Easing Lockdown: What it means

Boris Johnson, the Prime Minister of the United Kingdom, announced the next steps to ending lockdown on 11th May 2020. The message, which was broadcasted on television, has caused confusion because it was not clear enough. This is my brief attempt at explaining its meaning. I will only cover Stage One of the government’s plan though.

The Five Alert Levels

Boris set out the five alert levels. These are how the government is gauging the threat of the current coronavirus pandemic. This version of the virus is being called COVID-19, although it is also known as SARS-CoV-2. The levels are on a scale of one to five and will be assessed in different parts of the country by a new “joint biosecurity centre”. The new system will be able to detect a raise in infections in your area and inform the national situation. This will determine what protective measures are needed to balance safety and freedom. There is some doubt, however, as to how independent the biosecurity centre can be, given there is political influence and objectives.

We will be at Level One (Low Risk) when the virus is no longer present in the UK. This is unlikely to happen for a very long time, if ever. Unless we all become immune to COVID-19 via recovery or a vaccine, it will be here to stay, and we will have to learn to live with the risk.

We will be in Level 2 (Moderate Risk) when there is low transmission and the NHS is operating normally. At this point, schools and businesses will be open with open some

special measures. Social distancing will still apply, and vulnerable people will continue to be shielded.

Level 3 (Substantial Risk) will be in place when the virus is in general circulation and the NHS is operating at extra capacity. We are now moving into this level, which is also the first stage in the government’s plan. Restrictions will remain on the public sector, business and everyday life. What these restrictions will look like remains unclear. There are some indications of what this means; I talk about these below.

We have been in Level 4 during full lockdown. People had to stay at home unless they had reasonable excuse. The regulations also provide some examples, which can be found in Regulation 6. I will not include them here to avoid overcomplicating this article.

Level 5 will be in place if the NHS gets overwhelmed, which is unlikely at this point.

The Value of ‘R’

The “R” value, which is the infection rate, is the average number of people that can get the virus from one infected person. COVID-19 has a natural reproduction number of 3, which can result in a rapid increased in infections if measures are not taken. The Prime Minister said, during last night’s announcement, that the value of R is currently between 0.5 and 0.9. The virus will die out as not enough new people will be infected to sustain the outbreak if the value of R remains under 1. The value of R will be heavily monitored and determine how the UK moves forward.

Work

The government’s position on work will change on Wednesday. The current advice is that ‘you should work from home if you can, and only go to work if you must’. The new position is that ‘anyone who can’t work from home, for instance those in construction or manufacturing, should be actively encouraged to go to work’. If you work in sectors of the economy that are allowed to be open, you will be expected to go to work if you cannot work from home. This includes food production, construction, manufacturing, logistics, distribution and scientific research in laboratories. Further guidance on this is expected soon.

How you should get to work is causing confusion. The Government previously announced it will be spending 2 billion pounds on a walk/cycle to work initiative to deter people away from public transport. This is supported by the new guidance but is not an option for some. The government is still working on getting public transport back to normal though. Even when full services resume, public transport will only be able to carry 10% of the usual capacity with social distancing in place.

Outdoor Activities

The Prime Minister said that ‘from this Wednesday, we want to encourage people to take more and even unlimited amounts of outdoor exercise’. He continued to say, ‘You can sit in the sun in your local park, you can drive to other destinations, you can even play sports but only with members of your own household’.

The guidance makes clear that you can now also spend unlimited time outdoors alone. You can also meet with one person from outside your household as long as you remain outdoors. The government believes we are safer to meet outdoors than inside a building. You have to remain two metres (6ft) away from people outside your household though. You can only exercise with up to one person from outside your household. Team sports are only allowed with people from your household.

You can drive to outdoor open spaces irrespective of distance. When travelling to outdoor spaces, it is important that people respect the rules in Scotland, Wales and Northern Ireland.

Face Coverings

People should aim to wear a face-covering in enclosed spaces where social distancing is not possible. The guidance says:

‘Homemade cloth face-coverings can help reduce the risk of transmission in some circumstances. Face-coverings are not intended to help the wearer, but to protect against inadvertent transmission of the disease to others if you have it asymptomatically.’

‘A face covering is not the same as a facemask such as the surgical masks or respirators used as part of personal protective equipment by healthcare and other workers. These supplies must continue to be reserved for those who need it. Face-coverings should not be used by children under the age of two, or those who may find it difficult to manage them correctly, for example primary age children unassisted, or those with respiratory conditions. It is important to use face- coverings properly and wash your hands before putting them on and taking them off.’

Vulnerable People

Clinically vulnerable people are over 70 or specific chronic pre-existing conditions and/or are pregnant. If you are in this group, the government advises that you should minimise contact with people from outside your households, but you do not need to be shielded. The conditions in this group are:

· Chronic (long-term) mild to moderate respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis;

· Chronic heart disease, such as heart failure;

· Chronic kidney disease;

· Chronic liver disease, such as hepatitis;

· Chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), or cerebral palsy;

· Diabetes;

· A weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets; and

· Being seriously overweight (a body mass index (BMI) of 40 or above)

Clinically extremely vulnerable people are strongly advised to stay at home at all times and avoid any face-to-face contact. Clinically extremely vulnerable people may include the following people:

· Solid organ transplant recipients;

· People with cancer who are undergoing active chemotherapy;

· People with lung cancer who are undergoing radical radiotherapy;

· People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment;

· People having immunotherapy or other continuing antibody treatments for cancer;

· People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or parp inhibitors;

· People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs;

· People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease;

· People with rare diseases that significantly increase the risk of infections (such as SCID, homozygous sickle cell); and

· People on immunosuppression therapies sufficient to significantly increase risk of infection.

International Travel

The Government will require all international arrivals to give their contact and accommodation information. They will also made to self-isolate for 14 days unless they are on the list of exemptions. Accommodation will be arranged by government where international travellers are unable to demonstrate where they would self-isolate.

Conclusion

The situation is forever changing, and more information keeps becoming available. I have tried to set out the next steps as simply as possible. You will need to read around each section of this blog post, Stage Two and Stage Three to have a comprehensive understanding, but I hope this help.