Coronavirus exit strategy ‘in limbo as Boris Johnson recovers’

Ministers are failing to take decisions on the lockdown ‘exit strategy’ because Boris Johnson is off work, Keir Starmer has claimed.

The Labour leader said the government had not acted ‘quickly enough’ throughout the crisis as he insisted it need to show the public how normal life might start to return. 

He accused Foreign Secretary Dominic Raab of being ‘reluctant’ to sign off a strategy while the PM is still recuperating from his own infection at Chequers. 

The jibe came amid mounting alarm at the scale of the havoc being wreaked by the lockdown on the economy, with warnings GDP could be slashed by a third and millions of people lose their jobs.

Announcing in Downing Street last night that the draconian curbs will stay for at least another three weeks, Mr Raab said there was ‘light at the end of the tunnel’ and the outbreak was coming under control.

But he rejected calls for an ‘exit strategy’ to be unveiled now, amid fears that the public would assume the restrictions are about to be lifted. ‘We are being as open as we responsibly can at this stage,’ he said.  

Speaking on the BBC’s Coronavirus Newscast podcast last night, Sir Keir said: ‘I think that throughout this they’ve struggled with taking decisions quickly enough. 

‘The other factor though, I think, is we all know that the Prime Minister has been in hospital. 

‘We’ve all been pleased to see that he’s come out and is feeling better. And it feels as though they’ve been in a position probably for a week or 10 days now where it’s been difficult for the Government to make big decisions. And I think there’s a bit of that lying behind this as well. 

‘I suspect, although I don’t know, that Dominic Raab is just reluctant – he probably does know that it’s time for an exit strategy – but he’s probably reluctant to sign it off without the Prime Minister and I think there’s a bit of that in the mix.’  

In another helter-skelter day in the coronavirus crisis: 

  • China has revised its coronavirus death toll in Wuhan province upwards by 50 per cent, fuelling suspicions it has covered up the scale of the outbreak; 
  • London mayor Sadiq Khan has urged Londoners to wear facemasks despite doctors warning that they can actually make people more likely to get infected; 
  • A survey of thousands of care homes for ITV has revealed that 42 per cent report coronavirus cases, amid fury at shambolic testing and a lack of PPE for staff; 
  • The UK announced 861 more deaths from the coronavirus, taking the total number of victims to 13,729.  But the rising number of cases remains stable, with just 4,618 positive tests in the past 24 hours resulting in a total case count of 103,093.  

Labour's Sir Keir Starmer

Sir Keir Starmer (right) accused Foreign Secretary Dominic Raab (left) of being ‘reluctant’ to sign off a strategy while the PM is still recuperating from his own infection at Chequers

Raab’s five criteria before loosening lockdown 

Dominic Raab batted away calls to to set out an ‘exit strategy’ from lockdown tonight.  

Instead he merely offered five criteria for when the lockdown could start being loosened. #

They are: 

1. Ensure NHS can provide enough critical care treatment 

2. A ‘sustained and consistent fall’ in daily death rate 

3. Reliable data showing rate of infection is decreasing to manageable levels 

4. Testing capacity and PPE supply are ready to meet future demand 

5. There is no risk of second peak to overwhelm the NHS 

Instead of an exit plan, Mr Raab last night merely offered five criteria for when the lockdown could start being loosened. They are certainty that the NHS will not be overwhelmed, a consistent reduction in the death rate, evidence that transmission is at manageable levels, capacity for wide scale testing and PPE provision, and low danger of a ‘second peak’. 

In a sombre speech in Downing Street, Mr Raab – who is deputising during Mr Johnson’s recovery – said: ‘Overall, we still don’t have the infection rate down as far as we need to.

‘As in other countries we have issues with the virus spreading in some hospitals and in care homes and in sum, the very clear advice we have received is that any change to our social distancing measures now would risk a significant increase in the spread of the virus.

‘That would threaten a second peak of the virus and substantially increase the number of deaths.

‘It would undo the progress we have made to date and as a result would require an even longer period of the more restrictive social distancing measures.

‘So early relaxation would do more damage to the economy over a longer period and I want to be really clear about this.

‘The advice from SAGE is that relaxing any of the measures currently in place would risk damage to both public health and our economy.’

WHAT IS R0? AND WHAT DOES IT MEAN IF IT IS LESS THAN ONE? 

Every infectious disease is given a reproduction number, which is known as R0 – pronounced ‘R nought’.

It is a value that represents how many people one sick person will, on average, infect. 

WHAT IS THE R0 FOR COVID-19? 

The R0 value for SARS-CoV-2, the virus that causes COVID-19, is estimated to be around 2.5. 

But some experts analysing outbreaks across the world have estimated it could be closer to the 6.6 mark

Estimates of the R0 vary because the true size of the pandemic remains a mystery. 

HOW DOES IT COMPARE TO OTHER VIRUSES? 

It is thought to be at least three times more contagious than the coronavirus that causes MERS (0.3 – 0.8).   

Measles is one of the most contagious infectious diseases, and has an R0 value of 12 to 18. 

Chickenpox’s R0 is estimated to be between 10 and 12, while seasonal flu has a value of around 1.5.  

WHY IS IT IMPORTANT TO HAVE A LOW R0? 

The higher the R0 value, the harder it is for health officials control the spread of the disease.

A number lower than one means the outbreak will run out of steam and be forced to an end. 

This is because the infectious disease will quickly run out of new victims to strike. 

HOW IS IT CALCULATED

Researchers take into account several factors when assessing an infectious disease’s R0.

They include how long patients stay infectious for, contact rate and the mode of transmission.

INFECTIOUS PERIOD 

For instance, some strains of influenza and the common cold are contagious for up to eight days. 

Experts say COVID-19 is infectious up to three days before symptoms begin until three days after symptoms end.

But one Yale University study found that patients were still infectious up to eight days after symptoms vanished.  

NUMBER OF CONTACTS 

Another factor depends on how many people the infected come into contact with that aren’t vaccinated or immune.

If the infectious disease causes severe symptoms early, many patients would stay at home and have little contact.

For example, Ebola is known to have a low R0 (2) because it tends to develop before tell-tale symptoms appear.

But if it had a longer incubation period – the length of time before symptoms begin – then it would have a higher R0.

This is because the infected would come into contact with more people, allowing the virus to spread.  

TRANSMISSION MODE 

Transmission mode can also play a role, with viruses spread through the air known to be more contagious.

With COVID-19, evidence shows that it can be caught by breathing near an infected patient.

The virus can also live on surfaces, meaning it can be picked up without ever touching someone. 

But Ebola is spread through bodily fluids, making it harder to catch the virus. 

HOW DOES A LOCKDOWN BRING DOWN THE R0?

The UK’s draconian lockdown imposed on March 23 has slowed Britain’s coronavirus crisis, studies show.

Scientists at the London School of Hygiene and Tropical Medicine last month analysed the virus in the UK.

They estimated each infected patient may now only be passing COVID-19 on to 0.62 others, down from 2.6.

The team said the virus was struggling to spread because people were having less contact with others.

They used a survey of 1,300 people who were asked to list what human contact they had in the past 24 hours.

This was compared to a similar survey done in 2005 to give an idea of how it had changed because of lockdown.

He added: ‘Based on this advice which we very carefully considered the government has decided that the current measures must remain in place for at least the next three weeks.’ 

Mr Raab said the public needed to show ‘patience’ and stick with the restrictions to stop the spread of the virus.

‘There is light at the end of the tunnel but we are now at both a delicate and a dangerous stage in this pandemic,’ he said.

‘If we rush to relax the measures that we have in place we would risk wasting all the sacrifices and all the progress that has been made.

‘That would risk a quick return to another lockdown with all the threat to life that a second peak to the virus would bring and all the economic damage that a second lockdown would carry.’ 

Mr Raab said when the government has met its criteria it will look to adjust the measures to make them ‘as effective as possible in protecting public health whilst allowing some economic and social activity to resume’.

‘But we will only do it when the evidence demonstrates that it is safe to do it,’ he said.

‘It could involve relaxing measures in some areas while strengthening measures in other areas.’ 

Mr Raab insisted ‘there is light at the end of the tunnel’ but refused to set out a ‘definitive timeframe’ for easing the lockdown measures.

He said: ‘The Prime Minister said at the outset that it would take three months to come through the peak and I think that, broadly, is still the outline.

‘We can’t give a definitive timeframe, that would be to prejudge the evidence, that wouldn’t be a responsible thing to do.

‘But our message to the British public is: there is light at the end of tunnel, we are making progress, but at the same time we must keep up the social distancing measures.’    

But the stance contrasted with that of Nicola Sturgeon earlier, when she pledged to set out a ‘framework’ for loosening lockdown when the time comes.  

Answering questions from other Scottish party leaders over video conference this afternoon, Ms Sturgeon said: ‘We must continue the lockdown measures for at least another three weeks… we are not yet confident enough that the virus has been suppressed sufficiently.’ 

Ms Sturgeon said ‘people do want to know what the thinking is for beyond that period and she wanted to ‘share the thought process’. 

‘I hope over the course of next week to not announce those decisions… but to set out the framework of decision making.’ 

In a bad-tempered interview earlier, Health Secretary Matt Hancock said he recognised that ‘everybody wants to know what the future looks like’.  

But he flatly dismissed calls for the government to flesh out how the restrictions will finally be eased, despite mounting fears that they are wreaking havoc on the economy. 

Mr Hancock said the ‘clarity of messaging’ had a ‘direct impact on how many people obey’ social distancing rules. 

In bruising clashes with Nick Robinson on BBC Radio 4”s Today programme, Mr Hancock angrily told the interviewer to stop interrupting. 

‘The communications are part of the policy. That is why we will not be distracted in to confusing that messaging. The scientists can say what they like, the commentators can say what they like,’ he swiped.  

One of the government’s own key experts warned yesterday that curbs cannot be eased until mass testing is in place.  

Professor Neil Ferguson insisted schools and more shops should not be open until everyone with symptoms, and everyone they have come into contact with, can been screened. Even then, he warned there is no possibility of the country returning to ‘normal’ until a vaccine is produced. 

The epidemiologist – who has been modelling the outbreak for the government – delivered a withering verdict on the performance of ministers, urging them to ‘accelerate action’. He suggested the organisation in Whitehall was not on the same scale as the effort on Brexit, despite the crisis being much bigger. 

Discussing whether lockdown measures could be eased after another three weeks, Professor Ferguson told BBC Radio 4’s Today programme: ‘I think that will very much depend on quite how quickly case numbers go down, and that does require us to get on top of things like transmission rates in hospitals and care homes.

‘I think the other thing I would say is that it really requires a single-minded emphasis in Government and the health system on scaling up testing and putting in place the ability to track down cases in the community and contact-trace.

‘Because without that, our estimates show we have relatively little leeway; if we relax measures too much then we’ll see a resurgence of transmission. 

Around half the public are now resigned to the draconian 'social distancing' curbs being in place into June

Around half the public are now resigned to the draconian ‘social distancing’ curbs being in place into June

‘What we really need is the ability to put something in their place. If we want to open schools, let people get back to work, then we need to keep transmission down in another manner.

‘And I should say, it’s not going to be going back to normal. We will have to maintain some form of social distancing, a significant level of social distancing, probably indefinitely until we have a vaccine available.

Asked whether the Government is moving towards having an exit strategy in place, Prof Ferguson said: ‘I’m not completely sure. I think there’s a lot of discussion. I would like to see action accelerated.

‘We need to put in place an infrastructure, a command and control structure, a novel organisation for this.

‘I’m reminded by the fact we had a Department for Brexit for Government – that was a major national emergency, as it were – and we’re faced with something which is, at the moment, even larger than Brexit and yet I don’t see quite the same evidence for that level of organisation.’

Prof Ferguson added: ‘There needs to be more co-ordination I think, yes. That may be going on, I don’t have unique insight, but I think it could be enhanced.’   

Graph shows the UK's average daily coronavirus deaths for the previous seven days, based on official figures. The dip at the end shows the numbers falling for two days - the first drop since the crisis began. Although it could be a sign of numbers plateauing, Chris Whitty yesterday said he expected a rise in deaths today as officials catch up with a lag in reporting over Easter

Graph shows the UK’s average daily coronavirus deaths for the previous seven days, based on official figures. The dip at the end shows the numbers falling for two days – the first drop since the crisis began. Although it could be a sign of numbers plateauing, Chris Whitty yesterday said he expected a rise in deaths today as officials catch up with a lag in reporting over Easter