A leading fertility specialist has said it is unlikely that IVF treatments will resume in Ireland before June.

Fertility clinics have been closed since the middle of last month leaving hundreds of patients in limbo.

Dr John Kennedy, Group Medical Director of Sims IVF, told RT's Morning Ireland that the cancellation of treatment was "awful", but that it was not possible to keep clinics open and maintain social distancing.

"You can take all the precautions with regard to Personal Protective Equipment (PPE), but it is by no means perfect and if you have a good stockpile of PPE that should probably be in the hands of the general hospitals at this point," he said.

Around 6,000 IVF cycles are undertaken every year in Ireland.

"We generally would have (egg) transfers booked four to six weeks in advance so we had a full transfer list for April.

"That's four or five transfers a day, five days a week. We are having to cancel all of them on a rolling basis so the numbers are mounting up all the time," Dr Kennedy explained.

He said Sims, like other clinics around the country, are still carrying out video consultations and responding to patient queries. However, no clinical procedures are being undertaken.

The initial decision to stop treatment came following advice from the European Society of Human Reproduction and Embryology (ESHRE) on 15 March.

The ESHRE recommendation was based on concerns over the impact of Covid-19 on early pregnancy, however, many IVF patients felt their personal choice was being taken away.

Speaking to RT's Morning Ireland, awoman, who did not want to be named, said:"We have been treated like brood mares. I feel as though my rights, my liberty has been taken away.

"I do not have autonomy over my own body, my own reproductive system. It is abhorrent."

Dr Kennedy described the timeline for reopening clinics as the "million dollar question".

"My gut is telling me nothing good is going to happen in April, it is unlikely something will happen in May, but certainly after that if all the clinics are still closed really everything is going to start to struggle an awful lot."

Caitriona McPartlin, Chief Operating Officer of the ReproMed clinics in Dublin and Galway, said they were attempting to establish protocols to continue to treat patients.

"Once we know that we can open safely following the guidance of the Department of Health, we will do so," she said.

Dr Kennedy said that "in the fullness of time" clinics may have to "live with" additional risks.

"A lot of women that we have are on the clock and as months go by and people get older statistical chances of success drop and that's a terrible thing," he said.

Denise Phillips from Newbridge, Co Kildare, was just about to start a cycle of IVF when she was told the treatment could not proceed.

"It was a big shock because you mentally build yourself up so much that when somebody tells you that you can't go ahead it is just devastating. Beyond devastating."

Denise and her husband, Mark, have a five year-old daughter from a previous IVF treatment and had hoped to expand their family this year.

"I had an initial consultation and was going in to start my scans, get my medication and start our journey but then I got a phone call saying that all IVF cycles were postponed or cancelled.

"Obviously, the Government has to do things that are right, but it's awful for somebody to take away your chance after all that's already been taken from you. What happens if this is around for a long time?"

Denise said that fertility patients are suffering "huge anxiety".

"Their families don't know they are having treatment and they are in isolation. They don't want to leave the house in case they pick up something and then won't be able to get treatment once the clinics reopen. Everyone's mind is racing."

Once fertility services resume, there are concerns over a potential backlog of patients. However, Dr Kennedy said plans are being made to increase opening hours and treatment capacity.

He said: "We are retaining staff and holding on to people so when it comes time to hit the ground running we are in a position to do so.

"It is in everyone's interest to reopen. It will be all hands to the pump."

See original here:
Hundreds of patients affected by closure of IVF clinics - RTE.ie

Faith, safety, panic, control

With these uncertain times we saw a spate of panic buying. This got me wondering why humans would react in this way. My first thought was that it was the fear of the unknown. We had little to no information or knowledge of COVID-19, how it could be managed or treated effectively. The only information was on China's experience of the seriousness of COVID-19, its impact on communities and the death rate. With this in mind, and the clearing of essential goods on supermarket shelves, our animal instincts were triggered by what we had control over - protecting ourselves and family by making sure our food and medical reserves were stocked sufficiently when we were in isolation. We were faced with the unknown. The lack of certainty in terms of treatment for the virus as well as limited supplies of essential goods and protective equipment. Why is certainty important? Certainty is the amount of confidence attributed to particular knowledge; like available and effective medical treatment and the replenishing of stocks and supplies to meet demands in a timely manner. The need for certainty is part of the human search for order and security. But certainty is only certainty, as far as it can be. We are certain when we know something is true, and have no doubts. If the facts are unknown, validation is important to convince compliance, in other words 'seeing is believing'. Hence the gathering at the beaches and backyard parties in Bondi instead of practising social distancing. There are seven fundamental human needs and the seventh is subsistence. Maslow's hierarchy of human needs are survival, safety, security, self-care, structure and control. Survival needs include physiological needs such as food, water, air, breathing, excretion, reproduction, warmth, shelter, rest, sleep, homeostasis, etc. Safety and security needs include personal security, work, resources, property, and health. Self-care needs include things like leisure, entertainment, healthcare, etc. Subsistence includes everything needed to sustain life. Individuals also need control and structure their lives to make them feel safe and secure. According to research by Dr Lauren Leotti and her colleagues, "the need for control is a biological imperative for survival". Globally, COVID-19 is affecting our physical and psychological health and safety. People are losing their jobs, essential services are stretched with limited resources, and fatigue management is non-existent. With lockdown and indefinite isolation, humans may develop cabin fever and begin to feel stressed and anxious. To get through this outbreak, communication and connectivity is essential among colleagues. It provides support and unity in these times of isolation and uncertainty. Faith Eeson is a safety consultant with FOCCALE Safety Management

https://nnimgt-a.akamaihd.net/transform/v1/crop/frm/SZjBdCvXzdW4Ygt94axh3r/f65e6ef0-4127-44c6-a6f2-61e3052ef008.JPG/r0_183_1192_856_w1200_h678_fmax.jpg

OPINION

April 6 2020 - 8:00PM

Faith Eeson

With these uncertain times we saw a spate of panic buying. This got me wondering why humans would react in this way.

My first thought was that it was the fear of the unknown. We had little to no information or knowledge of COVID-19, how it could be managed or treated effectively. The only information was on China's experience of the seriousness of COVID-19, its impact on communities and the death rate.

With this in mind, and the clearing of essential goods on supermarket shelves, our animal instincts were triggered by what we had control over - protecting ourselves and family by making sure our food and medical reserves were stocked sufficiently when we were in isolation.

We were faced with the unknown. The lack of certainty in terms of treatment for the virus as well as limited supplies of essential goods and protective equipment.

Why is certainty important?

Certainty is the amount of confidence attributed to particular knowledge; like available and effective medical treatment and the replenishing of stocks and supplies to meet demands in a timely manner. The need for certainty is part of the human search for order and security. But certainty is only certainty, as far as it can be. We are certain when we know something is true, and have no doubts. If the facts are unknown, validation is important to convince compliance, in other words 'seeing is believing'. Hence the gathering at the beaches and backyard parties in Bondi instead of practising social distancing.

There are seven fundamental human needs and the seventhissubsistence.

Maslow's hierarchy of human needs are survival, safety, security, self-care, structure and control. Survival needs include physiological needs such as food, water, air, breathing, excretion, reproduction, warmth, shelter, rest, sleep, homeostasis, etc. Safety and security needs include personal security, work, resources, property, and health. Self-care needs include things like leisure, entertainment, healthcare, etc. Subsistence includes everything needed to sustain life.

Individuals also need control and structure their lives to make them feel safe and secure.

According to research by Dr Lauren Leotti and her colleagues, "the need for control is a biological imperative for survival".

Globally, COVID-19 is affecting our physical and psychological health and safety. People are losing their jobs, essential services are stretched with limited resources, and fatigue management is non-existent.

With lockdown and indefinite isolation, humans may develop cabin fever and begin to feel stressed and anxious.

To get through this outbreak, communication and connectivity is essential among colleagues. It provides support and unity in these times of isolation and uncertainty.

Faith Eeson is a safety consultant with FOCCALE Safety Management

Read the original:
Opinion | Why panic buying highlights the human need for control and structure - Newcastle Herald

You may have seen a version of the infographic (below) that explains the potential impact of social distancing. It nicely illustrates that reducing the total number of disease-spreading contacts each infected person has can have a dramatic effect on the total number of infections a short time later. The numbers rely on the mathematical concept of exponential growth.

The total number of infected people reduces dramatically after 60 days with relatively small changes to the reproduction number of the disease. Christian Yates, Author provided

Recently, Boris Johnson, the British prime minister, told the press that it looks as though were now approaching the fast growth part of the upward curve. And without drastic action, cases could double every five or six days. The consistent doubling of cases in a fixed period is the hallmark of exponential growth.

The number of new infections that a single infectious individual will cause during their infectious period is known as the basic reproduction number of a disease. This number is key to determining how widespread a disease will become.

For COVID-19, early estimates of the basic reproduction number have it somewhere between 1.5 and 4. The infographic assumes a figure somewhere in the middle, at 2.5 infectious contacts per infectious individual.

If the reproduction number of a disease can be brought below one, then the spread will slow until the disease dies out. The revised infographic below shows the number of currently infected people. Reducing contact with others by 75% will bring the reproduction number below the critical level, allowing the number of infected people to decrease almost to zero in just two months.

The number of currently infected people after 60 days (assuming recovery after 10 days) changes with the reproduction number of the disease. Christian Yates, Author provided

However, the basic reproduction number of the current stage of the outbreak is way above one. This means that each newly infected person will pass on the disease to at least one more person, on average, and consequently the disease will take off exponentially.

But what, precisely, is exponential growth? The mathematical definition says that a quantity that increases with a rate proportional to its current size will grow exponentially. This means that as the quantity increases so does that rate at which it grows. The more infected people we have in the early stages of a disease outbreak, the more people they will infect and the more the cases will rise.

The total number of confirmed cases of COVID-19 in the UK is increasing exponentially. Max Roser, Hannah Ritchie and Esteban Ortiz-Ospina (2020) Coronavirus Disease (COVID-19) Statistics and Research, CC BY

Other situations in which exponential growth plays a critical role range from pyramid schemes to nuclear weapons. In a pyramid scheme, each new investor invites two more recruits who in turn invite two more. This rapid growth, at a rate proportional to the current number of members, inevitably leads to a situation in which there arent enough new recruits to keep the scheme going and it eventually collapses. When the pyramid tumbles, most investors lose their money.

In a nuclear fission bomb, a single uranium atom splits in two, jettisoning fast-moving neutrons and large quantities of energy in the form of electromagnetic radiation. The neutrons then collide with more atomic nuclei, splitting more atoms and releasing yet more energy in a nuclear chain reaction that increases exponentially.

At about 8:15 in the morning of August 6 1945, the atomic bomb known as the Little Boy detonated releasing energy equivalent to 30 million sticks of dynamite in an instant, devastating the Japanese city of Hiroshima. The surrender of Imperial Japan was announced nine days later. This is the awesome power of exponential growth.

Although the concept of exponential growth is not new in the public consciousness, a lot of misconceptions surround the idea. Exponential is often used as a byword for rapid or large. As a counterpoint, consider the money in your bank account. Provided the interest is compounded (that is, interest is added to your initial amount and earns interest itself) then the total amount of money in your account increases in proportion to its current size the hallmark of exponential growth.

As Benjamin Franklin put it: Money makes money, and the money that money makes, makes more money. If you could wait long enough, even the smallest investment would become a fortune. But dont lock up your rainy-day fund just yet. If you invested 100 at 1% per year it would take you over 900 years to become a millionaire. Very few people would accuse the exponential growth associated with their bank account of being large or rapid.

So exponential growth does not necessarily deal with big quantities, and it is not necessarily fast. Unfortunately, across a wide range of different countries, the term exponential is appropriate to describe the rapid spread of SARS-CoV-2, the virus that causes COVID-19. With cases doubling every three to four days in the UK and deaths doubling every two to three days, things could get ugly quickly.

One small crumb of comfort is that almost nothing can grow exponentially forever. The only exception, ironically, is the all-too-slow growth of money in your bank account, which, at least on paper, could grow indefinitely. Unfortunately, COVID-19 cases dont have to grow exponentially forever, or even for much longer, before the disease becomes one of the most devastating pandemics the world has ever seen.

Because the exponential proliferation of the disease is so undeniably dramatic, any changes we can make at this relatively early stage can make a huge difference even a few days down the line. Now is the time to act, to double down on our containment efforts to bring the exponential spread under control.

This article is republished from The ConversationbyChristian Yates, Senior Lecturer in Mathematical Biology, University of Bathunder a Creative Commons license. Read the original article.

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Coronavirus is growing exponentially here's what the numbers mean - The Next Web

When Laura Dykstra was finishing up high school, she had research on her mind. Dykstra, from West Chester, Ohio, saw opportunity just a few hours to the north.

There are a lot of diverse ecosystems and wildlife species in Michigan and the Great Lakes area, and I thought it would be great to study them in person, said Dykstra.

So, she visited some schools, looking for an opportunity to get started.

Calvin was one of her stops.

I was impressed by all of the research opportunities at Calvin even freshmen are able to get involved in the lab or in the field, said Dykstra.

It didnt take Dykstra long to realize the unique opportunity she would have at Calvin to pursue her dream. So, she chose Calvin, and with the help of her professors she was plugged into research right away.

One of the greatest things about Calvin is how much the professors are invested in their students; I feel like Ive gotten to know my professors well and that they care about my career goals, said Dykstra, a biology major.

Along with two other undergraduate students, Dykstra is working in biology professor Keith Grasmans lab. They are monitoring the impact of environmental contaminants on the health of Great Lakes colonial waterbirds.

Following World War II, industrial and agricultural activity introduced high concentrations of pollutants into the Great Lakes ecosystem. These chemicals persist in the environment and bioaccumulate in organisms at higher trophic levels, including fish-eating birds. Since contaminants are associated with poor reproduction, reduced chick survival, immune suppression, and deformities in fish-eating birds, gulls and terns are effective indicators of contamination in the Great Lakes.

In the summer, we travel to herring gull and Caspian tern colonies at contaminated sites in Michigan, including Saginaw Bay, Grand Traverse Bay, and the River Raisin in Monroe, said Dykstra. At the colonies, we measure egg size, embryo viability, nest productivity, chick growth, and chick immune function.

I appreciate that Im involved in every aspect of the research: preparing for fieldwork, collecting data, and analyzing that data, said Dykstra. Thats a unique experience for an undergrad to have.

Dykstras experiences at Calvin have led to some important discoveries.

Our research has found that chicks at contaminated colonies continue to show reproductive, growth, and immunological impairments, which informs U.S. Fish & Wildlife remediation efforts at these sites.

And these discoveries have led to bigger platform

Dykstra, in her third year at Calvin, has already presented posters at the Society of Environmental Toxicology and Chemistrys North America Meetings in 2018 in Sacramento, California, and in 2019 in Toronto, Canada.

She also works with a group studying suburban red-shouldered hawks and recently published an article in the Journal of Raptor Research titled Red-Shouldered Hawks Banded in Suburban Southern Ohio, 1996-2018. And she has another submitted paper that is still under review.

These experiences have set Dykstra up for her crowning achievement at Calvin. In late March, Dykstra was awarded a Goldwater Scholarshipwidely considered the top research award for undergraduate students in the sciences. Only 396 college students across the United States received this honor in 2020-2021. The scholarship, a partnership between the Barry Goldwater Scholarship and Excellence in Education Foundation and the Department of Defense National Defense Education Programs, comes with a $7,500 scholarship to support students in their research journeys.

The Goldwater opens up opportunities for studying in the future, said Dykstra.

For Dykstra, that means more opportunities to do what she loves: research!

And with the research experience she has had at Calvin, and the prestigious Goldwater honor, she should have her pick at where she wants to go to graduate school to study Wildlife Ecology.

Im most interested in wildlife conservation, Im hoping to work in academia or in a government agency, said Dykstra. Im interested in how anthropogenic activity affects wildlife, and how our work can influence policies that protect the environment and human health.

Read the original here:
When research on the water turns to gold - Calvin News

Study design

The present study is a retrospective cohort study (Trial registration: ChiCTR-OOC-14005389, 2014). In this study, 321 PCOS cases was conducted from October 2015 to April 2017 to assess the effect of short-term vitamin E administration on infertile PCOS women undergoing ovulation induction with CC and HMG in the Reproductive Medicine Center, Jiangsu Province Hospital of Chinese Medicine, Nanjing, China. This retrospective cohort study was approved by the Institutional Review Board of the Department of Chinese Medicine Hospital of Jiangsu Province.

The inclusion criteria of this study were as follows: (i) Undergoing ovulation induction with CC and HMG; (ii) no previous infertile treatment; (iii) age less than 40 years; (iv) normal in hysterosalpingography; and (v) normal in semen analysis. The diagnostic criteria of PCOS was according to the 2006 Rotterdam criteria [17]: (1) Anovulation or olig-ovulation, (2) Clinical evidence of hyperandrogenism (on the basis of hirsutism or an elevated testosterone level), (3) Polycystic ovaries (a more than 10ml ovarian volume or at least 12 antral follicles with 29mm in diameter). PCOS could be confirmed if any 2 out of the following 3 criteria were met and if any other diseases that caused hyperandrogenism or anovulation could be excluded.

Other disorders that mimic the PCOS, including hyperprolactinemia, thyroid disease, late-onset congenital adrenal hyperplasia, androgen-secreting tumors and Cushings syndrome were ruled out. The PCOS patients with the major myocardial, liver and renal disorders, and taking confounding medications (primarily sex steroids, other infertility drugs, and insulin sensitizers) were excluded. Patients were divided into 3 groups according to the vitamin E used.

In this study, as shown in Fig. 1a, 110 of 321 PCOS cases underwent controlled ovarian stimulation but without vitamin E administration (Group A, n=110). Based on previous clinical medication experience, a dosage of 100mg/day vitamin was selected. Two-hundred eleven of or 321 PCOS cases underwent controlled ovarian stimulation combined with vitamin E administration (100mg/day, p.o.) started from follicular phase (Group B, n=105) and luteal phase (Group C, n=106), respectively. Administration of vitamin E in follicular phase(Group B) began from the 3rd day of the menstrual cycle to 14th day of luteal phase. Administration of vitamin E in luteal phase (Group C) started when ovulation was confirmed, and lasted for 14 consecutive days. After 14days of the HCG administration, serum -HCG was measured. The presence of a gestational sac on ultrasound was performed at 6 and 12weeks of gestational age to determine clinical pregnancy rate and ongoing pregnancy. The women enrolled in this study were followed up until miscarriage or delivery.

Summary of patient flow diagram a and Vitamin E administration and stimulation protocol b. EV=estradiol valerate; HCG=urinary human chorionic gonadotropin; Pg=progesterone;CC=clomiphene citrate;VE=vitamin E;TVU=Transvaginal ultrasonography; HMG=human menopausal gonadotropin

As shown in Fig. 1b, the ovulation was stimulated with CC (Merck Serano, China) at 100mg/day for 5days starting on day 3 of a spontaneous menstrual cycle or withdrawal bleeding. Starting from day 8, HMG (Livzon, China) was injected at 75IU every second day and estradiol valerate (Progynova, Bayer, China) was administered at 2mg/day. Transvaginal ultrasonography was performed from day 10 to adjust the HMG dosage. When at least one follicle had reached a diameter of 18mm, 10,000IU urinary human chorionic gonadotropin (hCG) (Livzon, China) was administered. All patients received luteal phase support by oral administration of progesterone (Dydrogesterone, Abbott Biologicals B.V, China) at 10mg three time a day for 14days starting on the day of ovulation. In each cycle, medroxyprogesterone acetate was used to induce withdrawal bleeding in cases in which there was no response. The complete participation considered as pregnancy or anovulation within a total of 6 cycles.

Body mass index (BMI) was used to evaluate the body weight. According to World Health Organization(WHO) criteria [18], women with a BMI <18.5, 18.525, 2529 and30kg/m2 were defined as underweight, normal weight, overweight and obese, respectively. Scores on the modified FerrimanGallwey scale [19], range from 0 to 36, were used for hirsutism evaluation. Higher scores indicated a greater degree of hirsutism.

Age, height, weight, waist, FerrimanGallwey hirsutism score, age of menarche, incidence of oligomenorrhea and amenorrhea, numbers of previous pregnancies and previous ovarian were obtained from patient medical records.

Levels of estradiol (E2), androstenedione (T), luteinizing hormone (LH), prolactine (PRL) and follicle-stimulating hormone (FSH) were tested by RIA (Beijing North Institute of Biological Technology of China and the CIS Company of France). Peripheral blood samples were taken on the 3th day of menstrual cycle after overnight fasting.

In this study, we measured four oxidative stress serum markers (malondialdehyde (MDA), ischemia modified albumin (IMA), total antioxidant capacity measurements (TAC), and vitamin E) in 3 time points (T0:before stimulation, T1: the day of HCG treatment, and T2: the day of complete participation) to evaluate the levels of oxidative stress. Serum levels of MAD, an end-product formed during lipid peroxidation that is released into the extracellular space and finally appears in the blood [20], were measured using a thiobarbituric acid-reactive commercial kit (Jiancheng Bioengineering Institute, China). Serum TAC, provided better information on antioxidant status than individual antioxidant compounds [21], were tested using an antioxidant assay kit (Jiancheng Bioengineering Institute, China). Serum levels of IMA, a novel marker of oxidative stress, were evaluated by cobalt to albumin binding capacity kit (CUSABIO, China). Serum contents of vitamin E were evaluated by colorimetric method using assay kit (Jiancheng Bioengineering Institute, China).

Statistical analysis was carried out by SPSS (version 23, USA). Data were presented as either median (Min-Max) or meanSD as appropriate. Quantitative data analyses were carried out by independent samples t-test or Mann-Whitney U-test depending on the normality of data. Categorical variables were compared with Chi-Square test. A P value <0.05 was considered as statistically significant.

See original here:
Effect of a short-term vitamin E supplementation on oxidative stress in infertile PCOS women under ovulation induction: a retrospective cohort study -...

Britain has been in lockdown for two weeks and it has been the grimmest of fortnights. The number of daily deaths from Covid-19 has continued to rise steadily and large chunks of the economy have been brought to a standstill.

As yet, there are few hard numbers to judge the economic impact, but the collapse seen in the past few weeks is without precedent both in its speed and its severity. The increase in the numbers applying for universal credit suggest that unemployment is rising rapidly despite the government schemes to support both the employed and the self-employed.

The aim of the Treasury and the Bank of England is to get the UK through the crisis with a minimum of scarring. Hence there are loan guarantees designed to prevent businesses that were perfectly viable a month ago from going bust as a result of the shutdown. The hope is that wage subsidies will prevent workers from losing touch with the labour market and becoming long-term unemployed.

But clearly the longer it takes to tackle the health emergency the greater the economic damage will be. A 20% drop in output in one quarter a perfectly feasible possibility would be bad enough, but what if the lockdown were extended into the summer or the autumn?

Mervyn King, the former governor of the Bank of England, said last week that it was unrealistic for the government to keep the lockdown in place indefinitely and that if it went on for months on end there would be a rebellion against it.

That assessment is almost certainly right. The government does need an exit strategy but it is also being warned by epidemiologists that if the restrictions are relaxed too soon the virus could return. A second lockdown would not just be hugely unpopular, it would also magnify the economic damage.

The government says any decisions it takes on ending the lockdown will be based on science, but the scientists dont always agree. Thats because they are using models and these have limitations. Why? Because the results of epidemiological models depend on what is fed into them, and this requires the scientists to make a number of assumptions about human behaviour.

This is a point made by Gerard Lyons and Paul Ormerod in an important new paper that might just offer the government the sort of exit strategy that King was talking about.

Lyons and Ormerod do not dispute that a lockdown was necessary. Indeed, they think that the governments initial idea that the population would develop herd immunity to the virus was dangerous nonsense.

The evidence from other countries is that social distancing, shutting the restaurants and bars, discouraging unnecessary travel and getting people to work from home if they can does have an impact.

Before the lockdown began, estimates suggested that on average each person with the virus infected between two and 3.5 other people. Without action, the virus would have carried on spreading, putting intolerable pressure on the NHS and killing many more people. This is known as the reproduction number: if it is above one, someone who is infected will pass it on to more than one person. If it less than one, it will fade away. The experience of China and Italy is that lockdowns will get the reproduction number below one.

But the danger is that the reproduction number could go back up again if Britain went straight back to business as usual the moment the lockdown restrictions were lifted. If people celebrated en masse by going to the pub, to the football or by having a street party, there would be risk that the reproduction number would go up again and the virus would return. It is this possibility that concerns the epidemiologists.

Taken to extremes, this would involve continuing the lockdown until there was no longer a risk of someone with the virus infecting anyone else and so ensuring that no one dies. But as Lyons and Ormerod points out, a similar approach would involve the banning of all road traffic to prevent the nearly 2,000 deaths a year on the road in Britain.

Instead, they suggest that the return to normal life takes place under a traffic light system that will exploit the fact that people are going to be a lot more cautious in their behaviour after the crisis than they were before.

If people revert very quickly to the patterns of behaviour before the crisis, the epidemiological models are correct. There would be a second wave of infections. But behaviour will be different, either because of the lessons people have learned during this crisis, or because of the constraints placed upon them by rules and regulations.

The paper suggests that phase one of the process involves moving from lockdown to red. In this period, more but not all shops would open and they would have to observe the strict social distancing currently seen in supermarkets. Travel would be discouraged and many international flights banned.

In the amber phase, unlimited car journeys would be allowed, and the wearing of face masks and disposable gloves would be mandatory on public transport. Restaurants would be allowed to open only if they had strict seating demarcations to keep people at a safe distance.

It would only be when the light turned to green that any sort of sporting event or other mass gatherings, such as music festivals could take place, and the churches, temples and mosques open their doors.

Inevitably there will be those with different views about what should be included in the red, amber and green phases. But its worth noting that Lyons was once an adviser to Boris Johnson when he was mayor of London. The prime minister might just be listening.

Read more here:
The traffic light exit strategy to free the UK from lockdown - The Guardian

Epidemiologists measure how a disease spreads through a population using the basic reproduction number, otherwise known as R0. Typical seasonal flu has an R0 of 1.2, while that of Covid-19 is reported to be approximately 2.5.R = Reproductive number: How many people a given patient is likely to infect. If R >1, each case on average is giving it to at least one other person. The epidemic will increase. R0 is affected by factors like population density, environment, host factors (age, immunity), etc. Typical seasonal flu has an R0 of 1.2, Spanish Flu had an R0 of 2-3, while that of Covid-19 is reported to be approx. 2.5. From a policy planning perspective, it offers a very clear objective: Reduce R

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Strategies that can be used to fight Covid-19; their merits and demerits - Standard Digital