From releasing young people first to immunity passports or a regional approach, several gradual options are available

While ministers and their medical advisers refuse to be drawn on an exit strategy from the UK lockdown, discussions are under way in Whitehall to explore how a graduated return to work could soften the economic blow while avoiding a surge in deaths from the virus. What options are available?

Release the youth

Young workers are among the most resilient to the virus, but often the hardest hit financially. A “youth first” policy would be aimed at releasing them initially, at least in part, so that they can get back to work and soften the financial impact of the epidemic. Research from Warwick University this week made the case for easing restrictions on people in their 20s and 30s who no longer live with their parents. Andrew Oswald and Nattavudh Powdthavee estimate that the move would allow 4.2 million people to return to work, of whom 2.6 million are in the private sector, and get the economy moving again.

“A young workforce release of this kind would lead to substantial economic and societal benefits without enormous health costs to the country,” the authors write.

As recent deaths have shown, however, the young are not impervious to the disease. The Warwick group calculate that their youth-first policy could lead to 630 premature deaths. But if all goes well, others could follow them back to the workplace, their order determined by age and type of work.

Reopen schools

Shutting schools reduces the spread of coronavirus among pupils and teachers, and creates a distance between parents who have inevitably built up social bonds. But it has a significant impact on economic activity, as so many working parents need time off for childcare and home schooling.

An influential review published this week found a “remarkable dearth” of data on the value of school closures during the Sars and Mers outbreaks, but noted that the measure seemed to have relatively little impact on the spread of those coronaviruses.

Quick guide UK government support for workers and businesses during the coronavirus crisis Show Hide Income subsidies Direct cash grants for self-employed people, worth 80% of average profits, up to £2,500 a month. There are similar wage subsidies for employees. Loan guarantees for business Government to back £330bn of loans to support businesses through a Bank of England scheme for big firms. There are loans of up to £5m with no interest for six months for smaller companies. Business rates Taxes levied on commercial premises will be abolished this year for all retailers, leisure outlets and hospitality sector firms. Cash grants Britain’s smallest 700,000 businesses eligible for cash grants of £10,000. Small retailers, leisure and hospitality firms can get bigger grants of £25,000. Benefits Government to increase value of universal credit and tax credits by £1,000 a year, as well as widening eligibility for these benefits. Sick pay Statutory sick pay to be made available from day one, rather than day four, of absence from work, although ministers have been criticised for not increasing the level of sick pay above £94.25 a week. Small firms can claim for state refunds on sick pay bills. Other Local authorities to get a £500m hardship fund to provide people with council tax payment relief. Mortgage and rental holidays available for up to three months.

More sophisticated options are available than simply reopening schools en masse, which would risk fuelling a second wave of infections. A more cautious approach might lead to schools staggering their opening hours, lunch and break times, keeping playgrounds closed and class groups constant, introducing more space between students and having a shorter school week.

There is a case for opening primary schools first: they tend to be smaller than secondaries and it is predominantly younger children who keep adults from working. That said, the impact of closures on mental health and education are more severe for secondary students.

“One problem is that we don’t have much information to guide us,” said Prof Russell Viner at University College London, an author of the review. “We need to get the clever modellers looking at this, and looking at how these might interact with other elements. But I think society also need to discuss it.”

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Immunity passports

Britain desperately wants an effective antibody test that reveals who has had the virus. Those who test positive for coronavirus antibodies will presumably have some immunity and in principle might be allowed back to work. It could make a dramatic difference for NHS staff and other carers who work with vulnerable people.

Immunity passports are not straightforward, though. A positive antibody test does not mean that someone is well protected, or protected for long. What the immune response means in the case of this particular disease is still unknown. Another concern with immunity passports is that they blur the rules of the lockdown and encourage others to take the restrictions less seriously.

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Reopen businesses

A gradual easing of restrictions on shops and businesses would help the economy, but the spectre of a second wave of infections is ever present. Certain types of shops could reopen, but with strict limits on hours and numbers. The construction and manufacturing industries have already been sent new guidance from Alok Sharma, the business secretary, who said work could continue if done in line with physical distancing rules “wherever possible”.

Health officials will be watching European countries that are starting to relax their own lockdowns. In Austria, where new cases have been falling for some days, the schools will remain closed, but small shops, DIY and garden centres have begun to reopen.

A regional approach

London was hit early, and could already be reaching its peak. One option could be to ease the lockdown there – a move that would also benefit the economy.

Dr Michael Head, a senior research fellow in global health at the University of Southampton, said he would expect to see a staggered easing of quarantine measures, but that it is a complex process.

“All decisions can have foreseen and unforeseen consequences,” he said. “For example, we may see regional easing of lockdown, but there’s the potential that any such announcement may see increased travel of people into and out of those areas.”

There are also concerns that the reasons why London was so heavily affected in the first wave of Covid-19 could mean it is more at risk of a second wave, while there are also questions about the practicalities of easing restrictions region by region.

Prof Keith Neal, an emeritus professor in the epidemiology of infectious diseases at the University of Nottingham, noted that within one region there could be urban and rural areas with very different experiences of the pandemic.

He also said there were questions around whether restrictions should be eased only when a peak has passed, noting that there could be some areas, such as remote parts of the UK, which are unlikely to have a large “peak”. “[In some places], in rural areas, they haven’t had any cases – so one or two cases will be a peak,” he said.

Temperature testing

Using temperature screening may seem an attractive way to work out who may have Covid-19, particularly as testing – even for current infections – is far from ubiquitous.

But Head urged caution. “Taking people’s temperature is a partially useful approach to surveillance, but will miss anyone who is infected that doesn’t have a fever,” he said. “For example, we know that most people are infectious and can spread the coronavirus at least a day or two before showing symptoms. Therefore, monitoring for fever should only be considered as part of a wider package of interventions.”

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