The government has a lockdown dilemma – difficult trade-offs have to be considered

Experts say it’s too early to think about lifting restrictions, but even so the government will soon have to think about the economy, writes John Rentoul

Dominic Raab will announce more about the lockdown next week (AFP/Getty)

We all want to know how long this strange state of social distancing is going to last, which is why politicians – the ones who are left in charge while the prime minister is in hospital – are under pressure to provide answers.

So far, Dominic Raab, the acting prime minister, has come up with a timetable for making the decision about the coronavirus timetable. Following the Cobra meeting today, there will be a meeting of the Scientific Advisory Group for Emergencies (Sage) tomorrow, and a decision about extending the lockdown next week.

That is roughly what Boris Johnson said when he announced the measures on 23 March: that they would be reviewed after three weeks, which takes us to Easter Monday. But everyone knows that the lockdown is going to be extended for some time to come, so shouldn’t Raab just say so now?

This is what happens when a government says it will act on scientific advice, and is open about the advice it is receiving. We have all heard the scientific and medical experts at the daily news conferences, and their message has been consistent: that it is too early to start thinking about lifting the restrictions.

There is some evidence that the rate at which the infection is spreading is starting to slow, but as it takes about three weeks from infection to death, we haven’t yet seen the effects of the lockdown on UK deaths figures.

But Raab doesn’t want to be definite about extending the lockdown because he wants to be able to say that he is acting on the scientists’ advice. That has led to some confusion, with Welsh and Scottish politicians, who are briefed for Cobra meetings, saying that the lockdown will carry on – because they have seen the same evidence as the rest of us, only a few minutes earlier.

The attempt by Raab and by No 10 spokespeople to hold the line about being guided by the science on the timetable set out has also opened up a chance for Keir Starmer, the new leader of the opposition, to demand the publication of an “exit strategy”. This is essentially a demand that ministers do what they are already doing: namely, trying to work out how they will know that the lockdown is working, and how and when to start easing the restrictions.

That is hard, because there is still so much that we do not know about the coronavirus. The hope that it might simply lose its potency after a while seems not to be realistic. Places that seemed successful in controlling its spread, such as Hong Kong and Singapore, are now facing second waves as new infections are brought in from outside.

Which raises the prospect of an “epidemic yo-yo”: that once restrictions are eased, and after another delay of several weeks for the effects to feed through to a newly rising death toll, the extreme lockdown might have to be reimposed. This alternating easing and restriction might have to go on for more than a year, until vaccines or treatments are developed.

If the decision on medical grounds on when to start to lift the lockdown is hard enough, on the basis of incomplete evidence, it is linked to a further set of equally difficult decisions. For all that politicians say they are acting on scientific advice, there are some factors that have to be weighed in the balance that the medical experts cannot know. At the heart of these questions is the trade-off between immediate deaths and economic damage, which can have indirect effects on mortality.

These are the kind of trade-offs that the NHS makes implicitly all the time, although it has subcontracted some of the harder ethical decisions, such as how much public money a “quality-adjusted life year” is worth, to Nice, the National Institute for Health and Care Excellence. But now politicians are being asked to make that kind of decision on behalf of us all.

So far they seem to have public opinion behind them in tilting the balance in favour of minimising the immediate death toll, rather than trying to restart the economy too early.