It has been more than two months since the UK went into lockdown. Schools and high street shops are preparing to reopen. Car journeys have roughly doubled since April. Overseas, the economy in Italy is groaning back into action. In Greece and Spain, the tourism industries are jostling for a summer relaunch. Normality could be just around the corner.
But is the UK in the same position as other European countries? How sure are we that the UK has negotiated at least the first wave of Covid-19, and that we are not instead on the precipice of another surge in cases and deaths?
Italy and Spain were struck first, so they may give a glimpse into our future, although the picture is murky.
Italy’s daily cases peaked in late March, followed by a long, drawn-out decline. Case numbers averaged near 5,000 a day at the start of April and now stand at around 600 a day. Daily cases are currently running at around 8 per cent of peak level. At the point when Italy’s shops reopened — 18 May — that figure was around 15 per cent.
Compare that with the UK. Here, daily cases topped out in early-to-mid April at more than 5,000 — and nearer 6,000 on some days. And unlike in Italy, our caseload stayed high, with less of a discernible peak to the curve.
A broader peak
The number of new daily infections in the UK is around 39 per cent of peak levels. The UK averages 2,000 new cases every day, more than three times as many as Italy, four times as many as Germany (400) and nearly seven times as many as France (300).
A slower decline
The UK’s lockdown has been much less strict than other coutries. Spain, which implemented one of the strictest lockdowns in the world — children were completely banned from going outside for more than six weeks — eased restrictions on shops at a time when daily infections were at 33 per cent of their peak. Germany, by contrast, eased when infections were just 18 per cent.
The UK’s lockdown strategy looks more like Iran than Italy
The UK’s current daily case rate and the total number of infections are therefore considerably higher than any other major European country at the point where it left lockdown. The UK’s strategy looks less like Italy, and more like Iran. Iran, like Italy, saw daily new cases peak in late March. But unlike Italy, Iran is now experiencing a second wave of cases.
This is clearly tied to the way in which Iran raised its lockdown. On April 11, just two weeks after Iran had seen case numbers peak and with infections still at 61 per cent of peak levels, the government ordered tens of thousands of businesses to reopen. A week later, many businesses in Tehran — home to 8.7 million people, and more densely populated than Singapore — also reopened.
Soon there were pictures of traffic jams on Iranian state TV, and health officials took to the airwaves to protest the growing public disregard for social distancing. Initially case numbers continued to fall; but within two weeks they were on the rise again.
It doesn’t take an epidemiologist to figure out what happened. Covid symptoms typically show after one to two weeks of contracting the virus; it isn’t until then that most people are tested and diagnosed.
Iran’s second wave
But it is also true that when Covid-19 strikes a country, not all areas see cases peak and fall in unison. In the UK, London was hit hard and hit early. The capital saw hospital patients surge well before Scotland and Wales, yet it now has fewer than the North or the Midlands. Northern Ireland had more hospital patients with Covid-19 in the final days of April than at any other point of the crisis.
When we look at the UK as a whole, deaths recorded by the ONS and attributed to Covid-19 peaked in the fortnight between 4-17 April. For 39 local authorities the peak actually arrived almost a month later, in the first two weeks of May.
Which parts of England and Wales are peaking late?
In Hull, Carlisle, Sussex and Herefordshire, between one in three and one in two Covid-related deaths occurred between May 1 and May 15. Eastbourne saw more deaths from Covid-19 in mid-May than at any other point during this crisis.
So while London and other inner cities appear well past the peak, many other parts of the UK are still at Iran-like levels of infection rate.
And just as some parts of the country have peaked later than others, so too have its care homes. Nearly a quarter (23 per cent) of known Covid-19 deaths in care homes occurred between May 1 and May 15.
Some areas of the UK have only just peaked
Policy that applies to some people or areas is bound to be unpopular, but a failure to recognise geographical differences could be very dangerous.
England’s relative lack of devolved structures would also make such variation difficult to implement. While Germany has handed control of lockdown-lifting to the 16 Bundesländer, and America’s rules vary by city and by state, it’s far from clear how such a patchwork system could work over here. Wales can, and has, refused to allow people from England to cross the border for exercise. Yorkshire or Cornwall could hardly do the same.
Data cannot make policy; it can only inform it, and explain its effects. But the current timetable, which will see schools partially reopen on 1 June, suggests the UK will be abadoning large sections of its social distancing with an infection rate at 37 per cent of peak levels. By mid-June, most shops will follow.
This is a bigger gamble than any of our nearest neighbours have attempted, with none of the local levers to provide a more sophisticated brake if things go wrong.