Prof Ian Fraser (who developed the cervical cancer vaccine) and others such as Dr Guy Campbell have proposed that IF a vaccine for COVID-19 is developed it is likely 12-18 months away. Therefore we need to think about “controlled contagion” whereby younger (less vulnerable) people are gradually allowed back into society.

The reason for this is the questions that have been rightly asked by many about the negative effects of the social isolation policies (or lockdown as colloquially phrased), including:

• Deterioration in mental health – increasing anxiety, depression, domestic violence and suicide.
• Missed cancers in people not presenting to their usual doctor or hospitals as they usually would.
• Deterioration of chronic diseases such as diabetes and cardiovascular disease
• Delayed surgery
• Not to mention the broad and likely long-lasting economic and employment effects of the social isolation policies to combat the COVID-19 pandemic.

The idea with “Controlled Contagion” is to slowly develop a community “heard immunity” in a sustainable way. This could be done by bit by bit allowing those at lowest risk of severe disease and death from COVID-19 back into society. Noting that statistics from Imperial College London, UK, show only 0.06% of those younger than 40 who are diagnosed with COVID-19 require intensive care. The risk of mortality in those under 40 years is less than 0.03%, and so is less than the current consequences of influenza.

However, 23% of those infected with COVID-19 who are over 60 year old will require hospital admission, of which 47% will require ICU. As a result, those over 60 will account for 90% of ICU demand, even though they make up only about 20% of the population.

Nobel Prize winner Professor Peter Doherty is strongly convinced re-infection is unlikely, and “even if it was … your prior infection would give you very rapid immunity and you would recover very quickly.”

By allowing all healthy individuals under the age of 60 to return to work under the present restrictions of social distancing, the virus would be allowed to spread in a sustainable and more controlled manner.

We could start with those under 40, and then under 50, and then under 60, while maintaining self-isolation for those over 60-years of age.

This is a proposal worth reasoned consideration – to minimise the medical, economic and societal consequences of the COVID-19 pandemic (in their totality over the next number of years as all of the consequences play out).

Dr Lachlan Soper