Could Boris’s four tests slow down the route out of lockdown? PM sets criteria for freeing UK

Boris Johnson this afternoon unveiled his long-awaited roadmap out of lockdown for England, along a road that has four potentially sizable obstacles in the carriageway. 

The 60-page document  set out the steps that will be taken to return the country to normal after more than a year of shutdowns and disruption.

It will start with children returning to school from March 8 and expected to include further easing of outdoor meeting restrictions at the end of March.

Shops would then reopen in April and pubs, bars and restaurants in May.

This plan is already under attack from critics who want a more ambitious pace to be set amid increasing good news about the efficacy of vaccine in cutting down the number of deaths and cases of coronavirus. 

But Mr Johnson’s roadmap also sets out four tests that will have to be met before each stage can be completed.

Failure to meet just one of the four would allow ministers to postpone the latest easing, although Mr Johnson has been adamant he wants the lockdown release to be irreversible.

The criteria are:

  • No new concerns emerging about variant strains
  • Vaccine rollout continuing well
  • Jabs shown to reduce hospital admissions and deaths, 
  • No surge in hospital cases.

These four tests might be seen as pretty vague and seem designed to allow ministers wriggle room.

Notably the rules do not mean that the loosening must stop if infections rise – as ministers believe they inevitably will when schools open. Instead the focus will be on serious illness that increases pressure on the NHS, with the goal of keeping the R number below one apparently downgraded. 

Previous modelling has suggested that a third peak will happen when restrictions are eased, with the question whether it risks overwhelming capacity.

He we look at each of the four tests and their strengths and weaknesses.   

Mr Johnson’s roadmap sets out four tests that will have to be met before each stage out of lockdown can be completed.

Vaccination programme continues successfully 

So far the news about vaccinations has been almost uniformly positive.  

This news can be seen in context with the announcement yesterday that every adult in the country will be offered at least one dose of a Covid vaccine by the end of July. 

Health Secretary Matt Hancock also confirmed that everyone over 50 will be offered at least a first dose by April 15, rather than by May, as previously suggested.

But there is still the issue of the second dose required of all the vaccines currently available. 

As more people have been given the first dose, so more will need the second. Officials have already said that the rate of first does is likely to fall in future as more people are given their second dose.

Conservative former minister Mark Harper asked why restrictions are required after the most vulnerable groups have been vaccinated.

He said: ‘Could I just press (the Prime Minister) on the thoughts behind vaccinating groups one to nine, so that’s everyone over 50 and those 16 to 64 with a health condition that makes them vulnerable to Covid.

‘Those groups account for 99 per cent of deaths and around 80 per cent of hospitalisations. So for what reason, once they’ve been vaccinated and protected from Covid by the end of April at the latest, is there any need for restrictions to continue?’

Boris Johnson responded: ‘(Mr Harper) makes an excellent point. The difficulty is that of course there will be at least a significant minority who either have not taken up the vaccine, in those vulnerable groups for the reasons that the House has been discussing, or who, having had the vaccine… not given sufficient protection.

‘We believe that the protection is very substantial but there will be a large minority who will not have sufficient protection and the risk is that if you let the brakes off, then the disease could surge up in such a way as again to rip through those groups in a way that, alas, I don’t think anybody in this country would want to see.

‘So I’m afraid it’s pure mathematics, there is still a substantial body of risk and we also need to wait and see exactly what the effects of the vaccine are. There are some promising data but I think what the country will want at this stage is caution and certainty and irreversibility and that is what we aim to provide.’

Evidence vaccines are cutting deaths and serious cases 

Today it was revealed Covid vaccines being used in Britain are working ‘spectacularly well’ and cutting hospital admissions by as much as 95 per cent, according to the first real-world evidence of the roll-out.

Researchers today called the results ‘very encouraging’ and claimed they provided ‘compelling evidence’ that they can prevent severe illness. Scientists counted Covid hospital admissions in Scotland among people who had had their first dose of a jab and compared them to those who had not yet received a dose of either the Pfizer or Oxford/AstraZeneca vaccine.

In a ray of hope for Britain’s lockdown-easing plans, results showed the jabs slashed the risk of being admitted to hospital with Covid by up to 85 and 94 per cent, respectively, four weeks after a single dose.

The study — carried out by academics from the universities of Edinburgh and Strathclyde, as well as Public Health Scotland — was the first of its kind. But it currently doesn’t have enough data to analyse how well the jabs prevent death or stop transmission of the virus.

Similar data emerged from tests in England. A single shot of the Pfizer vaccine cuts the chance of hospital admission and death from Covid-19 by more than 75 per cent among the over-80s, according to real-world data from Public Health England (PHE).

A separate study found the Pfizer/BioNTech jab also offered a high degree of protection for younger age groups.

Among the over-80s, Covid testing data on more than 12,000 people found at least 57 per cent protection against coronavirus 28 days after vaccination with a single dose of Pfizer, rising to 88 per cent after a second dose. 

No surge in hospital cases with coronavirus

One of the key aims throughout the pandemic and the three lockdowns has been making sure that NHS hospitals are not overwhelmed.

Nightingale hospitals were set up to provide added capacity, but in the end were hardly used, even at the height of the crisis.

Hospital admissions data is easy for scientists, NHS leaders and politicians to monitor.

It seems unlikely that there would be a surge in hospitalisations that wasn’t preceded by issues with the vaccination programme as outlined above, so it would seem likely that this would be the last of the four tests to be failed.

But the risk is nonetheless still there in the background.  Britain today recorded 10,641 coronavirus infections in the first week-on-week rise since the beginning of January.

But at the same time deaths have tumbled to the lowest levels since mid-December with 178 new victims. This is because there is a lag between new cases being recorded and those cases coming to a conclusion, for better or for worse.

Department of Health figures show Covid cases are 9 per cent up on last Monday, when 9,765 were declared. But fatalities have dropped by almost a quarter, from 230. Today’s toll is the fewest daily deaths recorded since the 144 on December 13.

No new concerns emerging about variant strains

This is probably the largest question mark hanging over the roadmap out of lockdown and the reason why international travel is one of the last restrictions to be lifted.

The Oxford/AstraZeneca vaccine is less effective against the South African strain, although a booster jab should be ready in the autumn.

However, there is also the possibility of one or more strains emerging in the coming weeks and months that the vaccines offer even less protection against.

This could cause a hold-up in the lockdown release. An April review will provide recommendations about when and how full international travel should resume, while managing the risks of new variants of coronavirus.

Much will depend on the spread of variants deemed ‘of concern’, as well as vaccine roll-outs at home and abroad.

Britain tightened its borders earlier in February, introducing additional Covid-19 testing requirements and hotel quarantines for arrivals from some countries over worries about new variants that might be more resistant to current vaccines.

Unwinding restrictions could involve making greater use of the test to release scheme, under which those arriving from abroad pay for a test to shorten a 10-day quarantine.

The government is also looking at a system of allowing vaccinated people to travel more freely abroad, it said.

The Scottish study showed that both vaccines offer a high level of protection against being hospitalised with Covid from just two weeks after a single dose, with the protection kicking in only a week after injection. There were not enough data to compare the two, the scientists said, although AstraZeneca's appears to work better in the early stages

The Scottish study showed that both vaccines offer a high level of protection against being hospitalised with Covid from just two weeks after a single dose, with the protection kicking in only a week after injection. There were not enough data to compare the two, the scientists said, although AstraZeneca’s appears to work better in the early stages

In a ray of hope for Britain's lockdown-easing plans, results showed the jabs slashed the risk of hospital admission from Covid by up to 85 and 94 per cent, respectively, four weeks after the first dose. The graph above shows how the vaccine worked in different age groups

In a ray of hope for Britain’s lockdown-easing plans, results showed the jabs slashed the risk of hospital admission from Covid by up to 85 and 94 per cent, respectively, four weeks after the first dose. The graph above shows how the vaccine worked in different age groups

But such a system would have to be fair and not unduly disadvantage those who have not been vaccinated, it said, warning it would take time to implement.

Conservative MP Richard Fuller today urged Boris Johnson to rethink international travel restrictions.

Mr Fuller told the Commons: ‘May I thank the Prime Minister for his statement and in particular the inclusion of dates that help businesses plan.

‘But with respect to international travel, the inside page of our passport states that ‘in the name of Her Majesty, all those whom it may concern, to allow the bearer to pass freely without let or hindrance’.

‘And with regard to quarantine hotels, may I remind the Prime Minister that just because a policy is popular does not mean it is right.’

Mr Johnson replied: ‘I have a high regard for (Mr Fuller) who I’ve known for many years and I know he speaks for many in our party and beyond in what he says.

‘These are very difficult judgments to make, as I know he appreciates, but I think that it is right when you are facing a pandemic like this and the risk of new variants to have a very tough borders and quarantine policy indeed.’