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In @TheCriticMag, I've set out the case for ending the lockdown on April 14th, the day after Easter Monday. Or if the Government must extend, by the following Monday so children can return to school after the Easter holidays. https://thecritic.co.uk/has-the-government-over-reacted-to-the-coronavirus-crisis/
I make three main arguments.
First, that the cost of the economic bailout Rishi Sunack has proposed is too high. Spending that kind of money to extend the lives of a few hundred thousand mostly elderly people with underlying health problems by one or two years is a mistake.
First, that the cost of the economic bailout Rishi Sunack has proposed is too high. Spending that kind of money to extend the lives of a few hundred thousand mostly elderly people with underlying health problems by one or two years is a mistake.
That may sound callous, but in normal times the National Institute for Clinical Excellence (NICE) puts an upper band of £30,000 on the cost of adding one quality-adjusted life year (Qaly) and by that metric we're massively over-spending. If we're going to spend hundreds of
billions to extend life, there would be much more efficient ways of doing it, i.e. to yield more Qalys. For instance, we could simply invest it in the NHS.
Second, this isn't a trade-off between public health and economic health, but between saving lives now and saving them
Second, this isn't a trade-off between public health and economic health, but between saving lives now and saving them
in the future. When economies contract, life expectancy declines, due to, among other things, a rise in poverty, violent crime and suicide. During the global financial crisis of 2007– 09, the suicide rate in Europe increased by 6.5% according to the @WHO https://www.latimes.com/science/sciencenow/la-sci-sn-recession-suicide-prevent-20140611-story.html
Philip Thomas, professor of risk management at Bristol University, has calculated that if the UK’s GDP falls by more than 6.4% per person as a result of a prolonged lockdown, more years of life will be lost than saved http://jvalue.co.uk/papers/J-value-assessment-of-combating-Covid-19-Thomas-23.3.2020.pdf
And it's likely the the impact of a prolonged lockdown on the UK economy would be greater than the global financial crisis – a 15% fall in GDP over two years, rather than 6%. In effect, the cure will be worse than the disease.
Admittedly, ending the lockdown will be politically
Admittedly, ending the lockdown will be politically
difficult if it results in the NHS being overwhelmed and the television news starts broadcasting nightly footage of patients dying in hospital corridors. But – and this is my third argument – I think that's unlikely to happen. There's growing evidence the @imperialcollege team
over-estimated the demand for hospital care and under-estimated the surge capacity of the NHS. According to Sunetra Gupta and her team at @UniofOxford, 50% of the UK population has already been infected https://www.medrxiv.org/content/10.1101/2020.03.24.20042291v1
That means the demand for hospital care will be far lower than anticipated by Neil Ferguson and his team at @imperialcollege if the measures are relaxed. Moreover, the superb response of the NHS in the two weeks since Ferguson published his report (March 16th) suggests its surge
capacity is greater than he anticipated. For instance, the Nightingale Hospital, with the capacity to treat 4,000 patients, is due to open this week.
Even so, the Government may still be unwilling to take the risk – or, rather, it may be unwilling to risk taking a decision that
Even so, the Government may still be unwilling to take the risk – or, rather, it may be unwilling to risk taking a decision that
will mean a rise in *visible* deaths even though prolonging the lockdown will inevitably mean a greater number of *invisible* deaths. In which case, as soon as the @DHSCgovuk takes receipt of the 3.5 million serological tests it has ordered, it should test a large representative
sample of the UK population to determine just what percentage has been infected. That will enable the Government to make a more accurate estimate of the number of people likely to require critical care if the suppression measures are relaxed. I strongly suspect it will be well
within the NHS’s newly-enlarged surge capacity. One reason for optimism is that in Sweden, where the Government has continued to pursue a mitigation strategy, the health service has not been overwhelmed https://unherd.com/2020/03/all-eyes-on-the-swedish-coronavirus-experiment/
I'm not suggesting we end social distancing altogether, just return to a mitigation strategy – home quarantining of suspect cases and those living in the same households, and social distancing of the elderly and others most at risk. But get the economy working again ASAP.
One final point. Some people reading this will think, “I bet he changes his tune if he gets the virus.” In fact, I think I’ve got COVID-19. I became symptomatic seven days ago and am now anxiously waiting to see if the disease spreads to my lungs. I’m 56 with no underlying health
conditions, so my odds are good. But if the Government does end the lockdown, and it turns out that by the time I require critical care the NHS cannot accommodate me, I won’t regret writing this. Yes, I probably have at least 20 years of healthy living ahead of me, but I’ll be
the exception. In the unlikely event of the NHS being overwhelmed, the majority of people whose lives could have been saved only have one or two years left and those will not be good years. It isn’t worth spending hundreds of billions of taxpayers' money to save them, nor is it
worth a 15% drop in GDP which will inevitably result in more loss of life. My death would be acceptable collateral damage. //ENDS
