Prime Minister Boris Johnson tonight announced that the coronavirus is ‘only just’ under control, admitting its reproduction rate may be close to 1.
The reproduction rate – known as the R – explains how many people the average COVID-19 patient passes the virus on to before they recover. It is used to measure how fast the disease is spreading.
If it rises above 1, the numbers of cases will start to grow rapidly and the virus could spiral out of control. A rate of 0.5, for example, would mean every 10 infected people pass it on to only five others, while a rate of 1.2 would see them give it to 12.
As Mr Johnson tonight revealed small changes to England’s lockdown rules, he made clear that the future of how the UK emerges from its crisis will hinge entirely on its R.
In an address to the nation he said: ‘We have the R below one, between 0.5 and 0.9 – but potentially only just below one…
‘With ever increasing data, we will be monitoring the R and the number of new infections, and the progress we are making, and if we as a nation begin to fulfil the conditions I have set out, then in the next few weeks and months we may be able to go further [in easing lockdown].’
The Prime Minister said the Government ‘will not hesitate to put on the brakes’ if the virus starts to spread widely again.
If the R rate rises above one Britain’s outbreak will start to grow again after weeks of shrinking. A rate of 0.5, for example, would mean every 10 infected people pass it on to only five others, while a rate of 1.2 would see them give it to 12
Prime Minister Boris Johnson tonight said the reproduction rate of the coronavirus may ‘only just’ be below 1, the critical number for keeping it under control
Mr Johnson said the UK will be able to ease more of its lockdown restrictions as the R rate continues to fall along with the numbers of people who are infected
In his speech tonight – the first one he has given since he announced the start of the lockdown on March 23 – Mr Johnson said: ‘We must make sure that any measures we take do not force the reproduction rate of the disease – the R – back up over one, so that we have the kind of exponential growth we were facing a few weeks ago.’
He added: ‘As we go everyone will have a role to play in keeping the R down by staying alert and following the rules,’
The R number is something that all infectious viruses are given and it changes depending on the circumstances in which the virus is spreading.
All have an original R, an R0, which dictates how fast it would spread in uncontrolled conditions, but measures like social distancing are able to force this down.
Scientists believe that, when the COVID-19 outbreak, started in the UK, the virus’s R rate was close to 4.
But, as people have followed social distancing rules, stayed home and self-isolated when they are ill, the number has been forced below 1, potentially as low as 0.5.
Boris Johnson today announced small steps towards loosening the COVID-19 lockdown in England
The PM has dropped the ‘stay at home, protect the NHS, save lives’ slogan in favour of a ‘stay alert’ version – which notably has green edging instead of red
If the number can be kept below 1 for long enough, the virus will eventually run out of road and the number of people infected will hit zero.
For example if 100 people are infected when the R is 0.5, by the time they have recovered they will have passed it on to 50 people. If the rate stays the same, those 50 people will pass it on to 25 people before they are no longer infectious.
This will then reduce to 13 people as those 25 recover, and then to 7, then to four, to two, to one and then the virus will die out because it cannot spread any further.
Reacting to the speech, Dr Ron Daniels, an intensive care consultant based in Birmingham, said: ‘The reality is that the effect of a second wave is just so unknown that it is too risky in most health professionals’ view to relax lockdown right now.
‘We would like to see our capacity in NHS hospitals back down to below usual levels before we can safely do that.’
‘Do we have enough beds to cope with a second wave if lockdown is relaxed too much? Absolutely not. We’re still over our usual capacity.’
He added: ‘The relative impact of any second wave all depends on how many members of our public have already been exposed to this novel coronavirus. Of course, we don’t know.
‘It may be, as some optimistic estimates suggest, as high as 60-80% of the public who have been exposed. That would mean that a lot of people had had exposure to (the virus) and not developed symptoms and just gone about their lives as normal.
‘But the more pessimistic, the more wary estimates, suggest that somewhere under 10% of our population have been exposed.
‘If that’s true, then we expect the second wave – if lockdown is relaxed too quickly and too aggressively – could even be bigger than the first.’
Dr Kit Yates, senior lecturer in mathematical biology at the University of Bath, and author of the Maths of Life and Death, said the only way to find out how easing lockdown will change the R rate is to try it.
He told MailOnline: ‘Until we actually go through the experiment of lifting the different restrictions we will not really know the effect on R.
‘You can expect a great deal of caution in the measures the government start to relax.’
He added: ‘If the UK relaxes social distancing now, while most of the population is still susceptible, it runs the very real risk of a second wave.
‘At the moment suggestions are that R0 might be around 0.7 which means we have a bit of room for manoeuvre in letting up on complete lockdown.
‘Provided we keep R0 below 1 then the disease will continue to die out. The reason we are holding on to complete lockdown for so long is because we want to bring cases down to a very low level and the quickest way to do that is to keep R as low as possible.’
Scientists think the R rate of the coronavirus in Britain has plummeted from almost 4 to close to 0.5 since the lockdown was introduced on March 23, but it has ticked up slightly in recent weeks because there are still problems in hospitals and care homes, even if few people are catching the infection in the community
Graphs provided by researchers at the University of East Anglia compare how separate lockdown measures affected their ‘risk ratio’ – an algorithm which predicts how likely the virus is to spread. The gradients show that risk dropped over time after mass gatherings were banned, schools were closed and ‘initial businesses ‘ were shut, including gyms. Gradients which showed less of an effect, or apparently no effect at all, on the risk ratio are pictured, showing that total business closures, staying at home, and wearing masks do not appear to impact the risk of virus spread
Results of the study – based on data from 30 countries – also showed how the same measures worked to keep death tolls down
The Prime Minister’s comments today come just days after chief government scientists said the R rate actually appeared to be rising in the UK because of outbreaks in care homes and hospitals.
Chief advisers have made clear that there are differences in the rates of spread in different regions and in different settings.
Professor John Edmunds, from the London School of Hygiene & Tropical Medicine, told MPs on the Science and Technology Committee last week that he estimates 20,000 people per day are still getting infected.
And he believes the R is between 0.75 and 1, explaining that it appears to have gone up in the past two weeks because of worsening outbreaks in care homes around the country.
The chief statistician at the Office for National Statistics, Professor Ian Diamond, agreed with the assessment at a Downing Street press conference last week.
Professor Diamond said: ‘It is important to recognise that the R number itself is only relevant if you look also at the context of the prevalence.
‘I think we need to look at the two together to properly understand where we are… we need certainly to get on top of the epidemic in care homes and in hospitals.’
He said that, if the R was 1, the number of cases would flatline because no more than one person would catch the virus at a time but the number would also not decline.
The trend of people getting diagnosed is not clear currently, although it looks stable.
Today, the Government announced 3,923 people tested positive yesterday – significantly lower than a peak of 8,719 on April 11.
However, on Wednesday this week, May 6, 6,111 people tested positive. The average daily number for the week has been 4,654 and the figure is fluctuating because of a changeable number of tests being carried out.
In retort to Professor Diamond’s agreement that the R was rising, Foreign Secretary Dominic Raab last week said that ‘overall, the R is down’, and that controlling infection rates in hospitals and care homes was now the Government’s ‘top focus’.
Despite the R rate being high in hospitals and care homes, which are higher risk areas, it is believed to be very low in the community because people are no longer having regular face-to-face contact with others.
Professor Edmunds told the science committee that, a couple of weeks ago he would have said the R in the community was between 0.6 and 0.8.
But because of higher infection rates in medical facilities, he said, the overall estimate now stood at close to 1.
‘It’s a big problem that we have in hospitals and care homes,’ he said.
‘I think what’s happened is that the community epidemic has come down and that epidemic is now being concentrated in these settings.’
And Professor Edmunds added: ‘Our data are really not really good enough to give us any certainty about what the reproduction number really is in hospitals and it’s probably variable between one hospital and another, and care homes is even worse.’
Mr Johnson today explained how the UK could move out of lockdown over the next two months as long as the R rate can be kept below 1.
He has urged everyone to return to work if they can, saying that from tomorrow anyone who cannot work from home – even if they are not carrying out an essential function – is being ‘actively encouraged’ to return to their duties.
Mr Johnson said they should try not to use public transport, and safety guidance had been developed for businesses, but in a clear signal he said: ‘Work from home if you can, but you should go to work if you can’t work from home.’
Mr Johnson insisted the wider lockdown will remain in place, including ‘social distancing’ rules for people to be two metres apart where possible, and fines will even be increased to a maximum of £3,200 – with details to be fleshed out to Parliament tomorrow.
He said sunbathing and unlimited outdoor exercise – even if it is not local to your home – will be permitted from Wednesday. Sports such as tennis and golf can happen, albeit only with your own household.
And his ‘road map’ makes clear that as long as the battle against the disease is succeeding, primary schools could start opening from the beginning of next month, with reception, Year 1 and Year 6 the first to go back and an ‘ambition’ for secondary students facing exams get ‘at least some time’ with teachers before the summer holidays.
More shops could reopen in June – and Mr Johnson even suggested that some parts of the hospitality industry could be making a comeback by July.
But the moves, which will only apply in England, go much further than those in the rest of the UK, as the united stance looks to be crumbling.
Scotland’s First Minister, Nicola Sturgeon, joined Wales and Northern Ireland in condemning Mr Johnson’s decision to ditch the powerful ‘stay at home’ mantra.
The First Minister said the new ‘stay alert’ version – which even has a green rather than a red border design – was ‘vague’ and raised the risk that ‘people will die unnecessarily’. None of the rest of the UK will be using the new slogan.
How Britain’s R number plummeted when the lockdown was introduced and what it means for emerging from the other side
Prime Minister Boris Johnson has put detailed science at the heart of Britain’s coronavirus crisis and said the status of the lockdown now depends on the virus’s reproduction number – known as the R.
Watching the number of new patients and the rate at which it goes up or down will be the best way officials can monitor how quickly the virus is spreading, which will in turn guide which risks the Government feels it can take in lifting lockdown.
The data that lays out Britain’s R value will shape the lives of everyone in the UK over the coming weeks and months, and MailOnline here explains how:
What is the R number?
Every infectious disease is given a reproduction number, which is known as R0 – pronounced ‘R nought’ – or simply R.
It is a value that represents how many people one sick person will, on average, infect.
Most epidemiologists – scientists who track disease outbreaks – believe the SARS-CoV-2 virus, which causes COVID-19, has an R0 value of around 3.
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, and how fast the virus spreads depends on the environment.
As an outbreak progress the R0 may simply be referred to as R, which means the effective rate of infection – the nought works on the premise that nobody in the population is protected, which becomes outdated as more people recover.
How does the reproductive rate compare to other infections?
SARS-CoV-2 is thought to be at 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 between 12 and 18 if left uncontrolled. Widespread vaccination keeps it suppressed in most developed countries.
Chickenpox’s R0 is estimated to be between 10 and 12, but this is controlled in the UK by herd immunity. So many people catch it as children and become immune to reinfection that it is unable to spread among adults.
Seasonal flu has an R value of around 1.5 but it mutates so often – there are often one or more new strains each year – that people cannot develop total immunity to it. Recovering from one strain of flu does not protect someone from others.
Ebola has an R0 of between 1.4 and 1.8 – this is low but it has so far only spread in countries with poor health facilities and its extremely high death rate (50 per cent) makes it a threat.
Mumps has an R0 of between 10 and 12, making it highly infectious, but the measles vaccine (MMR) protects most people in Britain from catching it.
The R0 for whooping cough, known medically as pertussis, is estimated to be 5.5. The NHS urges mothers to have the pertussis vaccine during pregnancy because they are able to pass immunity on to their baby naturally.
How is it calculated? And can scientists ever be sure of the number?
The R is not a set number and scientists calculate it by studying how fast the virus spreads in its perfect environment and also in society.
While the biology of the virus and the way it spreads – whether through coughs or blood, for example – will have some influence, but human behaviour is a bigger factor.
Tracking the rise in numbers of new cases, and how quickly the number of patients is doubling, are two of the best ways to estimate the R, according to senior lecturer in mathematical biology at the University of Bath, and author of the Maths of Life and Death, Dr Kit Yates.
He told MailOnline: ‘Most modellers will give uncertainty ranges with their estimates suggesting R could be as high as this or as low as that.
‘The R0 is not a fundamental property of the virus. It will change depending on the community through which the disease is passing.
‘[It] depends on three factors: the transmissibility (how easily the disease passes between people); the infectious period (the longer it is, the more chances there are for an infectious person to pass on the disease); and the population through which the disease is passing.
‘The more people there are and the more densely packed they are the easier it will be for the disease to spread, so we can’t just take the R0 measured in one country and use it in another.’
Dr Jennifer Cole, a biological anthropologist at the Royal Holloway university in London said: ‘It’s incredibly difficult to calculate [the R0] without doing it in retrospect.
She explained that detailed data can show how fast the virus has spread but they are most accurate when you’re looking back in time, not at the present day.
‘At the moment we don’t have exact numbers but we have a rough idea,’ Dr Cole added.
‘As long as you can say the R0 is between one and two, or between three and four, that’s broadly enough to make the decisions you need to on social distancing.’
Did Britain’s R number plummet when the lockdown was introduced?
Imperial College London’s COVID-19 Response Team estimated the R0 value for the coronavirus was 2.4 in the UK before lockdown started.
This meant that, before Prime Minister Boris Johnson ordered the national shutdown on March 23, every 10 people who caught the virus would infect 24 others.
But scientists have since calculated that the rate has fallen below 1, meaning the crisis will peter out if the situation stays the same.
London School of Hygiene & Tropical Medicine researchers said in a paper published at the start of April that they thought the number was 0.62.
They surveyed 1,300 people about their movements and contacts and to judge how many people they were likely to have infected if they were carrying with the virus.
And England’s chief medical officer Professor Chris Whitty told MPs in a Science and Technology Committee meeting recently the R was between 0.5 and 1.
His counterpart – the chief scientific adviser Sir Patrick Vallance – has also claimed it was at a similar rate, saying it is now between 0.6 and 0.9 across the UK.
In a Downing Street press conference, he said it was thought to be lower in London and added: ‘It’s not exactly uniform across the country’.
If the number is dropping, why are we still in lockdown?
Substantial drops in the virus’s reproduction rate and the number of people infected are vital for the UK to even consider moving out of lockdown.
Number three on the Government’s list of five criteria that must be met before lockdown can end is: ‘Reliable data to show the rate of infection is decreasing to manageable levels across the board’.
While Sir Patrick and Professor Whitty say they believe the R is now below one, the Government is, arguably, lacking the ‘reliable data’ to prove it.
COVID-19 testing had, until last month, been restricted to only hospital patients and medical staff, meaning the true scale of the outbreak was unclear.
Tests are being rolled out more widely now to people who think they might have the virus and also to more than 100,000 random people across the population.
A landmark report published by Imperial College London on March 30 showed politicians in the UK how the virus’s reproduction rate could change as the country progressed through lockdown, using models from other countries that had introduced strict social distancing measures earlier (pictured in series). That report came after one by the same team that estimated up to half a million people could die if the Government didn’t act, which was credited with persuading Boris Johnson to order the nation to stay at home on March 23
Officials will now want to see the number of new cases being diagnosed stay low even as they scale up testing, which would show the virus is on its way out. If numbers continue to stay low and even to fall for weeks that would demonstrate the illness is spreading slowly.
Because so few people have had the disease and developed immunity, it is vital that the number of people currently infected drops as low as possible before lockdown lifts, to avoid those patients triggering another outbreak.
Bath’s Dr Yates said: ‘If the UK relaxes social distancing now, while most of the population is still susceptible, it runs the very real risk of a second wave.
‘At the moment suggestions are that R0 might be around 0.7 which means we have a bit of room for manoeuvre in letting up on complete lockdown.
‘Provided we keep R0 below 1 then the disease will continue to die out. The reason we are holding on to complete lockdown for so long is because we want to bring cases down to a very low level and the quickest way to do that is to keep R as low as possible.
‘To some degree the impact of various different measures is quantifiable and modellers are running through a range of different scenarios in order to advise the government on the best policy.
‘But until we actually go through the experiment of lifting the different restrictions we will not really know the effect on R. You can expect a great deal of caution in the measures the government start to relax. Expect it to be conservative initially.’
Movements in Government suggest the lockdown in its current state is likely to continue until June, after Scotland’s First Minister, Nicola Sturgeon, yesterday said she thought it would still be too soon for change at next week’s three-weekly review, due to be held on May 7.
Professor Whitty did, however, offer a glimmer of hope in a science and technology committee meeting last week when he said the R being below one ‘gives a ‘little bit of scope for manoeuvre and ticking some things off while still keeping it below 1’.
How will testing 100,000 people track the R value after lockdown?
Sir Patrick Vallance, Britain’s chief scientific adviser, yesterday confirmed officials will move forward by using random population testing and numbers of official cases to work out how the R value changes in future.
He said at the Downing Street briefing: ‘At the moment we’re using a calculated R looking at all sorts of things including contacts, looking at genomics, looking at data from ambulances, hospital admissions, and so on, to calculate the R.’
As part of its three-point ‘test, track, trace’ plan, at least 25,000 people are being enrolled into a plan to test a sample of the population each month for a year to see if they are currently ill with the virus, tracking it over time.
Germany’s Robert Koch Institute is publishing the government’s daily best estimates of the country’s R0, showing it dropped by almost during April’s lockdown
In a second branch of the tracking project, people in 1,000 households across the country will submit to monthly blood testing to see if they have immunity to the coronavirus from being infected with it in the past.
The Government will also test 100,000 random people in a one-off swab testing scheme, to get an idea of what proportion of the population is infected at present.
Public Health England is carrying out ongoing antibody testing in its Porton Down laboratory to build up an idea of how many people have had the virus in the past and how they have developed immunity to it, and up to 10,000 people will be sent home antibody testing kits to add to this data.
Early results from these nationwide surveys are expected early this month and will help gather a picture of how many people are getting infected with the virus and how fast it’s spreading.
The London School of Hygiene & Tropical Medicine is also trying to estimate how much the virus is spreading by surveying people about their movements and social contacts in recent days and weeks.
It estimated in April that the R had dropped from 2.6 to 0.62 in the first month of the UK’s lockdown.
Will health chiefs publish the R number every day?
Health chiefs have yet to reveal whether they will publish the R number each day, despite the Prime Minister putting the number at the heart of the battle in his speech yesterday.
But ministers in Germany – which has been widely praised for its rigorous approach to halting the outbreak – do provide a daily update.
Situation reports published by the Robert Koch Institute, the country’s centre for disease control, show the R0 dropped below one on April 15.
The number fluctuates on a daily basis – it was 0.9 on Tuesday and 0.75 yesterday, meaning it may not be a reliable day-by-day measure, but could be useful to track over time.
Watching the R number as the country comes out of lockdown would be useful because it could reveal exactly how different measures affect the rate of infection.
The lockdown happened all at once but will be lifted piece by piece, meaning calculating how each restriction affects the number cannot truly be known until it is taken away.
Dr Robin Thompson, a mathematical epidemiology researcher at University of Oxford, said: ‘A key challenge now is to identify measures that can be relaxed that have only limited impacts on the value of R.
‘One of the reasons that this is particularly challenging is that interventions were first introduced in the UK within a few days of each other. As a result, it is hard to disentangle the relative effects of different interventions on the reproduction number.’