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Covid 19: How Should the Law React?

27/03/20. Dr. Mark Burgin BM BCh (oxon) MRCGP discusses reasonable adjustments to legal processes to allow compliance with Government Policy and Health and Safety.

Legal processes risk spreading the virus in a way that acts counter to the government’s present strategy of suppression such waiting rooms and courts.

With the previous strategy of herd immunity, spread of Covid 19 was to be encouraged so that all non-vulnerable people would get the disease.

The recent mathematical modelling from Imperial College suggested that the deaths would be 250k not 25k and so spread would be based on stop-start.

This makes advice more complex, the courts cannot simply say ‘no over 60s to come to court’ and must give tailored advice for both stop and start phases.

Face to face or video?

Vulnerable claimants and professionals should not be travelling to courts or clinics and should instead be talking with each other on video or telephone (whether in stop or start phase).

For those who are not vulnerable, clinics and courts can carry on as normal in start phases but there should be a gap between individuals both in time (to allow cleaning) and physical distance.

Handwashing in front of clients demonstrates that the professional is taking seriously the threat, although anything that was touched should also be wiped down.

During stop phases all non-essential work should be deferred and essential work should be carried out via video consultation or with minimum spectators on home visit.

Testing professionals for Covid 19

All legal and experts should consider whether the work that they do is essential and whether they can reasonably defer work to the start phases of the outbreak.

Those that work in the criminal courts and family courts, where delay may damage justice, are clearly essential whilst MedCo personal injury cases are clearly not.

At present the only testing available is nose and throat swabs which take 2 days to detect active virus and could be useful to help experts return to work after infection.

An immunity test is being trialled which will show previous infection from Covid 19, when it becomes available will allow restrictions on immune individuals to be lifted.

Corona Virus Anxiety

The current figures for Covid 19 suggest that death rate increases by age so that whilst under 60s have low rates (1 in 200) in the over 80s up to a quarter will die.

Research into the additional deaths due to Austerity found 120k deaths (most were over 60s in care homes) and yearly influenza deaths vary between 1.6k in 2018/19 to 28k in 2014/5.

The ONS total number of deaths in the UK in 2018 was 541,589 (1484 people per day) so that 25k deaths from Covid 19 is equivalent to 17 days of normal deaths.

Deaths caused by overreacting to the emergency (from later Austerity) and failure of herd immunity to protect the most vulnerable need to be considered.

Conclusions

The majority of the population is expected to acquire the infection and become immune, but the first peak will be the worst so urgent action is needed now.

There is a risk that by suppressing the virus with stop-start that more vulnerable people will become exposed as the virus will circulate for longer.

Legal bodies should be proactive in supporting professionals and clients to comply with government policy particularly protecting the vulnerable.

Until population studies find the numbers who have recovered from Covid 19 it will be uncertain whether suppression or herd immunity was the correct approach.

Doctor Mark Burgin, BM BCh (oxon) MRCGP is on the General Practitioner Specialist Register.

Dr. Burgin can be contacted on This email address is being protected from spambots. You need JavaScript enabled to view it. and 0845 331 3304 website drmarkburgin.co.uk

Surveillance of influenza and other respiratory viruses in the UK Winter 2018 to 2019 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/839350/Surveillance_of_influenza_and_other_respiratory_viruses_in_the_UK_2018_to_2019-FINAL.pdf

Watkins J, Wulaningsih W, Da Zhou C, et al. Effects of health and social care spending constraints on mortality in England: a time trend analysis. BMJ Open 2017;7:e017722. doi:10.1136/ bmjopen-2017-017722

Ferguson Report 9: Impact of non-pharmaceutical interventions (NPIs) to reduce COVID-19 mortality and healthcare demand Imperial College COVID-19 Response Team

https://www.gov.uk/government/publications/covid-19-track-coronavirus-cases

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