Coronavirus: When might the UK lockdown come to an end?
‘Nobody’s got any real idea what best strategy to use,’ says epidemiology professor
The UK was first placed in lockdown on Monday 23 March: Boris Johnson announced that all but essential businesses were to close with immediate effect, while members of the public were to stay in their homes except to shop for essentials or go out in certain circumstances, including one form of daily exercise.
Three weeks later, on 16 April, Dominic Raab announced lockdown would continue for at least another three weeks into May and said lifting restrictions too soon would only spread the virus, further damaging the economy.
Upon his return to No 10 Downing Street on Monday 27 April, prime minister Boris Johnson urged members of the public to be patient during the lockdown.
Mr Johnson warned that now is the point of "maximum risk" during the outbreak, stating that he understands "how hard and stressful" it has been to give up "ancient and basic freedoms" including seeing loved ones.
On Wednesday 22 April, England’s chief medical officer, Chris Witty, gave an indication of how long we can expect the measures to be extended. He told the daily televised conference that social distancing measures could be in place until the end of the year unless a vaccine is found sooner — which he added was unlikely.
He said a sudden lifting of all restrictions would be a “wholly unreasonable” expectation for the public to have.
He said: “In the long run, the exit from this is going to be one of two things, ideally. A vaccine, and there are a variety of ways they can be deployed... or, and or, highly effective drugs so that people stop dying of this disease even if they catch it, or which can prevent this disease in vulnerable people.
“Until we have those, and the probability of having those any time in the next calendar year is incredibly small, and I think we should be realistic about that.
“We’re going to have to rely on other social measures, which of course are very socially disruptive as everyone is finding at the moment. But until that point, that is what we will have to do.”
So when may the lockdown in the UK come to an end?
Unfortunately, this is not an answer that can be easily answered due to the lack of evidence currently available.
“We aren’t in a position yet to know when and how the lockdown will be relaxed,” says Katrina Herren, chief clinical officer at Doctorlink, the leading symptom assessment provider to the NHS.
“This is because we are only weeks into the lockdown and only from now onwards are we seeing cases where the virus has been transmitted since lockdown.”
Herren explains to The Independent that every day that passes provides “more information from our own country and from other countries that are ahead of us in the lockdown”.
“I don’t think the government or the experts have sufficient information yet to formulate a robust plan. That doesn’t mean they won’t soon,” she adds.
Professor Robert Dingwall, a part-time professor in the School of Social Sciences at Nottingham Trent University and a pandemic disease expert, says that in his opinion, it is “premature for any responsible scientist to start speculating about when it might end”.
“We certainly need another two or three weeks of data to have some sense of how the outbreak is playing out in this country,” he tells The Independent, adding that there is a “real danger” of providing people with “false hope”.
Professor Keith Neal, Emeritus Professor of the Epidemiology of Infectious Diseases at the University of Nottingham, explains that there are two “extreme ways of managing an epidemic”.
The first, he tells The Independent, would be to allow the virus to spread through the population quickly as a means of achieving herd immunity, which would inevitably result in health services becoming overwhelmed and an increasing number of fatalities. The second would be to keep the public in isolation until a vaccine is created, an eventuality that he doesn’t believe will come to fruition for another 18 months. As neither of these options are feasible, a different approach has to be taken, the professor states.
Could the lockdown be released in stages?
“Essentially, I think what will have to be done is as cases fall, the lockdown will have to be released, cases will go back up and it will have to be reapplied. Because there’s no other way of doing it,” Professor Neal predicts.
The coronavirus pandemic has been compared on several occasions to a wartime era. This, Professor Dingwall says, has led to people believing there will be “some sort of equivalent of VE Day, and we will officially declare it over and be able to go out and have a big party”.
However, it is “far more likely that what we’ll actually see is a progressive relaxation of measures over quite a long period”, he explains.
One measure that Professor Dingwall thinks could occur amid the lockdown is the reopening of schools. A recent study published in the Lancet Child & Adolescent Health journal found that the closing of schools do not appear to have a significant effect on the spread of infections during outbreaks such as Covid-19.
Following the analysis of 16 studies, researchers estimated that school closures would reduce deaths by around 2 to 4 per cent during the coronavirus pandemic in the UK, less than other social distancing measures.
The researchers warned that the “economic costs and potential harms” of mass school closures are very high, particularly for the most disadvantaged children, suggesting that playgrounds could be closed and social distancing introduced in classrooms if schools do reopen.
“It does look like the evidence for continuing with school closures might not be very robust,” Professor Dingwall says, stating that the reopening of schools “would be a huge step forward in getting the country running normally again”.
Professor Neal theorises that other changes to ease the lockdown may include the reopening of garden centres, so that the growing season is not “wrecked”, enforcing spaced seating arrangements at restaurants and removing queues from bars, should food and drink establishments be allowed to resume everyday operations.
However, the plan to ease the lockdown in the UK “will need to be very carefully planned to consider the potential risk of an increase in the cases, the economic impact and the wider health of people in society among other factors”, Herren stresses.
“One of the reasons why the government is not discussing it yet is that they don’t want us to take our eye off the ball when self-isolating,” the Doctorlink chief clinical officer says. “If we relax at this point in time the numbers will go back up and we will waste all the effort of the past fortnight.”
Could the distribution of antibody tests increase the likelihood of the lockdown being removed?
In a report published by the Department of Health and Social Care on 4 April, it states that the government is currently working with several companies who are offering antibody tests and “are evaluating their effectiveness”.
“These antibody tests are brand new. In fact, they are still being developed and there is not yet one that has been proven to work as we would require,” the report states. “No government in the world has yet rolled out a full Covid-19 antibody testing programme.”
Antibody tests would allow health practitioners to find out whether a person has already recovered from the coronavirus and thus built some degree of immunity to it. However, as Professor Neal points out, the antibody tests currently being trialled are “only diagnosing the severe infection”, as opposed to patients with mild cases or those who are asymptomatic.
“Once the antibody test is sorted, and we know exactly how to make the test, then it’s quite easy to make hundreds of thousands of them very quickly,” he says. “We’re in a real dearth of information.”
On Friday 3 April, health secretary Matt Hancock said that the British government had not yet found an antibody test that is “good enough to use”, also admitting that the tests are unlikely to become widely available until the end of April.
Gaining a better understanding of how many people have become immune to the virus could lead to lockdown measures being eased in future, Professor Dingwall says.
“It will help when we have some idea of what the actual level of immunity in the population is,” he says. “If we are approaching a level of immunity where the virus is beginning to run out of people to infect — we might be able to track that on something like a regional basis — then that might give us some more latitude for saying we can relax in these areas.”
On the other hand, if healthcare practitioners were able to state whether or not a person is immune to the virus, would that mean that only those who are immune would be allowed to leave their homes, Professor Dingwall asks.
Professor Neal adds that “at the moment, there is no perfect strategy”. “This may be a world pandemic, but it’s actually a series of epidemics in different countries,” he says.
“Nobody’s got any real idea what best strategy to use, it’s sort of making it up as you go along. I think it’s actually quite difficult to decide when to release the lockdown.”