Earlier this month Leo Varadkar, Ireland’s taoiseach, and Boris Johnson, Britain’s prime minister, each faced a fraught dilemma. Coronavirus infection rates were falling and the economic devastation from lockdowns was rising, tilting the calculus towards easing restrictions.
But some experts said it was too soon, that infection rates were still too high, that testing and contact-tracing systems were not ready and that the pandemic would roar back.
Varadkar extended Ireland’s lockdown to 18 May. Johnson rolled the dice and began to unlock – at least for England, while Wales, Scotland and Northern Ireland stuck with the “stay home” recommendation.
The verdict on each man’s decision may take months but the extent of divergence is already apparent.
On Monday, when Ireland started phase one of its gradual easing, new daily cases had tumbled to about 11% of the country’s late April peak.
When England started its first phase five days earlier on 13 May, new daily cases had fallen but were still about 75% of its late-April to early-May peak.
There was another stark difference. Ireland started lifting lockdown only after testing and contact-tracing systems were fully scaled up. England took the plunge before its systems were ready.
“I’d say it was recklessly premature,” said Seán L’Estrange, a social scientist at University College Dublin, who has written about testing and studied tracing. “I honestly fear [the level of cases in the UK] will go up fast in the coming weeks.”
That was especially concerning because the UK appeared to lack sufficient testing and contact-tracing capacity for such a surge, said L’Estrange. “Perhaps they can get it up and running quickly. But they’re behind the curve and playing catch-up. You have to have sufficient testing and contact-tracing capacity ready to go before you ease restrictions. They’ve put the cart before the horse. They released the virus without having the apparatus in place to control it, and they’ve released it at a high level.”
Ireland’s lockdown easing started after England’s and is scheduled to go more cautiously and slowly, with the last phase starting on 10 August, and schools opening in September. England’s plan envisages schools starting to open on 1 June and the final phase of lifting starting on 4 July.
John Edmunds, a professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine and a member of Sage, the government’s Scientific Advisory Group for Emergencies, told the House of Lords science committee on Tuesday that the decision about schools was political. “It is not a scientific decision. Scientists can offer some advice.”
Downing Street has defended its lockdown exit strategy as science-based and an expression of confidence in the public’s ability to “stay alert” while returning to work and interacting with others.
This week Matt Hancock, the health minister, announced that everyone over the age of five in the UK with symptoms could now be tested for coronavirus. Michael Gove, the Cabinet Office minister, said the government had recruited 17,000 contact tracers – on course to reach its 18,000 target – and that the first tracers started work on Monday.
However, L’Estrange fears the system will struggle because as the public becomes more mobile, the number of infections and number of contacts for each infected person rises. “Once you’re allowed out and about again the chance of you getting infected increases and so does your number of contacts. That’s why you need lots of surplus at the time of release.”
The UK is betting heavily on a contact-tracing app that has been trialled on the Isle of Wight and is due for national rollout at the end of May.
Ireland has been working on a similar app that relies on Bluetooth technology but officials are now playing down its importance amid privacy concerns and other obstacles. Both governments may end up dropping the technology, said L’Estrange. “I suspect the app is a white elephant.”
An editorial in the British Medical Journal this week excoriated the UK’s record on testing and tracing. “Meaningless political soundbites promising to recruit 18,000 contact tracers, test 200,000 people a day, or invest in unjustified contact tracing apps, divert focus and could lead to more deaths. These headline grabbing schemes should be replaced by locality-led strategies rooted in communicable disease control,” it said.
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