The prime minister’s move from the I.C.U. to a ward in a London hospital offered a ray of hope for a country still reeling from the trauma of the coronavirus pandemic.
Credit…Andrew Testa for The New York Times
April 9, 2020
LONDON — Prime Minister Boris Johnson of Britain was moved out of intensive care on Thursday, a ray of hope for a country that faces several more weeks under lockdown as its death toll from the coronavirus approached 8,000.
Mr. Johnson was hospitalized on Sunday evening after a 10-day bout with the virus and transferred to the intensive care unit on Monday after his condition deteriorated. On Thursday, Downing Street said the prime minister, 55, had been moved back to a ward at St. Thomas’ Hospital in London and was in “extremely good spirits.”
Dominic Raab, Britain’s caretaker leader, said that Mr. Johnson had made “positive steps” in his recovery, though he offered no timetable for when he might return to work. He also signaled that the government would extend the country’s lockdown beyond next week.
Mr. Raab, the foreign secretary deputized by Mr. Johnson to carry out his duties, said the government would not lift restrictions on April 13, the date the prime minister had set when he imposed the measures last month. The lockdown now appears likely to last several more weeks.
“Is it time to ease up on the rules?” Mr. Raab said to reporters at 10 Downing Street. “We’re not done yet. We’ve got to keep going.”
Mr. Raab said he had not spoken to Mr. Johnson since he was hospitalized on Sunday night. Now that he is out of intensive care, the prime minister “will receive close monitoring during the early phase of his recovery,” the government said in a statement.
Despite the good news, Mr. Raab appeared to be adjusting to the reality that Mr. Johnson will still be convalescing as the government faces one of the most sensitive decisions of the pandemic: when, and how, to reopen the British economy. The cabinet plans to make that assessment at the end of next week.
“We in the government have got this covered,” Mr. Raab said when asked whether he had the power to make that decision.
The debate over how to lift the lockdown is replete with trade-offs. Lifting it too soon, experts said, could reignite the contagion and force a new lockdown, which they said would shatter the confidence of businesses. But leaving it in place for too long could force many companies into insolvency and cause lasting damage.
Although the government put off the decision until next week, its hand has effectively been forced. Scotland’s first minister, Nicola Sturgeon, said on Thursday that the lockdown there was likely to continue “for some weeks to come,” with no prospect of the measures being lifted in the coming days. The authorities in Wales made it clear they felt the same way.
That reflected their worries that, without a clear pledge to continue the restrictions, Britons would take them less seriously over the Easter holiday weekend. But while there was a consensus that it was too soon to end the lockdown, there were growing calls for the government to clarify its approach.
Keir Starmer, the new leader of the opposition Labour Party, called on the government to publish its exit strategy, saying on Twitter: “I’m not calling for precise timings, but the strategy. This is incredibly difficult on people and we need to know that plans are in place, and what they are.”
There are at least four possible outcomes, said Devi Sridhar, the director of the global health governance program at Edinburgh University. They range from a coordinated global effort to close borders, which she said was highly unlikely, to intensive testing and contact tracing for people infected, which is more realistic.
“If we can actually test people and quarantine those who are carrying the virus, we could relax it for everyone else,” Dr. Sridhar said. “We could keep that person and their family home for two weeks.”
But the success of that approach would hinge on Britain vastly increasing its capacity for testing. The health secretary, Matt Hancock, set an ambitious target of carrying out 100,000 tests a day by the end of April. Britain, which got a slow start on testing, has fallen far short of those numbers.
Even within parts of the government, there appeared to be confusion about the duration of the lockdown. Employees responsible for processing passport applications were asked to return to work next week.
The deputy scientific adviser at the Home Office, Rupert Shute, said people were no more at risk in the workplace than at home or at the supermarket, according to a transcript of a conference call obtained by the BBC.
Mr. Shute also referred indirectly to “herd immunity” — a theory once advanced as part of the government’s strategy but now rarely mentioned. It holds that as many as four-fifths of the population will contract the virus and therefore develop natural immunity against it.
“We are working on the assessment that 80 percent of us, if we haven’t already, will get the virus,” he said. “We cannot hide away from it forever.”
On Thursday, however, the government’s chief scientific adviser, Sir Patrick Vallance, said that based on data from other countries, he believed that fewer than 10 percent of Britons had so far been infected.
The pressure to reopen the economy is immense. According to Britain’s National Institute of Economic and Social Research, the lockdown is triggering the largest contraction in economic activity since 1921. It projects that growth will decline by 5 percent in the first quarter of 2020, and by between 15 percent and 25 percent in the second quarter, if the restrictions continue.
“It’s a balance,” Jonathan Portes, a professor of economics and public policy at King’s College London, said of the decision. “You have to make sure that you have as much support for companies to keep them going.”
“But there will come a time when it will be too long for them,” he added. “My instinct is that about three months is a plausible limit at which you start doing a lot of permanent damage.”
Updated April 11, 2020
When will this end?
This is a difficult question, because a lot depends on how well the virus is contained. A better question might be: “How will we know when to reopen the country?” In an American Enterprise Institute report, Scott Gottlieb, Caitlin Rivers, Mark B. McClellan, Lauren Silvis and Crystal Watson staked out four goal posts for recovery: Hospitals in the state must be able to safely treat all patients requiring hospitalization, without resorting to crisis standards of care; the state needs to be able to at least test everyone who has symptoms; the state is able to conduct monitoring of confirmed cases and contacts; and there must be a sustained reduction in cases for at least 14 days.
How can I help?
Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities. More than 30,000 coronavirus-related GoFundMe fund-raisers have started in the past few weeks. (The sheer number of fund-raisers means more of them are likely to fail to meet their goal, though.)
What should I do if I feel sick?
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
Should I wear a mask?
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
How do I get tested?
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
How does coronavirus spread?
It seems to spread very easily from person to person, especially in homes, hospitals and other confined spaces. The pathogen can be carried on tiny respiratory droplets that fall as they are coughed or sneezed out. It may also be transmitted when we touch a contaminated surface and then touch our face.
Is there a vaccine yet?
No. Clinical trials are underway in the United States, China and Europe. But American officials and pharmaceutical executives have said that a vaccine remains at least 12 to 18 months away.
What makes this outbreak so different?
Unlike the flu, there is no known treatment or vaccine, and little is known about this particular virus so far. It seems to be more lethal than the flu, but the numbers are still uncertain. And it hits the elderly and those with underlying conditions — not just those with respiratory diseases — particularly hard.
What if somebody in my family gets sick?
If the family member doesn’t need hospitalization and can be cared for at home, you should help him or her with basic needs and monitor the symptoms, while also keeping as much distance as possible, according to guidelines issued by the C.D.C. If there’s space, the sick family member should stay in a separate room and use a separate bathroom. If masks are available, both the sick person and the caregiver should wear them when the caregiver enters the room. Make sure not to share any dishes or other household items and to regularly clean surfaces like counters, doorknobs, toilets and tables. Don’t forget to wash your hands frequently.
Should I stock up on groceries?
Plan two weeks of meals if possible. But people should not hoard food or supplies. Despite the empty shelves, the supply chain remains strong. And remember to wipe the handle of the grocery cart with a disinfecting wipe and wash your hands as soon as you get home.
Can I go to the park?
Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea.
Should I pull my money from the markets?
That’s not a good idea. Even if you’re retired, having a balanced portfolio of stocks and bonds so that your money keeps up with inflation, or even grows, makes sense. But retirees may want to think about having enough cash set aside for a year’s worth of living expenses and big payments needed over the next five years.
What should I do with my 401(k)?
Watching your balance go up and down can be scary. You may be wondering if you should decrease your contributions — don’t! If your employer matches any part of your contributions, make sure you’re at least saving as much as you can to get that “free money.”
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