COVID-19 in Proportion?

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COVID-19 in Proportion?

Seasonal Flu/respiratory illnesses strike every year. Compared to a typical epidemic, the current Covid-19 pandemic is hitting the UK badly.
However, since 1995 in England and Wales, there have been five seasons that were worse (measured in terms of cumulative deaths, all causes, weeks 49 to 15) - updated 2020-04-21.
Draconian lockdowns were not considered necessary then, why are they now?


Note: Updated 2020-04-21 using the latest data released by the Office for National Statistics and Public Health England, complete to 2020-04-17. Numbers will be lower than those given in daily government press releases as all figures here exclude Scotland and Northern Ireland. They also exclude estimated deaths between 2020-04-17 and the most recently announced.

For overall mortality, recent weeks have not been as bad as some previous flu seasons

The week ending 2020-04-10, was a bad week 18,516 people died. However, since 1996 there have been three weeks in previous years which were worse.


The lockdown may not be helping

If you compare Sweden with the UK, it looks as if the lockdown may not be helping

It is taken by many for granted that the lockdown will save lives by slowing the spread of the virus - including those who build the computer models used to forecast and set Government policy. This may not be true. In the UK strict lockdown measures were imposed on 2020-03-23. Sweden did not impose a lockdown. Sweden has done well compared the UK.



In other countries too, stringent lockdowns tend to be linked to higher infection rates

Sweden may be doing better than the UK because it is less densley populated. It is therefore useful to compare with more countries.
The Oxford University Coronavirus Government Response Tracker compares around 150 countries giving them a stringency score that reflects how strict a country's lockdown measures are. Oxford has plotted the stringency index against the number of Covid-19 cases for that country.
For example, Taiwan (TWN) despite its proximity to China has low number of cases (at time of writing only 6 Covid-19 deaths) associated with one of the least stringent lockdowns.

The trend line indicates that stricter lockdown measures are associated with an increased spread of the virus:


Many experts advise that strict lockdown is not the best policy

Dr Gérard Krause head of Department for Epidemiology at the Helmholtz Centre for Infection in Braunschweig
"We have to keep these serious social measures as short and as low as possible, because they could potentially cause more illnesses and deaths than the coronavirus itself."
[1]


Could it be that the lockdown is a cause of excess deaths in the short-term?

In the long term, there will be a price to pay for the lockdown in terms of damage to the economy and in knock-on effects to health and mortality. Everyone expects this. However, it may be that the impact of the lockdown is already having a measurable impact on mortality!
In the weeks ending 10th and 17th April, compared to the 5 year average, an excess of 4390 deaths occured not attributed to Covid. In these two weeks, 25,215 people died from causes other than Covid-19 - the extra non-Covid deaths would represent about a 20% increase on average deaths.

Did some of the 4390 die as a result of reducing the delivery of normal hospital services due to the lockdown? Are thousands already paying for the lockdown with their lives? (See discussion of this here)




England and Wales.

The following chart shows the proportion of weekly deaths that are due to Covid-19 in the context of total deaths in the same time period during 2000, when the peak overall mortality of the worst weeks exceeded what we have seen so far in connection with Covid.



Overall European mortality

In the following chart, provided by Euromomo on 2020-04-23 you can see overall mortality in for 24 participating European countries up until 2019-04-17 - that is deaths from any cause, including COVID-19. The latest peak is now higher than the one for the 2016/17 flu season, but this should be kept in proprortion.
The latest peak is not so much higher than recent peaks and importantly the those in 2016/17 and 2017/18 though not as high as the 2020 peak, may prove to be wider and include overall higher mortality (as was experienced in England and Wales for five seasons since 1995, as per Chart 4)


The next chart (also provided by Euromomo on 2020-04-23) shows deviation in mortality from the expected level in the countries providing data against week numbers. Current overall mortality in 2020 in Europe is still better than it was in 2018.



The question remains: Are our unprecedented quarantines and lockdowns a proprortionate response to the disease?

Is the cure worse than the disease?

To deal with the threat of COVID-19 the UK Government has ordered unprecedented shut-downs and quarantines, and many support this in the spirit of "better safe than sorry". However, this overlooks the fact that shutdowns and quarantines also kill. The economic, social and health costs will almost certainly include:
  • Earlier deaths for cancer sufferers due to diagnosis and treatment delays
  • Business failures leading to more business failures
  • Job losses leading to poor health, social problems and suicides
  • Fewer taxpayers available to fund an increasing need for social benefits
  • Reduced funding for the NHS and the rest of the public sector
  • Lost educational opportunities and disruption to exams and graduations
  • Inflation as Government "prints" and "borrows" more, while tax revenues fall
  • Pension values reduced by stock-market crashes
  • Reduced life expectancy for people moving deeper into poverty
Or in the words of a former UK Supreme Court Judge:
"The real question is, is this serious enough to warrant putting most of our population into house imprisonment, wrecking our economy for an indefinite period, destroying businesses that honest and hard-working people have taken years to build up, saddling future generations with debt, depression, stress, heart attacks, suicides and unbelievable distress inflicted on millions of people who are not especially vulnerable, and will suffer only mild symptoms or none at all?"
former Supreme Court Judge , Lord John Sumption, discussing the UK response to COVID-19, BBC interview 2019-03-30 [5]
“All I maintain is that on this earth there are pestilences and there are victims, and it's up to us, so far as possible, not to join forces with the pestilences.”
Albert Camus, The Plague
























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