The pattern of life under coronavirus is becoming clearer. Around the world, after national lockdowns to get the virus under control, from Leicester to Guetersloh we’ve seen that from here on the challenge is to intervene rapidly and decisively to tackle flare-ups in local areas and prevent wider spread – Boris Johnson’s so-called whack-a-mole strategy.
For these to work, it’s critical that the public and local businesses understand why their area is being put into a local lockdown. Done effectively, localised shutdowns can keep the rest of the country free. But if we act too late, or if adherence to local restrictions is partial, they will fail and the national health and economic consequences will be profound.
As we’ve learned in recent months, adherence is hard to enforce and requires the broad consent of the population. That will be much harder to secure in a flare-up area when residents of neighbouring areas will be free to go about their business unhindered. To have any chance of working the approach needs to be transparent, consistent and fair.
Unfortunately, the Leicester case has been met with an ad hoc and confused response from the government that fails these standards. It’s clear that there is no strategy for managing local outbreaks.
The national coronavirus strategy needs to be quickly adapted to the challenges that local outbreaks pose. The answer to four questions should define the approach: Who decides? How do they decide? Where does lockdown apply? And what extra financial support will be made available to those affected?
1. Who Decides?
The first question relates to whether local lockdowns should be in the hands of local authorities or central government. There’s a strong case to be made for empowering local authorities, most obviously in providing them the testing data and wider powers, that could allow them to pre-empt a flare-up with timely and targeted interventions when small clusters of cases develop. Central government’s withholding of Pillar 2 testing data from local authorities is as reckless as it is inexplicable.
But the decision to lockdown a whole local authority should be a national one for two reasons. The first is that the decision taken in one area have profound implications for the rest of the country. The consequences of one local authority failing to act could be catastrophic. What’s more, citizens are less likely to take a lockdown seriously, at great cost to their livelihoods, if they think their local authority is being more cautious than others. At this critical moment, we can’t afford the charge of a postcode lottery for lives and livelihoods. Fairness and consistency have to be hardwired into the approach and that means central government making the call.
2. How Should Local Lockdown be Triggered?
But central government’s decision can’t be arbitrary. For local lockdowns to be fair requires a transparent national framework with clear triggers and defined thresholds, so that every area understands how restrictions will vary with the scale of the outbreak.
The Health Secretary has explained that decisions are currently taken through the Local Action Committee Command Structure. But there’s little clarity over how or why local cases are escalated to a ‘gold’ meeting after which the Secretary of State might choose to lock down the area.
As we set out in our recent paper Reset, the decision framework should be linked to two metrics: virus prevalence and the estimate of R. In Leicester, for example, the Health Secretary says that there were 944 cases in Leicester in the week to 26 June, amounting to 135 cases per hundred thousand of population. That’s a rate of new infections roughly equivalent to what we were seeing nationally in at the height of the crisis, so unsurprisingly it has triggered a return to April-style lockdown measures. Nationally, there are currently roughly 10 weekly new positive tests per hundred thousand population.
To get people on board, the government should make explicit what’s currently implicit. It should fall to the Joint Biosecurity Centre to adjudicate the local alert level against published trigger that are tied to predetermined restrictions that should look something like Figure 1, below.
Local Alert Levels
This would be comparable to the French approach. There the alert level and associated lockdown measures are determined centrally for each Department on the basis of virus prevalence and estimates of R. Restrictions in each area shift from green to amber alert once weekly cases top 10 per hundred thousand population, and to red at 50 per hundred thousand. In Germany, too, districts are required to impose ‘comprehensive restrictions’ when weekly infections breach 50 per hundred thousand.
3. How Should the Areas be Defined
What should be the basic geographic unit of lockdown? In Leicester, the lockdown area is wider than the City of Leicester, taking in bits of Leicestershire, and therefore isn’t contiguous with any obvious administrative boundaries. Predictably this has led to confusion with the police, which risks undermining enforcement. But it’s more damaging for securing popular support and adherence if residents and businesses find the zoning baffling and arbitrary. Cutting across boundaries also seems inimical to empowering the local authority.
It’s not hard to see the attraction of micro-targeted lockdown zones. But for the sake of simplicity and transparency, following the German and French approach and using the basic building blocks of local authorities seems like the only sustainable strategy. This will become even more important if we start to see flare-ups in large and dense conurbations.
4. How Should Financial Support Work
Finally, local lockdowns will only hold if they’re accompanied by a comprehensive financial support package that’s automatically triggered by the local alert level. We have an ongoing debate about whether the withdrawal of the Job Retention Scheme (JRS) should be phased differently for different sectors. But local outbreaks mean it’s rapidly becoming clear that fiscal support needs also to be phased differently by geography.
For Leicester there’s a stopgap solution. No. 10 has made it clear that businesses that had already used the scheme will get to continue using it as the local lockdown takes effect. But, ahead of the phase out of the scheme in October, that would have been the case anyway. As new areas face lockdowns, and national support measures start to be phased out, companies that had returned to work will need to be allowed to make new applications to the JRS and loan schemes if the alert level in their area is increased back to level 4.
Things will get even more complicated for employees who live in a lockdown area but work elsewhere. A ‘flexible JRS’, based on both on where companies are based and where employees live, will no doubt test HMRC administrative systems to the limit. But it should be urgently explored. Otherwise once a flare-up hits a large integrated urban labour market like London, there may be no choice but to lock down the entire city at huge cost. It would also be hard to make such blanket interventions stick.
It’s becoming clear that managing local lockdowns is going to be a central part of the coronavirus policy challenge from here on. Securing public consent for these lockdowns relies on there being clear, transparent and timely information to ensure people understand why restrictions need to be re-imposed in particular places, while the rest of the country is enjoying their newfound freedoms. The government’s current approach – drip-feeding a series of briefings to newspapers before making an announcement shrouded in secrecy – falls a long way short of this ideal. Leicester is just the first, but we can already see growing outbreaks in places like Barnsley and Bradford. We have an opportunity to learn from Leicester. It’s time to get the whack-a-mole strategy straight.