Three things lockdown critics just don’t get

Here in England, the British Prime Minister, Boris Johnson, is under fierce attack from his backbenchers over both the four-week lockdown that is coming to an end, and the system of tiered restrictions that will replace it, which means that almost everybody will still be subject to heavy restrictions. These critics are, for the most part, very muddled. While I would not suggest that Mr Johnson’s management of the pandemic has been particularly competent, I do think his overall strategy is the right one.

Still, the critics are right about a couple of things. The first is that lockdowns will not eliminate the virus, which has been a realistic objective in Asia and Australasia. This is because, unlike them, we cannot seal off the country from people coming in. That would mean closing almost all airports, ferry ports and the Channel Tunnel. The trickle of people allowed in (including returning Britons) would be quarantined under guard. Goods would have to be picked from ports by drivers based in this country. It would make Brexit look like a walk in the park. No European country, or American one come to that, can enforce such a regime. It is remarkable that so many Asian economies, as well as Australia and New Zealand, are able to do this. Without having to deal with such a volume of incomers, it is possible for a rigorous test and trace system to stay on top of the virus. New Zealanders can now go to rugby matches and concerts without social distancing. The economic cost is substantial, but this regime seems to be popular with those that live there.

The second thing that the critics get right is that the costs of an effective lockdown are huge, in both jobs and wellbeing. and that the longer the lockdown goes on for, the greater the cost. But no supporter of lockdown suggests otherwise. They simply say that the alternative is worse. That is because of three things in particular that the critics mostly fail to grasp.

The first is that infectious diseases grow exponentially, and not arithmetically, unless you can impose restrictions that reduce the reproduction rate down to one or less. And that means being very restrictive: the virtual cessation of social life (England’s Tier 1 is not enough, current evidence suggests). If the reproduction rate is above one, then the disease keeps on getting worse, and will accelerate. The critics seem to suggest that there is some form of equilibrium to be found between the level of restrictions and the prevalence of the disease. So, for example, a high level of lockdown means, say, one hundred deaths a day, but a looser one means a thousand. If R is above one, however, there is no such equilibrium. The equilibrium is not a function of lockdown restrictions, but the achievement of herd immunity – which means that 70% or more must be immune (the widespread assumption being from having already caught and survived the virus), and so breaking the chain of infection. The cost of that is massive. In Europe levels of significant herd immunity have only been observed in Italian towns were the disease has killed 1% or so (see this article in the Economist).

And the second point that few critics grasp is that the damage wrought when the virus shows high levels of prevalence is about much more than a few extra dead bodies. The disease will reach a point where it is be seriously disruptive. That people can’t see this was driven home to me when a senior Conservative MP Mark Harper was interviewed on the radio. He trotted out the familiar trope than people were underestimating the costs of lockdown, which had to be weighed against the benefits. He gave star billing among the costs to reduced access to healthcare services during lockdown. And yet there will be no access to such services once the epidemic starts to overwhelm them, and it is fear of just that which is the main driver of lockdowns; without lockdown health services will be overwhelmed as sure as night follows day. And it won’t be just health services that suffer. Absenteeism will rise dramatically, disrupting all manner of services. And fear will keep at least 40% of the population at home, with the inevitable toll on mental health and the economy. Covid-19 is much deadlier than flu (or at least the strains of flu normally seen each winter), and cannot be weathered in the same way.

And the third point? It is simply not feasible to shield the vulnerable while letting those with a low risk of being seriously ill to get on with life as normal. The disease will strike down even younger and apparently healthy people; and it can inflict lasting damage even if you survive it. But the chances of serious consequences for most people are quite small (and for them comparison with flu has more validity). But the flip side to this is that many others are at serious risk: anybody over 60 or with many quite common health conditions such as diabetes or heart disease. I have seen an authoritative estimate that these are about 20% of the population. But these people don’t live isolated lives: they depend on contact to some degree with healthier people. These people also have to shield, to protect those they are close to. This group is not only very numerous (somebody has plausibly suggested another 20%), but it is much harder for such people to successfully shield themselves form the outside world. In the second wave of the epidemic, where vulnerable people have been much more successfully shielded than the first, there has been a clear pattern. Firstly younger people catch it, largely without serious symptoms. Then it is passed on to working people whom they interact with (shop staff, security guards, and so on). and from these it moves on to the seriously vulnerable. It is not enough to suggest that people should simply take the level of precaution that is appropriate to themselves. That would mean that many working people would have to furloughed and somehow replaced at the front line.

There really are no alternatives if you cannot seal the country’s borders Personally I placed high hopes on rigorous test-and-trace systems, such as those operated in Germany. We have not attempted anything like German rigour in the UK, instead going for massed centralised families with a high theoretical volume but almost no impact on the course of the disease. But even in Germany the system gets overwhelmed once the virus reaches a certain level, and you are back to lockdowns. Sweden’s rather laxer regime is sometimes mentioned as an alternative, but that is breaking down too. Its advocates had suggested that infection levels would fall in the Autumn as herd immunity started to impact. But it hasn’t, because in fact Swedes had been exercising social distancing to such an extent that not enough people were being infested (and with the economic and other damage that followed). If enough people had been infected their health systems wold have collapsed.

All of which is very grim, were it not for one thing: the fact that vaccines are on the way. We don’t know much about the various vaccines, beyond basic safety and efficacy. In particular we don’t know how much they would slow transmission of the virus. But they are enough to make huge difference and allow lockdowns to be eased. Quite why Conservative critics are still banging on with their complaints about lockdowns when relief is at hand is one of the pandemics’ many mysteries.

One thought on “Three things lockdown critics just don’t get”

  1. A recent analysis in the FT has documented that as a percent of GDP the UK has spent 2-3 times as much as France, Germany and Italy in responding to the virus, yet it has one of the highest official coronavirus death rates and is on course to record the largest economic contraction in the G7. So something has gone wrong. But I agree with the thrust of this post that we are where we are, and that we have to keep the virus in check – indeed part of what has gone wrong is that of not acting pro-actively enough quickly enough; and the danger is that the mistake is going to be repeated again, for example in too lax a regime at Christmas in not offering sufficient help to people to isolate, and in not supporting employees at risk against employers requiring them to come to work..

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