The UK may have already “missed the boat” for a pre-planned lockdown, forcing the government to introduce emergency restrictions like the ones in March, a leading government scientific advisor has warned.
Professor Graham Medley, who sits on the Scientific Group for Emergencies (SAGE), told journalists that a two-week “circuit breaker” lockdown could “buy time” to improve systems such as Test and Trace.
But, he said, with coronavirus cases rising exponentially across the country, the UK might have run out of time to act pre-emptively.
“The whole point of this is to do it before you have to,” Prof Medley said. “We are moving into a regime where we are going to have to do something.”
The idea of a planned “circuit breaker” lockdown was one of five “interventions for immediate introduction” suggested by SAGE on 21 September, only one of which was implemented by the government.
The concept came from Prof Medley and scientists at the University of Warwick, including Professor Matt Keeling, a member of modelling committee SPI-M, who presented a paper to SAGE suggesting that a lockdown could be scheduled across the October half-term in order to minimise disruption to students.
Prof Medley said that it was now probably too late to introduce a “precautionary break” at that point, as it would not be possible to give advance notice to people, businesses and public services, a crucial part of minimising the damage caused by such lockdowns.
He added: “In some ways we kind of missed the boat a little bit for these precautionary breaks. But I think they are something certainly to think about in terms of the future.”
Possible times for circuit breakers, he said, could be early December or over the spring half term.
As cases would invariably rise again after the break – the scientists said – the short lockdowns might have to be introduced repeatedly.
The news that all but one of SAGE’s recommendations were ignored by the government in September has caused controversy, with opposition politicians accusing the government of failing to “follow the science”.
Labour leader Sir Keir Starmer has warned that without a “circuit breaker” lockdown, Britain will “sleepwalk into a long and bleak winter”. The Liberal Democrats have also joined the call for a pre-emptive lockdown.
Asked why his paper had not been released until today, despite being presented to SAGE in September, Prof Medley said: “I don’t know why the SAGE version of the paper has not been published.”
Asked on Sky News this morning whether the government was considering such a measure, cabinet minister Thérèse Coffey said: “I do not believe that the prime minister wants to set off on a national lockdown.”
She added that the move would “not be fair” on areas where the rate of infection is low.
The paper, which has not been peer-reviewed, suggests that a full lockdown, with stay-at-home orders and school closures, could save more than 7,000 deaths over the rest of the year if the virus was growing by 3% a week, although the scientists stress that this number is not a forecast.
But the paper does not consider crucial factors which would determine the success of any restrictions, including the level of public support, and what action would be taken during the “precautionary break” to ensure further restrictions are not needed in future.
“A precautionary break is not a lasting control measure, but effectively buys more time to put other controls in place; it takes us ‘back to a time when cases were lower’,” the authors said in a statement.
“The reduction in cases also allows measures which are resource limited [such as test, trace, and isolate] to potentially have a greater impact.”
The scientific paper, which used a model to estimate the impact of various interventions, concluded that stricter lockdowns were more effective. Another key factor, according to the model, was timeliness.
“There are no good epidemiological reasons to delay the break,” the scientists write. “This will simply push back any benefits until later, leaving more time for additional cases to accumulate.”
Other epidemiologists disagreed about conclusions of the model, which they said only considered new infections, and thus did not take into account the fact that case numbers, hospitalisations and deaths would continue to rise even after the lockdown was introduced, because of the lag in diagnosis.
Paul Hunter, professor in medicine at the University of East Anglia, said lockdowns “need more than a couple of weeks to achieve a substantial reduction in numbers”.
In order to keep cases at a steady rate, he said: “You would need to have as many as twice as many days in circuit-break lockdown as relaxed days, making such short lockdowns little different from the more prolonged lockdown we saw in March, April and May.”
The paper does not directly consider the economic costs of a circuit breaker lockdown, although it does note that “a short lockdown period would limit the economic costs of such a measure”, if it avoided the need to introduce a longer break.
Asked about this, the scientists said that while any lockdown would inevitably cause significant economic harm, as well as harm to mental and physical health, planning the intervention would mean the worst of these costs could be avoided.
If the outbreak was growing at 3%, then the paper suggests a circuit-breaker lockdown could reduce hospitalisations from 132,400 to 66,500.
If the infection rate was growing faster, the impact of the lockdown would be greater, saving as many as 107,000 deaths – although the scientists stress that this is not a realistic possibility, as “the worst-case scenarios would never be allowed to continue without intervention”.
A less strict lockdown, where schools stay open but hospitality venues are closed, would have less impact – the scientists estimate – cutting deaths to 15,600 under the moderate growth scenario.