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WHAT DOES A SUSTAINABLE EXIT STRATEGY LOOK LIKE?
“Lockdown saves lives but it isn’t sustainable.” Thus begins a 38-page report by the TBIGC research organisation, indicating the ideal path to ‘the new normal’ imposed by COVID-19. The researchers have stated that although confinement is a given at this point in time, the immense collateral damage it is causing (both economic and health-related) requires a smart exit strategy. In this article we summarise the main points made in the report.
THE CONSEQUENCES OF LOCKDOWN
• THE ECONOMIC AND HEALTH CONSEQUENCES OF LOCKDOWN: The GDP in the UK is predicted to fall by 35% and unemployment to rise to 10%. The health sector itself has currently suffered a change in activity of 50%. Confinement is hitting those earning lower incomes the hardest.
• HEALTH AND EDUCATION: Just six months of lockdown could result in 60,000 excess cancer deaths in the UK. Daily hospital visits for suspected heart attacks have been halved from 300 to 150. Learning has also been affected, with test scores expected to be reduced by 6% of a standard deviation.
SUGGESTIONS FOR LIMITED NORMALISATION
• SCHOOLS: The Institute reports that children are less likely to contract (or suffer severe symptoms of) COVID-19 (only 2.4% of cases are aged less than 19 and of these, only 2.5% showed severe symptoms). The Institute therefore sees the reopening of schools as a viable first step when easing lockdown.
• AGE SEGMENTATION: The Institute recommends that young people be allowed to return to work first, as they have the lowest personal risk. Warwick University proposes releasing workers aged 20-30 who do not live with their parents.
• SECTOR SEGMENTATION: Reopening lower-risk sectors of the economy (such as manufacturing industries) could help lessen losses and keep the Ro (reproduction number of the virus) lower than if everyone were allowed to return to work at once. Restaurants can eventually open if they maintain social distancing and cinemas can be half-filled (my opinion: the latter could take longer as dining out and watching movies often involve being in a closed environment with air conditioning currents).
• GEOGRAPHIC SEGMENTATION: Less affected areas can ease restrictions first.
MINIMISING THE TRADE-OFF
Relaxing confinement measures could raise the Ro. Two measures can be taken to lower risks. These are containment and shielding (protecting the most vulnerable – our elderly). The most obvious means of containment are:
1. Mass testing.
2. App-augmented contact tracing: apps can act as a ‘passport’ out of lockdown. The Institute estimates that 60% app usage could end the epidemic.
3. Mask acquisition and production on a vast scale for frontline workers and those in the retail, transport, and service sectors. Masks are most effective in public places but “fail to prevent infections in large crowds.” Shielding essentially means that the last members to exit confinement should be older people and those with pre-existing health conditions.
WHAT IS EUROPE DOING?
The Institute notes that many countries are past peak infection rates. Testing capacity is limited, and tracing is still in its early stages. The European Commission advises governments to expand testing, leave one-month gaps between different stages of exit, and lift measures locally, extending the possibility of exit gradually. They should relax EU borders before external ones, insist services have restricted opening hours, and continue to enforce confinement for vulnerable groups.
Plaza Cibeles of Madrid, empty due to the Coronavirus outbreak
TIMELINES FOR EASING CONFINEMENT
The Institute provides timelines for easing suppression depending on when the first infection peak occurred. They predict that Spain, for instance, will end lockdown on May 10, given that in midApril, manufacturing, construction, and some stores reopened. They noted that East Asia has a stricter outlook on confinement. Several countries have faced a renewed spike in infections (Singapore, South Korea, Hong Kong, Japan) though their numbers are way below those found in Europe.
CURRENT STRATEGIES:
The report has an excellent chart you should have a look at if you wish to compare strategies. It essentially shows that some countries (e.g. Germany) have already started their exit via the partial lifting of restrictions by sector, the partial use of masks, partial app-based tracing, and mass testing. Sadly, Spain is behind in these aspects with respect to other countries (including Italy, France, Austria, Denmark, South Korea). In fact it was dismaying to see Spain as the country with the largest number of red dots (meaning no action was being taken as of when the Institute recently printed its report) in areas such as mass testing, and app-based tracing.
SPAIN
President Pedro Sánchez
Spain also had red dots next to the reopening of schools and age segmentation, but given our numbers and infection rate, are we currently ready for these strategies? Taking more active steps in this respect is dependent, above all, on testing but we have faced so many setbacks – including the higher Ro following 8M and the government’s purchase of defective tests and masks (which resulted in tens of thousands of health workers being infected). The higher the rate of new contagions in a country, the slower the exit will be.
Early last month, (El País, April 7) the government announced its intention to conduct ‘rapid testing’ on 36,000 families. As stated by New York Governor Andrew Cuomo, however, the fact that people can potentially be infected with the virus a second time means that this type of test is useful in a limited sense – it enables us to understand what percentage of the population has been infected. Much wider testing is needed if we are to create a ‘passport’ system that will enable us to conduct an effective and safe lockdown that will kickstart the economy once again.
Recently, President Sánchez stated that Spain was one of the countries that conducted most tests on the public. This contrasts with data compiled by the University of Oxford, which does not include Spain in its list of top countries that conduct tests (the list measures the total number of COVID-19 tests per 1,000 people).
On 28th April the Spanish Government issued a four phase plan setting out the gradual lifting of the lockdown. You can access this plan in detail on our Facebook page.
The Spanish government recently announced that it would be creating a lockdown exit strategy that promises to be “asymmetric (i.e. lockdown will vary according to the extent of the problem in different areas), gradual, and organised.” The plan, President Sánchez said, would be announced in a matter of days to the Council of Ministers and sent to the respective Presidents of the autonomous communities. The consequences of these decisions are high but by Sanchez’ words, it seems our strategy won’t be very different from the one suggested by the TBIGC. It will involve exiting by age, sector, and state of health. The only real difference is the time frame. We could, in theory, have already begun taking many of the crucial first steps.
