Scotland’s new Chief Medical Officer, Dr Gregor Smith, can’t say when the lockdown measures will be lifted here. We “are not quite at the stage yet where we have got the data which would allow us to be able to pinpoint when these measures are likely to be lifted,” he told the BBC. Correct, but you can take the word “quite” out of that sentence.
How to get out of lockdown is increasingly weighing on the minds of European governments. Spain has now been in lockdown for nearly one month and is getting itchy feet. Non-essential work is set to restart from Monday, while the plan is to bring the lockdown to an end on 26 April. But the WHO believe it to be premature, with the past two days seeing cases and deaths rise, and insufficient work done on – you guessed it – community tracing and testing. Spain needs to ‘get the data,’ to borrow Smith’s phrase.
“Sustained transmission of the virus is to be expected if current interventions are lifted too quickly,” the WHO’s latest European risk assessment stated.
The danger of a second spike is real, and would be disastrous. So the quicker we get on with the mass contact tracing and testing work needed to get some control over this thing to prevent jumping in and out of lockdown for the next year, the quicker we can plot a safe route out of what everyone agrees is an intolerable way to live. That’s a big task, but it’s hardly a moon-shot. Other countries have already done it.
In a new paper published by Common Weal today on the cost to Scotland, head of policy & research Craig Dalzell finds that it will be around £1-1.5 billion to do the systematic work of contact tracing and testing the whole country. The figures are based on the work of Professor Tim Colbourn, associate professor of the Institute of Global Health at the University College London, who has produced a costed plan for mass contact tracing and testing UK-wide, and made his workings publicly available. Dalzell has applied this to the Scottish context.
That mass testing programme would involve “over 5,400 Public Health Community Officers to work in their local communities checking up on people, ensuring their wellbeing, asking if they have symptoms, testing people where possible and contact tracing”. It would aim for testing “every citizen once every four weeks using the current antigen test that tests for the virus and its byproducts”, with a higher rate – possibly multiple times a shift – for health workers and others who come into contact with infected people by necessity. That would then be the basis for “a shielded re-opening strategy which will allow everyone – not just those who have gained immunity – to gradually leave isolation on the proviso that further outbreaks will be caught and suppressed by the testing strategy over the course of the 12 months it may take to develop and deploy a vaccine.”
Dalzell provides a detailed breakdown of the various costs involved, based on Colbourn’s framework. Let’s say the figure is at the high-end, £1.5 billion. That’s just 3 per cent of the Scottish Government’s annual budget this year (£49 billion), or 10 per cent of its annual health budget for the year (£15.3 billion). It’s less than what the Scottish Government has spent on motorways and trunk roads for this year and last year (£1.58 billion).
And the cost also has to be set against the cost of not doing this. Based on the findings of a Fraser of Allander Institute report published on Wednesday on the costs to the Scottish economy of a three month lockdown being a 25 per cent fall in GDP, and add to that the additional costs to the public sector of lockdown in terms of mental health worsening, domestic abuse cases increasing, and so forth, Dalzell estimates a total cost to the Scottish Government of maintaining the current strategy over a 12 month period of £15 billion, ten times the cost of the mass testing programme.
Here is the final advantage of this strategy. We don’t need the UK Government to do this in Scotland. It would of course be far better if a mass tracing and testing programme was also initiated south of the border, but there is no necessity for the Scottish Government to move at the pace of Whitehall. Dalzell concludes with an urge to “the Scottish Government to either strongly lobby the UK Government to change its strategy or to unilaterally break from compliance with the ‘Four Nations’ approach that is clearly putting lives at risk”.
This appears to be a viable route for Scotland out of lockdown with sufficient safeguards. It at least deserves to be debated and discussed as a possible route forward.