Coronavirus: As we head out of lockdown, Government assurances the ‘five tests’ have been met are on shaky ground

To the relief of some and the concern of others, the Government has announced a significant drawing back of the strict social distancing rules the country has been following.

From Monday, schools and some shops will open and people will no longer be consigned to meeting just one person from outside their household – groups of six can gather and guests can be invited to private gardens.

Announcing the new rules, Prime Minister Boris Johnson talked about his oft-repeated “five tests”, strategy, introduced to act as a specific measure against which any lockdown measures would be analysed against.

He said all decisions were based on “data and evidence, about the spread of the virus and the impact of the measures taken so far”.

But what are the five tests and are they actually being met?

The Government said at the start of the coronavirus outbreak that protecting the health service and preventing it from becoming overwhelmed was a priority.

There were concerns it would not be able to cope with the additional pressures of the pandemic so elective and non-emergency procedures and treatments were temporarily paused and extra capacity was built for intensive care patients.

But as of 27 May, the Government said just 11 per cent of mechanical ventilator beds in the UK were occupied by patients with coronavirus. This is down from a peak of around 40 per cent in the middle of April.

On 26 May, 475 people were admitted to hospital in England with coronavirus which is down from the highest point of more than 3,000 on a single day at the start of April.

The Prime Minister said he was confident these figures show the country had met its first test.

But these figures only reflect part of the story. Primary care workers – GPs and surgery staff – have had to bear the brunt of patients who cannot or will not go to the hospital or emergency departments, putting them under acute pressure.

With services beginning to reopen there are concerns that this pressure on primary care services will be ramped up and the backlog in referrals and diagnosis could push the fragile NHS to breaking point again.

Whilst the NHS may not have crumbled under a wave of critical Covid-19 patients, as it had been initially feared, there is still a long way to go before the wider impact of the crisis is known.

The Government’s second test is somewhat simpler to assess – to see “a sustained and consistent fall in the daily death rates from Covid-19”.

This acts as a measure as to when the “peak” of the virus is so ministers can feel confident that it has passed.

As of Thursday, the UK daily death rate measured by a seven-day rolling average was 256. This is significantly reduced from the highest average of 943 on 14 April.

Whilst this shows the number of deaths has been decreasing, it doesn’t necessarily mean death figures are low enough to be able to confidently reopen parts of the country and economy.

For example, 256 is more than double the number of daily deaths last reported in France – 115 – and higher than both Spain and Italy who are both reporting daily death counts below 100.

The third test is to see data from the Government’s scientific advisers showing that the rate of infection – or the R number showing the average number of people catching the virus – is decreasing “to manageable levels”.

Mr Johnson said on Thursday that there had been an average of 2,312 new cases confirmed over the past week, reduced from 5,066 in the first week of May.

If the R number is greater than 1.0 the virus will spread and the epidemic will grow, whereas if it is less than 1.0 then fewer than one person is being infected by every positive case – meaning it will shrink and eventually disappear.

Government scientists estimated that, as of 22 May, the R rate across the UK as a whole was between 0.7 and 1 – although this is an average and there is regional variation.

Whilst the number is below 1.0, there are concerns that it is not low enough to prevent a second peak of the virus if the lockdown is eased too soon.

When people are allowed to socialise more freely and mix with more than one household at a time, the infection rate could creep up a few points and, for areas where it is already 1.0, rapidly return to concerning levels.

The Government’s fourth test specifies that ministers must be confident that “operational challenges” seen across the country – such as shortages of personal protective equipment (PPE) and testing – have been resolved.

Mr Johnson said he “fully acknowledges the difficulties on testing and PPE that we have faced” but insisted the country was now “making progress”.

Testing capacity has indeed increased and is now at more than 160,000 per day – but only around 120,000 of those tests are actually being used.

Mr Johnson previously said he wanted to get up to 200,000 tests a day by the end of May which is not looking likely.

Whilst this might just seem like pointless numbers, the higher the number of tests carried out successfully the more effective the new test, track and trace system will be in monitoring closely the spread of the virus.

Mr Johnson also said he has signed 100 new deals with various PPE suppliers around the world – including for over two billion items of PPE, such as facemasks, visors, gowns and aprons.

As a result, he said, the Government would be able to start to “rebuild stocks” of equipment to prevent another shortage seen at the start of the crisis.

The final test is perhaps the hardest to asses – that the Government is “confident any adjustments to the current measures will not risk a second peak of infections that overwhelms the NHS”.

Mr Johnson said the new lockdown rules were “carefully designed so that we can ease the burdens of lockdown while expecting to keep that R below one”.

“I cannot and will not throw away all the gains we have made together, and so the changes we are making are limited and cautious,” he added.

As explained, with the death rate still relatively high – compared with neighboring countries – and the R number extremely close to be over 1.0, the current state of the epidemic in the UK is incredibly fragile.

So whilst the Government might be assuring the public that it has only reduced the measures because it deemed it safe to do so, it remains to be seen whether ministers are acting prematurely or not.

If they are the risk of a second peak would be very real and the knock-on impact would be huge.