The government has said it can only consider easing the lockdown once the country has passed five tests. To do so beforehand would risk a deadly second wave of coronavirus – one that could overwhelm the NHS. On Thursday the government is expected to formally extend the powers needed to continue the lockdown, but on Sunday the prime minister is likely to set out how the country might lift the strict measures that have paralysed the economy. What the government does and when will depend on safety considerations. Here we consider whether the government’s five tests have been met. Test one: making sure the NHS can cope and continues to have sufficient capacity It is increasingly clear that the much-feared surge that had threatened to overwhelm the health service has been overcome. As far back as mid-April, NHS Providers was confident enough to say hospitals should be able to cope with a peak. Now cancelled operations are being restarted, as less than a third of critical care beds are occupied by people with Covid-19. In London, one of the first Nightingale hospitals set up to help meet demand is to be placed on standby and will no longer admit patients. Verdict: met. Test two: a ‘sustained and consistent’ fall in daily deaths Coronavirus deaths in hospitals have been falling and a peak has now been passed. However, as the government’s deputy chief scientific adviser, Angela McLean, acknowledged on Tuesday, the UK is yet to “get to grips” with the number of deaths in care homes. The UK now has Europe’s worst coronavirus death toll, having reached 29,427 on Tuesday, exceeding Italy’s 29,029, which does not include suspected cases. McLean said the daily number of deaths had been falling steadily since the middle of April, though those in care homes were still rising in the week to 24 April. Verdict: being met. Test three: solid data showing the rate of infection is decreasing to ‘manageable’ levels An indicator that will be closely watched in the coming days, the UK’s infection rate stopped rising on 21 April. However, England’s deputy chief medical officer, Jonathan Van-Tam, said on Monday that new cases of Covid-19 across the UK needed to come down further. Figures released on Wednesday showed 6,111 cases had been recorded since Tuesday, up 1,700 on the day before. Yvonne Doyle, the director of health protection for Public Health England, said the figures “may be a matter of concern”. Doyle’s suggestion that testing could account for some of the increase in cases was greeted with scepticism, given testing appears to have gone down. The success of the contact-tracing app developed by the NHS, which is being trialled on the Isle of Wight from this week, will be a crucial element in meeting the test. The chief scientific adviser, Sir Patrick Vallance, told MPs on Tuesday that the infection rate (R number) needed to be below one before lockdown measures could begin to be lifted. He said the current estimate of the value of R was between 0.6 and 0.9. There are ongoing worries about increased transport usage, supported by government data. Verdict: not met. Test four: ensuring that supply of tests and personal protective equipment (PPE) can meet future demand An area where the government continues to face sustained criticism from the opposition and representative bodies for health and social care workers. On PPE, the pressure has lifted somewhat since 17 April, when hospitals came within hours of running out of supplies, but Boris Johnson conceded in parliament on Wednesday that there were continuing challenges. Operators of care homes complain that they are still struggling to source sufficient equipment and that staff are having trouble accessing testing. Testing remains an issue more broadly. While a programme for key workers has been ramped up, there are complaints that some testing centres are too far away from where they are needed and accessible only by car, while problems have arisen around delivery of home testing kits.
As highlighted by the Labour leader, Keir Starmer, the UK has fallen back below the 100,000 daily tests target reached at the end of last week, with only 69,463 carried out on Tuesday. The government also faces awkward questions about why it abandoned community testing early in March. Verdict: not met. Test five: avoiding a second peak that would risk overwhelming the NHS In the absence of a vaccine, which is not expected to be available until next year, this is potentially the most difficult test to overcome. At a basic level, the transformation of the NHS and creation of Nightingale hospitals at least give some degree of confidence that there are the beds and resources to avoid the health service being overwhelmed. But among other factors, meeting this test relies on the widespread and effective creation of a contact-tracing system. The health secretary, Matt Hancock, has described this as a “huge national undertaking of unprecedented scale and complexity”, involving the rollout of the new NHS app and the recruitment of an army of contact tracers. He previously said 18,000 tracers might be needed, but on Monday he indicated that this figure would be adjusted if a survey showed the virus was more prevalent than previously thought. A raft of questions persist, not least about whether the public will use the app in sufficient numbers. Verdict: not met.