What is your exit strategy, Boris?

That’s that then. Funs over, lads Christmas has been cancelled. No one has even gone to the bother of cancelling Halloween, but I won’t be getting my Pink Panther suit out of the attic.

Winter is coming, and a grim one at that. No solace can be sought over a pint with old friends, no winter getaways — in Northern Ireland, a full lockdown over the next four weeks.

The heady days of August when staycations were on the horizon, and Rishi was paying for lunch, are but a distant memory.

Boris and his team of advisors are betting on lockdown measures. Putting the house on black, so to speak.

To use an investment analogy, it’s all well and good lobbing £10k at Apple shares — but when are you getting the money back? At what price do you withdraw?

Any broker worth their salt knows that an exit strategy is critical to shrewd investing.

Looking at the pandemic performance of the UK government, the worst of both worlds is apparent. Chart-topping figures in terms of excess deaths with economic destruction riding shotgun.

We’re back in lockdown now, and what is missing to my mind, is a coherent way out. An exit strategy, if you will.

A look at our current options:

Vaccine. There is no guarantee of one. As time ticks by, it looks increasingly like a long shot. It easy to forget that there is no vaccine for the common cold, for instance, let alone life-threatening illnesses such as HIV and Malaria.

Herd Immunity. Like the vaccine, this is talked about as a viable policy option. The difficulties are two-fold:

1. Herd immunity refers to a state of populace where most people have been infected, and therefore the virus no longer has enough human carriers to spread exponentially. This would mean an awful lot of deaths to achieve the estimated 70% infection rate required — and even at that, is predicated on the virus not mutating.
2. The SARS virus has been around for 18 years, and we do not have herd immunity to it. Same with Ebola, Zika and good old influenza. Remember swine flu? Still a threat. Herd immunity requires a steady-state virus. So, herd immunity isn’t exactly a guarantee for Covid 19, which has mutated already.

Cure. This is the element of the strategy that has seen most development since the outbreak. People aren’t getting quite as sick, the mortality rate has fallen as Doctors have acquired practical learnings over the efficacy of certain treatments — but this does not mean there is a cure, yet. It’s not like taking antibiotics for an infection.

The tenuous nature of these options at our disposal has led Governments to focus on preventing the spread of the infection; things like social distancing, masks and hand washing are all pretty well embedded in the population now.

Lockdown measures are a “blunt tool” used to further drive down infection rates — but this comes at a huge, huge economic and societal cost. It should be a last resort.

Lockdown

To be clear, I wholeheartedly support the current lockdown measures. No question. If it’s a question of avoiding thousands of unnecessary deaths, then it’s not a question at all — save lives.

To my mind, though, we have forgotten what lockdown is for. It’s not about guarding against infections, nor saving lives. It’s about protecting the health care system from being overwhelmed. If the NHS topples over, so does civilised society.

Perhaps our leaders have developed myopia or tunnel vision around protecting the NHS; it can be done in two ways:

1. reducing demand on its services, i.e lockdown measures
2. increasing supply capacity.

What if lockdown wasn’t needed?

We’ve all seen or been exposed to the horror stories surrounding critical pressures being exerted on the NHS. Long waiting lists, packed A&E departments, undetected cancers and care home deaths.

Perhaps Covid-19 is the that broke the camels back.

To date, the focus has been entirely upon reducing the demand on the NHS with lockdown measures — but, to my mind, the only coherent way out of this lockdown misery is by investing heavily in the NHS to increase its supply capacity.

It has been estimated that the treasury has already spent £110 Billion on economic measures to redress the impact of lockdown.

If our NHS had not been chronically underfunded and mismanaged for decades, there would be no need for a lockdown. We are now paying a high economic tariff for neglecting our most vital resources.

Perhaps if the £110 Billion in furlough, job retention and industry bailouts were to be devoted to;

• Properly remunerating health care staff
• Building hospitals
• Investing in specialist care
• Increasing critical care capacity

Then there would be no need for lockdown. The sick would get treated. The economy would remain open. More nurses, doctors, hospitals and exponentially greater treatment capacity.

Nightingale hospitals are a band-aid approach, that will only stem the flow of NHS bleeding.

Exit Strategy

It’s the uncertainty that is currently killing our economy. Businesses can no longer plan, and individuals are reining back their discretionary spend because they just aren’t sure what is round the corner.

People need clarity around rules and timelines.

Boris Johnson has implemented a tier system across the UK as a response to rising infection hotspots. As far as I can see, there is a linear route into progressively worsening tiers — but no route out.

It is no longer good enough to rely on the weather warming up, and people moving outside, to quell the threat of Covid-19. It is no longer good enough to tell our local pubs to close, our University students to stay indoors and our sick to avoid the hospital. A clear plan is needed.

Sweden

People talk about the approach Sweden has adopted. Certainly, it has been an interesting and encouraging stance and I would suggest they have had a great deal of success — moderate death toll, minimum economic damage.

Why have they been able to do this? Because of their health care capacity, prior to the pandemic, greatly exceeding our own on a per capita basis.

Look at this graph:

Sweden has the third-highest health spending in the EU as a share of GDP (11.0% in 2015 compared to the EU average of 9.9%), and the fifth-highest in per capita spending (EUR 3 932 compared to the EU average EUR 2 797).

Sweden had no need for lockdown measures because they were ready. They had invested in their healthcare system and had excess capacity.

It’s time to look at the root cause of the need for lockdowns. It’s time to properly fund our NHS — even if it is in a reactive fashion, it has been 7 months since the erection of temporary morgues and Nightingale hospitals…that is ample time to properly fund and staff our healthcare system to avoid another lockdown.

Boris, we need an exit strategy.