It was always going to get worse before it got better. But three weeks after Britain went into lockdown, the official death toll, certainly an underestimate, is unbearably bleak: the daily toll is nudging a thousand; total deaths stand at almost 10,000. That is 10,000 people who have had their lives cut short; 10,000 people who have left behind grieving partners, parents, siblings, children, most of whom would not have even been able to be there with them when they died. The scale of it is hard to comprehend.
There are early signs that three weeks of stringent social distancing measures may be starting to slow the growth in infection rates, a testament to the fact that the vast majority of the public have done as they were asked. Thanks to the superhuman efforts of frontline medical staff and a concerted push to expand critical care capacity, the NHS has not been overwhelmed to the point where the critically ill are being turned away from intensive care.
But the death toll at this point is surely higher than it needed to be. Why, when we had longer to prepare than countries such as Spain and Italy, are our daily tolls higher than the figures at what looks to be their peak – even though we are still thought to be at least two weeks away from ours? Why was the government so slow to introduce the social distancing restrictions that we know save lives and to procure ventilators and testing capacity? Why are so many frontline staff in hospitals and care settings working without the personal protective equipment they need, putting themselves, their families and the health service at unnecessary risk?
There is a disconcerting juxtaposition in the rising death toll and the blazing bank holiday sunshine, in the relief that the prime minister is recovering well and the briefing by government sources that the public has, to the detriment of the economy, followed social distancing rules more closely than expected. There are clearly those in government – who should know better – who believe that the benefit of the lives that will be saved by the social distancing of the past three weeks will be outweighed by the economic and health impacts of the lockdown and are making their views known anonymously, without sharing any of the evidence or modelling on which they are based, so that they can be critically assessed.
It is hard to overstate just how feckless this is. The World Health Organization rightly warned last week that a premature lifting of restrictions risks a deadly resurgence of coronavirus cases. For government sources to suggest that the public has, if anything, followed the rules too closely, undermines critical government messaging at a time of national crisis.
There must, however, be an open debate about the government’s plans for eventually loosening the lockdown. There are no easy answers – countries around the world are struggling with this question. The ultimate lockdown exit strategy is obviously the mass production of a vaccine, but that is thought to be at least 12 to 18 months away. Until then, there are two reliable routes to reducing the need for social distancing: investing in the discovery of new treatments that could reduce the risk of hospital admissions, and developing a robust system of widespread testing and contact tracing – along the lines of what the South Korean government has implemented – that could halt the spread of future outbreaks once we are past the peak of this one.
Testing is critical, yet, like so much of the government’s pandemic response, the approach to testing has been far too mixed and hampered by a lack of urgency. There is a lack of detail about exactly how the government intends to meet its target of 100,000 tests a day by the end of the month – already reduced from a 250,000 a day pledge – and it looks to be at risk after a bulk order of antibody tests has been found to be ineffective.
The government deserves credit for pledging £510m towards international efforts to develop a vaccine, one of the larger pledges from countries around the world. But there still remains an $8bn (£2.8bn) funding gap for vaccine development and production and the development and testing of effective treatments. Moreover, there is a real risk that a lack of global leadership means that the co-ordination needed to ensure equitable access to a vaccine does not happen. That could result in second and third waves of the virus bouncing back to countries that thought they had contained it. In an interconnected world, any successful exit strategy will be global, not national.
The lockdown inevitably comes at huge economic cost and will have an effect on the nation’s physical and mental wellbeing. But this can be minimised. In the moment of crisis, the government has broadly responded in the right way: an eye-wateringly large economic rescue package and targeted support for at-risk groups such as vulnerable children and domestic violence victims that must be further extended. But just as big a test is how it will act in the future. Will it take a similar approach to that of Conservative governments over the past decade: paying down the debt by cutting back vital public services and support for low-income families, while delivering expensive tax cuts for affluent individuals and highly profitable businesses? That will cost lives too, but those lives lost will be the result of a political choice, not an inevitability. They must not be used to make the case for relaxing social distancing at the cost of countless lives in the here and now.
There is a glimmer of hope: social distancing is working and the public remains supportive. But this support cannot cast away the shadows of these dark times. Thousands of families are mourning the loss of loved ones this Easter weekend; thousands more will do so in the weeks to come. In time, there will be scope to reduce the costly restrictions on our everyday lives, but for now, it remains as important as ever to stay at home to protect the NHS and save lives.