Finding a route out of lockdown

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Why testing is key to ending this nightmare

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The Telegraph

Thursday March 26 2020

Front Bench


Good morning. The pandemic may now be under control. If it is, we've still got to figure out how we safely get out of lockdown and save the economy.

NHS secure if public sticks to rules, but route out of lockdown still missing

By Daniel Capurro,
Front Bench Editor

There is cautious optimism in the Government and among its scientific advisers that with the current measures in place, the NHS should be able to cope with the peak of the coronavirus outbreak in Britain.

– Stay at home. It’s working –

Dr Neil Ferguson of Imperial College London, whose modelling has been central to Government decision making, told MPs yesterday that while there might be some individual spots of high pressure, at a national level the NHS would not exceed capacity.

He also said that the number of deaths may be below the “best case” 20,000 he outlined a few days ago, and that perhaps two-thirds of those deaths were likely to be of people who would have died this year of other causes.

This does not mean that the UK is out of the woods at all. While the peak in the number of cases is now expected in the next two to three weeks, one rather substantial question still hangs over the country (and the world): when can we get back to normal?

To answer that question, scientists need to know a lot more about the epidemic and the virus itself.

– The battle of the models –

Assuming the current models are correct, a best-case scenario for the coming months in the UK might look something like South Korea. With mass testing, contact tracing and isolation, life might be able to return to some kind of normality, but with a return to more stringent measures on a hair trigger.

As Dr Ferguson told MPs yesterday, it became clear early on that the UK did not have the testing capacity to take that route at the beginning of the outbreak, but it could do so in a few weeks.

But the key thing to know is how widespread the virus actually is. A study from Oxford University this week caused a stir by finding that Covid-19 might have arrived in the UK a month earlier than thought and that 50 per cent of the population could have it already.

That would match up with our report today that the UK’s patient zero could actually be a British tourist who returned from a skiing holiday with the virus back in January.

If correct, it would mean that the vast majority of cases are asymptomatic, with hospitalisation rates possibly as low as one in one thousand, and that herd immunity may actually already be close. If so, the lockdown could be short-lived.

Government scientists have not ruled out the modelling being correct.

Equally, a symptom-tracking app developed by scientists at King’s College London suggests that the infection level could be one in 10 at the moment. That’s higher than the current modelling being used, but nowhere near as high as the Oxford study found.

Test, test, test and then test some more

All of which is why testing is essential and why a new antibody test, which would show if someone has had and recovered from Covid-19, is being hailed as a game-changer.

Dr Chris Whitty, the Chief Medical Officer, was keen to downplay expectations that such tests are imminent and will soon be available for the general public. But that is the ultimate objective and it could be possible in a few weeks.

The Government has purchased 3.5 million of the tests, and they could, if they prove to be accurate and reliable, eventually be rolled out for online purchase and use at home.

But before that happens, there will be two priorities. One is to get the antibody test, as well as that for the virus, to frontline healthcare workers. The NHS needs as many staff available as possible, but is losing many to self-isolation. Getting those who are not ill or are immune back to work is crucial. After that, other key workers could be tested, and eventually the general population.

The next priority is to use the antibody tests for community testing, to interrogate the modelling and find out how widespread the virus has really been. Only then can scientists start to calculate how stringently lockdown measures will need to be enforced and for how long.

There are, of course, many other factors to take into account. For one, it’s not clear how long acquired immunity lasts for. If it’s short-lived, Covid-19 could become a seasonal problem.

Still, all of the above serves as a reminder of one key thing. While a vaccine against the coronavirus is clearly the way out of this nightmare, there’s another vital strand of the fight which can be won much sooner: the battle for information.


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Westminster Round-up

You can find all of our Covid-19 coverage on our special coronavirus home page, while the latest news is on our liveblog.

Another piece of the puzzle | Britain’s self-employed will finally get the lifeline they have been waiting for today from the Chancellor, Rishi Sunak. The issue of the self-employed is key to both fighting the epidemic and its economic consequences. Without the financial support to stay at home, the self-employed are more likely to be out and about and spreading the virus. Self-employment also played a huge part in the “jobs miracle” of the past decade and the ability of people to survive the fallout of the financial crisis. If the self-employed are not compensated now, it could be disastrous for the economy.

However, designing help for them has been fiendishly difficult for the Treasury. For the employed, the PAYE system makes it relatively straightforward. But the self-employed are far more heterogeneous and their income is often unevenly distributed, intermittent and highly variable. Many switch between being employees and being self-employed, and sometimes are both at the same time. All of which has made it very difficult to design a system that isn’t vulnerable to fraud, and doesn’t give money to those who don’t need it.

The details of the financial help have not yet been briefed, but one possibility is to follow the model used in the Nordic countries where the self-employed are paid based on an average of their income calculated from three years of tax returns. Anna Mikhailova reports that the money will only be available to those who can prove they have been directly affected, which could limit it to just one in three of the UK’s five million self-employed.

So long, jobs miracle | In a sign of the immediate impact of the lockdown, nearly half a million new claimants have already signed up for Universal Credit in just nine days. The Department for Work and Pensions is having to take on thousands of staff to process the claims. The number of claimants is said to dwarf those during the financial crisis, and already accounts for five years’ worth of jobs growth.

While the hit to the national balance sheet is one thing, this is also a stark reminder that if the economy is not successfully put into cryogenic deep freeze, to be revived instantly at the end of the pandemic, the economic fallout could be catastrophic.


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