home?

The Government had been on the verge of a major publicity campaign urging people to return to their offices until the recent surge in cases forced them to put it on ice.

Now it may even revert to telling more people to work from home if they can do so.

A survey last week found that more employees now commuting than at any stage of pandemic.

Nearly two thirds of working adults have returned to commuting to work, according to latest government figures, although many are only doing so part-time.

According to the Office for National Statistics this was the first time that the proportion of working adults travelling to work had risen above 60 per cent since the weekly survey began in early April.

But the effect of that may be to increase close social contact and drive up the infection rate.

The Welsh Government has already said it wants people to continue to work from home, even into the longer term as a way of not only stemming the spread of the virus, but reducing congestion and pollution, and improving work-life balance.

Deputy Minister for Transport and Economy, Lee Waters, said: "The UK government instruction for everyone to go back to the office is not one we are repeating in Wales. We believe many people will want to continue to work remotely in the longer term and this could be a step-change in the way we work in Wales."

But the employers' organisation the CBI has warned city centres could become "ghost towns" if ministers do not do more to encourage staff back to the office.

Changes to 'organised sports' rules?

Organised team sports carried out in a Covid-19-secure way, with guidance issued by a sports governing body, are currently allowed to have more than six participants.

This saw the restart of Premier League football, rugby and cricket, played in empty stadiums.

The Government would be reluctant to reimpose a ban on professional sport, but plans to allow even a small number of spectators into venues from October 1 could be scrapped.

Pilot schemes are taking place at a select number of gourds this weekend, but longer term plans are now uncertain.