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The sudden rise of COVID-19 in the fall has shown how difficult it is to suppress a highly infectious virus.
Sky data shows that 50 areas in England have endured local restrictions since the national lockdown was lifted in July.
But only one, Luton, has come out of the restrictions, and the prime minister in the House of Commons praised the local population for following the health guidelines.
Just a day later, the city was again classified as an area of concern after another surge in cases.
Hand washing, masks, and social distancing slow the spread of the virus, but they don’t seem to stop it.
Cases nationwide are increasing, with the R number above one, indicating that the epidemic is growing exponentially.
But figures from the Imperial College REACT study show that there is great variation in England.
In London, the R number is estimated to be just below one. But in the Northwest, where people have been living with restrictions for many weeks, it’s still 1.27.
And that is also reflected in prevalence rates.
The North West and North East have the highest rates in England, with around one in 100 people infected.
The Southeast has the lowest prevalence, with about one in 400 positive results. London is in the middle, one in 200.
A two-speed epidemic, for sure.
Young people have played an important role in the rise. One in 80 of those between the ages of 18 and 24 tested positive in the Imperial study.
That’s concerning because young adults are less likely to have symptoms, but they are just as infectious.
But age doesn’t explain why the virus has become so focused on hotspots.
That has much more to do with deprivation.
The poorest people live closer together, often in multi-generational households, and tend to do more public-facing jobs. In other words, they are more likely to come into contact with the virus and then spread it through the community.
So the new three level system help?
Banning household contact should make a difference in slowing the spread at hotspots.
But you need good communication to gain support and a devoted audience willing to forgo all your normal social gatherings.
Even then, the underlying problems of deprivation will remain.
A large number of people who were told to isolate themselves have continued to work because they have to put food on the table. Banning social contact won’t stop that.
The national lockdown in the spring was a success because it was absolute. Our cities were ghost towns. The economy went into a coma.
It led to a rapid decline in the epidemic: the R number plummeted from around three to around 0.6 in one week.
This time there is more of a geographic mosaic.
As much of the economy as possible is kept open. And in the inevitable exchange between lives and livelihoods, some people will feel badly made.
At its most basic level, science is simple. To get the epidemic back under control, you must prevent infected people from meeting others who are susceptible to the disease.
But there is no evidence from the past to serve as a basis and no manual to guarantee success.
