CORONAVIRUS HOUSE (BUBBLE) MANAGEMENT PLAN

CONTENT

Objectives & Context……...…..……..1

Level One Measures ………………..4

Scenario Planning…….……………...6

Risk Assessment….....……………….7

Visitor Evaluation……..…...………….8

B’s Bubble Guideline…..….………...11

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Objectives and context

This document explains the strategy of the residents of a large London household for handling the COVID-19 crisis. Our objective is to minimise the risk of contracting COVID-19 for several months at least, and below we hope to effectively explain why. This strategy may not be relevant for those who are open to a higher probability of contracting Coronavirus, but even if this is you, we would urge you to read on to understand why we recommend taking these precautions.

At this point, it seems likely the disease will enter general circulation similar to the way in which H1N1 (swine flu) did a decade ago. This means that for the majority of the global population it will be difficult to avoid contracting this disease in the longer term. However, we believe there is a very compelling case to take serious action to avoid contraction within the next few months at least due to these key factors (inter alia):

1. Contagion and asymptomatic cases: If we contract the disease, we will likely be contagious prior to having any symptoms, and some of us will never develop any symptoms at all. This means if one of us contracts it, we will almost certainly spread it to others before fully isolating, and possibly might not even know we have it at any point! This means that even if we feel fine, we ought to act as though we could have COVID-19, particularly if/when we have been in (direct or indirect) contact with someone who has tested positive.[1]

2. Safeguarding the vulnerable: Threatening the lives of older and/or more vulnerable people, whether through direct or indirect transmission, is extremely undesirable and irresponsible.

3. Uncertain consequences: At present there is considerable uncertainty about both the short and longer term consequences of contracting COVID-19. There are reports of young people in Wuhan sustaining permanent lung scarring, but beyond this the disease is also presenting differently in different geographical locations, genders, ages, and many other factors. Early research has shown that there is a significant risk of comorbidity with patients already suffering from Cancer, Type I Diabetes, and many other health conditions[2]. We will have more certainty about how this disease affects different groups -- and how to treat them -- as better quality data is collected over time.

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4. Prevention and management options will soon become available: Treatment and vaccine options will likely be developed this year. If it is, and you do not isolate, based on current estimates you are likely to transmit COVID-19 to at least three people, which would result in 250 infected within a month, including two mortalities -- and it continues to grow exponentially after then. This places you at the centre of a causal chain which will very likely result in unnecessary pain - and possibly death - from a disease which will likely become preventable and treatable within less than a year. What we do in the next few months has irreversible consequences that will soon enough be remedied[4].

5. Health system buderning: The best thing you can do for the time-being is wait for the system to recover, treatment to be developed, and more data to be collated. Unlike the flu, this disease appears to cause pneumonia and other easily treated respiratory problems which can kill you without access to the right medical care. If too many people are affected simultaneously, many more preventable deaths can occur due to overburdening of the health system. In the UK the NHS is most stretched during the seasonal flu period, and there are only around 167,000 hospital beds across the entire country -- most of which were already taken by non-COVID related patients. It is therefore very important that if you are unwilling/unable to isolate, that you help to spread the curve in the rate of transmission of COVID-19 by carefully choosing if/when you expose yourself to contamination risks, if treatments and vaccine developments are radically delayed, in order to avoid further burdening our [already] fragile systems.

6. Productivity, pain, and knock-on effects: We personally would simply rather avoid becoming very unwell for two weeks, which would have an effect on our ability to be productive and cause a non-negligible amount of personal suffering. It would also create an inconvenience cost for the wider networks we have been in contact with as they would then need to completely self-isolate for two weeks due to their contact with you.

Why create a bubble?

* Your strategy is only as strong as the weakest link in your chain. There is no point in establishing a high standard of quarantine if you are meeting with other people who have a lower standard of quarantine. To make it even more complicated, those you meet with also meet with people, and *they* might have low standards of quarantine.

* The idea of a bubble is to define a group of friends who are all setting an equally high standard of quarantine. No one in the bubble meets with anyone with a lower standard of quarantine and so everyone ‘in the bubble’ can feel comfortable spending time with each other. In the sections below we provide a framework for managing this, which you are very welcome to copy for your household and network.

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Level one measures

EIF: 14.03.2020

* Guests: Non-bubblers who are being proactive in taking reasonable measures to avoid COVID-19 contraction are defined as people who are:

1. Not using/drastically minimising use of public transport;

2. Sanitising regularly;

3. Avoiding busy events/mass-gatherings;

4. Maintaining a high level of awareness about