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  • Will the Government publish the advice and calculations on which the plan is based?  There’s a good argument against: that the scientists who provide it will react badly to criticism of their work; that they will then withdraw their services, and that Ministers will thus find it harder to get scientists to serve at all.  But there’s a better argument for: that open sourcing the data means that errors are less likely to be be missed, and that the stakes are so high that this consideration must be paramount.
  • On what basis are Ministers responding to the R rate?  What matters most isn’t the reproduction rate of the virus in itself.  But, rather, where that rate is rising and falling – and among whom.  If it’s increasing faster in hospitals and care homes, for example, than in factories or workplaces (as appears to be the case), that would suggest ordering a faster relaxation of the lockdown rules than the headline rate of transmission might seem to imply. Or regional variations in lifting could follow regional variations in rates.
  • What’s the Government’s worst case scenario for the NHS?  The foundation stone of its strategy to date has been “Stay Home. Protect the NHS. [Our italics.] Save Lives.”  This being so, it must have an estimate of the worst case scenario for the service – one that would risk Italy-style pictures on our TV screens of patients in waiting rooms “gasping for air, clutching at their chests and at tubes pumping oxygen into their oxygen-starved lungs”.  What is it – and when could the NHS cope with the numbers, if ever?
  • Is the 200,000 number for testing an aspiration or a promise, and does it cover tests or capacity?  Ministers now want to protect the health service through a South Korea-style plan: first by reducing the number of cases and deaths; then stamping out reoccurences by testing people, and then tracing others than those infected have been in contact with.  Boris Johnson has referred to 200,000 tests by the end of the month.  But it isn’t clear what this means in practice.
  • How many tracers will it have and by when?  Ministers will need a volunteer army of tracers to track down those people who tests show to have the virus or who report having it; then find out who they’ve been in contact with – and then trace those contacrs.  Matt Hancock wants to recruit 18,000 tracers. But that number will be related to our last question – how many people are being tested and by when.  If the number gets up to 200,000 by the end of the month, that 18,000 number could be an underestimate.
  • What level of App take-up are Ministers expecting?  The Government is relying on people downloading and using an app as part of its test and trace plan.  What level of take-up does it need to work?  One estimate is that if 60 per cent of the population use the app then new Coronavirus cases could be “substantially reduced”.   The take up of apps abroad for the same purpose has been about 2o per cent.  It may also drop its own centralised model in favour of the Apple/Google decentralised one.
  • What’s the Government’s estimate of non-Coronavirus healthcare costs to date?  That there is an cost is uncontrovertible: cancelled operations, impaired mental health, domestic and child abuse, and so on.  Some of these are human costs – deaths that wouldn’t otherwise have happened. Some are also costs that the police and social services may eventually have to meet.  But the specific healthcare are an obvious starting-point for enquiry – given the centrality of the NHS to Ministers’ strategy.
  • What’s its estimate of the costs of lockdown to the economy to date? The costs to the economy are not the costs of the lockdown.  The economic contraction set in during early March; the lockdown was imposed on March 24.  Social distancing would have happened anyway.  So the question, rather, is what the additional cost of this shutdown, and the less stringent one that preceded it, has been.  It would be impossible to find an exact answer, but government must have, or be able to calculate, an estimate.
  • What’s its calculation of the total cost and total saving of the lockdown? Again, it would be impossible to find an exact answer, but possible to work out an estimate.  The method?  To assign a monetary value to each human life in Britain (and, yes, such calculations are made); then to estimate how many lives have been saved, from which a figure can be produced; then to calculate that total costs of the lockdown and, to see whether these are  greater than the saving.
  • Are there any elements of the lockdown that wouldn’t be reintroduced? There’s still much that isn’t known about the virus.  But more is known now than was in early March.  Do the Government’s advisers now believe that there is relatively little risk of catching it in the open air?  If so, doesn’t that suggest that the present strict bars on outdoors activity, introduced in late March, wouldn’t be reintroduced even were the present lockdown first relaxed but then later tightened again?

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There will be better questions than these and there will be worse.  Boris Johnson will strain to avoid answering any of them, and ask the public to take the Government on trust.

His policy has had its successes (ramping test numbers up quickly) as well as its failures (settling on test-and-trace the best part of a month into the lockdown, in its third iteration of policy on the subject).

Like most people, we think it’s better to wait for the eventual inquiry before making a final judgement, let alone rushing into one now when so much about the virus is still unknown.

But it’s fair to say that even though international comparisons are plagued with difficulty, Britain is unlikely to win any prizes for keeping cases and numbers down – or for consistent Government handling of the crisis.

Which is why the plan that the Prime Minister will announce tomorrow evening can’t simply be taken on trust.  It should be questioned.  Hence all the above.

Finally: we believe there is a solid political basis for a slow easing, based on the centrality of the NHS’s capacity to cope to the Government’s strategy.

If it didn’t, Johnson would be left with a bust healthcare system.  Leading to mass reactive social distancing.  Leading to continued economic paralysis.  And to a broken-backed Government with shot authority.

Changing that centrality would mean a national conversation about Britain’s folk religion – NHS worship.  That can only be done by a kind of national Entmoot.

It would discuss whether the short-term imperative of keeping the hospitals on their feet is more important than the medium-term one of coping with other healthcare penalities: more cancer deaths, mental illness, domestic abuse, etc.

Plus the costs to the economy, and thus soon to the NHS, of this near-shutdown stasis.  Asking questions like some of the above might enable that conversation to begin.

251 comments for: Ten questions for Johnson about his lockdown plan

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