What Our Lockdown Exit Strategy Should Be, According to Three Experts

Since the government is refusing to share how it plans to ease the UK out of lockdown, we asked some experts for their thoughts.
April 21, 2020, 9:00am
screen on the green coronavirus

As of last Thursday, the UK will be under lockdown for at least another three weeks. Considering the government is required by law to assess the situation every three weeks, we'll likely see another three weeks announced three weeks from now, and perhaps a further three weeks after that. The question is: what happens next?

Many of our European neighbours have started setting out exit strategies – plans on how to ease restrictions when the time is right. France's lockdown, for example, has been extended until the 11th of May, but president Emmanuel Macron has announced that schools and nurseries will begin to reopen first – gradually. Large gatherings of people won't be allowed until at least the middle of July.

In Austria, shopping centres and hairdressers will be able to open their doors from the 1st of May, alongside outdoor sports facilities like tennis courts. In Germany, social distancing measures will stay in place until the 3rd of May at the earliest, but as of yesterday chancellor Angela Merkel allowed shops of up to 8,600 square feet to resume business.

Meanwhile, the UK government has remained conspicuously silent on its plan for taking the country out of lockdown, reportedly for fear of confusing the public with conflicting messaging – a rationale so condescending it hasn't just drawn criticism from Labour leader Keir Starmer, but also from Conservative MPs like David Davis and Iain Duncan Smith.

The approaches reportedly being considered by the government include easing restrictions for individuals based on age, vulnerability or geographic location, while for businesses it could come down to their size and the extent to which they require close personal contact. But what strategy is the best? And which is the most likely to actually happen? I asked some experts.

David McCoy, co-chair of the Centre for Health and the Public Interest, and professor of Global Public Health at Queen Mary University of London

supermarket london coronavirus

VICE: What conditions do we need to meet as a country before we can even think about easing the lockdown?
David McCoy: The decision needs to be weighed against the capacity to do case detection, contact tracing and isolation. So being able to do rapid tests on large portions of the population to identify people who are infectious and trace who they've been in contact with. The second thing I would say is that we need to rebuild our public health teams across the country, so that we can respond at the local level in a really effective manner once we've identified people who are infectious in order to quarantine them.

From there, what do you think would be the safest way to relax the lockdown rules?
It needs to be gradual. Widespread testing would allow us to make the lockdown more targeted and selective, rather than applying in a very blunt way to the entire population. So you isolate those with confirmed cases and those they have come into contact with. Because it's very difficult to identify asymptomatic carriers, we also have to continue with some other measures, like limiting the number of mass gatherings and stringent hygiene measures, like using face masks in public – although the evidence on that is still mixed. And there may be a need for more limited lockdowns in parts of the country which demonstrate an outbreak of the disease. This strategy is very dependent on us being able to do testing, so this really requires the government to pull out all the stops to increase capacity.

How likely do you think that is?
We should be able to increase our testing capacity. The question is how quickly can we do it, and how much effort is the government putting into making this happen? I think the government is starting to make more of an effort, but I think it could be doing even more.

What are the risks involved with coming out of the lockdown too quickly?
The worry is that we will once again see a rapid rise in infections which could overwhelm the NHS, making it difficult to treat people with other conditions and putting frontline health workers at risk. Those concerns have to be balanced against the problems that will occur as a result of continued lockdown, which is also having all kinds of health effects. The repercussions of the lockdown are more chronic – less dramatic and visible – but past data has shown that unemployment also results in premature deaths. And there's evidence of lockdown creating mental health problems, problems with domestic violence and alcohol. Weighing up these options requires further research and analysis that hasn't yet been done. At the moment, no one has the right answer because we're all learning as we go along. Every country is having to set sail on a ship while they are still building it.

David Alexander, Vice-President of the Institute of Civil Protection and Emergency Management, and professor of risk and disaster reduction at University College London

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VICE: Last week, an epidemiologist advising the government said that even when the lockdown is eventually eased, social distancing measures will likely need to stay in place until a vaccine is found. What would that look like in practice?
David Alexander: It doesn't mean that we're all trapped indoors for the next year-and-a-half. It may well include imposing some rather relaxed measures and monitoring carefully what their impact is, and if it's not good enough they will have to be tightened up again. It’s about finding the measures that are perhaps the least painful but still work. For example, if we all go to the beach in the summer, what are the implications of that? Is it going to lead to a tremendous rise in infection rates? The resurgence of the disease will manifest itself in direct relation to what people do. In many ways, we're in a sort of gigantic experiment. Yes, there have been pandemics before, but they weren't quite as worldwide as this one.

Some researchers have suggested easing the lockdown by risk group, so allowing younger people without pre-existing conditions outside first. Would that work?
I personally don't think that's a very good idea. Of course we have to safeguard vulnerable groups, but they're not getting infections from other vulnerable individuals. They're getting infections from ordinary people. And if infections spread in the general population, it's very difficult to see how you would protect the elderly or those with pre-existing conditions. Think of a care home – what happens when the staff becomes infected? I think there's a very good argument for doing more testing, including for people who aren't showing symptoms. I think the UK didn't do enough testing, hasn't done enough testing and isn't doing enough testing. One of the lessons that's been very clear is that testing is very helpful, because it not only identifies people who need to be isolated, but also those who haven't got it and are safe for the time being.

Introducing: The Lockdown Jogger

And what about having the country come out of lockdown by geographic region?
There is really no evidence, no precedent for this – as I say, it's an experiment. We could try letting rural people go back to work first – we certainly have a major problem with crops being ploughed back into the land and rotting on trees because there isn't the labour to collect them. What we don't want is food costs rocketing and shortages appearing, so this needs to be dealt with. So that's a very powerful argument for allowing at least one sector to liberalise from the lockdown. But it also means that you have to get the seasonal labour in, which means migratory movement. That, too, could only be dealt with if there were enough monitoring and testing.

When you're talking about this situation as a sort of experiment, what would you say is the best possible outcome?
I think there is bound to be a second wave in some form, but we hope that it can eventually be a situation where enough people are immune, so that there are few cases that are life threatening. The idea of herd immunity achieved by letting people get it is currently not a good idea, so there will be herd immunity once enough people are vaccinated against it. In any mass vaccination scheme there is a tremendous medical ethics issue to deal with in terms of who gets vaccinated first. No matter how rapidly we try to achieve a vaccine and mass produce it, there will still be short supply, at least in the early stages, while there are very large numbers of key workers and vulnerable people. So this will need some detailed planning if it is to be done properly and fairly.

Christopher Rauh, professor of labour economics at the University of Cambridge

domino's delivery driver coronavirus

VICE: You just published research showing that young people and low-paid workers are being hit hardest by the contraction of the economy and the job market. Is there any way that we can ease this lockdown in a way that helps these people get back on their feet?
Christopher Rauh: Some researchers from Warwick University are arguing that measures should be relaxed and work permissions given to younger people with no underlying health conditions first. But the problem is that a lot of those jobs that were lost involve close contact with customers – food preparation, personal services like hairdressing and so on. So we have to think about other ways, like social safety nets, to support these people, rather than allowing them back to work and risking spreading the disease.

I think what's important is that we try to keep the relations between workers and firms in place so that the recovery can be as smooth as possible. If I tell a company next week, "Okay, you can reopen," and they've laid everybody off, they're going to have to rehire workers, which is a huge process, and then you have to retrain them. So I think one thing that will help make the recovery as smooth as possible is continuing the furloughing scheme, because it means employees can just tap back in.

Is there anything we can learn from how other European countries have been stratifying the reopening of their businesses?
A lot of countries have been allowing shops to reopen based on the size of the premises, so the amount of air that is circulating and how socially distanced people can be there. I'm not sure that these types of rules of thumb are necessarily the ones that we should be copying.

So what criteria should we use instead?
A lot of production is not simply one manufacturer producing a good, but actually a long supply chain. So you have to think where the bottlenecks in these chains are when we're discussing which industries or firms should open first. I can't call for us to reopen schools, because that's a medical decision, but schools are a bottleneck. When a school doesn't offer its services, parents can't go to work. If parents can't go to work, we might see many disruptions along supply chains, and we also see a lot of gender inequality here. Another bottleneck is IT production. Companies now heavily rely on work from home, which requires laptops and tablets. If a worker does not have this equipment, they can't do the job and can't produce the tools or materials needed for someone else to produce their product. These are some examples of jobs that one might think are not existential, but actually they can be a key in a complex production network.

What kind of businesses should we reopen last?
I think sports venues, concert halls, nightclubs. After all, a club with social distancing measures is not a very appealing concept. I think everything where face-to-face contact and social proximity is a real necessity, and which is more of a leisure activity, these are the ones we should probably be thinking about last, even though we're all looking for distractions.

In other words, time to put to bed the dream that we'll all celebrate the end of lockdown at the pub?
Yeah... in the beginning, I kept thinking, 'The day when this is over…' but realistically it's not going to be a day. It's going to be a process. There will be ups and downs, rather than "everything is back to normal now".

@theotherjenhahn