If an exit strategy doesn’t come soon, Johnson will lose his grip on lockdown
The Government says it is following the science, but a standoff as tense as that which belatedly pitched Britain into lockdown is looming over the exit strategy.
It’s a boil that has been festering throughout the Prime Minister’s absence and one that must now be lanced. The locum was too junior to pick up the phone, but now the surgeon’s back. Unless he acts quickly and decisively, there is a real risk that the patient will take things into its own hands, with uncertain consequences.
The pictures this morning of a long traffic jam at London’s Blackwall Tunnel and police unable to stop crowds gathering in local parks reflect the problem. Britain is sick of lockdown and – in the absence of an exit plan – is starting to abandon it.
Boris Johnson prefers crime drama to hospital soaps. Yesterday he compared our current predicament to having wrestled a deadly assailant to the ground and then losing concentration for a moment. He’s right. We’ve all seen the movie. You turn away for an instant and then – boom! – the psycho blows your head off.
Covid-19 is that nutjob; a viral serial killer that will bounce back again and again given half a chance. It’s still killing now, with more than 1,400 deaths reported in the past three days alone. If it is set free and allowed to spread exponentially again, a second peak will hit us in the cold winter months, which would be considerably more brutal than the first.
It’s worth remembering that the Imperial College modelling, which told us lockdown would restrict total deaths to around 20,000, also warned that, unmitigated, the virus would kill 510,000 people in Britain.
Note, too, that the assailant is devious. An “urgent alert” issued to doctors across the country over the weekend warned that Covid-19 may now be affecting children. “In the past three weeks, there has been an apparent rise in the number of children of all ages presenting with a multisystem inflammatory state requiring intensive care across
London and also in other regions of the UK,” it warned.
Unfortunately, that is where the Prime Minister’s crime analogy ends. It’s as if he has left us to make a citizen’s arrest alone on a dark street without backup. How long can we reasonably be expected to hold the killer down without guidance? We might stick it out if we saw blue lights in the distance, but without that, it’s temping give up and to run.
The blue lights will come in the next few days from the Government’s Scientific Advisory Group for Emergencies (Sage), but they may not be what many are expecting. Worse, the capacity needed for the solutions proposed may be beyond what can be delivered anytime soon.
A solid hint of what is on the way came from Professor Neil Ferguson, the epidemiologist and Sage member, in an excellent interview at the weekend. Further nuggets come from Sir Jeremy Farrar, a Sage member and the head of the Wellcome Trust, and a study to be published tonight in The Lancet on the impact of China’s “test, trace and isolate” strategy.
What Prof Ferguson knocks on the head is the idea we might escape lockdown simply by shielding the most vulnerable. This is something the Government would be very keen on if it could be made to work. But Prof Ferguson is pessimistic. The most vulnerable are the most difficult to shield because they require the most care, he points out.
“We are modelling exactly those scenarios … [but] I’m very sceptical we can get to the level of shielding which would make that a viable strategy,” he
says. “In theory, it might be [possible], but until I see a country or even a community do a better job than we’ve seen so far, then I remain sceptical that it’s achievable.
“And if you achieve just 80 per cent shielding, [an] 80 per cent reduction in infection risk in those groups, we’d still project you get well over 100,000 deaths later this year through that sort of strategy.”
The exit strategy that Prof Ferguson prefers was neatly summed up by Sir Jeremy on Twitter last week. He said that if restrictions were to be eased, we would need in place “rapid, easyaccess testing at scale, contact tracing [and] isolation”.
This is the South Korean model. You drive down transmission of the virus as far as you can (or in South Korea’s case, don’t let it peak to begin with) and then keep it low by hunting down every new case and those its transmission chain. Social distancing is not dispensed with entirely, but it allows much more freedom than we have in Britain today.
“I think the country we should be looking at … is South Korea, which is a much better model and has a way lower mortality rate per capita,” said Prof Ferguson. “The real benefit of those policies is that if you drive transmission down to the very low levels they now have in Korea, it’s not that disruptive or resource-intensive.
“You only have a few hundred cases a week. Yes, that results in a few thousand people a week requiring isolation, but it’s very different from having a harsh chunk of your population in isolation.”
The difficulty for the Prime Minister is this. The “test, trace and isolate” infrastructure is not in place in Britain and is highly unlikely to be for another month at least. Meanwhile, the business lobby is agitating for change and the wider population is growing restless.
So what to do? Well, if the Mr Johnson were a cop on a radio trying to keep a local hero holding down a killer until help arrived, he would explain in very clear terms what the strategy was. He would give a solid approximation of how long we had to wait. There would be tips and encouragement on what to do in the interim. And – most important of all – he would tell us exactly what to expect when the blue lights screeched into view.
Prof Ferguson adds in his interview that he is not in the business of making political decisions; he just gives politicians the numbers to “inform” their decision making.
With the numbers like the ones he’s talking about, he might as well be saying: “You’ve got to ask yourself a question: ‘Do I feel lucky?’ Well, do ya, punk?”
Britain is sick of lockdown and – in the absence of an exit plan – is starting to abandon it