Half-hearted early measures could mean lockdown remains until the end of May

On Monday night, Boris Johnson took the unprecedented step of curtailing individual freedoms to prevent the further spread of coronavirus. He said the measures would be in place for three weeks – until April 13 – and then reviewed.

But, given the expected trajectory of the disease, and the decisions taken by other countries who are ahead of Britain in terms of virus progression, it is unlikely they will be lifted then.

For a start, compared to most countries, the UK had a porous and half-hearted beginning to its isolation measures, with seemingly few people choosing to stay inside. Less than 12 hours after the Prime Minister’s historic address to the nation, the London Underground was jammed with workers, while builders were seen eating together in communal canteens, making a mockery of the rule that no more than two people can gather together in public.

Prof Susan Michie, the director of UCL Centre for Behaviour Change, warned that some people would simply not be able to carry out the measures, even if they wanted to.

“Five million self-employed people are being left potentially destitute by the Government failing to offer financial support as they have done for directly employed workers,” she said.

“Since £94 is not enough to pay rent, bills, food for a family etc, they will be forced to carry on as usual.”

The British Transport Police will be on hand to make sure only critical workers use the Tube. But such an inauspicious start suggests the virus will be spreading further than it would have, had stricter lockdown measures been implemented earlier. And it means the measures we do have are likely to be in place for longer to “flatten the curve” in a way that would prevent a second dangerous peak.

Yesterday, China announced it would be ending lockdown in Wuhan on April 8, a huge milestone for the country, and a signal that the crisis – for them at least – is nearing its end.

Yet that has taken more than two months of extremely draconian restrictions, including travel bans and quarantine zones, to achieve such a level of containment. Britain is nowhere near that level of lockdown.

The Chinese restrictions were not lifted for more than 12 weeks after the first death, so if Britain follows a similar path, ours may need to be in place until the end of May/early June. That is when the Government has said it expects cases to peak and then level.

However, from papers released last week, we know the Government is at least considering restricting movement for the rest of the year.

The Scientific Pandemic Influenza Group on Modelling, which feeds into The Scientific Advisory Group for Emergencies (Sage), proposed that because of the length of the outbreak, parts of the country could be placed in six-month lockdowns at a time, before being allowed more freedom.

Prof Rowland Kao, a professor of veterinary epidemiology and data science at the University of Edinburgh, said: “It must be hoped that such measures will only last a relatively short time. However, we must be prepared for this not to be the case, and for them to be in place for an extended period.”

The next three weeks until the

Prime Minister’s review will be crucial, as the unfolding epidemic will now be seen in real time, rather than through modelling, allowing experts to make more accurate predictions of when it will peak, and finally die away.

It is also possible that after three weeks it becomes apparent that the costs to shutting down society far outweigh the benefit of slowing the spread and the Government may choose to lift restrictions even before the peak.

Mark Woolhouse, professor of infectious disease epidemiology at the University of Edinburgh, said: “We now enter a phase of careful monitoring. We are looking for indicators first that the epidemic is slowing down and then for numbers of new cases to start to fall. After three weeks we will have to decide whether the restrictions need to be continued, can be relaxed, or can be relaxed temporarily with the expectation of imposing them again later.

“We must also monitor the damage that the lockdown is doing; damage to the economy, to education, to psychological well-being and to health and social care provision in the community. The impacts of this epidemic are too far reaching for policy decisions to be driven by epidemiology alone.”

There are also hints that countries in Europe may be on a slightly faster course than China.

While cases in China peaked some 72 days after the first recorded infections, public health officials in both Germany and Italy believe they are starting to see a plateauing now, which could mean a peak of around 57 and 53 days respectively.

Earlier this week Mr Johnson said we were two weeks behind Italy, so Britain may end up peaking by the beginning of April. China left lockdown restrictions in place for nearly a month after the peak, so it is possible restrictions could be lifted early in May. Some experts are still concerned the current restrictions do not go far enough, while others say the Government has been hit by an ‘epidemic of action’, and is now bringing in measures that have little rationale.

However, Dr Andrea Collins, senior clinical lecturer in respiratory medicine at the Liverpool School of Tropical Medicine, said: “I believe that they have not quite gone far enough. We need permits across controlled areas to go to a workplace.”

Recent modelling from the Universities of Exeter, Bristol and Warwick suggested that without any measures at all, the epidemic would have peaked around 133 days after first person-to-person transmission in the UK, which happened around Feb 29.

So the lockdown has the potential of curtailing the spread by around seven weeks. A welcome relief for people who could have been facing lockdown for most of the summer.

It is also possible that the warmer weather in the coming months will stop the virus from replicating, ending our epidemic far sooner than it would have had it played out in the winter months. If so, restrictions will be lifted earlier.

‘The impacts of this epidemic are too far reaching for policy decisions to be driven by epidemiology alone’