Lockdown easing is being ‘misjudged’, say public health directors

Updated 4 June 2020

Public health experts have called on the government to delay the full implementation of phase 2 measures designed to ease lockdown.

The Association of Directors of Public Health (ADPH) warned that the test and trace programme is “far from being the robust operation” that is now “urgently required as a safeguard to easing restrictions”.

ADPH wants assurances that the test and trace system will be able to cope before easing restrictions, and has argued previously that an effective system is “vital” to keeping R consistently below one. It warned the R rate can go above 1 in a very short space of time and once it does it can take months to bring back down. ADPH has set out a statement of principles to outline what needs to be in place.

These comments were made in the ADPH presidential blog, published yesterday evening, just before the phase 2 easings started.

ADPH president Jeanelle de Gruchy said directors of public health are increasingly concerned the government is misjudging the situation and “lifting too many restrictions, too quickly”.

Gruchy said in the blog: “We are at a critical moment. We need to weigh up the balance of risks between easing restrictions, to enable more pupils to return to school, more businesses to open and more social connections to happen, with the risk of causing a resurgence of infections.”

Bus she warned: “The risk of a spike in cases and deaths – and of the social and economic impact if we have to return to stricter lockdown measures – cannot be overstated; this needs to be understood not only by the public but also by the government.”

Flagging concerning signs over the weekend that public adherence to social distancing is fatigued and waning, it urged for a renewed drive on hand washing, social distancing and self-isolating if symptomatic, positive for COVID-19, or a contact of someone who is.

On PPE, ADPH said supply chains are stronger but meeting demand remains “an enormous challenge”, testing capacity has “undoubtedly increased” but it does not have confidence the system is effective in getting priority tests done and the results out swiftly enough.

ADPH said that COVID-19 is a new disease with evidence still emerging and much uncertainty. Before progressing easing of lockdown, further consideration of the ongoing trends in infection rates and the R level was needed to be sure of outcomes. The effects of easing measures only become visible two weeks later, so making multiple changes at the same time will make for an unclear picture of what’s going on.

Gruchy said now was the time for “steady leadership, careful preparation and measured steps”.

She added: “A second peak cannot be ruled out – whether it will overwhelm the NHS is an important question to ask. But perhaps the even bigger one is, do we really want the same number of deaths again? The scale to date represents an unimaginable tragedy and we must to everything possible to limit further loss of life.”

• CIEH supported ADPH's stance, adding that much of the decision-making around lockdown easing appears to have excluded the views of local authorities.

Debbie Wood, CIEH's director for membership and external affairs, said: "The most worrying pattern is the government’s approach to the role of local authorities, and the persistent over-centralisation – whether that be in the planning and design of the contact tracing programme, where local and regional expertise were sidelined, or producing guidance to businesses on safe reopening."