The story on the front page of today’s Times is referring to the latest coronavirus data from the Office of National Statistics (ONS) for the week ending April 17th which showed a big jump in care home deaths compared to the previous week. The number of overall deaths in care homes for Week 16 (April 11th – 17th) was 7,316. That’s 2,389 higher than Week 15, almost double the number in Week 14 and almost triple the number in Week 13. However, deaths from COVID-19 in care homes in Week 16 was 2,131, less than the number of deaths in hospitals (4,766). So what is the Times basing its story on? Turns out, this is the view of David Spiegelhalter, the Cambridge statistician. Here’s the key sentence: “Professor Spiegelhalter said that it was possible that coronavirus deaths in the homes now exceeded those in hospitals, with both running at about 400 a day but heading in opposite directions.” In fact, the average number of deaths in care homes in Week 16 was 304, although it may be larger now.
The ONS data, which was published yesterday, seems to show we’re on track for a big rise in excess deaths this year. The provisional number of deaths registered in England and Wales in the week ending April 17th was 22,351, an increase of 3,835 compared with the previous week (Week 15) and 11,854 more than the five-year average for Week 16. That’s the highest weekly total recorded since comparable figures begin in 1993.
However, let’s contextualise those figures. By my calculations, that’s a total of 207,310 deaths from all causes in England and Wales for Weeks 1 through 16. (I couldn’t find this figure in the ONS data, so I added up the weekly totals.) That compares to a five-year average for the same period of 185,213, so a total excess of 22,097 for the year to date. Does that mean the total deaths for the whole of 2020 will be significantly higher than the five-year average? Not necessarily. Don’t forget that according to Professor Neil Ferguson up to two-thirds of those who’ve died of COVID-19 might have died anyway this year, so it’s possible that the virus is just pushing some of the deaths that would have been spread out over the course of 2020 into the first four months. At the end of Week 16 in 2018, after a bad bout of seasonal flu, the total deaths from all causes in England and Wales was 198,943, just 8,367 lower than it is this year. Yet the total number of deaths in England and Wales in 2018 was 541,589, compared to 533,253 in 2017, a difference of less than 10,000. According to the ONS: “Although 2018 saw the highest number of deaths since 1999, when taking the age and size of the population into account, death rates have remained more or less stable since 2011.”
These sorts of comparisons only tell us so much, of course. If the total number of deaths in 2020 is no higher than the five-year average, the lockdown zealots will attribute that to the extreme social distancing measures imposed on March 23rd. But here’s a curious thing about the latest ONS data: if lockdowns are effective at reducing mortality from COVID-19, why did England and Wales’s numbers go up in Week 16, the lion’s share of which (five days) fell more than three weeks after the UK lockdown was imposed? Given the three week lag between infection and death, you’d expect the numbers to go down between Week 15 and Week 16, but they haven’t. According to the ONS: “Of the deaths registered in Week 16, 8,758 mentioned ‘novel coronavirus (COVID-19)’, which is 39.2% of all deaths; this compares with 6,213 (33.6% of all deaths) in Week 15.”
Admittedly, this isn’t conclusive because the people dying in the first two days of Week 16 – the Easter weekend – might have caught the virus exactly three weeks earlier on the weekend of March 21st and 22nd, just before the lockdown was imposed. And it can take more than three weeks for someone to die after being exposed to the virus. However, if the ONS figures next week show a rise in deaths from COVID-19 in Week 17, that really will suggest the lockdown has been ineffective.
Okay, now for some light relief. Following the publication of yesterday’s ONS data, CNN ran a story headlined: ‘Coronavirus death toll 54% higher in England and Wales than daily stats showed.’ To get this 54% figure, CNN’s Simon Cullen and Zamira Rahim compared the ONS data for the number of deaths registered in England and Wales in the week ending April 17th (22,351) with the number of people the Government said had died of COVID-19 in England and Wales up to April 17th (14,451). “The 54% difference is caused by multiple factors,” the reporters solemnly intoned, and went on to list some of them: the Government’s figures only include people who’ve died in hospitals, not care homes, and the official figures “fail to account for a lag in reporting some deaths”. But there’s a simpler explanation. The ONS figure (22,351) relates to all-cause mortality in Week 16 (April 11th – 17th), while the Government figure (14,451) refers to the number of people who’ve died from COVID-19 in the year to date. Talk about comparing apples and oranges! I’ve posted a screen grab below as, hopefully, CNN will eventually get round to correcting this schoolboy error.
I’m not suggesting there isn’t a discrepancy between the ONS’s Covid data and the Government’s, mainly because the latter just refers to deaths in hospitals. According to the Reuters report, which unlike the CNN report is actually accurate: “The Office for National Statistics said it had recorded 21,284 fatalities that mentioned COVID-19 on the death certificate as of April 17, compared with 13,917 in the daily hospital death stats published by the government.” (Those are both cumulative, year-to-date totals.)
But before we conclude that the ONS figure is the more accurate of the two, it’s worth bearing in mind that it includes deaths outside hospitals recorded as being from COVID-19 when the doctors issuing the death certificates merely suspected the virus was the cause of death without having a test result to base that on. I’ve checked the guidance in the Coronavirus Act 2020 and it says any medical practitioner can sign the death certificate, even if they weren’t present during the patient’s final illness; they can record COVID-19 as the cause of death even if it’s the “underlying” and not the “direct” cause; and they don’t need “diagnostic proof” that COVID-19 was the cause of death provided they’re satisfied “to the best of their knowledge and belief”. Not exactly rigorous! The true number, therefore, is probably somewhere in between the Government figure and the ONS figure, although we’ll never know for sure without exhuming the bodies and carrying out autopsies.
Manhattan Contrarian has looked at the way Covid deaths are recorded in the US and concluded that they’ve almost certainly been over-reported, including in hospitals, not least because hospitals have a financial incentive for inflating the figures. Worth reading his post on this. Will we see a big uptick in the number of deceased NHS workers being recorded as having died from COVID-19 now that the Government has said it will compensate their families to the tune of £60,000?
This morning’s Telegraph leads with with the fact that the Government has changed the wording of its fifth test, watering it down considerably. It used to stipulate that the Government would only start easing the lockdown if it was “confident that any adjustments to the current measures will not risk a second peak of infections”. But at yesterday’s Downing Street briefing, the words “that overwhelm the NHS” had been added. That gives Boris considerably more wiggle room, particularly as the NHS’s critical care capacity has more than doubled since the lockdown was imposed. That capacity is now sufficient to accommodate the rise in infections associated with reopening schools and universities as estimated by no less an authority than Professor Ferguson and his team in their March 16th paper, a point I made in a blog post for the Critic yesterday.
If you can’t get beyond the Telegraph‘s paywall, the Mail also has the test tampering story. ‘Is the government preparing to ditch lockdown?’ it asks. We can but hope. (According to Christopher Snowdon, the whole story is fake news.)
Several papers report the fact that the NHS England issued an alert yesterday, warning of a “growing concern” that a coronavirus-related inflammatory syndrome might be affecting children. However, only 20 children, at most, have been hospitalised with the condition, the symptoms are remarkably similar to those of Kawasaki disease, a majority of the children affected have already been diagnosed with Kawasaki disease and some of the children affected have tested negative for COVID-19. Overall, the admission of children to hospital with Kawasaki disease is lower than normal this year, not higher.
At yesterday’s press briefing Matt Hancock announced that one of the six drugs currently undergoing clinical trials for treating COVID-19 is being tested on humans. He didn’t reveal whether this was hydroxychloroquine – or whether hydroxychloroquine is one of the six drugs being trialled – but the research evidence that it’s an effective treatment is growing. The Association of American Physicians and Surgeons (AAPS) has written to the Governor of Arizona claiming the drug helps 91% of patients recover. This contradicts the preprint published by the Veterans Health Administration that I referred to yesterday which found that Covid patients given hydroxychloroquine were more likely to die than those who weren’t. That study only involved 368 patients, whereas the AAPS’s involved 2,333. Incidentally, the woman whose husband died after ingesting chloroquine sulphate – a death that Donald Trump was widely blamed for in the mainstream media, following his praise for hydroxychloroquine – is now under investigation by the Mesa City Police Department’s homicide division. The Washington Free Beacon has the story. (Someone has pointed out in the comments that that AAPS is a conservative advocacy group.)
The ranks of lockdown sceptics received an unexpected addition yesterday: Theresa May. The ex-Prime Minister posted a video urging the Government to lift the lockdown. “The Government must also think about the impact of lockdown on our overall health and wellbeing as a nation,” she said. “That of course includes the economy, but it must also include the impact on domestic abuse and mental health. We cannot have a situation where the cure for the disease does more damage than the disease itself.”
Another unexpected recruit is Thomas Friedman, the Pulitzer Prize-winning New York times columnist. Speaking on Indian television, he said the sub-continent’s best hope is to go for herd immunity, sheltering the elderly but allowing the young and fit to return to work. “The trick is to get your people out to acquire immunity naturally but get only those out who may experience COVID-19 virus mildly or asymptomatically so that you don’t overwhelm the healthcare system,” he said. India Today has the story.
That strategy certainly seems to be working in Sweden, as the New York Times reported yesterday. Sweden’s death rate of 22 per 100,000 is about the same as Ireland’s and far better than in Britain or France. And the graph showing the daily death tolls up to April 27th shows the Swedes have flattened the curve:
In spite of mounting evidence that lockdowns are ineffective – see this new research by a group of Israeli professors, for instance – the British public remains passionately enthusiastic about them according to a new opinion poll. The FT writes:
Most British people would prefer to delay lifting lockdown measures until the virus is “fully contained”, and would feel worried about leaving their homes even once rules have been eased, according to a poll by Ipsos Mori. As many as 70% of UK residents said they were concerned about restarting the economy prematurely, while 71% expected they would be “nervous” about venturing outside once businesses had reopened. The results suggest that Britons are more cautious than other nations that took part in the survey of 28,000 people, conducted between April 16th – 19th. When asked if they would favour opening the economy before the coronavirus pandemic is fully under control, 65% of Mexicans were against, followed by 61% of Australians and 59% of Americans.
How to explain the British people’s supine acquiescence to being placed under house arrest? Could it be that our medical-industrial complex has completely terrified the public with its apocalyptic prognostications of doom? That’s the theory I come up with in an article in the latest issue of the Critic entitled ‘The return of Project Fear‘. Another possibility is that it’s due to the blob-like growth of ’elf-and-safety culture, particularly in the public sector. One reader thinks this is the reason:
The Covid thing has revealed the complete divide between the risk averse and risk takers and unfortunately that divide seems to fall in large part between the public sector and the private sector. Bureaucracies are not exactly the place to find people ready to jump – free fall or bungy or otherwise. I am in the latter category and I fear the long term consequences of the lockdown will be devastating. Look it’s complicated, I get that, but life is a risk and we have spent many decades hopelessly in thrall to reducing all forms of risk, in our parenting, our education, higher and lower, in government, nanny state, etc. People are far more fearful than they need/should be. Roosevelt’s quote is as pertinent today as it was then.
I’m reminded of another quote, this one by CS Lewis: “Of all tyrannies, a tyranny sincerely exercised for the good of its victims may be the most oppressive. It may be better to live under robber barons than under omnipotent busybodies.”
One consideration when assessing the effectiveness of lockdowns is understanding how coronavirus is passed from person to person. If large droplets and contaminated surfaces are the dominant mode of transmission, then washing your hands, wearing masks and social distancing may be sufficient to suppress infection. But if clouds of tiny aerosol droplets are found to be the dominant mode then ‘shelter-in-place’ orders make sense. My colleague Jonathan Kay, who like me works as an editor at the online magazine Quillette, has tried to answer this question by analysing what are referred to in the scientific literature as “superspreader events” (SSEs) – large COVID-19 infection clusters, such as the bartender who infected numerous people in an Austrian ski resort. Jonathan couldn’t find any comprehensive database of COVID-19 SSEs so he built his own, cataloguing 58 SSEs in 28 different countries (plus ships at sea). It’s worth reading the piece in full, but his conclusion is that virtually all SSEs feature forms of human behaviour that permit the direct ballistic delivery of a large payload of droplets from face A to face B. No aerosol transmission, in other words.
I should stress that Jonathan isn’t an out-and-out sceptic – he’s agnostic on whether lockdowns have had any positive effects and, being more scientifically-minded than me, won’t reach a conclusion until there’s more data available. But I like to think he’s on our side. I interviewed him for the latest Quillette podcast.
A reader has been in touch to complain about an article I linked to a couple of days ago:
I’ve been stewing over Andrew Sullivan’s column in which he quotes Damon Linker – “A life without forward momentum is to a considerable extent a life without purpose.” Sullivan, who identifies himself as a faithful Catholic, should know better. The Catholic church has a long, rich tradition of cloistered nuns and monks who surely are not engaged in “forward momentum” but are valued for their constant prayer and contemplative lives. And what about stay-at-home parents who homeschool their children and keep the household running? Are those lives without purpose? Just wanted to get that off my chest.
And finally, another reader has suggested a few more verboten phrases to add to the swear jar list that RDawg came up with yesterday:
- ‘The “R” number’
- ‘The “Lag”‘
- ‘NHS Heroes’
- ‘The Peak’
- ‘The five tests’
- ‘Test, track and trace’
As always, a big thanks to those who donated to pay for the upkeep of this site yesterday. Maintaining it – and doing these daily updates – is proving to be quite a bit of work, so if you feel like donating you can do so by clicking here. And if you want to flag up any stories or links I should include in the site, or have points you think I should make, you can email me here. See you tomorrow.
P.S. Congrats to Boris and Carrie on the birth of a son.