Thread by @drraghibali

A brief review of where we are - & why we need a plan B.

In general, I think the current government strategy of suppression to keep cases low enough to maintain NHS services and minimise non-COVID health harms while protecting education and jobs is a reasonable compromise.

Furthermore, if virus levels get too high, fear increases and people don’t come to hospital, don’t go out and the economy suffers, etc. I also understand the governments rationale of not wanting to reintroduce shielding due to the mental (and other) health harms it would cause.

I also support the targeting of restrictions based on the local level of cases as opposed to blanket national ones. I find it hard to understand how it can be possibly be fairer to destroy jobs and businesses all over the country including in areas where hospitalisations are low

than to target restrictions on those areas where they are highest and the NHS is under pressure. This should not be a political issue, or North vs. South – it’s just common sense.

We can only get through this crisis by supporting each other and, by keeping the economy open in as many places as possible, we can help fund businesses and jobs in those areas that are forced to temporarily close until the pressure on the NHS subsides.

The evidence for the effectiveness of the current measures is mixed – while it is true that R nationally is about half the level of the first wave, data from todays REACT-1 study shows that it is rising but with large regional variations (0.6 in the North East to 2.9 in London).

And while the NHS as a whole is not yet being overwhelmed, hospitalisations continue to double every 2 weeks and are on course to pass the first peak in 3 weeks – which will make it very difficult to keep all NHS services running and lead to significant non-COVID health harms.

The key problem is compliance, and we need to focus more on how we can improve compliance with existing restrictions rather than increasing restrictions. After all, the purpose of restrictions/lockdowns is to reduce social contacts and enforce social distancing / self-isolation.

We urgently need to analyse levels of compliance by local area and to understand what is driving lack of compliance. e.g. despite good intentions only 20 per cent of those required to self-isolate are doing so, and it may be that paying people (as in Sweden) may be more effective

We need to improve the public health messaging and try different strategies to improve compliance - without resorting to fear (with all its health harms) with different messages, and different messengers, including more hospital doctors and GPs who are most likely to be trusted.

For now, I think the government should continue to resist the increasing calls for a second national lockdown and maintain its current strategy for at least two more weeks to assess the effectiveness of the Tier Two and Three restrictions and devolved nations ‘circuit-breakers’.

However, we also need a Plan B to get us to Spring – and potentially longer if vaccines / treatments / mass testing are not as effective as hoped – which I will describe in tomorrow’s thread and is also outlined below:

conservativehome.com/platform/2020/…