the times | Monday June 29 2020 1GM 35

CommentBusiness

The blanket lockdown came at

a huge economic cost to the UK

Funding the treatment

of Covid-19 affects

other NHS spending

W

hen the dictionary

publishers identify

their word or phrase

of 2020 surely

“Please unmute

yourself ” has to be it. For those of us

who can work from home meetings,

webinars, job interviews and family

gatherings as well as home-

schooling via Zoom or Teams or

another platform have become part

of life — as long as we remember to

turn our microphones on.

But can you imagine the online

world being such a big part of our

lives in the era of dial-up internet?

However, the prime minister’s fabled

“pizza wheel of doom” isn’t entirely

consigned to history. So, as he and

the chancellor contemplate an

economic stimulus package the

promised “shovel-ready” projects

must include investing in even faster

broadband and mobile connectivity.

As a former digital secretary, the

ability of the UK to power ahead in

digital, data and technology is clear

to me. In January I launched our

digital strategy: to provide a holistic

and unified approach for tech

companies, consumers and investors.

It covered better connectivity, our

approach to online harm regulation,

protecting freedom of expression,

supporting tech companies to start

and scale up in the UK, ensuring they

have sufficient talent to recruit as

well as working on current and

future data protection policy and

cross-border data flows.

It is reported that three of the

areas the government is likely to

want the UK to focus on in the

future are computing, robotics and

AI. All require a flow of people with

a capacity for innovation and a

willingness to be open to the

possibilities of technology.

As our labour market is changed

by Covid-19, social distancing

measures will mean there will be

some jobs and sectors which won’t

be able to keep the staff they had.

An activist government strategy is

needed which doesn’t allow those

staff to be lost to the labour market.

There are schemes such as TechUK’s

Returner Programme or

#techmums already leading the way.

The government can use their

experience of giving confidence to

people about their future tech skills

to ensure more people are ready for

employment in the digital age.

Today, the Telecommunications

Infrastructure (Leasehold Property)

Bill returns to the House of Lords.

The UK has a real opportunity, with

great 5G coverage, to set the global

pace in the era of the internet of

things. It is understandable that

some of my fellow parliamentarians

have concerns about who is helping

to build our 5G network. The

government has already made clear

it wants more diversity of providers

and work is starting on that.

However, stalling our progress now

by restricting suppliers because of

their links to China will not only put

a real barrier in the way of 5G

opportunities but, closer to home,

simply make it harder and slower for

leaseholders to get improved

broadband. A joint government and

private sector approach to building a

broader 5G supply chain over the

next few years will instead ensure

we continue to build our 5G

capability in a sustainable way.

The UK is a world leader in other

ways. Our Centre for Data Ethics and

Innovation and our Office for

Artificial Intelligence ensure that in

embracing new technologies we also

identify the downsides. Algorithms

that bake in bias or data capture

which ignores privacy concerns risk

undermining advances. And we

shouldn’t just accept the power and

reach of big tech companies without

question. The recent NHSX test-and-

trace app experience must not mean

that we only rely on big tech and its

way of doing things. We wouldn’t

accept that in other industries and

technology is no different.

Stimulating our post-coronavirus

economy should include building

even faster connectivity, building

stronger tech skills and sectors and

technology that works for all.

David Miles

Nicky Morgan

stopping screening for serious

conditions, etc); it ignores the future

damage of disruption to education.

This is a macabre calculation, but

one that puts cost of the extended

lockdown high relative to benefits. It

is also a calculation that is hugely

pessimistic about what would have

happened in terms of lost lives with

no blanket lockdown, since people

would have taken precautions even if

not instructed to stay home.

But why use that £30,000 figure per

Qaly as a guide to how much we

should pay for policies that might

save years of life? The £30,000 figure

is used in decisions within the UK

health system; it is not an arbitrary

number. It is not based on likely

future earnings lost or the value of

future consumption — calculations

that are open to the moral objection

that they reduce the value of human

life to how much people would have

spent on commodities.

Instead it is what is considered the

highest level of spending that should

be used in the UK health system to

generate extra quality-adjusted years

of life — and it is the saving of lives

that the lockdown is for. In using this

yardstick, one is treating decisions on

how to face Covid-19 in the same way

as decisions in the UK are made

about treatments for cancer, heart

disease, dementia, diabetes and many

other health conditions. On that basis

it would seem as though the benefits

of continuing with the lockdown are

lower than its costs.

A case can be made for using much

higher values placed on potential

good years of life saved. Yet our

analysis suggested that even using

values three times as high as the Nice

guidelines meant that maintaining

the blanket lockdown for as long as

three months was likely to have taken

costs beyond benefits.

The evidence suggests that now we

need to normalise how we view Covid

because its consequences are

comparable to other health

problems. A movement away from

blanket restrictions that bring large,

lasting and widespread costs and

towards measures

targeted specifically

at groups most at

risk is now

imperative.

In early March 2020

it seemed that the

Covid-19 virus in the

UK was spreading

exponentially; the

fatality rate was unknown and the

ability of the NHS to deal with

rapidly rising numbers of seriously ill

people was unclear.

Estimates made at that time by

Professor Neil Ferguson’s team at

Imperial College London put the

possible level of UK deaths if there

was no change in behaviour at

500,000. Based on that and other

assessments, the government

followed the example of other

European countries in introducing

severe restrictions on individual

movement. The key message was to

stay at home; this was a blanket

lockdown.

Was the length of this lockdown

warranted and should restrictions

now be eased significantly?

In recent research, undertaken with

medical researchers at Manchester

University and at the health

consultancy company RES

Consortium, we estimated the costs

and benefits of the lockdown.

We have found that the costs of

carrying on with such a lockdown are

likely to become greater — perhaps

far greater — than its benefits. We

need to move beyond a generalised

lockdown to measures targeted at

those most at risk.

Any such assessment has to place a

value on possible lives saved. There is

no way to do this in a way that is

clearly ethically justifiable,

empirically reliable and widely

accepted. One approach is to focus on

quality-adjusted life years (Qalys) that

may have been saved. The NHS has

established guidelines about how

much should be spent on medical

treatments that on average

yield benefits in terms of

life years saved. This

effectively values a

Qaly at £30,000.

One can use that

rule with

estimates of lives

that might have

been saved due to

the restrictions

and compare those

with the costs of

lockdown. Those costs go well beyond

a simple focus on GDP lost. Health

costs from telling people to stay at

home are likely to be large and long

lasting. Referrals for cancer

investigations were 70 per cent down

in April 2020; there were hardly any

follow-up routine appointments for

long-term conditions in UK primary

care between mid-March 2020 and

the beginning of June; the number of

outpatients seen was 64 per cent

down and elective admissions to

hospitals fell 75 per cent; attended

appointments in general practice

were down 35 per cent. The impact of

the stress of the lockdown on anyone

with a pre-existing mental health

condition, let alone the population as

a whole, is yet to be determined.

Suppose one took a very favourable

set of assumptions about a widespread

lockdown that lasts three months.

Suppose that without this lockdown

that required people should not leave

their home there would have been no

change in behaviour at all (wildly

unlikely) and that the estimate of

500,000 deaths with no change in

behaviour made by the team of

Professor Ferguson is accurate.

The lockdown could then have

saved around 440,0000 lives — the

500,000 deaths net of 60,000

estimated deaths that have occurred.

Assume those who would have died

lose ten quality-adjusted years of life

(Qalys) on average (though in fact

those who might have died are likely

to have had substantially lower life

expectancy). Using the £30,000 figure

generates a value of potential years of

life saved of £132 billion.

What is the lowest plausible

estimate of the cost of the lockdown?

Suppose we only count lost GDP. The

Office for Budget Responsibility and

the Bank of England has put this at

13-14 per cent of GDP if

restrictions are eased

now and the economy

bounces back.

If we ascribe

only two thirds of

this lost GDP to

the lockdown,

this generates a

cost of

£200 billion. This

cost ignores all

future lost GDP

beyond 2020; it

excludes all medical

side-effects (not

treating cancer patients,

“

’’

David Miles is Professor of

Economics at Imperial College

London

Baroness Morgan is a former secretary

of state for Digital, Culture, Media and

Sport and Education Secretary and

Minister for Women and Equalities

Graham Ruddick is away

Shovel-ready projects

must pave the way for

Britain’s digital future

Premises connected to BT

full fibre

Source: BT

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