The UK may need local lockdowns. But can it make them work?

The UK is currently in the middle of a difficult balancing act. As lockdown measures are relaxed, they bring an increased chance of fresh spikes in coronavirus infections. In parts of the country, the balance appears to be swinging in the wrong direction. In the northwest and southwest of England the R number – a figure that measures the rate of transmission of the virus – is now likely to be above one indicating that the spread could start to increase exponentially in those areas.
But elsewhere in the country, the R number is more comfortably below one. According to a model from the University of Cambridge and Public Health England, in the midlands the R is likely to be around 0.9. When asked about the differences between regions at the daily press conference on June 8, health secretary Matt Hancock said that the task now is to squash outbreaks at a more local level – raising the prospect that parts of the country will face lockdown measures while other regions are relaxed. But putting that in practice may be a lot harder than that sounds.


To keep on top of local outbreaks, the government is setting up a Joint Biosecurity Centre, an independent body made up of civil servants that will sit alongside the Scientific Advisory Group for Emergencies (SAGE). The group will monitor the spread of coronavirus across the country and run an alert system, advising the chief medical officers of England, Scotland, Wales and Northern Ireland, who in turn will advise ministers on how to deal with regional spikes in infection. How exactly the alert system will work has not yet been outlined.
Other countries can give us some hints about how local lockdowns might work, however. Germany has been closely monitoring regional flare-ups and some cities are already considering reimposing the recently lifted restrictions if the number of new infections exceeds their threshold. The city of Göttingen in Germany has seen a number of local outbreaks in recent weeks, including after families gathered on the Pentecost weekend and after 30 people in a high-rise block celebrated the end of Ramadan together, breaking social distancing rules. Because there are children among the new confirmed infections, schools have already been temporarily closed and a strict city-wide lockdown is on the table.
In the UK, deciding what local measures should be put in place will require keeping a close eye on transmission rates. Keeping a tally on new daily cases, local hospital capacity and using contact tracing to spot super-spreading locations such as care homes, prisons, churches and potentially schools, can paint a picture of a regional outbreak. However, a cluster of new cases cropping up in a care home or prison requires different measures than one in the wider community, where a lockdown might be more effective in containing the spread of the coronavirus.
Keith Neal, emeritus professor of the epidemiology of infectious diseases at the University of Nottingham, explains that the number of cases would also need to be weighed against the size of a local population, the time period they occured over, and how other outbreaks are evolving across the country. Colour-coded maps of regions where coronavirus is spreading and where hospitals are overstretched are already being used in Germany and France, and could be one way of monitoring local outbreaks.


Spotting regional flare-ups is one thing, but deciding how to tackle them will be more challenging. “The biggest problem would be identifying an individual area. This needs to be clear to those on both sides of the border,” says Neal. The boundaries may be clear on an island like the Isle of Wight in England where the NHS contact-tracing app is currently being trialled, but in other parts of the country that operate under a single-tier council structure (for instance, Brighton and Hove or County Durham) the lockdown rules may run through the middle of a road in a town.
Recent lockdown measures proved that this can even be confusing on an international level. Baarle-Hertog-Nassau sits between Belgium and the Netherlands and is known for its complicated border. As both countries enforced lockdown rules differently, residents catching a bus on the Dutch side Baarle-Nassau had to put on a mask as soon they entered the Belgium side of Baarle-Hertog. Stricter rules also applied to Belgium shop owners who had to close their doors even though Dutch shops on the same street remained open.
But locking down entire cities or towns are not the only options in England. Instead they could decide to shut schools or workplaces, or close hospitals to new admissions if there is an outbreak in that hospital. On May 25, Weston General Hospital in Somerset temporarily shut its A&E department to new patients because the hospital already had a high number of patients with coronavirus.
The leader of Brighton and Hove City Council has called for more local powers to keep visitors away if the popular seaside city sees the number of coronavirus cases shoot back up. “We have several specific challenges in Brighton and Hove that we and the police are trying to manage, but in reality, our resources are limited and our powers few when it comes to the scale of the task,” council leader Nancy Platts said in a statement on May 31. These new measures could include restricting the number of people coming into the city every day or closing and compensating bars and cafés.


If Brighton and Hove were to ban visitors, what would this mean for workers commuting into the city? And how could this be policed? “It obviously gets more challenging to enforce these restrictions when they differ between different parts of the country or even different neighborhoods,” says Raphael Hogarth, an associate at the Institute for Government and visiting lecturer at City Law School. Under the nationwide lockdown, people’s movements were initially restricted to all but for essential work, food shopping, medical reasons and daily exercise. As new restrictions are localised, they become more complicated and as they become more complicated, they become more difficult to enforce.
Explaining to the public what scientific evidence local rules are based on will be key. “Under local lockdowns it seems very likely that people who live not very far from each other will end up receiving very different policing responses. So it will be important that those most affected understand the basis of those decisions, else they may feel they’re being unreasonably or unfairly dealt with,” says Stuart Lister, professor of policing and criminal justice at University of Leeds.
England’s blanket stay-at-home orders have largely relied on the public’s willingness to comply with existing rules and recommendations, unlike in Italy where the police could stop residents and check that they carried a self-declaration form stating a valid reason for leaving their home with them. And it seems to have worked: the reproduction number of three at the start of the epidemic is still hovering below one in most regions of the country. But if cities and towns start introducing their own rules, it might become more difficult for police to secure compliance among the public, says Lister. “The message may become blurred as to who can do what, but also some people may be less willing to comply with the law as they see those in other communities having more freedoms.”
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