Let’s plan before we need the plan
Even Baldrick knew that you actually had to have a cunning plan before you could action it.
On 10th April, Matt Hancock announced his distribution plan for Personal Protective Equipment (PPE). It involved guidance on what and how much to use, a website to order it and fulfilment. Nothing wrong with the plan — apart from it being several weeks too late.
It is too soon to know when the lockdown exit strategy should be triggered but we have reached the point where we all need to know what it might be so that we can prepare for when it is actioned. If the form so far is anything to go by, the exit strategy will only be announced after it should have been implemented. And neither that, nor alternative strategies, will have been exposed to the sunlight of debate and improvement.
The lack of planning
Here are some more examples of this not-in-time Covid-19 planning. The government announced the emergency on 30th January but it was not until mid-March that briefings began. We were told there would be stages of restriction in order to spread the load on the NHS, but there was no plan for the specifics; it would be “steered by the science” coming mainly from the Scientific Advisory Group for Emergencies (SAGE). But SAGE provides only scenarios and opinions, not actual science nor proposals for government action. Being “guided by science” looks like a smokescreen to conceal the lack of in-time planning.
To be fair, government has well planned the provision of additional hospital beds and intensive care. The arithmetic was suspect but the 50, 000 extra beds (15K from ejecting bed-blockers, 15K from the private sector and 20K from Nightingales) looks, so far at least, enough. But the plan to increase bed capacity should have led immediately to plans for manufacturing and distribution of PPE, ventilators, oxygen and relevant medicines.
The lack of timely planning is most conspicuous in the case of antigen test kits. Prompt action (and results) in South Korea in February indicated their critical importance. On 2nd April, in response to criticism that UK testing was too little and too slow, Matt Hancock announced a goal of 100,000 tests a day by month end, up from 10,000 a day at that time. Since then, reporters have pressed him for the plans for reaching that ambitious target, but none have been forthcoming.
The need for a future plan
For the future, the government needs public acceptance of whatever the lockdown exit programme turns out to be. Only two trends matter: hospitalisations and deaths, which will peak at different times, and sooner in some regions than others. The number of Covid-19 infections not requiring hospitalisation should not affect the exit programme or the trigger date for starting it: they do not drain NHS resources.
We also know that the lockdown exit programme can begin sometime (hopefully soon) after those peaks are apparent. For that, the public needs to see decent tracking curves, nationally and by region, for Covid-19 hospitalisations and deaths. Figures need to be accurately allocated to the right days; it is not apparent that they are now.
The programme will almost certainly proceed by stages, e.g. age groups, regions of the country and types of congregation and commercial activity. For example, it seems likely that schools should open first followed by wage-earners with seniors last. We need to know what other countries have done and what those experiences appear to be. Denmark, for example, has opened its golf courses, but not clubhouses, to two-ball games. Germany has kept DIY stores open.
Whatever solution is adopted, there is an urgent need for transparency and debate so that the public can support whatever is decided and help carry it out.