We have reached our limit. That was the most striking message from Chris Whitty today, as he and the Prime Minister held a press conference to reiterate a series of new lockdown measures in the north of England and to announce a postponement of further reopenings in England that were due to take place on 1 August.
We are at the “outer edge” of what we can do in terms of opening up society, the Chief Medical Officer for England said. “What that means is that if we want to do more things in the future we may have to do less of other things.”
So what does it mean for the weeks and months ahead?
Firstly, if there was any question as to which side of the debate the government would eventually fall in the “schools or pubs dilemma”, as it has been dubbed within Whitehall, we now have our answer. As the CMO acknowledged the need for trade-offs in forthcoming policy to balance opening up against the public health risks, the Prime Minister confirmed that bringing schools back is a “national priority”, the clearest sign yet of an incoming trade-off on other recent restrictions, such as tightening rules on households meeting, or on pubs and restaurants, in order to bring children back to school in September without seeing an overall uptick in cases.
More broadly, it indicates a willingness on the part of government to make sharp U-turns and abrupt gear changes in an attempt to keep case levels low. This was in clear evidence when the government introduced a snap quarantine on people returning to the UK from Spain, and it is in evidence again as abrupt changes are introduced in Greater Manchester, Blackburn with Darwen, Burnley, Hyndburn, Pendle, Rossendale, Bradford, Calderdale and Kirklees, meaning around 4 million people are no longer allowed to meet with other households indoors or in gardens, at no notice, as other England-wide plans to reopen casinos, bowling alleys, allow weddings with 30 guests, and indoor theatre performances are also postponed.
The government doesn’t seem to care about whether the approach is criticised as “chaotic” or whether abrupt changes risk looking inconsistent: after crucial months in which it has been accused of being fatally slow, all it wants to do is appear firm and fast. It means, basically, that we should expect many more announcements like today, of local lockdowns, new quarantine rules and regulation changes.
But there was a notable difference in tone between the Prime Minister and the Chief Medical Officer, as Boris Johnson unveiled a new slogan: “hands, face, space” to emphasise the need for continued compliance with social distancing measures. He seemed to suggest that things can continue to reopen with stricter adherence to hand washing, face masks, meetings outdoors, keeping a distance, and other mitigating measures. Whitty, however, gave the lie to that idea: “the idea that we can open up everything and keep the virus under control is clearly wrong.”
It suggests a fundamental tension between the public health realities and the government’s desperation to reopen large parts of the economy. It won’t have been lost on people watching today’s press conference, or who have been following Chris Whitty’s media and select committee appearances, that he is still keen to emphasise that the number of social interactions people have is the fundamental determinant of the spread of the virus, and, implicitly, that we need to keep our social contacts down to keep the spread of the virus low. The government champions mitigating factors as hand-washing and social distancing, as well as immediate testing and isolation; its Chief Medical Officer, standing alongside the Prime Minister, endorses those measures but quietly suggests they aren’t enough to accommodate an exponential increase in the number of social interactions we all have.
Despite the headline notes of caution, delays and new restrictions in the north of England, the Prime Minister confirmed that a pause on people shielding will still go ahead from tomorrow, as will the advice on returning to work. The government remains determined to press ahead with measures that will see more economic activity, and hopes that measures to mitigate, but not eliminate, the risk, will be enough. But standing right beside the Prime Minister there’s the quiet whisper of another public health message from the Chief Medical Officer: keep your social contacts low to avoid a second spike. One wonders which message will be louder.