Dr Jack A T Edmonds MB BS FRCGP

Your Health in Our Hands

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Has the UK really failed to manage COVID ?

One of the distressing problems with this pandemic is the interpretation of data which is fluid and open to the criticism that ,  "There are lies , damn lies and then there`s statistics" . Trying to base political and health policy on what we think we know about COVID-19 has proven to be an extremely tricky balancing act dependant on which numbers you think are relevant. Do you react to deaths attributed to COVID? Or do you think the number of new cases a day is more important ? Or maybe the number of people admitted to hospital? Or the R number?

All the above have their merits and detractions. Every government in the world and the experts advising them is struggling to make sense of the lies or the statistics and put their message over to the public - the people who get sick , the people who have to change behaviour, the people who lose their jobs , the people who vote in elections.

So here is another statistical way to look at what has gone on before. Two graphs are shown. They describe excess deaths in comparison to other years when COVID did not exist. Excess deaths are not user biased. They do not depend on evidence of COVID within 28 days or a doctor`s judgement about whether the patient died because of COVID or not . A death is a death. If rates are higher in the first 11 months of 2020 there must be a reason and I do not think anyone could argue that this year , the reason worldwide is the current COVID pandemic . 

Excess deaths during pandemicWhat can we make of the graphs? One graph shows that a lot of people died between February and October particularly in Western Europe and the USA but the excess mortality was much worse in some countries than in others . Why? That of course is the big question and there are numerous theoretical reasons . Speculation on the reasons is the job of media and politicians and we can all make up our own minds . But, nobody owns the right answer. The graph just tells you what has happened, no ifs or buts.

Excess deaths since May with COVID

The other graph tells you about excess mortality since May. In other words, when action was taken in March and April, what was the effect on excess deaths - which we have agreed must be due to COVID. Remember that deaths from COVID occur about 3 weeks after the acute infection which is why excess deaths from May are relevant. Now, we can see that again some countries made big inroads to excess death rates, others did not do quite as well but everyone reduced their numbers. Again, how and why this was achieved can be debated but the common thread throughout was an imposition of behavioural changes, mask wearing and social distancing. Some countries have done more of these than others and so there is a variation in the successful reduction in excess deaths.

By way of personal comment, I think that Sweden (little of no lockdown) the UK (inefficient lockdown?) and the US (terrible, negligent lockdown) all have the worst stats. By comparison, Germany, Canada and Spain seemed to have done really well so perhaps we should model our public health response on their policies.

Of course, all of this has been blown out of the water since the beginning of October with resurgence of COVID cases across the world. We will not see the effect until November and those statistics, or lies or damned lies, are not available yet. Meanwhile, I think doing nothing is a bad policy. Sweden has not done better than the UK despite radically different approaches. The interesting thing to see is whether there will be a difference in excess deaths in this second wave because the theory is that Sweden may have developed herd immunity. I predict that they will not have much better outcome than the UK and that the US will fare much worse because they have no effective policy, a leader who holds mass meetings with no mask wearing and who has totally undermined his public health department.

enquiry@drjackedmonds.co.uk

Date posted: 02 November 2020

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Information source: BBC Health