Plans to build 19 new homes in the heart of Exmouth’s town centre have been opposed by the town council.

In Owl’s opinion cost benefit analysis, where a monetary value is used to measure costs and benefits on a common scale, is as contentious as the use of obscure algorithms.

This article discusses some of the tricky ethical issues that arise when trying to evaluate the costs versus the benefits of lockdown. It doesn’t make for comfortable reading.

Larry Elliott www.theguardian.com

Cancer treatments cancelled. Children deprived of schooling. More cases of domestic abuse. Continued restrictions on personal freedom. Over and above the direct damage caused to the economy, the collateral damage from the Covid-19 pandemic has been colossal.

And the crisis is not over by any means. Travel restrictions come and go with mind-boggling frequency. Local quarantining has replaced national lockdowns. Every leading policymaker in the UK, from the chancellor, Rishi Sunak, downwards, knows that the job losses to come threaten to leave permanent scars.

An obvious question, therefore, is was it worth it? Have the costs of shutting down a great chunk of Britain for three months and leaving many restrictions in place after six months been outweighed by the benefits?

An obvious answer is that this is the wrong question to ask, because you can’t measure the value of a human life in terms of gross domestic product, the unemployment rate or the size of the national debt. The tough action taken by the government at the end of March saved lives, end of story.

By the same token, though, it is impossible to put a price on the fact that the number of cancer referrals fell by 70% in April, that there were hardly any follow-up appointments for people with long-term conditions and elective admissions dropped by 75%.

What’s more, the government does put a monetary value on a life when it comes to deciding on resource decisions when it comes to medical care.

It does this by estimating the number of years of life that will be saved adjusted for quality of life. A quality-adjusted life year is valued at £30,000.

Using this figure and estimates for the direct hit to the economy caused by the pandemic, a team of researchers including David Miles, a former member of the Bank of England’s monetary policy committee, have had a go at assessing the benefits of the lockdown against the costs.

This is by no means a simple process. Firstly, it is unclear how big the loss of output will be from the Covid-19 recession, and estimates of the length and the depth of the slump are changing all the time. Secondly, nobody is sure how many lives were saved as a result of the lockdown. Finally, the £30,000 figure for a quality-adjusted life year might be too low, even leaving to one side all of the ethical considerations in making such a calculation.

To allow for these difficulties, Miles and his colleagues use a range of estimates both for the number of lives that might have been lost in the absence of a lockdown, and for the drop in GDP caused by the Covid-19 recession. The trigger for the imposition of the lockdown was the prediction from Prof Neil Ferguson of Imperial College London that 500,000 lives would be lost unless tough restrictions were imposed. In their paper, using data from the summer, Miles et al say the number of excess deaths in the UK caused by the pandemic was 60,000. Subtracting that number from Ferguson’s 500,000 leaves an estimate of 440,000 saved lives.

Based on the ages of those who died from Covid-19, the Miles study assumes the loss of 10 quality-adjusted life years on average, each valued at £30,000. That generates a value for potential years of life saved at £132bn. The figure falls to £30bn if 100,000 lives were saved by the lockdown, and to £6bn if 20,000 lives were saved.

Early estimates that Britain was heading for a slump unparalleled since the first decade of the 18th century have proved too pessimistic. Instead of a 14% drop in national output, the latest forecast from the Bank of England is for a 9.5% contraction, making it merely the worst recession since the one after the end of the first world war.

The value of Britain’s annual output is roughly £2tn , so a 9.5% drop in GDP is worth £190bn. Obviously there would have been a drop in GDP even without a formal lockdown because people would have taken their own precautions. Miles and his colleagues assume that the lockdown was responsible for two-thirds of the damage, leaving a monetary cost of just under £130bn. That figure doesn’t take into account any further setbacks to the economy or the health and education costs.

This is all very well, but did the government have a choice? Wouldn’t going down the Swedish route, a country where far less stringent measures were imposed by the government, have led to Ferguson’s predictions coming true?

This is explored in another study, by Rickard Nyman and Paul Ormerod, in which they look at the difference between Covid-19 cases and deaths in Sweden and England and Wales.

Deaths in both Sweden and England and Wales peaked on the same day – 8 April – and by early August they were again similar. In between, however, the number of deaths in England and Wales was initially higher than in Sweden but then fell more quickly. In the early stages of the pandemic, there were estimates that Sweden would have 80,000 deaths as a result of not having a lockdown. In the event, the total currently stands at just under 6,000. Nyman and Ormerod estimate that the UK lockdown saved 17,700 lives in England and Wales, which they scale up to 20,000 for the UK as a whole.

If that estimate is anywhere near right, there are some obvious conclusions: namely that Britain has paid a very high price for tackling Covid-19; and the government needs to think long and hard before ever resorting to a blanket shutdown during this pandemic or any that may follow.

Dozens of schools across England and Wales have reported coronavirus outbreaks, prompting some to shut their doors while others have sent staff and pupils home to self-isolate.

Amy Walker www.theguardian.com 

A week after children began returning to classrooms for the first time since lockdown in March, a number of schools across parts of the UK have been battling outbreaks.

In Liverpool, an estimated 200 pupils and 21 staff are self-isolating following positive cases at five schools in the city. In Suffolk five teachers tested positive for coronavirus, leading the school to close, and in the Midlands a school which was visited by the prime minister less than two weeks ago has had one teacher test positive.

In areas including Bradford, Leeds, Lancashire, Manchester, Nottingham and Leicester, small handfuls of pupils and staff who tested positive for the virus have led to schools asking some pupils to self-isolate.

Five members of the teaching staff at Samuel Ward academy in Haverhill, Suffolk, tested positive, with the school shut on Monday following advice from Public Health England. Two other members of staff are awaiting results. The school said the closure was a “precautionary measure” and it hoped to reopen on Tuesday. A deep clean is to take place.

Stuart Keeble, the director of public health at Suffolk county council, said: “Understandably, this news may worry parents across Suffolk, but it is important to remember that the risk of children contracting Covid-19 is still very small. Evidence suggests that children are more likely to contract Covid-19 at home.”

Anyone who had been in close contact with the infected staff had been contacted and asked to self-isolate for 14 days, the school said. Further contact tracing will continue and other pupils and staff may be asked to self-isolate.

Meanwhile in Liverpool, “bubbles” of pupils and 21 teachers at Liverpool college, Sudley junior school, West Derby school, Hunts Cross primary school and Our Lady Immaculate primary school have been asked to self-isolate after positive tests.

At Castle Rock school in Coalville, Leicestershire – which was visited by Boris Johnson on 26 August – one member of staff tested positive. In a letter written by the head of the school, Michael Gamble, he told parents the school had “sought immediate advice” from Public Health England and was “continuing to closely follow … government guidance”.

In Cardiff, 30 pupils in year 7 at Ysgol Bro Edern have been asked to self-isolate for 14 days after a student tested positive. Iwan Pritchard, the headteacher, said: “Due to the procedures we have in place, restricting contact between different classes and logging seating plans of all lessons, we have been able to limit the numbers of pupils needing to self-isolate and there is no need for parents or pupils that have not been contacted to self-isolate or be unduly concerned.

“Having kept to the 2-metre social distancing rule, or worn a face covering if this hasn’t been possible, no school staff need to self-isolate.”

On Friday, 100 pupils were also asked to self-isolate for 14 days at the JCB academy in Rocester, Staffordshire, after a pupil tested positive.

Coronavirus cases have also been confirmed at six schools in the area around Middlesbrough, although they will not be closing. On Monday, close contacts of a year 8 pupil at Ian Ramsey Church of England academy who contracted the virus have been asked to self-isolate, while two primary schools – understood to be Marton Manor and Hemlington Hall academy – have notified parents of cases within the schools.

Redcar and Cleveland borough council said on Sunday that a positive case had also been recorded at St Benedict’s Catholic primary school. St Aidan’s CE primary school in Hartlepool said in a Facebook post to parents it also had a confirmed Covid-19 case, while Outwood academy Ormesby in Middlesbrough said in a short statement that a confirmed case had been found “within the school community”.

The National Education Union said that though the disruption caused by pupils and staff having to self-isolate was “inevitable”, there needed to be more planning in place for schools to cope with outbreaks.

Kevin Courtney, the NEU’s joint general secretary, said: “This should include employing more teachers and looking for additional space to seek to minimise disruption as well as ensuring IT access for children and young people who need it when they have to be at home.

“Dozens more elected mayors and the abolition of many councils are being planned under a shake-up of local government due to be unveiled next month………However, a fight looms over plans to abolish significant numbers of district councils, many of them Tory-controlled, as part of plans for a slimmed-down local government system.”

Chris Smyth, Whitehall Editor www.thetimes.co.uk 

Dozens more elected mayors and the abolition of many councils are being planned under a shake-up of local government due to be unveiled next month.

Ministers want to devolve more power to areas that agree to new elected mayors, who they argue are more accountable and better at boosting local economies.

Conservatives have also proved more successful in winning mayoralties in “red wall” areas than they have in winning Labour-controlled councils.

However, a fight looms over plans to abolish significant numbers of district councils, many of them Tory-controlled, as part of plans for a slimmed-down local government system.

Downing Street denied that they wanted to abolish two thirds of authorities by replacing district councils with unitary authorities, and insisted change would happen only with local consent.

However, ministers do want to move towards more single-tier council areas, which the County Councils Network estimates would save £3 billion a year.

District councils oppose the move, saying it would create unwieldy mega-authorities responsible for more than a million people each, far larger than local government units in other countries.

A cap of about 600,000 people in any unitary authority is being considered as one way of avoiding this.

A spokesman for the local government ministry said: “We want to devolve and decentralise to give more power to local communities, providing opportunities for all areas to enjoy devolution. But there will be no blanket abolition of district councils and no top-down restructuring of local government.”

Robert Jenrick, the communities secretary, will publish a white paper on devolution next month, which the spokesman said “will set out our detailed plans and we continue to work closely with local areas to establish solutions to local government reform”.

About four in ten residents in England will be represented by city mayors once West Yorkshire elects its first next year and ministers say directly elected leaders “stimulate job creation, build homes, improve transport and reduce local carbon emissions”.

Despite the distraction of the coronavirus pandemic, government sources say that “now is the time to finish what we’ve started” by allowing more mayors.

Ben Houchen, the Conservative mayor of Tees Valley, is seen as the prototype for winning Tory control of local government in the north and Midlands. A government source told The Sunday Times: “This is all about red wall empowerment. It’s about giving a stronger voice to the regions and levelling up by handing more power down to the people and breaking Labour’s traditional stranglehold over local authorities, especially in the north.”

The UK has recorded a massive rise in the number of people testing positive for coronavirus, amid concerns the government has lost control of the epidemic just as people are returning to work and universities prepare to reopen.

Caroline Bannock www.theguardian.com

Labour has demanded the health secretary, Matt Hancock, give an urgent statement to the House of Commons to explain the increase and why some people are still being told to drive hundreds of miles to have a test.

On Sunday almost 3,000 people in the UK tested positive for Covid-19, a 50% increase in a single day and the highest daily total since May.

“They’ve lost control of the virus,” said Prof Gabriel Scally, a former NHS regional director of public health for the south-west. “It’s no longer small outbreaks they can stamp on. It’s become endemic in our poorest communities and this is the result. It’s extraordinarily worrying when schools are opening and universities are going to be going back.”

As seen in other countries opening up after lockdown, the majority of new cases appear to be in younger people who typically have milder infections than the over-50s. The number of people needing hospital treatment has remained steady, but these lag behind new cases by about two weeks.

Public Health England reported 2,576 new cases on Sunday and 2,988 for the UK overall. “It’s a massive jump,” said Christina Pagel, a professor of operational research at University College London. “There is no way you can look at these figures and feel confident that things are going in the right direction.”

The rise came amid concerns that testing centres were struggling to cope with demand. Many people who sought tests in recent days were advised to take round trips of more than 100 miles because their local centres did not have capacity.

Andy Burnham, the mayor of Greater Manchester, said many people had contacted him in recent days saying they had been offered tests in Leicester and Scotland.

“The fact people are being directed to bizarre locations is yet another example of national test and trace not working. That’s why it needs to be under local control. The danger is someone who is symptomatic in Greater Manchester, where many areas are still classed as high risk, tries to book a test, gets directed to Leicester and thinks ‘sod that’ and then potentially passes on the virus. It is so obvious that the system should always offer you a test at your local centre, it should keep you within your geography.”

A government source said there was significant concern that the UK was “six weeks behind France”, where the trajectory showed more young people being infected, leading to increased hospitalisations of vulnerable groups.

Hancock said the rise was “concerning” but said workplaces should still be operating safely.

“The cases are predominantly among younger people but we have seen in other countries across the world and in Europe this sort of rise in the cases among younger people leading to a rise across the population as a whole, so it is so important that people don’t allow this illness to infect their grandparents and to lead to the sort of problems that we saw earlier in the year,” he told Sky News.

Paul Hunter, a professor of medicine at the University of East Anglia, said while some of the new cases may be because of catch-up from delayed tests over the past few days, it was still “a marked increase”. He said reports of people making long journeys to get tested did not bode well for the autumn and winter when cases are expected to rise. Having people driving around the country with coronavirus would help spread the disease, while focusing testing on hotspots risked missing fresh outbreaks that could be brought under control, he said.

“It’s got to be a better managed and better put together system than the one we have now. If we’re not coping now, it’s going to be awful in two months’ time when case numbers have doubled or quadrupled,” he said.

Jonathan Stoye, a virologist at the Francis Crick Institute in London, said his son travelled 80 miles from St Albans to Gatwick to get a test. “It’s ridiculous. If you want to get people back to work, you’ve got to get the testing system to work, or people won’t go if they are being responsible.”

It took 59-year-old Jackie Cawkwell, who works as an administrator in Nottingham, three days to be offered a coronavirus test close to home. She started feeling unwell on Thursday with Covid symptoms including nausea, diarrhoea and temperature. “When I tried to get a test on the Friday, it only gave me the option of going to Oldham, that’s 57 miles away,” she said. “I tried three times and I was only given Oldham and when you are feeling that poorly, it’s just not feasible to do a 100-plus round trip. I was despairing.”

Labour is likely to ask the Speaker for an urgent question in the House of Commons on Monday to force Hancock to explain the issues. The shadow health secretary, Jon Ashworth, said ministers urgently needed to get a grip on the system’s failings.

Ashworth said the increase in coronavirus cases was “deeply concerning” and a stark reminder that there is no room for complacency in tackling the spread of the virus. “This increase, combined with the ongoing testing fiasco and the poor performance of the contact tracing system, needs an explanation from ministers,” he said.

“Last week Matt Hancock was boasting of his ‘moonshot’ plan to test millions of the population every day but he can’t even get basic testing delivered for people who are experiencing symptoms,” he said.

“What’s more, ministers still aren’t testing care homes staff and residents routinely despite promising to do so. They claim test rationing is to help hotspots but on Friday a Leicester constituent tried to book a local test at a drive-through and was told to travel 55 miles to Sheffield instead. This simply isn’t the ‘world beating’ system we were promised by September. Matt Hancock should come to the Commons today and explain what has gone wrong and how he will fix it.”

A spokesperson for the Department of Health and Social Care said there was a “high demand” for tests, but that capacity was being targeted at outbreak hotspots. They claimed testing capacity would reach 500,000 per day by the end of October, and that new technologies would process tests faster.