IT won’t be this week, or next week. But it cannot be put off forever. Exiting lockdown: when should we do it, how do we do it, and should Scotland strike out on its own?

Political leaders in all four nations will have an increasingly impossible task balancing the interests of public health and the NHS against a nosediving economy and a restless population.

Already in Scotland there are signs that hospital admissions are levelling off, the majority of intensive care beds (or at least, “potential” ICU beds – that extra capacity is on standby if needed) lie empty, and the NHS Louisa Jordan field hospital in Glasgow may never be used.

The death rate from the virus in Scotland also appears to be substantially lower than England’s for a variety of reasons likely to include population density and the fact that the lockdown measures came into effect at an earlier stage of the epidemic curve in Scotland.

READ MORE: Why is England's death rate per head from Covid twice as high as Scotland's?

There have also been suggestions that compliance with social distancing has been higher in Scotland.

All of this will contribute to mounting pressure on politicians to relax restrictions. But the threat from the virus remains, so what lessons can we learn from other countries’ exits?

In Europe, most countries are lifting restrictions very gradually. In Denmark, nursery and primary schools have reopened, the Czech Republic allowed some “non-essential” shops to reopen, and Austria said small shops, garden centres and DIY stores could resume trading this week with plans to reopen cafes and restaurants in mid-May – though schools remain closed indefinitely.

None of the three have re-opened their borders to foreign visitors, and Austrian leaders have implied that any leisure travel outside of Austria may be banned until a vaccine is available.

This sort of gradual approach – lifting some restrictions but not all, while giving citizens enough hope of a normal life to persuade them to hold out a bit longer – seems like a scenario that will soon play out here.

The World Health Organisation stated this week: “To reduce the risk of new outbreaks, measures should be lifted in a phased, step-wise manner based on an assessment of the epidemiological risks and socioeconomic benefits of lifting restrictions on different workplaces, educational institutions, and social activities...

“Ideally there would be a minimum of two weeks (corresponding to the incubation period of Covid-19) between each phase of the transition, to allow sufficient time to understand the risk of new outbreaks and to respond appropriately.”

Testing will play an important role in helping to ease the UK out of lockdown. When the epidemic first began escalating, our capacity to test en masse was woefully inadequate.

As a result, when evidence of community transmission emerged, efforts to contain the virus – through testing, contact tracing and isolating infected individuals and anyone they might have exposed – were abandoned.

READ MORE: Hospital admissions slowing and half of intensive care beds lie empty

In contrast, countries like South Korea, whose experience of another coronavirus, MERS, had put it on an epidemic war footing, was ready at the outset to test thousands a day and provide results within hours. They used location data from mobile phones, credit-card transaction records and CCTV footage to identify, notify and test people who might have crossed paths with an infected person.

Combined with hand-washing, and social distancing measures such as closing schools, museums, gyms and discouraging public transport use, it has so far limited its Covid-19 mortality rate to four per million, compared to 180 per million in the UK.

Scotland aims to have a capacity to process 3,500 tests a day by the end of April, by which time pressure to start exiting will be escalating.

Other tools such as a contact-tracing app are in the pipeline. The technology, produced by the UK Government, Apple and Google, will let people self-report Covid symptoms, then alert possible contacts.

Much-touted antibody blood tests have so far proved too unreliable for use on the NHS, although if and when a breakthrough comes so-called ‘immunity passports’ could be a route out back to normality for some. However, there are reports of some people acquiring the infection a second time, which, if true, would muddy the waters somewhat.

READ MORE: Poverty, lockdown or missed Covid cases - what's behind Scotland's mystery surge in deaths 

In Scotland, lower incidence of the virus per head compared to elsewhere in the UK suggests we probably also have slightly lower herd immunity, especially in rural areas.

This could make us more vulnerable to a second wave, but this risk could again be mitigated through testing, contact tracing, quarantining, and adherence to voluntary social distancing (though arguably this may crumble in the face of a rare Scottish heatwave).

Finally, going it alone and breaking Scotland out of lockdown first raises questions about whether, and how, we would police the border with England. This would no doubt be a political headache as much as a public health one.

Nicola Sturgeon urges caution in interpreting declining hospital and ICU admissions, but is she really just buying herself time for the difficult decisions ahead?

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