The government’s five tests are not sufficient for an exit strategy from the coronavirus lockdown

At the end of March, in the face of rising fatalities from Covid-19, the UK government did not face a meaningful choice between minimising deaths from coronavirus and the needs of the economy. In mandating the lockdown, the government wanted to control the spread of the coronavirus, slow the rising number of cases and fatalities and prevent the NHS from being overwhelmed.

The government has so far set out five tests that it says will guide its decision about when to ease the current social and economic restrictions. These focus exclusively on limiting the spread of coronavirus. Taken at face value, the tests imply the government’s top priority is minimising deaths from Covid-19, to the extent it far outweighs other possible objectives – such as reducing deaths from non-coronavirus causes or limiting the harm to people’s living standards and wider wellbeing.

But as the threat is brought under control, as testing capacity grows and as the NHS’s capacity to treat Covid-19 patients increases, there start to be trade-offs between different outcomes.

Successfully restricting the spread of Covid-19 has increased the risk of other possible harm

The continued shutdown of the economy and focus of healthcare resources on tackling coronavirus are reducing the chance of people dying of Covid-19. But they are likely to increase the risk of other possible harm – such as low standards of living, mental health problems, domestic abuse and deaths from non-coronavirus causes.

Boris Johnson must take a series of decisions which are perhaps harder than any that have faced a peacetime prime minster. These choices are made harder by a lack of evidence on important issues. This includes uncertainty about features of the disease – such as how long any immunity lasts – but also uncertainty about, for example, how the lockdown is affecting the economy or how people will behave if restrictions are eased.

The government should gather as much evidence is available to help inform its decisions. The UK will have the advantage of being able to see what happens in other countries as they release restrictions first, and it may have to adapt its approach as new evidence emerges in the UK and abroad.

The prime minister must deliver on his promise of transparency over the exit strategy

But science cannot provide all the answers. These will ultimately be political choices between unpalatable options. The government will have to walk a tightrope between the risks of another surge of infections and lasting harm to the economy, people’s livelihoods and prospects. Ministers must be upfront with the public about what their priorities are and how they are weighing up potentially conflicting objectives.

The five tests that the government has set out so far for starting to lift the restrictions were fit for the priorities at the start of the lockdown. Is the NHS able to cope, and does it have sufficient personal protective equipment (PPE)? Has there been a “sustained and consistent” fall in the daily death rate and is there reliable data on decreasing infection rates? And can we be sure that the risk of a second peak that would overwhelm the NHS will be avoided?

But these questions do not provide an adequate guide to the longer-term exit strategy, which must take into account what it takes to get the economy moving – and how other negative outcomes to the lockdown can best be avoided. On his return to Downing Street, the prime minister promised new transparency about decision making. He needs to make good on his promise as he charts the way forward.