Why lockdown? Simplified arithmetic tools for decision-makers, health professionals, journalists and the general public to explore containment options for the novel coronavirus

Gerry Killeen; Samson Kiware

Unfortunately, the most obvious exceptions to lock down restrictions who will facilitate continued transmission will be health service personnel, [104] [105] [106] [107] notably those caring for those most vulnerable to the disease. However, all other essential workers in shops, markets, kitchens, food processing facilities, factories, banks, post offices, transport services and law enforcement agencies will also inevitably mediate more transmission than they would if they stayed at home. Indeed, it the crew that enabled self-sustaining levels of COVID-19 transmission to persist aboard the quarantined Diamond Princess cruise ship. 108 It is also worth remembering that the anti-hero of infectious disease epidemiology, the infamous Typhoid Mary (real name Mary Mallon) was a cook by profession who infected at least 53 people, three of whom died. 109 Like many COVID-19 cases, 1-23 Mary was a silent carrier of the disease: She herself lived to a ripe old age and died of a stroke rather than typhoid. This is not to say that such essential services should necessarily be suspended, but rather that the roles and working practices of these personnel should be scrutinized particularly carefully. How essential is essential? What is the minimum level of service needed to facilitate extended lock down while mitigating indirect effects on health, well-being and economic welfare that are even worse than COVID-19? What procedures, behaviours and protective equipment could most effectively minimize persistent workplace transmission?