The release on Monday of a UK government report into its three-tier coronavirus lockdown strategy has failed to quell the growing tide of anger from politicians. The main finding of the document, titled <em>Analysis of the Health, Economic and Social Effects of Covid-19 and the Approach to Tiering</em>, is that it is too early to draw conclusions on the wider effects of the measures, which were imposed on districts with varying levels of restrictions depending on local levels of transmission. “It is not possible to know with any degree of confidence what path the economy would take if restrictions in place were not sufficient to prevent exponential growth or in the absence of restrictions entirely,” it said. “On the one hand, fewer or no restrictions would allow many people and businesses to operate as normal, if they chose to do so. “On the other hand, more widespread infections and the consequences of pressure on the NHS [National Health Service] would affect spending in the economy due to voluntary social distancing, effects to confidence and impacts on businesses, including through high levels of employee sickness.” Whether this ambivalent verdict will sway any wavering MPs before Tuesday’s vote on the tier system in Parliament remains to be seen. But UK Health Minister Matt Hancock quoted another report as evidence of the effectiveness of lockdown. The React-1 study by Imperial College London found that Covid-19 cases had fallen by a third during lockdown. “They have been working,” Mr Hancock said. “This is clearly good news. It shows the national restrictions have been successful … we have got this virus back under control.” Prime Minister Boris Johnson had been under increasing pressure from the large number of lockdown sceptics in his party to produce evidence to support measures regarded by libertarian Conservatives as draconian. The government’s report was intended to ease their concerns but instead has sparked more frustration. “I am disappointed MPs, journalists and the public have been given so little time to digest information of this magnitude,” said Covid Recovery Group chair Mark Harper, an MP. “We are, after all, talking about imposing some of the most severe restrictions on our constituents and the way they lead their lives and run their businesses.” Mr Harper’s concerns are also unlikely to be eased by Mr Hancock’s optimism over the fall in daily coronavirus cases, which were down to their lowest level since September on Monday at 12,330 infections. Instead of concluding that the fall is a sign of the need for restrictions, anti-lockdown Tories believe the opposite applies. While the report fails to address the central question over the long-term economic impact of the tiers, it does seek to provide a compelling case for restrictions on public health grounds. The report claims that without mitigating measures, hospitals would soon be overwhelmed. When the R rate – the average number infected by a person with Covid – was greater than 1, there was rapid growth in hospital admissions in England. The below graphic shows the rise in admissions up to this point and the tapering during the second lockdown. The report warns that if hospital capacity were exceeded, avoidable Covid and non-Covid deaths would have resulted. It says this would be “intolerable”, although it admits that the size of any possible breach could not be predicted because of the number of variables. The report lists what is at stake should the NHS become overwhelmed: One of the arguments used against lockdown is its effect on mental health. The report rebuts this, saying adverse effects on mental health would rise if the pandemic were left unchecked. “It would be expected that higher rates of post-traumatic stress disorder would be seen amongst health and social care staff, patients who contract Covid-19 [including those admitted to hospital and in intensive care], and the relatives of those who die,” it states. “People in the high-risk category may also experience higher levels of worry.”