There are few ways out of the lockdown that do not contain significant risks. Testing, contact tracing and accurate data will be essential to any exit strategy.
Owl agrees but wonder on past form whether the Government is reluctant to organise the effort. Indeed this Times Editorial goes further and asks whether this Government is capable of organising the effort.
Owl is unimpressed by the way the immediate increase in testing has been organised in central locations with the expectation that Care Home staff, for example, should drive many miles, in some reported cases for hours, to the nearest test centre. Then the Government expresses surprise that these testing centres are not fully used.
To Owl this looks like a “London centric” approach. Well – hello London – the rest of the country is different, especially with regard to connectivity by public transport (assuming it is running).
In the film Contagion a scientist impusively injects herself with an untested vaccine. It works, is rapidly distributed globally and the people of Earth are saved from a lethal pandemic. No such fantasy solution awaits in the real world of today’s coronavirus. Although it is good news that human trials are beginning in Britain, the road to a vaccine is long and by no means assured. Extensive testing must be followed by manufacture and then distribution on a vast scale. That will take many months. A second hope, that large numbers may already have had the virus and acquired immunity, appears to be fading too. On Monday the World Health Organisation suggested that only 2-3 per cent of the global population have been infected. And while several existing drugs are being tried on very ill patients, none so far offers a panacea.
Yet there is a limit to how long the hard lockdown can be maintained. Its alarming cost is becoming clearer. Jobs and livelihoods have been lost, public debt has risen precipitously, and the longer the crisis continues, the greater the toll on the public’s physical and mental health. The International Monetary Fund has predicted a 3 per cent contraction in the global economy in 2020. That is not its worst-case scenario. The longer the pause, the deeper the economic scars.
That suggests Britain must find a way to live with the virus. The best that lockdowns can do is to suppress it to a level at which the restrictions can be safely lifted. The government must decide what that level is and how the rate of infection can subsequently be contained. A second wave that overwhelms the health system and necessitates further lockdowns would be disastrous. Not only would it cost more lives but it would risk destroying public confidence in future attempts to lift restrictions, thereby deepening the economic damage.
One possible way out of a lockdown is to suppress the epidemic to a point at which it is possible to introduce the kind of test, trace and isolate strategies being deployed in countries such as China, Singapore and South Korea. This is an established method of containing disease. But this approach is not straightforward either. It would require the rate of new infections to be suppressed to very low levels, given that everyone who had come into contact with someone who had tested positive would need to be traced and tested. It would also require a massive expansion of testing capacity, something the government has struggled with.
Another challenge would be to assemble a task force capable of rapidly identifying and then getting in touch with all those who had come into contact with the recently infected. Smartphone apps may provide clues but they are only a partial solution. Much of the work will need to be done by human beings. The overwhelming response to the NHS’s call for volunteers suggests no shortage of willing hands. The question is whether the goverment is capable of organising them. A better option may be to delegate the task to local authorities. Professor Allyson Pollock, a consultant in public health medicine, believes they could set up a national task force within a week.
Of course the alternative way out is to return to some variant of the government’s original herd immunity strategy, easing restrictions for those of working age while continuing to isolate the elderly and vulnerable who are most likely to need critical care. But distinguishing between different segments of the population raises difficult ethical issues. Besides, such a strategy would work only if younger people were convinced that the risk to their health was sufficiently low. That would require better data on morbidity rates than is currently available as well as research on how long immunity may last. Until such information becomes clearer, lifting the lockdown is perilous.